Hello, everyone. I have been lurking around this board for months, since it is slowly becoming apparent to me that I am going to need some medical intervention in my quest to achieve a pregnancy. You guys seem like a knowledgeable bunch, so I am hoping for some advice about my options. I am sorry if this gets long, but this is my story:

My ob/gyn recently sent me to a reproductive endocrinologist. The ob/gyn did not even want to do some basic tests or procedures to test my hormone levels, as soon as he reviewed my entire medical story, it was just go to the RE, go directly to the RE, I have my hands full dealing with straightforward pregnancies, and yours, if we can even get you pregnant, would be anything but straightforward. At your age, you don't have time to fool with me or anyone except someone who deals with this stuff every day and can offer you the whole range of services. And don't let the doorknob hit you on your way out the door. I felt like he had just given me the evil eye and I had been banished from his practice. I was so disappointed, I had thought I would finally get some basic info about the state of my reproductive picture through him, yet I was being sent on my way, still just as much in the dark as I was before, and I just went to my car and cried.

Though I do understand what he means by not having time at my age and going to the doctor who can do it all where infertility is concerned, it's just that I have to consider not only time, but also money, as I am sure many of you know. He could have done some tests that would have been covered under my insurance and then sent me on to the RE later if and/or when things got beyond him, but the RE will have to be paid for out-of-pocket, something that is just absolutely not possible for me right now. This situation has thrown me into a state of constant panic and depression as every month passes, as I desperately want to proceed, but can't because of finances, and I feel like I am being cheated out of my last chance to see if something is wrong and if it can be fixed so that a pregnancy could happen. My husband and I keep trying it the natural way and doing it when I am fertile and whatever, but I feel more and more that this is futile. It is hard to function daily when I constantly feel like running through the streets and wailing and tearing my hair out.

I have been (re)married for a year and trying to get pregnant the whole time. No prior children or pregnancies. Husband is 51, and has four other children already with his exes, so his sperm are not really in question, although we will have them tested to be sure (more on that later). I feel like I have so many strikes against me that I don't even know where to begin. A pregnancy would be high-risk for me. The reasons that the ob/gyn ran screaming from the room are:

-My age-38-not totally ancient, but less than ideal, especially considering that I haven't gotten pregnant after one year.

-The fact that I have: 1) Endometriosis (lasered out 14 years ago, no treatment of any kind since), 2)Lupus, an immune disorder where your body attacks itself and can cause various complications during/after a pregnancy. Lupus has already caused some damage to my kidneys, which could possibly worsen during a pregnancy. But I have been given the all-clear to try to get pregnant, as my disease has been under control for a couple of years now and I am really healthy at this time. My status could change at any time, which is another reason why I am pulling my hair out with every month that passes.

-My husband has rheumatoid arthritis and recently began taking a drug for this that can reduce sperm count, which he would have to stop taking for a time while we try try to get past this infertility thing. But that means that he would be suffering more with the arthritis and the damage it is doing to his joints if he went off his medication. This tears me up, as I don't want him in more pain, but I try to keep the perspective that it would only be for some months or at most a year or two, but if I don't try this pregnancy thing right now, I will be childless FOREVER.

The question I am asking is have any of you gotten at least some basic diagnostic tests and treatments for infertility through an ob-gyn (perhaps they were done under the name of looking for other things, so that they could be covered under the insurance)? I know every ob/gyn has different skill levels, so I might have some luck looking for one that includes some infertility treatment in their practice and is in my insurance network. The nurse at the RE's office explained that it is possible that some things could be partially covered by my insurance at the rate of 60% (they are out-of-network), but that once I became diagnosed as officially infertile and requiring treatments for this, that would drop to zero. And they don't do payment plans, you have to have money or arrange for financing some other way, or pay your part of the bill at the time of service. I know that it would be best if I could stick with the RE and go full speed ahead, but money rules that out for me at the moment (working on changing jobs, but that is a big question mark), and I need to do SOMETHING. Thanks for any advice, I am losing my mind....

