Talk to Me about "Preemptive" Fertility Testing

[expatpumpkin]

DH and I are 38 and 34, respectively, and would like to put off having children for another 2-3 years.  But of course we're worried that we'll be just a tad bit past prime in a few years.  

Are there any tests we can undergo to check the state of our fertility affairs?  What do we ask for and which kind of doctor do we go to?  Together or separately?  

Important note:  I know there are no guarantees one way or the other, regardless of the test results.  However, if there IS a possible problem (only ovulating from one ovary, DH's sperm are lazy, etc.), we'd like to know as that would probably cause us to accelerate our family planning.

TIA

[thoseareradishes]

I would recommend charting for a few months to see if you have any issues (not ovulating, short LP, etc). It can take a healthy couple up to a year to conceive, and insurance doesn't usually cover testing until you have tried for a year (or 6 months if you are over 35) unless you have a known issue.

Basically, you just need to try and see what happens.

[vmars]

You should pick up Taking Charge of Your Fertility. If you begin charting your temps/fertility signs you can confirm you are ovulating and have a normal luteal phase, etc. This is a mostly free & fairly easy way to determine if there are any fertility problems before seeing a doctor. If you are taking BC you make consider stopping so your cycles can regulate too. I am not sure what doctors will do any pre-testing - you may have to try a few cycles before seeking help.

[expatpumpkin]

I should have mentioned that I've been charting (to avoid) for about three years and I'm on cycle 42 right now. My average cycle is 26 days and luteal phase is 13 days. Everything looks really good, but I don't want to rely on that alone. Plus, this tells me absolutely nothing about my husband.

We're expats and have amazing private health insurance coverage as well as access to "cheap" (by US standards) medical services.

Ideas?

[thoseareradishes]

Try and see what happens. Don't borrow trouble.

[expatpumpkin]

I don't want to try and see what happens because I definitely don't want a baby this year. All I want to know is whether we have any underlying issues that would cause us to move up our plans a year or two. Why wouldn't I want to discover this at 34 rather than 37?

[vmars]

call your insurance company/OBGYN. I dunno if insurance will cover testing but if you want to pay for it oop I am sure you can get it done.

[thoseareradishes]

I don't think anyone on this board is going to tell you to go get tested before trying, since you don't seem to have any issues.

You would be using up resources that women who have known issues could be using - money, time, appointments.

[expatpumpkin]

Feb 26, 2013 21:08:16 GMT -5 vmars said:

call your insurance company/OBGYN. I dunno if insurance will cover testing but if you want to pay for it oop I am sure you can get it done.

Which tests?  I'm not sure what to ask for.

[sonrisa]

Talk to your doctor about what tests they are willing to run. (sperm analysis, bloodtests on days 2/3 and 21/22/23 of your cycle, etc.). 

But good test results are only a part of the issue. Many people who can't conceive have good results on those initial tests. Plus, finding out everything is okay at 34 means nothing for ttc at 37. Three years at this age can make a huge difference in fertility. Frankly, unless it is a matter of being able to put food on the table or something that matters more to you than eventually having kids, don't delay. Time is fertility at this point.

[bleubook]

If you want children eventually and you are 38 now, you shouldn't wait any longer.

[awick14]

Feb 26, 2013 21:20:39 GMT -5 sonrisa said:

Talk to your doctor about what tests they are willing to run. (sperm analysis, bloodtests on days 2/3 and 21/22/23 of your cycle, etc.). 

But good test results are only a part of the issue. Many people who can't conceive have good results on those initial tests. Plus, finding out everything is okay at 34 means nothing for ttc at 37. Three years at this age can make a huge difference in fertility. Frankly, unless it is a matter of being able to put food on the table or something that matters more to you than eventually having kids, don't delay. Time is fertility at this point.

I agree, if you are wanting children eventually why not start now? You will never know what the future brings until you get there.

Unless you can't afford TTC then I would start now. (I know we are younger but first put off TTC because we didn't want to be pregnant for a few events so I waited and did not come off BCP until TTC and I had a whole list of problems coming off BCP. It has been almost 2 years since we first wanted to TTC and we are only 5 months in and I wish I went off BCP earlier. )

[vmars]

Feb 26, 2013 21:15:48 GMT -5 expatpumpkin said:

Feb 26, 2013 21:08:16 GMT -5 vmars said:

call your insurance company/OBGYN. I dunno if insurance will cover testing but if you want to pay for it oop I am sure you can get it done.

Which tests?  I'm not sure what to ask for.

I don't either, hence calling your OBGYN. They will tell you what tests you can take at this point.

I do agree that if you don't have any compelling reasons to wait to ttc to start now. It takes a few months for a healthy couple to conceive so by the time you get PG and have a child it could be within you 2 year time frame. After 35 your fertility decreases dramatically so if you are 37 you could to face even further problems.

