RE appointment update

[mac08]

So Friday was my first RE appointment, and it went pretty well.  It was more like a consultation, no exam.  I have already had some testing done by my OB, which I had forwarded to the RE, so we discussed how to move forward in light of that information.  He said it looks like I have PCOS, even though I don't have a lot of the symptoms, but he says he tends to put people in that category easily.   I didn't totally understand this and will have to ask for clarification next time, at the time I was a little overwhelmed.  I am going on vacation this week into next, and that is when I am expecting Cd1, so I will probably have to wait until May to start any treatment.  The doctor recommended starting by doing an IUI with Clomid and ovidrel trigger shot.  I liked the doctor, and the practice overall, and I am feeling good about moving forward.

Before this appointment I was searching the boards quite a bit to see what others said about their first RE appointment experiences because I like to know what to expect.  In case this is helpful for anyone, this is how it went: I first met with a nurse who took my vitals and a history.  I then went back to the waiting room, then the doctor called me in and we discussed the history, my previous test results, and his recommendations.  This took about a half hour.  After waiting in the waiting room for a bit longer, the nurse called me back in to give a urine sample and then I met with her and she went over step by step instructions for what I needed to do next as far as getting things squared away with insurance and also how the whole IUI procedure and monitoring would go.  I then waited some more, and then was called back to give blood, they took at least 8-10 vials.  All in all, I was there for about 2.5 hours.

[Mushe]

Interesting! Will they do an HSG/SA before moving to IUI? Or did you already do one with your OB?

[mac08]

Mar 30, 2015 13:28:06 GMT -5 Mushe said:

Interesting! Will they do an HSG/SA before moving to IUI? Or did you already do one with your OB?

Yes, I already had those.  I forgot to specify what testing I had with OB.  I already had bloodwork, ultrasound, HSG, and my husband had SA, everything came back normal.  I already took clomid for 3 cycles, the first one I had one monitoring ultrasound on CD 14 and progesterone draw on CD21.  The other 2 cycles of clomid were unmonitored with OB.

[Mushe]

Mar 30, 2015 13:49:59 GMT -5 mac08 said:

Mar 30, 2015 13:28:06 GMT -5 Mushe said:

Interesting! Will they do an HSG/SA before moving to IUI? Or did you already do one with your OB?

Yes, I already had those.  I forgot to specify what testing I had with OB.  I already had bloodwork, ultrasound, HSG, and my husband had SA, everything came back normal.  I already took clomid for 3 cycles, the first one I had one monitoring ultrasound on CD 14 and progesterone draw on CD21.  The other 2 cycles of clomid were unmonitored with OB.

It's nice that that's all out of the way!  I hope you can get started ASAP.

[riffraff]

Mar 30, 2015 13:18:21 GMT -5 mac08 said:

So Friday was my first RE appointment, and it went pretty well.  It was more like a consultation, no exam.  I have already had some testing done by my OB, which I had forwarded to the RE, so we discussed how to move forward in light of that information.  He said it looks like I have PCOS, even though I don't have a lot of the symptoms, but he says he tends to put people in that category easily.   I didn't totally understand this and will have to ask for clarification next time, at the time I was a little overwhelmed.  I am going on vacation this week into next, and that is when I am expecting Cd1, so I will probably have to wait until May to start any treatment.  The doctor recommended starting by doing an IUI with Clomid and ovidrel trigger shot.  I liked the doctor, and the practice overall, and I am feeling good about moving forward.

Before this appointment I was searching the boards quite a bit to see what others said about their first RE appointment experiences because I like to know what to expect.  In case this is helpful for anyone, this is how it went: I first met with a nurse who took my vitals and a history.  I then went back to the waiting room, then the doctor called me in and we discussed the history, my previous test results, and his recommendations.  This took about a half hour.  After waiting in the waiting room for a bit longer, the nurse called me back in to give a urine sample and then I met with her and she went over step by step instructions for what I needed to do next as far as getting things squared away with insurance and also how the whole IUI procedure and monitoring would go.  I then waited some more, and then was called back to give blood, they took at least 8-10 vials.  All in all, I was there for about 2.5 hours.

Did he do an ultrasound?

I find it very strange that he says "I put people in the PCOS category easily" There are medical tests that prove pcos, once being a transvaginal ultrasound and bloodwork.

[HoneySpider]

I'm glad you have a plan! FX for good luck moving forward.

[mac08]

riffraff he did not do an ultrasound, but he was looking at the results of the one done by my OB.  I definitely need to ask for clarification at my next appointment because my OB told me she ruled out PCOS based on my blood work and ultrasound.  I had my entire file sent from OB to RE, and RE says that in my file from OB it says that I'm in the "PCOS category"  I was so overwhelmed at the appointment that I just accepted that, but now that I am thinking about it more it is bothering me, I need more information.

[riffraff]

that is very strange.

Do you have any of the symptoms? I was dx'd at 15 with bloodwork/ultrasound plus I had alot of the classic symptoms.

[riffraff]

aside from that, I'm glad it was a relatively productive apt and you have a plan

[mac08]

riffraff I have a few of the symptoms- irregular cycles, often anovulatory, overweight, and acne.  I don't have any of the others that I know of.

[riffraff]

Mar 30, 2015 16:37:21 GMT -5 mac08 said:

riffraff I have a few of the symptoms- irregular cycles, often anovulatory, overweight, and acne.  I don't have any of the others that I know of.

I would def have him do a follow up ultrasound, just for peace of mind.

[tiptoetulips]

I'm glad it went well and you have a plan in place

[swiftlyirun]

Mar 30, 2015 16:15:55 GMT -5 mac08 said:

riffraff he did not do an ultrasound, but he was looking at the results of the one done by my OB.  I definitely need to ask for clarification at my next appointment because my OB told me she ruled out PCOS based on my blood work and ultrasound.  I had my entire file sent from OB to RE, and RE says that in my file from OB it says that I'm in the "PCOS category"  I was so overwhelmed at the appointment that I just accepted that, but now that I am thinking about it more it is bothering me, I need more information.

I've been hanging out on TTTC a lot more lately since I hit the year mark, but I saw your post and wanted to comment because I have a similar story (like, seriously do we go to the same RE/OB?!). 

I too was told by my OB that I did not have PCOS and after being in the RE's office for about 10 minutes he told me definitively that I have "lean PCOS" i.e. I don't have a lot of the outward symptoms (possibly due to the high amount of mileage I put in each week) but that my blood tests pretty definitively show PCOS, that combined with the fact that I have trouble keeping weight off (even with 40-50 miles running/week and a low cal diet). A vaginal ultrasound later confirmed the cysts. 

My doctor described the broad categorization of PCOS by saying that now that the thought is that you can be defined as PCOS by just having one or two of the symptoms. For me it was the bloodwork and being anovulatory.

I know he explained this WAY better, because it made a lot of sense at the time, but honestly I was so focused on the fact that OB missed this I think I kind of zoned out. I'd be interested to hear what your RE says!


GL! 

[boiler717]

I've also had PCOS or not debated by my OB and two REs. I think it's pretty confusing!

Personally, no one checked on u/s on me before declaring PCOS or not. Initial testing showed I had high testosterone, high prolactin, and insulin resistance. My cycles were pretty normal. But there was debate about if it was because I'm overweight or because I have PCOS. My AFC was in the upper 30s and my AMH was 13.6 which is pretty clearly PCOS.

[mac08]

Thanks swiftlyirun and boiler717 it's good to hear I am not the only one in this boat!  

[MrsMB]

Gl going forward!!

Sent from so-called "smart" phone. Please forgive any errors!