If you had issues becoming pregnant and consulted reproductive endocrinologist (RE), or other fertility specialist, and now find yourself expecting, you may be wondering what your next steps are. Any transition (even an exciting one) can be intimidating and uncomfortable, and you may have questions about transitioning from a fertility specialist to an OB/GYN.
Will I need to transition from a fertility specialist to an OB/GYN?
This depends on your physician. Some OB/GYNs are board-certified in reproductive endocrinology.1 If you were not referred to a specialist when you were trying to get pregnant, your OB/GYN should be able to help you throughout your entire pregnancy. If you were seeing a specialist, and not your regular OB/GYN for your fertility issues, then yes, you will want to transition care during your pregnancy.
How soon will I need to transfer care?
Typically, you will begin to transfer care between 7-10 weeks of gestation.2,3 Your RE or fertility team will let you know when they think is the best time to transition. Most teams will recommend to make an OB/GYN appointment after the first ultrasound, or when the first fetal heartbeat is detected, usually around 5-5 ½ weeks of gestation. It is recommended that you call your OB/GYN sooner than later to make the appointment. Even if you’re working with a physician that you’ve established care with in the past, there can be a delay in the first available appointment.2 You can always make an appointment for further out, but it can be much harder to get you in quickly.
Should I bring anything to my OB/GYN appointment?
It is recommended that you bring your own set of your medical records to your first OB/GYN appointment. This includes any testing you may have had and lab results that you have.2,3 It is a good idea to keep a copy of your own records rather than expecting the RE/fertility specialist to transfer these records. You should be able to request your records; there may be a small fee to get a copy for yourself.
How often will I see my OB/GYN?
You will see your OB/GYN about every 4 weeks, and as your pregnancy advances, you may begin to see them more often.2,3 Some OB/GYNs like to see patients every 2-3 weeks after 26 weeks of gestation, and every week after 36 weeks gestation.3
Is my pregnancy at greater risk for miscarriage or other complications?
At the time that you transfer your care to your OB/GYN, your risk level is equivalent to a woman who conceived naturally.2,3 If you are classified as high-risk pregnancy, it is not because of receiving fertility treatment. Usually, high-risk pregnancies are due to other factors such as multiple gestation (carrying more than one fetus), advanced maternal age, or chronic conditions such as diabetes, and high blood pressure.2 If you have any of these factors, you may have to see a high-risk OB.
Is it normal to have anxiety about the transition from my RE/fertility specialist to an OB/GYN?
Absolutely! Trying to conceive is a stressful time. You may have cultivated strong relationships with your fertility specialist team, and transitioning care to a new team means starting those relationships all over again.2,3 You also now have the anxiety of a new phase of your fertility journey, while trying to establish new care relationships. This is completely normal and understandable. If you notice that your anxiety is interfering with your day-to-day activities, you may want to ask your OB if they have any support groups or recommendations for counselors. If you have any worries, questions or concerns, it is completely acceptable to reach out to your OB team; their job is specifically to take care of you and your pregnancy.2
Fertility Specialist or Ob/Gyn: Which Is Right for You? – Penn Medicine. Pennmedicine.org. https://www.pennmedicine.org/updates/blogs/fertility-blog/2014/june/fertility-specialist-or-obgyn-which-is-right-for-you. Published 2018. Accessed September 30, 2018.
Transitioning from Reproductive Endocrinologist to OB/GYN. RESOLVE: The National Infertility Association. https://resolve.org/support/pregnancy-after-infertility/transitioning-from-re-to-obgyn/. Published 2018. Accessed September 30, 2018.
Goodbye Infertility Team, Hello Obstetrician - Reproductive Medicine Associates of NJ | RMANJ.com. Reproductive Medicine Associates of NJ | RMANJ.com. https://www.rmanj.com/goodbye-infertility-team-hello-obstetrician/. Published 2018. Accessed September 30, 2018.