The Infertility Guidebook: Reproductive Endocrinologist (RE) Consult

The RE consult can be an intimidating part of the infertility process, but it may be the best decision you ever make. Check out this guidebook for what to expect at your first RE appointment!

The Infertility Guidebook

Stage 3: Reproductive Endocrinologist (RE) Consult

Cost: $35-150
*Costs from this point on vary greatly, depending on your insurance coverage. This visit can be anything from a specialist copay if you have diagnostic coverage, to a full out-of-pocket consult fee if you have no coverage, which varies from practice to practice.
Meds: N/A

So, at this point, you’ve probably already had some initial testing done through your OB/GYN, and maybe you’ve done a few rounds of Clomid, with no success.

If you’re anything like me, you’re probably filled with anxiety at the mere idea of having to see an infertility doctor and being branded “infertile.” I get it. I cried and cried and cried when we were sent off to our fertility doctor. It felt like such an ominous, daunting step, and I was not emotionally ready for it.

But after our very first consult, I immediately felt so much more at ease. So trust me, do the consult! It’s all about finding the right doctor at this stage, so if you don’t feel completely and totally comfortable with one, meet with another.

Everyone has different needs from a doctor, and responds to different bedside manners, but for me, I need a doctor who will be straight with me. I’m a researcher, so I want to know all. the. things. I want her to get science-y with me, and draw me diagrams, and give me notes, and tell me all my options.

Luckily, the first RE with met with (at the recommendation of my OB, who also happened to go through infertility and used this doctor herself) did all of these things and more. She, too, suffered infertility due to PCOS, and had her babies through IVF. She is a Godsend. I’ve literally missed her since we’ve been in between treatment cycles the past couple years. When was the last time you *missed* a doctor? That’s what you want to find in an RE.

What to Expect:
  • The RE will review your history from your OB/GYN and your husband’s semen analysis (so make sure to get all of that sent over!)
  • He/she will talk through your different treatment options, and make a recommendation for your next steps
  • He/she will run more blood work, to take a deeper look at your hormones, like:
    • Thyroid (TSH, T3 & T4)
    • Prolactin
    • Estrogen
    • Progesterone
    • AMH
  • He/she may do another vaginal ultrasound, to take a look for themselves
    • The benefit of the RE is that they can typically do this right away, and do it themselves, versus having to schedule a separate appointment with a separate tech. Benefits of specialist care!
  • Schedule an HSG (hysterosalpingogram)
    • You’ll likely have to do this before moving forward with any treatment, to make sure your fallopian tubes aren’t blocked. Basically, they shoot some dye into your uterus while watching on an X-ray to make sure the dye spills out of your tubes. You’ll hear horror stories about this test if you Google it, SO DON’T DO IT. Yes, it hurts. But it only hurts for a maximum of 5 seconds. Literally 5 seconds and it’s completely over. It’s essentially a contraction, so it’s good practice! When you schedule this, ask about taking ibuprofen before the test.
Questions to Ask:

Questions to ask your RE during this consult will obviously change based on your particular struggle, but here’s a starter list to think about.

  • What are your success rates?
    • Are those rates based on pregnancies or live births?
  • What do you think my chances of having success are?
  • Are there any lifestyle changes we can make to improve our odds?
  • Are there any supplements we can take?
  • Do you have price sheets for all the treatment options? Do you offer self-pay discounts? Finance plans?
  • Does your office have any early/late hours for scans and blood work?
  • Do you have weekend hours?
  • Do you have an after-hours phone line?

After this consult, you’ll have a solid plan of attack, and hopefully you’ll feel empowered and in control. For many women (like myself), the next step is another oral medication called Femara. It does the same thing as Clomid, but a lot of women respond better to it. Head over to Stage 4 to learn more about that!

The Infertility Guidebook

  1. Diagnosis
  2. Clomid
  3. RE Consult
  4. Femara + Injectables
  5. IUI
  6. IVF
  7. FET
  8. …and Beyond
*This should go without saying, but this is the internet and therefore it doesn’t: I am not a doctor and you need to consult your doctor about any kind of medical treatment.

 

The complete guide to infertility treatments, from clomid all the way to IUI, IVF, and FET.

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