What to Expect on 1st RE Visit?

[KaliLily]

I looked through Family Planning and Family Planning Groups and didn't find anything on experiences with REs. I have my first appointment with an RE next month. What can I expect on this first visit?

TIA!

[karlatta]

It will vary from practice to practice, but I'll try to share what I remember from my first visit to the RE (over two years ago!).

I filled out all the paperwork then went back with a nurse for the initial stuff. Height, weight, medical history, and we talked a lot about my cycles and other symptoms. At that point, she told me what she thought was going on (PCOS), and then the RE came in. He again said that they suspected PCOS and he told me what some of my initial options were. (I needed drugs to ovulate, so we talked about that.) He also discussed what testing I would need before we could start. I was fortunate that I was there on Day 3, so I had my Day 3 bloodwork done right then. We also scheduled a SHG (most people have an HSG, but I'm allergic to the dye, so I have to have an SHG).

I started treatments about 3 months later. Some of my bloodwork came back crappy, so we had to wait to get started. For example, it turned out that I was no longer immune to rubella, so I had to go be vaccinated and then wait the customary time before we could TTC again.

[honeygirl]

I had to turn in my records and history prior to the appointment, but they had other paperwork that day as well. They took my weight and height, bloodpressure and basic medical info (meds, etc). Then the RE came in and reviewed my medical records with me. He asked lots of questions about my symptoms, what tests I'd already done, family history, etc. I wish that DH had come with me b/c he had questions about him as well (I brought him to the follow-up appt). He suggested a course of treatment and answered my questions.

Then we went to an exam room and he did a (pelvic) exam, ultrasound and took some samples (they tested for yeast, STD's, etc).

That was it and it took about 1.25hrs.

Good luck!!

[c'est la vie]

Like the other ladies, the doc reviewed my medical records and talked to DH about his family health history. I had an u/s and we both got blood drawn. Then we talked about our options and after that we were told what our insurance would cover and what it wouldn't.

[Asha]

we had to submit all of our fertility testing and records for review. they also took an ultrasound that day. we didn't have blood taken that day. i don't know if you should expect it, but we did receive a possible diagnosis that day. the re discussed which treatment was best for us considering our circumstances. we didn't make any decisions that day bc we wanted time to process the information. we made ourselves wait a month before we made a final decision.

[Scooter]

Usually you go over your medical history, get a diagnosis, make a treatment plan, and then the RE orders (further) testing or tells you to call on cd1 to begin a treatment cycle.

My ob/gyn referred me to the RE and also started the testing. She had me do the cd3 bloodwork and the HSG on the very next cycle, while I waited to get in to the RE. Ahead of time the RE's office also sent DH & me a long packet for both of us to fill out a detailed medical history. ETA: During this time DH also called his GP for a lap slip to get an SA done.

My 1st appt was about an hour long. It was just sitting at a desk with my RE, going over the packet page by page. My HSG had shown something to be concerned about, so she ordered an SHG to get a better diagnosis. (Basically the same thing as an HSG, but using saline & an u/s instead of dye and an x-ray.) We came up with a treatment plan based on the preliminary diagnosis she gave me that day.

Later I switched clinics (to get partial insurance coverage), and my 1st appt with my new RE went the same way. Sitting at a desk with her for an hour, reviewing my fertility medical records & talking about a treatment plan.

[j*east]

We both filled out long forms in the waiting room (be prepared to offer up everything about your sexual and medical history), then went over them with the dr., then I had an u/s to look at a possible cyst. Then we discussed that, DH's SA results (he got one about a week before our appt), my charts, and the plan...bloodwork (cd3 and around O time) and repeat ultrasounds (mid-cycle), post-coital test (mid-cycle), etc.

If you happen to be scheduled for an u/s between now and your RE visit, you might want to think about putting it off. I got one for my cyst the week before my RE appt, but the RE wanted to look at it for himself again anyway, so the first was kind of a waste. Check with the RE office if you're in that situation.

I wrote about my RE visits in great detail in the last few pages of my journal, because I didn't think to create a thread like this and I would have benefited from reading others' experiences. :) Feel free to look at that if you like.

[jennylou]

It's been a while, but I brought records, went over treatment to that point, took more bloodwork and talked with the RE about a game plan for me.

Oh, and we also went over my charts - she really liked my charts. :D Apparently, at that point (almost 2.5 years ago) people that were charting were paper charting, and she really liked the charts from FF. :)

[t3h_wookiee]

I'm glad that you asked, as I was wanting to know too! I'm making my appointment with an RE on Monday, and was really wondering what to expect that first visit. I'll have to remember to print out my charts and bring them. I at least won't have to worry about remembering to transfer records, as I haven't seen an OB or anything about IF stuff, or anything besides that blasted pap smears. :p

[Scooter]

I forgot about the charts (it was 3yrs ago I went!)--definitely bring them if you chart.

