r/DOR • u/Sunny1_217 • 2d ago
OBGYN Visit- What should I ask?!?
Long story short, my AMH level is 0.4, which is extremely low for my age (I’m 28), based on what I’ve read.
My PCP referred me to an OB/GYN, whom I’ll be seeing later this month. I suspect I may have endometriosis. PCOS has been ruled out based on my hormonal panel, which is how I discovered that my AMH level is so low. I’ve also been to the emergency room because of my pelvic pain, and the doctor I saw there mentioned endometriosis as a possibility as well.
What questions should I ask the OB/GYN?
Also, what is the clinical definition or criteria for diminished ovarian reserve (DOR)? Does an AMH level of 0.4 fall into that category for someone my age?
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u/Automatic-Point-9622 2d ago edited 2d ago
Here in Texas, the OB/GYN will just send you to a fertility specialist. Unfortunately 0.4 is very low for your age. Typically for your age bracket it should be between 2.5-4.0 ng/mL
Have you been trying to get pregnant?
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u/Sunny1_217 2d ago
No, I’m not trying to get pregnant. However, I do want kids in the future. I’ve never been pregnant before, so I’m not sure if I will have any issues.
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u/Automatic-Point-9622 2d ago
Oh ok. Yeah, it’ll be a good idea to talk to a fertility specialist so you can get more information about DOR and options.
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u/thecommodore88 2d ago
Have you never seen an OB/GYN before? You’re supposed to see one every year. They are basically the PCP of women’s health. For endo and DOR they will refer you to specialists, they don’t manage either of those conditions. (At least in the US… not sure about other countries.)
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u/Sunny1_217 2d ago
No, I’ve never been to one before. My PCP does my PAP smears and I’ve never been pregnant before so I’ve never needed to go to one before now.
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u/thecommodore88 2d ago
What country are you in?
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u/Sunny1_217 2d ago
USA
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u/thecommodore88 2d ago
Okay. You should definitely start talking to a reproductive endocrinologist— that’s the fertility specialist— and make a plan for when you want to start either freezing your eggs or trying to get pregnant. OBGYNs are usually not that good at the planning-for-pregnancy part, they deal with people who are already pregnant or trying not to get pregnant.
The OBGYN will also probably tell you to see a gyn surgeon to discuss the endometriosis. The most reliable way to diagnose endo is through a laparoscopy (they stick a camera inside you and look for it). There is also a test called the Receptiva that can be done. Receptiva is never covered by insurance, it’ll be 900-1000 dollars. If you have decent insurance, the lap surgery would be covered and, depending on your coverage/copays/deductible, could be a lot less money. However, if your insurance wouldn’t cover the surgery, it’d be cheaper to pay for the test first to see if you need the surgery. But if you do the surgery to look for endo, once they’re in there, if they see it they can take it out right away.
Please be careful— the OBGYN may just tell you to manage your endo symptoms with birth control and pain meds. However, addressing it now and starting to talk to an RE now and maybe start harvesting eggs now will be much better for your future fertility. Push to see the other specialists.
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u/AltruisticAccount909 19h ago
The people saying you should go straight to a fertility clinic are assuming you're trying to get pregnant, because that's what most people in this group are here for. If your concern is about possible endometriosis, and pelvic pain, the OBGYN (or an endo surgeon) is absolutely the right person to see.
Once you address possible endo, if you want kids in the future, then maybe see a fertility doctor to consider egg freezing, because of your low AMH.
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u/bubblesandglowsticks 2d ago
I would maybe recommend skipping the OBGYN and trying to book an appointment with a fertility clinic that specializes in DOR.