New RE Appointment

We just got back from my new RE's office and things went pretty well for the most part.

1. Meet with Dr. N.---I immediately liked her right off the bat. She's very Type A, lets get what we need to get and get it done. No dilly-dallying. I'm not sure if part of that is because I'm on cycle 22 and still not pregnant, or if she is just like that. I suspect its probably a bit of both. From the time I got called back until I was walking out the door was 30 minutes....and that was with several things being done, but not feeling rushed. My kind of office!!

We went over my history and she is concerned a little bit about my hypothyroidism and family history of certain auto-immune diseases. She said that may be playing a factor in why I can't get pregnant now, but the fact that I have had two successful pregnancies is very promising that its not a huge factor. We also talked about testing (or lack of testing) that Dr. K. did. She was not happy that he had me do a CIS instead of a HSG. (last year, Dr. K. said the CIS was very similar to the HSG and that he orders those in most cases since insurance covers more and its more comfortable on the patient.) Dr. N. said no, they are not similar enough when talking about tubal issues. The way the CIS works, you will see the free fluid in the uterus, but you will have no idea where its coming from (meaning you won't know if the tubes are blocked or not). CIS can be ok in some cases, but since I had a TL/TR, its VERY important the we know EXACTLY where/if my tubes are open or not. She was also not happy that he didn't do an AMH level (checks ovarian reserve), but more on that in a bit. And of course, she didn't have my chart from Dr. K's office either, which I promptly called and chewed them out for because they charged me $25 3 days prior to get them faxed over and they weren't even faxed!

2. Sonogram---After the consultation, she did a u/s on me. She was looking for any abnormal structures and wanted to get some measurements of my uterus and ovaries. At this point, she said she now knows why Dr. K. didn't do an AMH on me. They want to see at least 5-6 Antral follicles in each ovary for a woman my age. I had 15 on one side and 18 on the other. This tells her that I have good ovarian reserves, but she still wants to do the blood work just to make sure there are no surprises. She also said that with me being 11 DPO, that my uterine lining is VERY nice and thick, ruling out possible progesterone issues. All of these results were the same at Dr. K's office 2 years ago, so no surprises there.

3. Financial---They had me talk to a financial officer to go over cost associated with any testing, what insurance will/won't cover etc. Turns out, I didn't even have to pay anything today because my insurance has some sort of code on it! So they will bill me any difference insurance doesn't pay for. (They gave me a estimate on what I will probably owe.) This is very nice for budgeting purposes since I had to pay everything upfront at Dr. K's office (insurance covered some things, but not many there).

4. Blood work---I then went for some blood work. I asked if she would add a beta to it, since I'm 11 DPO, and she said no problem. I LOVE that this office does most everything (u/s, HSG, blood work, etc) in house. The AMH is a send out and takes 8-9 days to get the results back, but I will know the beta value sometime today.

So, the game plan is:
--If I'm not pregnant this cycle, once my AF starts, I will call the office to schedule my HSG to be done between CD6-10.
--Once they get my records rom Dr. K., they will review DH's SA (since he has fathered 3 children and his last SA came back fine, it more than likely won't need to be repeated).
--Review my records from Dr. K. and see if anything comes back that needs more testing, etc.
--See how my blood work comes back.