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01-18-2013 at 3:21 PM
mythaldo
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mythaldo is not online. Last active: 05-19-2013, 12:23 PMNewbie

Lurker Intro & Question about MMR

Hello, Bumpies! I'm new to TB although I've perused TK and posted a few times at TN. I am 28 and DH is 32, coming up on our 2nd anniversary (dated 3.5 years before that). I went off BCPs at the beginning of the year and started temping and charting to get used to my cycle after 11 years on BCPs. I told my doctor my plans in October to start TTC at the beginning of 2013, but yesterday, she sprung a crappy surprise I wanted to run by your ladies for some advice.

I had a preconception visit with my doc yesterday (mainly because I have pre-exisiting conditions like asthma, migraines and most recently interstitial cystitis) and I asked her the usual questions about vitamins, medications and whatnot. I reminded her that I got my Tdap booster in September (which I already told her about in the October visit) when she asked, "Have you had a MMR titer done yet?"

I said no; I had the vaccine as a baby, but didn't know I needed to do the MMR titer. I was kind of surprised that she didn't mention anything about it at my last appointment. 

"Oh, then you will need to get the titer and then get the shot if you're not immune. You'll also have to go back on BCPs for three months because it's a live virus vaccine." WTF?!

First, I've read that you don't need to do a titer if you had the vaccine as a baby; the vaccine is safe to get even if you are immune. I don't want to take off work for the titer, do the titer, pay for lab work, wait a week for results, then take off work for the shot, rinse, repeat. I asked if I could just skip the titer and get the shot, and she said she doesn't normally recommend it, but that I could. This warning weirded me out a bit, especially since my prego best friend's Dr. told her before TTC she didn't need to get the titer or even the shot until after the baby is born. I'm okay with waiting 3 months if it's best, but it's still disappointing to have to TTA.

Second, I told her I'm fine with charting and using condoms if I get the vaccine, but she kept pushing for the BCPs. I tried to level with her and said I can start using OPKs around CD10 and totally abstain until after I O; she said that might work if we're careful, but she would still recommend the BCPs since it's "less hassle and a better guarantee you'll be safe through that three-month window."

So here's are my questions:

1. Did your Dr. recommend the MMR vaccine before TTC? if so, did you get the titer first? 

2. If you were me, would you go back on BCPs for 3 months after the shot? Would you feel comfortable just charting BBT, baggin' it and using OPKs to TTA? Is my Dr. just nuts?

Thanks!


01-18-2013 at 3:25 PM
danagail14
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My Dr never mentioned it.

ETA: but my dr also tried to put me on clomid my 1st month ttc bc i have pcos! So this probably doesn't help! Sorry!



 

01-18-2013 at 3:28 PM
SweetC80
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I was told most people don't need to do the follow up booster to MMR, but when I had my initial testing w/ my RE they ran the bloodwork for it.

I don't think it is standard before you to TTC, but if you are concerned ask your doctor to do a blood test to see if you are immune or not.



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01-18-2013 at 3:28 PM
lovelym13
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lovelym13 is not online. Last active: 05-14-2013, 1:19 PMNewbie

My doctor has never mentioned anything about this and I also had a preconception appointment due to preexisting conditions. I would find a new doctor for a second opinion If I were you.

 

ETA: Welcome and GL to you! 



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01-18-2013 at 3:36 PM
nyahsbabyb...
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nyahsbabyblues is not online. Last active: 05-19-2013, 6:02 PMBronze

This was never mentioned to me either, and I've been pregnant twice.  The first time I didn't consult my doctor beforehand, but the second time I did, and he had nothing I needed to do prior to TTC besides go off my BCPs.  

Sorry I can't be of more help.   


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01-18-2013 at 3:37 PM
Twinkie061...
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1. Did your Dr. recommend the MMR vaccine before TTC? if so, did you get the titer first? 

My first RE did test Rubella antibodies.  So far it has been the only test that has been covered by my insurance.  Mine came back ok, so I didn't have to be vacinated again.

2. If you were me, would you go back on BCPs for 3 months after the shot? Would you feel comfortable just charting BBT, baggin' it and using OPKs to TTA? Is my Dr. just nuts? 

If I had to avoid I would just chart and use condoms. 





