ASRM requirements

ASRM requirements

Joined: March 21st, 2005, 7:45 pm

June 28th, 2012, 12:53 am #1

My husband and I have done two egg donor cycles and are about to start a third. All of a sudden, my RE told us that we must go see a high-risk doctor. Since we already did a slew of tests including stress echo, EKG, blood tests, etc. before the first cycle, we asked what it is that we need to go over with the high-risk doctor. I had no problems with the previous two cycles except that they ended up being chemical pregnancies. All the RE said is the ASRM guidelines stipulate that everyone over 45 must see a high-risk doctor. I'm in my 50s and am stunned that this came up at the last minute. Does anyone know if this is indeed an ASRM guideline?
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Dee
Dee

June 28th, 2012, 2:17 am #2

I do not know, but it sounds like it is only a guideline, not a law that is enforceable.

What kind of high risk doctor does he want you to see? If you were to get pregnant, you might see a high risk Ob/gyn, or you could probably see a regular Ob/gyn. I am sure it would be your choice, unless your regular Ob/gyn refuses to treat a pregnant patient who was past a certain age.
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Joined: September 13th, 2008, 5:13 pm

June 28th, 2012, 2:37 am #3

My husband and I have done two egg donor cycles and are about to start a third. All of a sudden, my RE told us that we must go see a high-risk doctor. Since we already did a slew of tests including stress echo, EKG, blood tests, etc. before the first cycle, we asked what it is that we need to go over with the high-risk doctor. I had no problems with the previous two cycles except that they ended up being chemical pregnancies. All the RE said is the ASRM guidelines stipulate that everyone over 45 must see a high-risk doctor. I'm in my 50s and am stunned that this came up at the last minute. Does anyone know if this is indeed an ASRM guideline?
An OB/GYN? Before you're pg? If it is an ASRM guideline, neither GIVF where I began nor the Czech clinic where I ended up cycling and which claimed to follow ASRM guidelines mentioned it. I was almost 47 when I started; just shy of 49 when I delivered. Maggie (in VA)
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Joined: December 21st, 2011, 7:41 pm

June 28th, 2012, 5:13 am #4

My husband and I have done two egg donor cycles and are about to start a third. All of a sudden, my RE told us that we must go see a high-risk doctor. Since we already did a slew of tests including stress echo, EKG, blood tests, etc. before the first cycle, we asked what it is that we need to go over with the high-risk doctor. I had no problems with the previous two cycles except that they ended up being chemical pregnancies. All the RE said is the ASRM guidelines stipulate that everyone over 45 must see a high-risk doctor. I'm in my 50s and am stunned that this came up at the last minute. Does anyone know if this is indeed an ASRM guideline?
Is he saying he wants you to see a high risk OB before he will let you cycle? Or just that you'll need one once you become pregnant?

Honestly, I think it's a good move although I'm not sure if it's a new ASRM guideline or not - the outdated ASRM guidelines I found are vague, but they say that the regular guidelines of women anticipating pregnancy should be applied to egg donor recipients - based on that, I'm assuming your doctor would like to have clearance from a high-risk OB due to advanced maternal age. It's unfortunate it didn't come up earlier, but it's really in your best interest. Similarly, I don't have AMA but I have other health complications and my RE asked for a letter of clearance from the physician who specializes in my disease to clear me for pregnancy. He just wanted to make sure my body could handle a pregnancy - sounds like you're in a similar situation. He's just being cautious - for his benefit and yours. If you'll need one anyway once your pregnant, then a consult beforehand will be helpful just to get established as a patient.
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Mrs. M
Mrs. M

June 28th, 2012, 11:57 am #5

My husband and I have done two egg donor cycles and are about to start a third. All of a sudden, my RE told us that we must go see a high-risk doctor. Since we already did a slew of tests including stress echo, EKG, blood tests, etc. before the first cycle, we asked what it is that we need to go over with the high-risk doctor. I had no problems with the previous two cycles except that they ended up being chemical pregnancies. All the RE said is the ASRM guidelines stipulate that everyone over 45 must see a high-risk doctor. I'm in my 50s and am stunned that this came up at the last minute. Does anyone know if this is indeed an ASRM guideline?
I was 45 when I started cycling at SG and they only required letter from my PCP stating I was healthy enough to sustain a pregnancy. RE left decision about whether add'l testing was needed (ie cardiology) to my PCP.
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Mrs. M
Mrs. M

June 28th, 2012, 11:57 am #6

My husband and I have done two egg donor cycles and are about to start a third. All of a sudden, my RE told us that we must go see a high-risk doctor. Since we already did a slew of tests including stress echo, EKG, blood tests, etc. before the first cycle, we asked what it is that we need to go over with the high-risk doctor. I had no problems with the previous two cycles except that they ended up being chemical pregnancies. All the RE said is the ASRM guidelines stipulate that everyone over 45 must see a high-risk doctor. I'm in my 50s and am stunned that this came up at the last minute. Does anyone know if this is indeed an ASRM guideline?
I was 45 when I started cycling at SG and they only required letter from my PCP stating I was healthy enough to sustain a pregnancy. RE left decision about whether add'l testing was needed (ie cardiology) to my PCP.
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Joined: August 17th, 2011, 2:17 pm

