Friday, January 1, 2016

Questions to Ask at Your First RE Visit

Visiting an RE, a reproductive endocrinologist, can be overwhelming. On one hand, you may feel eager to get started on the path to your future little one, but you also might feel fear, apprehension, and lots of uncertainty about what the next steps are. It's easy to feel like you are suddenly in over your head!

On your first visit, lots of things will be happening. You'll probably talk to a few different nurses and possibly even a few different doctors. On our first visit, we met with two different nurses and two different doctors. You may have blood work done and will most likely have both an internal exam and a vaginal ultrasound. So suffice it to say, a lot will be going on!

With so many things happening all at once, it's easy to get overwhelmed. That's why it's best to write down all of your questions ahead of time and do a little research so you can really understand what your doctor is telling you.

Here's a list of some ideas of what to ask your doctor:

What further testing do you recommend? And why?

Each case is different, so testing that is ordered for you may be different than what tests were ordered for your friend. Don't hesitate to ask your RE why a certain test is being ordered. Also ask what is truly necessary. In most cases, genetic testing is offered - but this can be expensive. It may not be needed in all cases, especially if you have no risk factors. 

How do my labs look? 

In many cases, by the time you've made your way to the RE's office, you've already had some basic fertility testing done by your OB/GYN. Be sure to bring these labs along to share with your RE. It may even prevent you from repeating tests you've already had. Ask your RE if anything jumps out at them from your previous lab work, because understanding your results helps you to understand your diagnosis.

What are my treatment options?

In some cases, you will be given a diagnosis at your first appointment. If this is the case, you may be able to have a complete treatment plan drawn up that day. Be sure to share your feelings on different treatments with your doctor. If you don't feel comfortable doing something, speak up. For example, we decided against doing any injectable IUI cycles, because we feel like we'd rather put our money towards IVF. Our treatment plan reflects our wishes because we've made our feelings known to our RE.

Do they accept your insurance or offer a discounted cash option?

Depending on your situation, finances might play a big role in your treatment decisions. Most people do not have fertility coverage, so may fertility clinics offer special discounts to cash only patients. But if you have coverage for fertility treatments on your insurance, you want to make sure you take advantage of it. The costs of appointments and bloodwork really add up fast! Confirm that your insurance is both accepted as is "in network" with your insurance company.

If you have questions later, who should you call?

In many cases, you will be assigned a nurse in your fertility center. Any time you have questions or concerns, you will call her. But every clinic is different and knowing who to get in touch with is very helpful.

When and how are test results given to me?

Knowing ahead of time when to expect your results can save you a lot of stress. Some clinics also have a cut off time for blood work. For example, if I have my blood drawn prior to 9 AM, I will get my results in the early afternoon. In some cases, a nurse will call you with your results, but other clinics use patient portals to relay test results.

Can you take a look at the supplements I'm taking?

Many of us going through infertility try different supplements. Be upfront with your doctor about what you are taking to ensure there is no negative reactions to medications they may prescribe. In some situations, such as my husband and me, the doctor will actually recommend specific supplements.

What is our chance of success?

This is a difficult question for some people to ask. We might not want to hear the answer, but it's better to know what you're up against. It may also help you to decide which treatment is the right choice for you. If you have only a 10% chance with IUI but a 60% chance with IVF, that might sway you in one direction.

What are the side effects?

If you have been given a prescription for any medication, even if it's just Clomid or Femara, ask your doctor what to expect and if there are any safety concerns.

What are my risks of multiples?

This is an important question to ask, because carrying multiple babies significantly increases the complication rates in the pregnancy. Your risk of multiples will also factor into your treatment. If you are doing IVF, your RE may feel very strongly about transferring only one embryo. If you are doing an IUI, your RE may not want you to have more than 2-3 follicles.

You may have lots of other questions, but this is just some ideas to get started with. Don't be afraid to take notes at your appointment because there will be a lot of information to take in. If you partner can go with you, that would be a big help as well.

Have you already visited a fertility specialist? What questions did you hope to get answered?

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