Hi,
Apologies if posted in wrong forum, but I'm not sure where I fit.
We have an appointment to see a FS to discuss testing and options.
We have not really been trying very long (8mths) have been able to fall pregnant but both times with blighted ovums.
We have been advised by our GP and OB to see a FS for genetic testing. But I have been told this is only possible when you go on assisted route being IVF.
Is this right? What tests should we ask about?
What else to expect?
I've had a heap of testing done without seeing an FS. They may mean to see a reproductive endocrinologist about recurrent miscarriages. Blighted ovum are usually one off events. Obviously they can reoccur. There's no harm in getting tested, but it doesn't mean you'll need IVf. Unless an identifiable chromosomal or genetic problem is found, in which case you cross that bridge when you get to it.
I'm sure there's a few people around with much better knowledge than me as it was a few years ago for me now. But there are quite a few tests they can do prior to commencing assisted conception. In fact my FS wouldn't let us proceed without doing these. I know there were some expensive genetic blood tests, and as N2L suggested a sperm test would be essential.
I would imagine they would do these tests first and if all look good and you go ahead with IVF or other then they may need to do additional testing of the embroys if you have no success. What state are you in? Have you been referred to a FS?
DF and I saw a FS last year because I have PCOS and we were having trouble conceiving. We had a heap of tests done (bloods for both of us, US for me and SA for DF) even though due to my BMI, the FS would not allow us to progress with any type of assistance. The tests all came back pretty clear and confirmed I had PCOS so he advised that it was likely I was not ovulating so encouraged us to focus on lowering my BMI before seeing him again, though encouraged us to keep trying to conceive naturally. In the end that's what happened. I guess it's a pretty long winded way of saying they'll still do tests to look into and rule out things without you having to agree to or be approved for any type of assisted conception.
Thanks for the advice ladies. There are some points there I will be adding to my question list.
We have had a referral to the FS, our GP wasn't quite sure what tests to ask for hence the referral.
I'm pretty sure DH will need to donate some test swimmers, and have a BT.
As for me, initially it was thought I had a hyper thyroid but after heaps of regular BT's, GP feels its not an issue. He also gave a referral to an endocrinologist, who yes does specialize in fertility, but the nurse there felt it would be better to see a FS, as my BT were not warranting enough evidence of a hyperthyroid for the endocrinologist.
When our GP wrote to the FS, he asked the FS to contact us to first off see if we are 'eligible' to see a FS and then if this FS would/could help us. The nurse called us and was great, informative and patient with answering questions.
LionsandBears - apparently 2 blighted ovums in a row, for a 'healthy' young (32) couple is not common, however we have now had an OB, GP and a couple of MW tell us it's the first they have come across in a long time. DH's cousin is studying to be a MW, and she recently went to a seminar on early pregnancy issues, and although miscarriages are more common than recorded data, out of that about 2% are blighted ovums and usually a genetic issue is present. But of course there are minimal studies done as not all women realise they were pregnant, in time to test or track outcomes.
Hi MLR,
I'm so sorry about your blighted ovums I also had two in a row in 2010 at age 28. The OBGYN I saw after them said he did not consider it to be normal.
He got me to start doing timed intercourse cycles through a fertility centre. They involved taking a fertility drug early in the cycle called femara (in case the BOs were caused by poor egg quality), lots of blood tests to monitor hormone levels and detect ovulation, using progesterone after ovulation and blood tests to monitor progesterone levels. DP also had his sperm tested (great sperm apparently) and I think I had my thyroid tested and some immune system related testing. The only abnormal thing they could find with me was a very short luteal phase and low progesterone.
When I couldn't seem to get pregnant again using this method, the Ob did a laparoscopy, d&c and hysteroscopy to check things out. I only had mild endo, everything else normal. After many more failed timed intercourse and then insemination cycles I actually ended up getting pregnant naturally the month before starting IVF. However, I had to go on a very high dose of progesterone to maintain this pregnancy. I'm now nearly 23 weeks and believe progesterone was the issue for me.
I've found that specialists haven't really been that interested in finding out what the problem is, they just try to treat all the possible things it could be. I think it's great that you're seeing an FS - there's nothing to lose... and there's plenty of things to try before you have to consider the IVF path
I would expect that at a first appointment, it will be the FS asking most of the questions to start with. Your only big question at the start is 'What can we do to achieve a full-term pregnancy?'
He'll probably take a general health history from both of you, review all the test results your GP has provided, and get a detailed reproductive health history, again, from both of you. Mine was especially thrilled that I'd brought printouts of my ttc charts with temps, cm, etc, from fertility friend, because he could tell in minutes that I was definitely ovulating, and had a normal luteal phase, etc, whereas DP came in with sadly low sperm count from his GP-referred sperm analysis, so I didn't need much more testing beyond bloods, because it was so obvious that it was significant male factor infertility, and the only thing worth trying was ICSI (a form of IVF). For us, that meant bypassing a lot of possible checks on me such as are my tubes open? (because IVF doesn't need open tubes). We were pleased not to have the expense, pain and time of a bunch of tests that might possibly show problems, but would not change the treatment plan. The message here is, bring every chart/test result you've had, including a copy of all your GP's testing (ask the receptionist for them if yo don't have them already) and any blood tests and scans from your 2 bighted ovum pregnancies, and any test results that were carried out on the remains.
He should then tell you what else needs to be investigated further before he can tell you for sure what's wrong, so he'll say things like 'It's most likely that one or both of you carries XYZ conditions, and we can test for that with a this test and that test which haven't been done yet, but abc and def are also definite possibilities, so we'll check for these as well. Most likely we'll get some answers from one of these, but there are other rare conditions that we'll consider if all of those come back normal'
Then it will be your chance to ask questions. What are the chances of another blighted ovum if we don't get all these tests? What are our chances of a successful natural pregnancy after 2 blighted ovums?
But many of your questions will be prompted by whatever he has just been saying about the possible causes of your 2 blighted ovums. How much are these tests likely to cost and how much will medicare cover? (Some are very expensive and not covered at all, others are totally covered.) If the tests come back showing problem X, what will the course of action be? What if it's condition Y or Z, then what? What's the rough cost of this course of action? What are the side effects? Do we have any options? Can we get tests for the most likely thing first, and then only get other tests done if there is still no answer (thereby saving money)? how long would the course of investigations take? Could there be several conditions rather than just one? Will the extra tests change the recommended treatment plan at all (ie, do we really need to investigate all of these things? What If we do all these tests, will we definitely find an answer? If it's unexplained, then what is the best course of action? What are the chances of a successful full, term pregnancy from this course of action vs that course?
I guess you won't really know what to ask until the FS has given you an idea of what he might be looking for and what might be recommended as a result.
Just one other thing, wh though it was really important for us to ahve an FS with whom we could communicate freely, and who was happy to ake the time to answer all or our questions. I think most people who become FSs probably are quite caring and communicative by nature, but if you feel that you are not getting your questions answered reasonably, I'd suggest you consider getting a second opinion before you carry out whatever he's recommended. AC is often a journey in which your comfort with your specialist and his team (nurses, etc) is paramount.
Thank you soooooo much Pholi!!
Exactly the type of info and experience I needed to read!
Hopefully the FS can get some answers! My GP's have been great and lucky the FS comes to their clinic so all the info he needs will be there.
Unfortunately as for after my D&c's the OB and hospitals haven't been very helpful, but maybe the FS can speak to them if he's unsure.
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Seeing a FS - Advice Please
I also had two in a row in 2010 at age 28. The OBGYN I saw after them said he did not consider it to be normal.
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