Looks like it's time to visit the fertility specialist.

I’m discouraged. I’m upset. I’m scared. Can I get a little support?

We’ve been trying to conceive for almost a year now, and being the nerd that I am, much of that was carefully charted basal body temperatures and ovulation tests; I wanted to give us the best possible chances. I know that in general, a year is not that long, and our lack of success doesn’t mean it will never happen, but now my primary care physician has recommended that I see a specialist. I saw my doctor a couple of weeks ago for a physical and discussed everything, and she’s concerned about my high (but still “normal”) TSH. I have long cycles (35-45 days), and I’ve “skipped periods” in the past, indicating 60+ day cycles, and she doesn’t like the sound of that. While investigating the skipped periods two years ago, an ultrasound found a cyst, and she said that could mean PCOS. The end result of our conversation was that she thinks that since I’m over 30, ideally want more than one child, and have been at it for almost a year, I need to get things checked out soon.

I made an appointment at a very well-regarded fertility center, and I filled out all the questionnaires they sent me. It was difficult, because I had to ask my mom a few questions, but I don’t feel ready to tell her about the appointment yet. I think she knows, even though she pretended she didn’t see through me. Moms are like that. I’m embarrassed about going to the clinic, about needing help, for some reason. And yet, looking at my friends who have been trying for years, with injections and IVF and all the emotional strain that brings, I feel like a fraud, like I’m taking the specialists away from someone who really needs them.

I have no idea what to expect from the clinic. They told me that the first day will be a conversation and a medical history evaluation - no blood work or testing. Then we’ll talk to one of their financial consultants to see how we will manage the insurance and deductibles and everything. I’m in a country whose health insurance system I don’t yet fully understand, and I’m hearing from online message boards that infertility treatment opens up a battleground between the patient and the insurance company, where many things are denied and need to be fought for. Will the clinic push IVF, because that’s where they make their money? I’m educated, I’ve done some research, and I’d like to think I’ll know if they’re taking advantage of my emotional state to push unnecessary testing and meds on me, but I’m new to this, and I may end up being a sucker.

Any advice? Stories? Hugs? Kicks in the ass and orders to suck it up?

I don’t have a lot, but I just want to put in that “over 30” and “trying for a year and haven’t conceived” is, indeed, a valid reason to see a specialist. You’re not taking experts from people who need them, you actually are someone who needs to consult an expert.

I’m hoping that if there is a problem it’s something relatively easy to correct. Just a question - has your husband’s fertility been examined? Infertility isn’t just a woman’s problem, men can have issues, too.

He’s coming with me to the appointment - the clinic treats us as a couple and will check us both out, depending on what our questionnaires tell them, I guess.

Just wanted to say good luck! It took us three years, but I am now 7 and a half months pregnant - so know that there is a very good chance that this route will take you where you want to go.

If I can offer one small piece of advice, it would be to try and get into a headspace where you can feel good & proactive about going to the infertility specialist. It can be a long road, particularly wih such long cycles (which I also have, although you’re smart to have charted &discovered this before going to the specialist!). Feeling nervous and shitty about the whole time will only make things more stressful for you and your husband. You’re taking action, and that’s a good thing!

No advice or anything – just wishing you the best of luck!!!

My wife was diagnosed with PCOS about 6 years ago. We tried and tried to conceive, including using fertility drugs, for two years, but after enduring two miscarriages my wife said “no more”.

We decided to go the (long, frustrating, expensive, bureaucratic) adoption route. Nearly two years ago we adopted the most amazing, brilliant, handsome little boy and even got to be in the room when he was born!

So why am I telling you all of this? Because we found out a while back that my wife is pregnant! We went in for the 12-week checkup last week and everything looks good, strong heartbeat, etc. 12 weeks is usually pretty safe ground, so we are very hopeful.

Good luck, and remember it can happen when you least expect it, it sure did to us!

Antigen, just here to wish you best of luck.