TTC #1 since August 2011
September 2012: Start IF testing
DH: SA is good
Me: CD 3 blood work is good, HSG all clear, 7 DPO blood work shows low progesterone
October 2012: Clomid + IUI = BFN
December 2012: Consultation with RE#1. Not impressed with RE#1.
January 2013: Consultation with RE#2
January 2013: CF screening shows that I am a carrier of CF. Thankfully, DH's screening shows that he is not a carrier of CF. Sperm antibody tests are negative for both of us. According to our RE we are Unexplained IF
March 2013: Post coital tests show possible hostile CM. So, maybe not so unexplained?
April 2013: Unmedicated IUI after yet another bad bad PCT. = BFN
Cultures find a bacterial infection that could harm fertility, DH and I both start antibiotics.
May 2013: Clomid + Trigger + IUI 
01-18-2013 at 3:38 PM
shecodes
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My MD reviewed my immunizations and never mentioned this -- and I had my MMR as a baby as well.   I'd probably get a second opinion if I was in your place.

As far as BCP goes, it's really your decision, if the two of you are positive that you can handle it with more natural means, and have a genuine contingency plan if somehow your plan fails, then go for it. 


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01-18-2013 at 4:00 PM
talon1226
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My doctor did test for Rubella antibodies to make sure I was immune, which I was. Most likely you will be ok since you had the shot. If you decide to have the test and end up needing to get the shot and have to avoid, I personally would just chart and/or use condoms instead of going back on BC pills.
CDC only recommends avoiding for 1 month. It's probably not clicky since I'm on my phone, sorry.
http://www.cdc.gov/vaccines/parents/pregnant.html

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2 cycles Femara + trigger = BFN/no response. 2 cycles Clomid + trigger = BFN
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01-18-2013 at 4:04 PM
FoxiePM
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I seem to vividly remember getting a booster shot for MMR in the 5th grade. I remember this because it was a live virus and I broke out in hives all over my body.

Are you sure you didn't get a booster in late Elementary School?


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01-18-2013 at 4:18 PM
hotpinkhee...
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Hi! I am in the same boat, just got off BCP and had preconception visit at the end of December.... My doc didn't say anything about needing any boosters. Just asked if my immunizations were current. Good luck!
 
01-18-2013 at 4:19 PM
elainelbuc...
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My OB never mentioned it, but I had to get a booster before going to college so I wouldn't have been concerned about it.  I'm not positive if my RE tested for it, I participated in a research study and they took 10 vials of blood at my first appointment.  I'm not sure of everything they tested then.

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01-18-2013 at 4:28 PM
Nechie122
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talon1226:
My doctor did test for Rubella antibodies to make sure I was immune, which I was. Most likely you will be ok since you had the shot. If you decide to have the test and end up needing to get the shot and have to avoid, I personally would just chart and/or use condoms instead of going back on BC pills.
CDC only recommends avoiding for 1 month. It's probably not clicky since I'm on my phone, sorry.
http://www.cdc.gov/vaccines/parents/pregnant.html


Same here. I think the calls to find a new doctor are a little extreme. Your doctor is just being cautious. Most likely you are fine and this is a nonissue. Most doctors probably don't mention it because rubella isn't common in this country anymore. However, the consequences of getting it while pregnant are terrible. And MMR vaccination rates in some areas are shameful thanks to the autism scare; old diseases are resurfacing.

My DH is a doctor and I asked him the same thing: can you have the shot and not be immune? The answer is yes. Some people do have waning immunity because there's no "perfect" vaccine. It would be rare and of course rubella is rare. But get the blood test for peace of mind.

ETA: The titer is not a booster, just a blood test for immunity. You probably know that but I couldn't tell from your OP. If you're NOT immune, it's obviously your choice whether to get revaccinated and TTA.

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01-18-2013 at 4:56 PM
mythaldo
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mythaldo is not online. Last active: 05-19-2013, 12:23 PMNewbie

Thanks for all the replies so far and for welcoming me to the board.

I'm surprised to read that other people haven't been told to do his! I'm beginning to wonder if I need this vaccine right now at all because I don't really want to get it if I don't have to. I told my Dr. DH and I aren't actively TTC until after a ski trip in March for our anniversary, but we wanted to just keep it casual in the meantime. Maybe she just assumed we're fine with waiting anyway. I'll talk more DH about this and see what he thinks.

