What occurs at a Reproductive Endocrinologist appointment?

[kittymommy]

I just miscarried for the third time. I am considering seeing a specialist of some kind, but am confused as to what type of testing would be done or even what type of specialist to see. I am not really infertile, as I ovulate regularly, have regular normal cycles, and have no trouble conceiving.  We have conceived all three times on the first attempt.  Our trouble is that the fetus always dies early.  I have had several internal ultrasounds throughout the past year, so I would think that if it were a physical problem in there it would have been detected by now.  I do not have luteal phase defect, endometriosis or any other problems that I know of either.  I strongly suspect that my problem is just that my eggs are too old at 35 and a half years old.  I guess my question is do any of you know of any testing that can be done to test egg quality?  The only fertility treatments I can find to read about all revolve around encouraging ovulation or artificial insemination, neither of which is what I need.  Of course, In vitro is out there, but I don't think that's a viable option for me with the cost.  Does anyone have any other suggestions as to any specific tests I could ask for, or what type of specialist consultation I should seek?

[Mediteranean Girl]

First, I'm so sorry for your loss. I can completely appreciate how devastating it is.
After my M/C last Just I went to see an Endocrinologist and found out that I have a polysistic ovarian syndrom (syndrome). My case is differetn than yours. I have hard time conceiving, and don't have regular cycles. My obg says that my eggs are not good enough. That's why i'm taking Clomid, but unfortunately it's not helping much. I've been trying for a almost a year after my M/C. So don't feel bad, you are not the only one; and please Keep your chin up and don't loose hope. I'm sur God will choose the best thing for you.
Good luck !

[Stacie30]

you still might be a good candidate for IVF. They can check the "quality" genetically before they implant the embryo's. that way you know that there aren't any chromosome problems ahead of time. that just might do the trick if your problem is egg quality.

[5kids247]

I FINALLY was sent to an endocrinologist with my last baby - after 11 m/cs and 12 babies-they discovered that I have a transformed chromosome - which is hereditary - and will more than likely be passed along to my girls -and I along with the endometriosis (sp?)I have - they found that due to both of these factors my body would not produce enough of the progestrone needed to sustain a pregnancy to the point that the uterus takes over -(I hope that I have all the terms correct - its been a while) so, my body would attack the fetus as if it were a foreign object - thank goodness I was able to get 4 here - but not without troubles mind you and a lot of heartache, before this was discovered.  My last pregnancy went the best as far as the early stages were concerned - no theat to m/c early on as with all the others plus the 12 babies that didn't make it- I even felt better - LOVED being pregnant! Of course - hated the worries - The best part of the testing was to know that it wasn't anything that I was doing or not doing - AND HOPEFULLY we will be able to spare my daughters this pain and heartache by knowing this.  It is not impossible - (I was 38 when my last "surprise" was born) Have they started you on the baby asprin? - I also had low blood flow to the uterus due to all the cysts that I have and scar tissue - baby asprin helps the blood flow - I took it through week 25 - They also put me on progestrone-most women will take this through week 11-13 / I remained on it through week 20 - I think mostly for my peace of mind - but also becuase I didn't have time nor the strength to "test" it out and try again if the pregnancy failed and my doctor just kept me on till he felt comfortable that I was out of the woods too. My testing wasn't horrible, in fact I wasn't tested until I found out I was pregnant because I wasn't even trying- we're still not sure how it happened - well - we know HOW it happens-but not HOW it happened~you know what I mean-we just call her our "BONUS BABY" - so, good luck to you - you may want to mention these things to your doctor also - my mother had lost 2 babies, by grandmother 4, my great grandmother - they aren't sure how many - but knew she had - but I have 4 sisters and 3 of the 5 of us have had multiple m/c's (7-12)(between 8-20 weeks - the other 2 sisters just got married) and the specialist said that in the studies that they have done it seems to be a very high percentage of "transformed chromosome" defects - although it is not a "visiual" defect - it seems to affect nearly every woman in a family, because it is hereditary and is very much "controlable" by the meds. Since then, because of what I found out my little sister - well 3 years younger, just had a baby after 7 m/c and 9 years trying - using the same stuff that I was given....so it may really not be all that complicated - I hope that all goes well for you - and I am so very sorry for your losses - one is more than any woman should EVER have to go through.  My prayers and blessings are with you. GOOD LUCK and may God bless you!