I at least won't have to worry about remembering to transfer records, as I haven't seen an OB or anything about IF stuff, or anything besides that blasted pap smears. :p
They may want your records anyway, so they have your full history. It's something to ask about, anyway.

[KaliLily]

Thanks, everyone, for the info. Sorry I've seemed MIA. I've been dealing with a sick cat and have only had the energy to lurk on here. (She's doing better now.) I'll come by later for a real follow-up, but wanted to at least pop in and thank you all.

[jennylou]

I thought there was a thread for this and found it tonight.
http://www.constantchatter.com/showthread.php?t=8947

[hiphopgirl]

I'm not sure if this thread belongs here or somewhere else. I looked and couldn't find a thread of this nature.

I am going to the RE tomorrow for an initial visit. I'm convinced that I have LPD. However, I don't want to steer the doctor towards a diagnosis at the risk of there being something else wrong. I just don't want to fool around with stuff I think would be useless.

I've read that RE's can measure your lining at 7DPO and check progesterone levels. I will be 6DPO tomorrow. Is that close enough? Would he be willing to run those tests at an initial visit or am I going to have to schedule another one? I really don't want to have to wait another month to go through any testing. I feel like I'm already wasting time by not having gone sooner. Also, will he be willing to write me a prescription for Progesterone? My OB wrote me a script a couple of months ago and I'm all out. I left a message with her office to renew my prescription, but nada.

I'm hoping that if there is a chance to help me this cycle he'd be willing to do what he could. Thoughts?

[karlatta]

I'm pretty sure there's a thread already, but I couldn't find it either.

It's impossible to know what any individual RE will do. My RE starts with CD3 bloodwork, so there's a chance yours may want to wait for that. I was fortunate that my initial visit was CD2, so I was able to get mine done right away. My RE also tested for Cystic Fibrosis and Rubella immunity before he'd do any treatments, so I had to wait on those before I could start treatment.

I know it's frustrating, especially when you've been waiting so long. Just remember that if you have to sit this cycle out, it's not because the RE just wants you to wait. It's that he wants you to have the very best chance at being successful, so he may need more information than he can get from an initial consult.

[hiphopgirl]

Thanks for bumping the thread. I guess it was so old that's why I didn't find it. This helps a bunch!

[laura]

Before my appointment they sent me a big packet of information where I had to fill out a complete medical history. I met with the doctor and we discussed my diagnosis (endo) and she asked some questions about my husband (he was not there). I had to do cd3 blood work also, as well as HSG, and a SA for my husband.

[Scooter]

hiphopgirl, I went ahead and merged your post with the other thread about this, so you can see some of the other responses, too. :) If you go to the common IF questions (http://www.constantchatter.com/forum/showthread.php?t=35004) sticky thread, there are some links that might be useful to you.

The 7dpo test you're talking about is the endometrial biopsy. Not all REs use that test for this reason, because some don't believe in the accuracy of the results. As for the diagnosis of LPD itself, that's also controversial. A lot of doctors see a short luteal phase (with or without spotting) as a symptom rather than a diagnosis in and of itself. For example, my LP tend to be short, and my RE's belief after seeing me for many, many cycles was that my ovaries just weren't producing the amounts of hormones or, therefore, mature enough eggs, so the corpus luteum wasn't producing enough progesterone and that led to my short LP. That's just one scenario, but if she'd just been treating the apparent LPD, I would never have gotten pregnant.

That's why the RE will want to know the whole picture. They tend to like to have the bloodwork be from the same cycle, since hormone levels can vary from month to month. So they'll probably send you home with lab slips for next cycle, maybe an HSG for that cycle, too, possibly an endometrial biopsy or post-coital test if they believe in doing those things. They would definitely have to make a separate appointment for the biopsy, because right now you are booked for a consult and that might just be in the RE's office. They'd have to have you booked for a procedure room to do the biopsy. HTH and good luck at your appt!

[BeachBum]

At my first visit the Dr. wanted to learn about what our TTC plans were, not just medical history. We talked about things like financial considerations (our insurance doesn't cover anything) and I also expressed the fact that we were not going to keep trying for more than a year. I think he was just trying to get a feel for how aggressive we wanted/were willing to be.

He then laid out a plan of how he thought we should move forward. We talked it over asked questions etc.

[hiphopgirl]

Scooter - Thank you. I guess I should have looked through those FAQ's before posting my thread. Sorry :( I think those FAQ's will help me a bunch. I'm just getting started down this road and I have a lot of questions.

[Scooter]

That's ok. :) Since sometimes it can be awhile in between some of these questions that get old, I think it's easier to link the threads in that FAQ than searching. Ever tried searching for RE? ;) Bump any thread in that post you want, very little (if any) of this info changes much over time.