My doc has generally been a good doc (she's an OBGYN, but she's also my GP), but she has seemed to be almost obsessed with hormonal birth control. I talked with her about doing an IUD a few years ago and she asked what was wrong with my BCPs, and I just said I didn't know what long-term hormonal birth control could do for my health (plus I was getting tired of being dryer than a brush fire down there). So she tells me that long-term BCP use is better for my health because it prevents ovarian cysts and that I can just shove estrogen suppositories up my vag for the dryness.

She also didn't want me to go off them until we were actively TTC because I have a migraine condition, but my preventive (Zofran & X-strength Tylenol) is safe for pregnancy and I don't have a severe condition like some people I know.

She said I need to find a new OB when I GP anyway (not sure why?) so I may try to gently cut ties and find a new GP when I look for an OB. Thanks everyone, and I look forward to reading and commenting on your posts!

01-18-2013 at 5:01 PM
mythaldo
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mythaldo is not online. Last active: 05-19-2013, 12:23 PMNewbie
Talon, I noticed that with the CDC and wondered about that, too. I read somewhere that some manufacturers of the vaccine say to wait 3 months, so I'm guessing that was why my doc went with 3. Still weird that she didn't offer any explanation though really :/.
01-18-2013 at 5:02 PM
Pikachu369
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When I told my gyno that we were going to TTC, she took blood to test for thyroid issues and also a titer to check for immunity from the MMR shot I got as a kid. They collected my blood sample at the office the same day.  It came back fine and I did not have to get a booster.  


Started TTC June 2012 
01-18-2013 at 5:03 PM
hopeful808
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Is there are reason why your doctor could think that you are not fully vaccinated for MMR? According to the CDC, it is administered twice once at 12-15 months and a second time at 4-6 years. Do your medical records not show both doses? 

If I was in your position and my records did not show both doses of the vaccine I would have the blood draw done. If I had to get the vaccine and TTA because of it I would chart and use condoms. But, I am on my last cycle of TTA for other reasons and I have been using condoms the whole time. 

 

CDC website

 http://www.cdc.gov/vaccines/vpd-vac/combo-vaccines/mmrv/vacopt-faqs-hcp.htm


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01-18-2013 at 5:13 PM
mythaldo
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mythaldo is not online. Last active: 05-19-2013, 12:23 PMNewbie

Good question. I don't remember if I got the MMR booster specifically, but I know there was some kind of booster I got in middle school. When I turned in my immunization records for college, I was never asked about boosters, so I assumed I was probably good to go prior to meeting with the doc, but she claims to have no record of a booster.

I have been trying to be discreet about what I say to my mom because I don't want anymore pressure that what I'm already getting, but I'm pretty sure she has copies of my immunization records still. I guess I could ask if she can check since I have a regular annual coming up anyway and I could just pretend that they asked if I wan to check for my bloodwork. My mom has basically had baby fever since we got married, so it's hard to determine if she might figure out why I'm asking and I don't want the pressure.

01-18-2013 at 5:22 PM
mythaldo
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My father is a doctor, so my parents were very diligent about getting any recommended vaccines on time and documented when I was a kid. I had my last doc transfer the records and and didn't think about asking to look at them. My doc recommended doing a titer because she said there has been a steady increase in the number of women in their 20s and 30s that don't have the immunity anymore. She made it sound like this was totally standard practice for TTC now. Of course, I'll bet that If I didn't mention immunization at this visit or if I just happened to come in KU, she wouldn't even have mentioned it.
01-18-2013 at 6:04 PM
seh0041
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My doc never mentioned it at my appt when I told her we were going to TTC. I'm around a lot of pregnant women and women who have had babies and have never heard of one of them having to do this. Not to mention, I've read a million "todobeforegettingpregnant" checklists and articles and haven't seen this listed. I'd get a second opinion.
 
01-18-2013 at 8:40 PM
coopsbaby
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I had the vaccine as  a baby, but found out when I was pregnant with ds that i was not immune. Honestly, I would just get the titer and find out if you are or not. They do recommend a third shot as a senior in high school now (ds had one as a baby, one in elementary and one in high school, his sisters have 2 so far but will get the third as seniors.) 

 

I was a nervous wreck when I was pregnant with ds and I wasn't immune. Suddenly you hear of mumps and measles everywhere! 


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