I wish you the best of luck. You are not alone. We were on the infertility roller coaster for about three years before our son was born.

Thanks for the good wishes, guys.

Is there anything I should be watching out for with the fertility center? They come highly recommended, but are there red flags to look for during my first appointment or beyond? Questions I should be asking them, or my insurance company? I’m still confused by my insurance here in the United States. For example, with my insurance, I thought an annual physical was completely covered, but I’m being billed for some of the labs my doctor ordered (and drew) at that physical. And then I don’t know who to call to figure out if it’s a mistake - my insurance, the doctor, or the lab? I don’t know what I’m going to do if I need to be sharp and stay on top of all the insurance stuff through the fertility process.

I’ve got my medical history and all my ovulation charts printed out, ready for the appointment in mid-June. I don’t have a copy of the ultrasound results from over a year ago - should I contact the medical center where I had the scan done, and get a copy to bring? Will the fertility clinic care about results that old, or are they likely to want to do all that stuff over again anyway?

I’m trying not to get too discouraged, but it’s hard. I’m feeling like I waited too long to start trying, and I have visions of Clomid and IUI and IVF floating in my mind and that really gets me down. My husband is so easygoing about the whole thing, and isn’t at all worried that anything is wrong. He sees no point in jumping to the worst conclusion before we have any information - so calm and logical. I sure hope any kids of ours get that trait instead of my neurotic tendencies.

Sad to say, it’s almost certainly not a mistake. You see, when the insurance company says they’ll pay for an annual physical what they mean is the actual visit to the doctor - not any medical testing associated with that visit. That is a separate thing to them.

When I get my annual physical I have to go to one particular lab a week in advance to get blood drawn/donate urine/etc. in order to have the lab testing covered. And I have to go to yet a different place for my annual mammogram to have that covered. They then send the results to my doc, so (in theory) he has them at the visit. One annual visit, in addition to labs, the spouse needed an ultrasound - that was yet another visit, which had to be at one particular place to be covered.

So… if the insurance says they’ll pay for “fertility treatments” you need clarification if they cover any medications, testing, or “procedures” (outpatient or inpatient) or just the doctor visits. You have to* go to the insurance company *to get this information, as almost certainly the doctors you see won’t know the particulars because there are so many different policies out there

Hi Antigen,

I remember this time I went to this female doctor at Kaiser. I had recently switched to Kaiser from Blue Cross due to a change in jobs. Jesse and I decided that it was time to conceive and I had been on birth control forever and a day at that point. I went off the pill in Dec 2010 and I saw her in Jan 2011 and I wanted to make sure everything was alright with me and my child bearing apparatus before we got started. After some tests, she called me into her office and in a very humiliating manner told me that I had some cysts and blah blah and that I have PCOS and then in the most insensitive way she began talking about how pretty my purse was and where I got my hair cut. Not once did she tell me anything positive, except for that nice purse comment. I left her office and never saw her again.:mad:
But I remember sitting in may car after the appointment and crying my heart out. I called Jesse and told him that I felt “defective” and I probably can’t have any kids. I had just turned 32. Of course I was way over reacting.

I saw a wonderful gynac after that who reassured me that women with PCOS can definitely conceive and have healthy babies. After looking at my tests, she said that I had “mild PCOS” and not to worry. She put me on some medication to get my period started so I could ovulate. My period was regular while I was on the pill but I couldn’t get one after I went off the pill. I forgot what the medication was called. Started with an “A”.
But most importantly, Jesse and I didn’t focus on it too much in the bedroom and we just continued to live life and have fun and love each other and let conceiving take its own course. Of course I wondered every now and then if I was pregnant and I would day dream about it. But I stopped obsessively taking my temperature, stopped checking for ovulation and all that. I had a period in Feb and then in March there was no period and I was pregnant.

Sorry. Long story.

But anyway…I wanted to remind you that things are possible and just like some one else mentioned that these things do tend to happen when you least expect it.
Sorry if I have missed this, but have you tried Clomid? My doctor said that she would start me on Clomid if we didn’t get pregnant in a few months.

