Preconception appointment and IUD “removal”

monsieurgn

New member
Hi everyone - I have mentioned that I was having my preconception appointment and getting my IUD removed today in recent Daily Chat threads, but decided to make a dedicated post.
  1. I’ve read posts and comments from others that their preconception appointments weren’t too helpful and mostly just gave basic advice (take folic acid, stop preventing, go for it!) and there was more info on Reddit.
Code:
 * a) Maybe there really isn’t much to worry about and it’s just because only a certain time of person (planner, worrier, etc!) joins a sub like this. But maybe others who don’t join a sub like this are more relaxed about it? Anyway, I will say my experience was similar. 

 * b)   The doctor didn't seem worried about anything I ate (things to avoid etc) except just to eat healthy and get 800 mcg of folic acid per day. He mentioned that I should be eating fruits/veggies/eggs. 

 * c)   He said that all I needed was the 800 mcg of folic acid and since I already was getting that (and more!) with my current vitamins that it’s fine. He did not recommend to switch to a prenatal... when I told him the other supplements that I took (Vit B complex, Magnesium, Fish Oil, Flaxseed Oil, Calcium), I could tell he didn't think it was necessary and maybe even over kill.

 * d)   The doctor didn’t want to do any tests -- I asked about titers and vitamin levels/deficiency. He basically just said that I’m young and healthy and that as soon as he removed the IUD I would be fertile and could “have my baby.” Essentially, it was his opinion that no testing of any kind was necessary.
  1. Since I asked about titers, we got onto the subject of vaccines.
Code:
 * a)   He again, didn’t seem worried and just said that if I got them all as a kid I’m fine. The only one he recommended that I get was Hepatitis B, it’s recommended in the country I’m currently living to get a booster every 10 years… and it’s been much longer than that for me. He did say that I was probably fine not getting it, and I think he thought that I wanted to start trying RIGHT AWAY and advised waiting until January to start TTC if I got the Hep B shot.

 * b)   I read online that the most common ones to be recommended in the US (I think from googling I ended up on a Harvard med school website) were MMR and Varicella. I haven’t had an MMR since 1994 and I had a very mild case of chicken pox in 1990… so I asked to get those shots as well as boosters since they wouldn’t test my titers!

 * c)   I found mixed results online anywhere from 4 weeks to 3 months for the 3 vaccines that I received… but also it says that it’s “fine” if you got pregnant before that time window was up. I’m not that worried about it, and honestly I don’t think we will start TTC until January-ish anyway!
  1. The country I’m in is a Zika risk; however, it’s not in the entire country and I asked the doctor about that. Again… he wasn’t that worried he just advised me to stay in the area which we are currently living and not travel to the areas where Zika is endemic. I didn’t find this particularly reassuring… and this actually may be something that pushes back our TTC timeline. Because I would actually like to visit those places before I return to the US.. but I’d also love if I got my BFP right before moving baxk to the US. So I’m definitely conflicted over this! My husband and I started discussing.. but he had to head to a meeting, so we’ll talk more later.
  2. Okay moving on to the exam/procedure part of the appointment:
Code:
 * a)   He did a transvaginal ultrasound… I believe known as “twanding” to locate my IUD and looked for both ovaries. He found the right ovary with a 5cm cyst… but again didn’t seem worried but that sounds HUGE to me! He made it seem like a common side effect of the Mirena and referred to the cyst as functional. He never found the left ovary. He said we’d look again next time.

 * b)   Then after inserting the speculum, he dug around for a LONG time looking for my IUD. But the strings weren’t hanging out and he couldn’t find the IUD. It was pretty uncomfortable and a bit of cramping... but not super painful. He kept telling me to let him know if I had any pain… but I didn’t say anything just laid there breathing. But for a relatively bad outcome, it really wasn’t too bad of an experience

 * c)   He said that he couldn’t perform the more invasive procedure in the exam room that we were in, and I’d need to come back for that procedure. Honestly, he didn’t tell me its name… and I’m a bit nervous. He explained the process needing to use an aesthetic and needing different tools to find it and remove it. He was reassuring that it wasn’t a huge deal and would be fine… If anyone’s interested I can describe that in detail when the time comes.. hopefully soon since I was expecting my IUD out today!!

Anyway, so that’s the story of my preconception appointment.. apparently nothing to worry about since I’m young and healthy (besides the IUD that’s trapped in my uterus!).

Edit: trying to fix formatting!

Edit2: formatting fixed. — And that was a bit of sarcasm at the end of my post and a bit of annoyance with receiving limited advice/recommendations and just being made to feel I was going overboard with planning or concerns about needing more advice before starting TTC.
 
@monsieurgn Omg thanks for all the info on how it went, this is helpful! My IUD strings have “migrated” so I am very nervous about them trying to get it out when it’s time haha. The doctor did say that it’s pretty common for the strings to do that, but what a hassle. Hope the next removal attempt goes better for you!
 
@sacredchaos Not OP but when I went to have mine removed the strings weren’t visible. The OB looked around for a bit and tried to “coax them out” with no luck. They scheduled a second appointment to try removing it while having an abdominal ultrasound. My first appointment was super uncomfortable so I was nervous for the second one. But with the ultrasound she was able to see where it was and removal was easy and painless.
 
@sillypuddy Oh thank you for the intel! I am nervous about it but luckily I’ve never had the excruciating pain some people feel with IUD insertion/removal. Like, it’s certainly not comfortable, but it’s tolerable. Hoping even with the strings situation it won’t be too bad…uterus/womanhood is certainly a journey!
 
@monsieurgn I would like to know more about the zika risk, as I am interested in traveling to a country in Central America (Guatemala). How can you determine which areas of the country have higher zika risk?
 
@putaojie I’m sort of freaked out about it to be honest. I can’t find a good detailed map online. The advice is to wait something like 2-4 months after travel before TTC. So it’s a long wait!

From the CDC website, it looks like there are no current major outbreaks… but there could be delay in reporting from various countries.
https://wwwnc.cdc.gov/travel/page/zika-information

In general, my assumption is that more “jungle-y” of locations are more likely to have Zika. But I’m not sure if that’s a false assumption. The doctor told me that if I stayed in the coastal area for my country I’d be fine, but I am majorly bummed because a few months ago I didn’t know I wanted to move up our TTC timeline otherwise I would have gone on a trip to the jungle 3-7 months ago! … but now I can’t go without pushing back the timeline that we just moved up. 😫😫 my husband actually just wants to skip visiting the high Zika risk areas and just travel there in the more distant future (with a baby?! Who knows how that would work..??). It’s just disappointing because I’m only living in this country 1 year and I wanted to go EVERYWHERE here during this time.. ugh wishing I had planned better or gone there sooner!!
 
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