[cdw]

Hello. Sorry for your losses. I had 3 m'c as well. I had been in fert tx in NY and Boston for close to 3 yrs prior to conceiving my my DD via IVF. I had 8 IUI and 2 IVF's. We found out from the failed IVF that I had very poor egg quality and they gave me a 5-10% chance of just conceiving via IVF. Well, I now have Madeline via 2nd attemp IVF(who is 17 months) and I am 20 wks pregnant au natural!! The FSH levels that they test during your cycles help give an idea of your eggs. Well, my #'s weren't bad! They only found it on IVF. All my losses they had analyzed the tissue and found nothing wrong. I wish you well in what your decide to do. I understand the cost issue..we spent over $50,000 and then I also went part time to decrease the stress. I also then stopped working prior to the last IVF attempt (which worked w/my DD). Because we knew that was our last try for genetic parenthood and I wanted to give myself 100%. I must say looking bck...If your going to do advanced infertility and you have to pay for it...go to the best!! We did and I feel it did make a difference! Boston IVF at the time was ranked #3 in the US. I also feel that destressing your life can play hugh! I was always saying I had no stress...well you always do and if you can find outlets take charge!! Support groups & Acupuncture have been proven to increase postive outcomes with advanced fert tx. Good luck and if you have and questions I'll try to help!

[kittymommy]

Thanks for your positive outcome story.  May I ask how old you are?  And how did they do the FSH testing to test your egg quality?  Is that a reliable test?  Do you know if it's something a regular doctor can test for?  I'll have to research that.  Congrats on conceiving #2 au naturel....I assume you mean it was unassisted?  So much for your 5-10% chance, huh?  I'm happy for you.

I am going to be discussing my plans to continue with my doctor tomorrow.  She gave me the option after my 2nd m/c to go to a specialist, but I declined.  From everything I have read, I just feel certain that my problem has been egg quality, which I don't think any specialist can help with.  IVF is not something that I would probably consider.  My husband and I both have good jobs, but I just don't think it would be fair to put us through that financially and physically.  I admire those who can make the decision to go through with it as you have.

[cdw]

Hi. I am 35 and to be 36 in August. The FSH level I believe needs to be done with Fert MD b/c they are time test according to your cycles. No, I don't believe they are true indicator of your egg quality. However, they look at a range and what I remember over 10 is not great and above 15 is close to menopause. I was always between 7-9. I'm going bck 2 yrs now since tx so my memory may be poor!! They found my egg quality to be poor and I also had failure to fertilize from my first cycle of IVF. They harvested 28 eggs and only 12 fertilized and 0 made it to transfer due to egg quality. We had done ICSI(intracytosperm injection/force fertilization...more $$ of course!) with both IVF cycle b/c of the lack of fertilization.  In the end the embroylogist gave me a pretty bad report. Emotionaly the whole process is difficult b/c of poor results and the hormones! However, I never..not once did not believe I would not have genetic parenthood. We did research a little on donor eggs b/c that was what my Dr were telling us to do. They wanted me to keep things open. Of course, you need only to focus on one means at a time. Your mental state can't handle anymore!  I just always believed it would work one way or another..I, we were very open about are situation and I discussed the issue with anyone. I always welcomed babies and children in my life no matter how hard it was to be with them. Pregnant woman were diffucult but I just kept believing! Don't get me wrong, each couple's situation is different and if the end goal is to have child..then you will need to look and just look at all options (Fertility DR/IUI/IVF/Donor/adoption/Foster children..etc)!  You may decide from the start you don't want to try something and you both agree then you move to the next. You go through the process like a check list and move on to the next step if doesn't fit your needs or just isn't working. All I am saying is you go through steps and when your ready you will move to the next step to help you acheive that dream! I hope this helps and whatever you decide I'll if I can...talk later!!