Also, some health professionals in this field can be insensitive about this matter and say things that can be hurtful. Just being aware of that can maybe ease some heartache.

Good luck!
Sending you lots and lots of hugs and good thoughts your way.

Thanks - I really do need to try and keep some perspective and just enjoy my life as it is while I wait for a pregnancy to possibly happen.

I haven’t tried Clomid. As I understand it, that induces ovulation, right? I am ovulating regularly, though on a long cycle, according to my charts, so I don’t know how Clomid would help me. And that’s the sort of thing I’m hesitant about… I know a little about this stuff thanks to my curiosity and medical lab background, and I want to be really sure that whatever treatments I undergo are started for the right reasons, not just because it’s the first thing on their list. I don’t want someone to say “Ah, looks like PCOS, try some Clomid” without explaining to me what the goal is of giving me that medication and why it’s warranted in my case.

I haven’t been diagnosed with PCOS. I fit some of the symptoms, but I’ve never been given that label. My primary care doctor thinks it’s a possibility, because of missed periods and one cyst detected over a year ago, but she also thinks my TSH is too high. She doesn’t want to be the one helping me down the conception path, because she’s not a specialist and she wants me in the best possible hands. I’m grateful for that.

Thanks again for the support, everyone.

Broomstick, I think I will wait to contact the insurance company until I know what the plan is, because asking about every possible treatment is too overwhelming. But I’ll be sure to have a written list when I call them, so I can be sure not to miss anything. I got the impression that the fertility clinic is very good about helping with the insurance part of things, so we’ll see how the initial consultation goes.

I promise I’ll be back with news.

Good luck, and I’m glad you took this step now! We waited for a few years before finally deciding to see an RE and it was a big mistake (things can take a long time). I hope for your sake all it takes is a round or two of Clomid and you’re pregnant.

My husband and I have been TTC our first for about five years now. Three rounds of Clomid, three IUI’s, one IVF, nothing so far except four early losses. I have been blogging about it for a while now, so if you’re interested I can give you a link for my blog. I describe a lot of my feelings, a lot of the tests and procedures, and how to take some types of injects (for IVF).

I strongly, strongly suggest you find a therapist for both you and your husband who specializes in couples with fertility issues. We have one and she’s been invaluable. Be aware of stress on your relationship and deal with it promptly - infertility is VERY hard on a couple.

If you have any specific questions about what to expect, let me know! All the best!

My wife and I have been through very similar stuff. She’s had PCOS for around 15 years, and was told by her doctor that she could “probably never have more children”. Clomid worked for us eventually, but it was a long and emotionally draining process. Our first pregnancy ended in miscarriage, as did a few others along the way, but we now have an amazing little two-year-old girl, with another due this week.

That said, I always hated listening to people tell us their success stories, because I knew there was a good chance we wouldn’t have one of our own. I think that’s the hardest part - trying to maintain hope while simultaneously not getting your hopes up. Every month we’d keep telling each other not to anticipate too much, but it didn’t work very well. And then to get pregnant and then lose it? Awful.

So, that’s all I have to say: keep hoping, but not too much, because that makes the disappointment that much harder. But you’re still in the very earliest stages - at least wait and see what the clinic has to say first.

Speaking as someone in an infertile marriage, one of the annoying things I’ve found about sharing the success stories has been the implication that anything other than producing one’s own biological child is a failure. I realize that this is often done with the best of intentions but it’s not always helpful.

Another annoying thing are those who push adoption.