June 28th, 2012, 11:58 am #7

My husband and I have done two egg donor cycles and are about to start a third. All of a sudden, my RE told us that we must go see a high-risk doctor. Since we already did a slew of tests including stress echo, EKG, blood tests, etc. before the first cycle, we asked what it is that we need to go over with the high-risk doctor. I had no problems with the previous two cycles except that they ended up being chemical pregnancies. All the RE said is the ASRM guidelines stipulate that everyone over 45 must see a high-risk doctor. I'm in my 50s and am stunned that this came up at the last minute. Does anyone know if this is indeed an ASRM guideline?
When I was getting approved by Shady Grove, my doc wanted me to see a high risk OBGYN as part of the screening, to get an "OK, this woman is healthy enough to have a baby." And also to give me a sense of what they would expect and recommend for my pregnancy. I was 45 at the time. I ended up getting a letter from my GP talking about my heart and general health, though, and they accepted it. But I don't think it's unheard of for a clinic to want a high risk OB to weigh in for women our age.

As to why they're asking for this now and not earlier, perhaps something has expired in your file (I originally got approved back in the fall and just was told that I have to repeat my bloodwork b/c what they have on file has expired), or something has changed (for example, have you turned a certain age since the original approval?).

Sorry this is throwing a new wrench into something that you thought was already resolved, but maybe you'll end up happy you've spoken with a high risk OB.

In any case, good luck!
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DeeinNYC
DeeinNYC

June 28th, 2012, 12:34 pm #8

My husband and I have done two egg donor cycles and are about to start a third. All of a sudden, my RE told us that we must go see a high-risk doctor. Since we already did a slew of tests including stress echo, EKG, blood tests, etc. before the first cycle, we asked what it is that we need to go over with the high-risk doctor. I had no problems with the previous two cycles except that they ended up being chemical pregnancies. All the RE said is the ASRM guidelines stipulate that everyone over 45 must see a high-risk doctor. I'm in my 50s and am stunned that this came up at the last minute. Does anyone know if this is indeed an ASRM guideline?
Hi,

I don't know if it's a guideline or not, but RBA requires that you get medical clearance not only from your GP, but a perinatalogist if you are 45 or older. It was a bit of a pain to obtain.
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Joined: September 13th, 2008, 5:13 pm

June 28th, 2012, 1:28 pm #9

I was 45 when I started cycling at SG and they only required letter from my PCP stating I was healthy enough to sustain a pregnancy. RE left decision about whether add'l testing was needed (ie cardiology) to my PCP.
GIVF did say they would want a letter from my GP stating that she felt my health was good enough to safely sustain a pregnancy. Take care, Maggie (in VA)

ETA: But that is a far cry different than requiring a separate appointment with a high-risk OB/GYN, and she could and probably would have written me a letter based on the results of my last physical.
Last edited by maggie1961 on June 28th, 2012, 3:54 pm, edited 1 time in total.
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Joined: March 21st, 2005, 7:45 pm

June 29th, 2012, 12:08 am #10

My husband and I have done two egg donor cycles and are about to start a third. All of a sudden, my RE told us that we must go see a high-risk doctor. Since we already did a slew of tests including stress echo, EKG, blood tests, etc. before the first cycle, we asked what it is that we need to go over with the high-risk doctor. I had no problems with the previous two cycles except that they ended up being chemical pregnancies. All the RE said is the ASRM guidelines stipulate that everyone over 45 must see a high-risk doctor. I'm in my 50s and am stunned that this came up at the last minute. Does anyone know if this is indeed an ASRM guideline?
Thanks very much for the replies. It sounds like our RE is not sharing something with us and we are totally in the dark as to what all of a sudden may have changed.

We're still up-to-date on all the requirements including a clearance letter from primary care physician, pap smear, mammogram and, as mentioned before, heart workups and blood workups. Yet, out of the blue, the RE insisted that we see a perinatologist and is not telling us whether I need an exam or if it's just going to be a consultation or what it is that she's seeking. This is before we cycle so I'm not pregnant. We last cycled 4 months ago and are wondering why this didn't come up sooner. Plus, the RE said we must see the the high-risk doctor and do the cycle before my birthday which is in 2 months. Yet, all the high-risk doctors she suggested said I must be referred by the delivering OB/GYN and have a condition which requires treatment.

It's very strange that the RE is claiming this is an ASRM guideline and that's all the information she'll give us and now we're playing beat the clock as well.



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