Aqua, I'm sorry, finding out that you are one of the "infertile bunch" is so hard. It sounds like your OB was not very helpful. They should be able to run at least some basic tests to see if you are ovulating regularly. It could be a quick fix with some clomid if that's the problem. And 38 is not over the hill. When I was trying to get pregnant with my first son at 24, my aunt who was 40 and best friend who was 38 were both pregnant without problem, while I was way younger and just couldn't get there. Age is only a piece of the puzzle.

The biggest lesson I've learned about infertility is that you have to take charge and manage the situation. Listen to your instincts. If you think that seeing a different, more compassionate OB would help, you should do it. Good Luck! :angel:

I was on the infertility board for about a year and a half, so I know the frustrations that come along with it. Have you explained your financial situation to your ob/gyn? He might be more likely to do some tests if he knows that you're not going to be able to go to a RE right now. If he can't help, you might want to go to a different ob/gyn. As if it's not hard enough to deal with having trouble getting pregnant, then to have to deal with paying for a RE too... life sometimes sucks!

Hi Aqua, you are certianly in a difficult situation and my heart goes out to you. Regarding treatment with an Obgyn, it certainly is a possibility if you find the right one. Because my insur convered nothing, we stuck with my Obgyn for about 18 months of our IF journey and only recently started seeing an RE.

I have mixed feelings about my decision to wait for an RE... obviously I did not have success with the Ob. However, if we had been successful, the financial savings would have been excellent. Unfortunately I never had confidence in my Ob with repect to treating me for fertility. It was very clear to me throughout that he was not a specialist and I had many questions that he could not answer (of course, there must be other obgyn's out there more knowledgable which may have led to a different experience). Now that I am with an RE I feel so much more confident and less stressed about my chances of conceiving with his help... which probably in itself is helping my cause.

If I had to do it again, I would go straight to the RE after I hit that 8-12mo mark. Fertility can be extremely complex even when you don't have any known obstacles working against you (my IF is unexplained). Having said that, this is an extremely personal decision and you have to do what is best for you and your DH. I think Vik is right and you do have to take charge and manage the situation so that it suits you best. Maybe you can have a consult with another Obgyn and get a second opinion on whether it really is necessary to go to an RE straight away. My only advice would be to give it plenty of thought and ensure you will be comfortable and confident in whatever decision you make. Good luck to you and please let us know how things progress.

Acqua,

Welcome to the board. My heart reaches out to you..but please do not lose hope..

my understanding is if your insurance covers Infertility, then it should cover for the tests irrespective of who orders them-the OBGYN or the RE..I say that because my insurance does not cover IF and so my blood tests which my OBGYN asked me to do where not covered. Things like LAP and medication for endo might be covered because they are "medical" conditions and not necessarily "IF" conditions. So the point is even though you go to an RE ,some of your tests could be covered if your insurance covers IF or part of it.

Like the others said IF is a situation where you have to take charge...Please don't lose hope- that is the one thing we have which keeps us fighting.

cheers,
bluewhite.

Welcome Aqua! I'm sorry to hear that you're having such a hard time with your dr. My OB/Gyn did some basic testing before sending me to the RE. She checked my thyroid, did a 21 day progesterone test, and ordered an HSG. She also ordered a SA for DH. The tests she ordered were covered, at least in part, by my insurance. However, once the diagnostic testing was done and IF was diagnosed, the coverage stopped. Our RE stuff comes out of pocket. Is there maybe another OB/Gyn you could see that would do some basic testing before sending you on? If it makes you feel a little better, my Mom was 39 years old when she got pg with me and my sister was 40 when she got pg with her youngest. I also have a cousin who struggled with IF and she is in her 40's, and she has a 1 yr. old. I will pray that everything works out for you and that you will get your BFP very soon! :)

Kat