Another annoying thing are those who insist I am the infertile one. Actually, it’s my husband. And if we get that established then it’s a toss up whether they start “informing” me (as if I didn’t know already) about artificial insemination or suggest I divorce my husband and find a fertile man. OK… :rolleyes:

Which is not in any way intended to discourage you from what YOU decide to do. In the end, our choice was to remain childless and make a happy life for ourselves as a couple rather than a couple+. It’s not the right choice for everyone. If, at some point, you elect to take that path it’s entirely OK, and entirely OK to not take that path. It’s just another option, that’s all. It’s OK to adopt. It’s OK not to adopt. It’s OK to try multiple rounds of IVF. It’s OK to only do one or none. It’s OK to use a sperm donor or an egg donor. We are fortunate to live in a world with more options than ever before. ALL of those choices are OK.

That’s the most important thing to remember - YOU are in charge. You are allowed to call a halt to proceedings at any time. You are allowed to take a break in rounds of treatment. You are allowed to try again and again. You are also allowed to give up if you’ve had enough.

Since you want biological children and you’ve chosen to pursue this I support you and give you my best wishes. No matter what you decide to do, or not do, I will support your choice and wish you the best. That, I think, is really what you need to hear right now. Whatever YOU choose to do is the correct thing for you and yours.

My experience is now ancient history. But we did several rounds of clomid, I was ovulating, but clomid had me producing multiple eggs per cycle upping my chances. Then a few rounds of fertinex, which was not covered by insurance. The fertinex made me insane (it was like super PMS) and with nothing else covered we got off the roller coaster. We took some time individually to decide if we wanted to adopt and after a few weeks both came to the conclusion that adoption would be the path we’d take. We did have a surprise bio kid, but at that point, according to my RE, that happens about 11% of the time, the same if you adopt or if you just stop intervention and wait, or if you never start.

I’m reading some concern about the expense into your post and a word of warning…fertility treatments and adoption are dagger cheap compared to daycare, hockey, gymnastics, band, feeding and clothing a thirteen year old boy, car insurance and college. Infertility is a reprieve to decide how much you want kids. They are wonderful, but they are also expensive, aggrevating, exhausting, anxiety producing. There are certainly days wh being child free looks attractive.

Yes, this is a good point. The cost is high, but we just see it as adding a few years of actual child costs on top of what we’ll pay once we (hopefully) have one. That said, you often have to come up with a lump sum rather then it being spent here and there.

Don’t feel guilty for seeing the specialist. Hopefully you’re one of the easy cases they can fix up and send on their way, and maybe that’ll count as a little win in their day :slight_smile: Do, do, do get your husband tested ASAP. I wasted four years of my life trying to figure out why my “mild PCOS” was preventing me from getting pregnancy because no one suggested my (then) husband should be tested. Turned out the PCOS thing was a red herring. You really need the whole story and you’ll only get that from having him tested too.

Good luck!

No, I’m not concerned about the cost. Like EmAnJ, I see it as part of the costs of having a kid, no big deal. My concern is more about surprises involving the insurance coverage - I don’t want to get screwed because I don’t understand enough about how the system works. I don’t want to find out something isn’t covered because I went to the wrong pharmacy, or something stupid like that.

We’ve been saving for a while, in anticipation of having kids - if we have to spend that money to get pregnant, so be it.

And **Broomstick **- thanks for making the point that any and all decisions made in this process are neutral, with no “right” or “wrong” attached. For now, I have made the decision to see a specialist. From there, I will be given other options, with other decisions to make. I’ve thought about it a little, but for now I want to take each fork in the road as it comes and make the best decision, for us, that I can at that time.

Cool. One of my triggers on this topic is the whole “it’s so expensive” - and kids just are, those of us with fertility issues just get a sampler up front. I knew too many people in my fertility and adoption groups who struggled to afford getting their kids, and that made for huge issues in having their kids. Not that affording kids should be a barrier,lots of people have happy families on a shoestring, but if the sacrifices seem big up front, that isn’t a great sign for not resenting those sacrifices when they continue of the next two decades (or longer).

The problem with the u.s. health care system is you are going to need to work it through yourself. Read your plan and understand it. It varies so much from plan to plan that it’s impossible to generalize what will or won’t be covered. And good luck… Dealing with insurance companies is never fun.