[sonrisa]

expatpumpkin - I'm not saying this to be argumentative. I had no trouble getting pregnant at 34. I spent the entire year I was 36 and now months of 37 unable to conceive a viable child (one miscarriage). My blood tests and DH's sperm analysis are all clean. Nothing at 34 would have hinted at the trouble we are having now.

[ilikedonuts]

Testing now isn't going to help you if you aren't going to TTC for another 3 years. So much can change in that time period.

[expatpumpkin]

Thanks for your feedback

[chia]

Feb 26, 2013 22:40:03 GMT -5 expatpumpkin said:

Thanks for your feedback

I don't usually post here (happen to stumble here from the app) - but, Fwiw, I'd probably make an appt with an RE, and say that we'd been TTC for 6 mo. Get the testing, then after getting the results, tell them you've decided not to seek fertility treatments at this time, since everything looks "normal" ( if it does...)

You could also just ask your PCP how much a sperm analysis( for dh) and a fertility panel ( for you) would cost. There's a test that basically serves as an approximate indicator of egg quality, but I'm not sure which test it is.


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[thoseareradishes]

Feb 26, 2013 22:49:25 GMT -5 chia said:

Feb 26, 2013 22:40:03 GMT -5 expatpumpkin said:

Thanks for your feedback

I don't usually post here (happen to stumble here from the app) - but, Fwiw, I'd probably make an appt with an RE, and say that we'd been TTC for 6 mo. Get the testing, then after getting the results, tell them you've decided not to seek fertility treatments at this time, since everything looks "normal" ( if it does...)

You could also just ask your PCP how much a sperm analysis( for dh) and a fertility panel ( for you) would cost. There's a test that basically serves as an approximate indicator of egg quality, but I'm not sure which test it is.


Sent from my Nexus S 4G using proboards

^o)

[belovedbride07]

I'm a little confused...if you aren't in so much of a hurry to have kids that you are starting today, waiting an extra six months before having testing in 1.5-2+ years really isn't that much time in the grand scheme of things.

That said, only you (and your doctor) can decide what is best for you in your situation. You can always call and ask, or talk to him/her at your next annual appointment.

[changedname]

If you really wanted to get an idea you could ask for an AMH blood test which will indicate your ovarian reserve. However, again that is no indication of how easy it will be for you to get pg. There are so many factors that come into play. According to my amh, I am fine and have plenty of eggs - I am 33, all tests come back normal and I am on cycle 16 about to start ivf.

[simpsongal]

Ditto OPs. If you want kids in two years, I'd probably start trying in the next few months. DH and I are both 30 and healthy and we're headed towards cycle 4. It's amazing how fast the time goes when you're TTC.

My friend got KU so easily for her first, the second was a huge struggle that had a late D&C in between. Not trying to frighten, but if you are really committed to having a family, don't wait too long. Especially if you want more than one child (I assume b/c you referred to children, plural).

[discogranny]

Feb 27, 2013 7:18:26 GMT -5 changedname said:

If you really wanted to get an idea you could ask for an AMH blood test which will indicate your ovarian reserve. However, again that is no indication of how easy it will be for you to get pg. There are so many factors that come into play. According to my amh, I am fine and have plenty of eggs - I am 33, all tests come back normal and I am on cycle 16 about to start ivf.

Just chiming in to second that AMH can be tested but can also be useless. I am 27 and my AMH is just enough on the low end of normal that my RE was not 100% sure I would respond well enough to fertility meds for IUI/IVF. Then we did the first cycle and I responded appropriately for my age. The AMH result meant nothing.

I know it's frustrating to read, but these ladies are right (with the exception of the PP who told you to lie that you have TTC for 6 months, I feel weird about that.) I am 27 (was 25 when we started TTC, pretty young in the fertility game), I ovulate every month, I have good egg quality, I make fertile CM, I have "normal" length cycles and no cysts or adhesions on anything internally, my husband has stellar sperm. Besides the near borderline AMH result, which was proven useless I have tested perfectly and would have been advised that we would have no trouble at all conceiving. We have been TTC for over two years, so while your doctor may discover something in testing, just keep in mind that not everything can be tested for and that you might still end up with surprise infertility in two years.

[Deleted]

Yeah, I wouldn't put it off either, especially if you are concerned enough about it to consider "preemptive testing". We waited 5 years to start because I wanted to travel and have all this freedom. Now we are 6 months into ttc and I discovered all these issues. I really wanted a baby at 30 and now 31 is creeping up. If I do get pg soon, I will be 32ish. But we wanted 2-3 kids and ...well time is flying, ykwim?