OB Not Doing Enough?

MissChrystal · 07-06-2008, 11:58 PM

I'm wondering if my OB is not doing enough or just being too lax about my TTC.

I just did my 2nd round of Clomid, even with "low" levels for my 1st Clomid round P4 he made no mention if it being low. He also said no P4 this time since he knows I do in fact O with Clomid. He did not want to up the dosage either.

I just wonder if he's not being aggressive enough with the steps as he should be...since I didn't have a strong O, should my Clomid have been upped?

Since insurance covers it, why not do the P4 to be sure it worked this time....it may not work everytime, right?

If I get a BFN this time around, I think I'll demand a P4 every month AND it be upped until he feels I've tried all I can.

Its been 2+ years without protection, 4 months since actively TTC and now 2 months on Clomid...I feel its time to step this up a bit!

Do you agree?

juliann456 · 07-07-2008, 02:21 AM

I had low p4 even though I did ovulate, and I got pregnant but m/c. They actually told me I had not ovulated, but then i got pregnant, so oviously I had. My Dr upped my clomid dose the next time around because he said that it would make me ovulate and it would likely make my p4 go up too, which it did. I would say just ask your dr. My dr is very open to doing whatever I want. He tells me what he thinks i should do , and then he leaves it up to me. But if you don't ask, then he will probably just do whatever he wants.

Juliann

Franca · 07-07-2008, 06:34 AM

MissChrystal, has your OB done all the regular fertility tests already? And will he move into things beyond clomid with you? I ask because clomid is where my ob-gyn stopped and I was sent to a fertility specialist. It was the best move ever! He ran a zillion more tests on me and created a better plan going forward (injectibles & IUI).

unctoothlady · 07-07-2008, 08:59 AM

With all I have been through, I have learned! You must DEMAND to be tested for these things. I had to do the same during my BFP cycle. They don't usually test P4 but I demanded!

If they won't go along with you, then I would be a little skeptical to continue on with them. If they won't test P4, how do we know if they will test your progesterone levels or beta? I found this out the hard way with my loss a few weeks ago.

The office I was in doesn't check progesterone, or betas unless there is a problem. Well at that point, would it not be too late? I have since switched to an office that does ALL OF THE monitoring prior to and after pregnancy. I would encourage you to do the same if your needs are not met.

JMO

scapoodle · 07-07-2008, 10:11 AM

My mom and I were discussing a similar topic yesterday. My gynie never does bloodwork on me and now that I'm ttc, I'm wondering do I need to change docs. I'm serious. I've been going to her for 10 years and she diagnosed me. She did the bloodwork on the original visit and checked all my levels but after that, other than the couple of time that she ran on test on pee for pregnancy, nothing! What do you think? When I go on the 29th should I ask for the works, or just find another doc? I'm concerned that the same thing will happen to me. I need to checked completely out so me and my beau can get busy. I mean should we have to do everybody's job and ttc?!

Franca · 07-07-2008, 10:18 AM

My Ob-Gyn flat out said, "I'm not a fertility specialist, so if you want more done, then you'll have to go to a specialist." Others are not so direct and try to dabble in areas that aren't their speciality. In my case, I've said it here before: Seeing my Fertility Specialist was like going to an orthodontist to get braces vs. having my doctor try to straighten my teeth out for a couple of months. I'm sooooooo glad I didn't wait the extra month to do it, like the ob-gyn had planned.

unctoothlady · 07-07-2008, 11:26 AM

I was in the same situation...I was going to a doc that I trusted but after this third miscarriage, I felt it was time to move on.

The group I found is a high risk group that checks levels A LOT!!! They said that by the time I am done with them, I will be so tired of seeing their faces!

I went in on the 26th of June for my first appointment. Went in again today for bloodwork and an ultrasound (follow up to my d&c) and have an appointment next week for a pelvic examination.

They are then, going to do a hysteroscopy to evaluate to see if my uterus is shaped funky and is the cause of my recurrent miscarriages. They are actually doing a lot of the testing that the specialist would do but they code differently so that insurance won't have a hissy fit.

It is so hard leaving a doc you have been with for a long time, but it has been an easy transition because these new guys are GREAT!!! Good Luck.

MissChrystal · 07-07-2008, 02:23 PM

This doc seems very wise, he's older and with the 3 names on the business his is the first mentioned....like a law firm? lol

He also comes strongly recommended by numerous women who are not connected....BUT, only when they got pregnant.

He seems to know what he's doing, I don't even have to ask before he says what I was thinking...such as Clomid, SA, etc.

Being in the office only 2 days a week, he seems rushed when I'm there and that 99% of his patients are pregnant...not trying to become.

He did not want me to come back until DF has his SA done, but with finances as they are this means we skip 1 month of TTC. Unless I can find a lab to bill us...

I'm sure a specialist would be better...I just don't know who to call!

amkoutsouris · 07-07-2008, 04:37 PM

I worked for a reproductive endocrinologist when I was in college, as a receptionist, not knowing a few years later I would be diagnosed with PCOS...

I feel better informed because of that experience, and I have watched my friends waste precious moments with an ob/gyn, who really doesn't understand infertility.

I am not yet TTC, I am hoping to start trying in August, and I am going to make a preemptive appointment at my reproductive endo for January, incase I do not get a BFP in those 5-6 months.

I actually suggest that people find a reproductive endo BEFORE TTC, get established as a PCOS patient. The insurance hoops are minimal for PCOS treatment as opposed to fertility treatment. Then when you are having problems, you can just go in and see the endo...as an established patient, not a new patient that needs to wait months to get in.

My conclusion in this long post is that you're your best advocate, and if you're not getting the testing you want and if your doctor is not giving you the testing you need, it's time for your to go to a specialist. You do not need to end your relationship with your gyno, because you will need to go back for prenatal care.

unctoothlady · 07-07-2008, 05:21 PM

With that being said, I still say that it won't hurt to do a consult with a different Obgyn 1st if you are not ready for the RE. I chose to do this and landed with doctors who work closely with an RE. My docs will do all of the preliminary testing as my primary care providers. If I have to be referred, the RE will not repeat the testing--saving me dollars in the long run.

BTW: I don't have PCOS....