BFP related - transition from RE to reg OB

[fairfax]

Hi all,

I hope it’s ok to post this here - I want to sensitive to those who have not had a BFP.

Tomorrow is my last appt and scan with the RE Dr. I had bloodwork this morning and am weaning off the meds (PIO, Prometrium and Estradiol) over the next week. They said there is no further bloodwork or screening with them - I’ll just transition to my regular OB.

However, I had a scan with my regular OB office last week (not my actual Dr but the Dr I saw was the chief of Womens’s Health) and they recommended I stay on with the RE through the first trimester. He said they basically aren’t equipped to handle anything out of the norm. They do have a reproductive health department I might be able to get into - it’s where I did my 6 IUI’s.

I’m just feeling very anxious at the thought of discontinuing all the meds without any plan to monitor and check to see if things are ok. I don’t even know when my next scan would be. I’ll talk with the RE tomorrow, but any advice or experiences to share?

If I shouldn’t post this here please let me know and I’ll take it down right away.

[G22]

How far along are you? I'm guessing 9weeks< if you are weaning off meds. At that point there isn't really anything left for the RE to do. I moved from my RE to OB asap last time. Not sure about this time, I'm with them through 6 weeks at least. There really isn't anything else for the RE to do at this point, so I'm surprised your OB is pushing you back to them still.

[fairfax]

Mar 11, 2019 17:54:39 GMT -5 G22 said:

How far along are you? I'm guessing 9weeks< if you are weaning off meds. At that point there isn't really anything left for the RE to do. I moved from my RE to OB asap last time. Not sure about this time, I'm with them through 6 weeks at least. There really isn't anything else for the RE to do at this point, so I'm surprised your OB is pushing you back to them still.

I’ll be 8w4d tomorrow. I guess I’m less concerned with the move and more concerned that there’s no follow up to weaning off meds - regardless of who it’s with. Like, all this effort has gone into getting this outcome - it seems scary to change a major component without even knowing if it’s going ok. And to not even have an idea of when my next scan would be. I have a phone appt with the reg OB office on the 19th so I won’t know their next steps until after that.

[kellikans]

With DS, I was with my RE through 10 weeks. But I know that some get released to their OB's after their first scan with the RE around 6 weeks. There's really nothing for your RE to do anymore at this point. I don't even think I continued blood work after my inital couple of betas... Just had the weekly scans. When I weaned off of my PIO, they didn't track my levels. I had my first OB appointment at 11w2d, and we did the NT scan and Panorama testing, and whatever other routine bloodwork she ordered.

Usually your OB will get you in around 10-13 weeks to do any genetic testing you want to do. If you're concerned about weaning off of your meds before going to your OB, let them know. They may keep you on longer for your peace of mind.

[G22]

Mar 11, 2019 18:01:03 GMT -5 fairfax said:

Mar 11, 2019 17:54:39 GMT -5 G22 said:

How far along are you? I'm guessing 9weeks< if you are weaning off meds. At that point there isn't really anything left for the RE to do. I moved from my RE to OB asap last time. Not sure about this time, I'm with them through 6 weeks at least. There really isn't anything else for the RE to do at this point, so I'm surprised your OB is pushing you back to them still.

I’ll be 8w4d tomorrow. I guess I’m less concerned with the move and more concerned that there’s no follow up to weaning off meds - regardless of who it’s with. Like, all this effort has gone into getting this outcome - it seems scary to change a major component without even knowing if it’s going ok. And to not even have an idea of when my next scan would be. I have a phone appt with the reg OB office on the 19th so I won’t know their next steps until after that.

Idk, from my previous experience that's normal. The placenta takes over the progesterone supply around 9 weeks, so most people wean of them around that time. If you're concerned you could request a progesterone blood draw from either doctor. But I never had any sort of follow up once I weaned off them in the past.

[knx9211]

Come on over to the grads board!

But I was discharged from my RE before 7 weeks. What do they think is “out of the norm”? Just because you’re on meds? My RE just told me the around 4 week plan to wean off Estrace and to take PIO until 12+6 and sent me on my way. I didnt have blood work with them since my ultrasound at 6+5 or so.

[woowoo]

fairfax, I was weaned off meds at 10 weeks and also did not have any follow up bloodwork leading up to or after that point. My first OB apt was at 10.5 weeks when we did NIPT testing and a few other things. I would feel comfortable transitioning over to the OB.

[icedcoffee]

With my first I graduated to the OB at 8w6d and with my second at 7w6d. They told me to discontinue meds at 10w. By 10w the placenta takes over. I've never had any tests before stopping meds. I was worried the first time too, but it really is ok! There is nothing high risk about your pregnancy. Now that you're pregnant you're just like any other pregnant lady. I would feel comfortable just transitioning to the OB. RE's are great at getting you pregnant, but they have very little experience with pregnant women. That's what OB's and MFM (for high risk pregnancies) are for.

ETA:  My OB did an u/s and some bloodwork (standard stuff like blood type, HIV, blood cell counts) around 9 weeks and then my NT scan at 12w.  That's pretty much it for the first tri.  My second pregnancy I also had NIPT bloodwork around 11w.

Also--the grads board is a great place for these kids of questions!

[fairfax]

Thanks all for the reassurances. Guess I am letting my anxiety get the better of me!