So, you’ve decided to take the initial step on your journey to parenthood? You plan to make an appointment with a fertility specialist, but you are anxious about what to expect.
That’s fine, many people have been in your position.
You may feel a bit worried since this is a new experience that you’re about to undertake — but let me be the first to say, congratulations on taking this courageous step! If you’ve been having trouble conceiving a baby, setting and keeping an appointment with a fertility specialist is imperative. With this, you’re taking proactive measures by consulting an expert about your fertility health.
If you’re a woman under 35, having heterosexual relations and have been actively trying to conceive, without using any type of birth control or barrier protection for 12 months or more, you should really see a fertility specialist. If you’re a woman who is 35 or older, you should see a fertility specialist, if it has been 6 months or greater since you’ve been having heterosexual relations and actively trying to conceive, without using any type of birth control or barrier protection. If you are in a same sex relationship, or if you are single but desiring to become a parent, you should see the fertility specialist, right away without any delay in time.
To prepare you, expect to go through a series of tests and evaluations to determine the root cause of your infertility. Your fertility specialist may also provide you with a comprehensive program and treatment which will be tailored to your condition. Also, please know that in up to 30% of patients, no specific cause for someone’s infertility can be found and the case is then categorized as, “unexplained infertility”.
At Nevada Fertility Institute, we believe that information is power. We also believe that information is the best antidote to address your fear and worries. Your first appointment may be unnerving, but when it comes to helping you overcome the odds of conception, a fertility specialist could make a difference.
Here are the things you should learn about to help you establish a clear awareness of your first visit and to allow the fertility specialist to give you the most information, right up front.
1. Status of Ovulation
One of the things your fertility specialist would like to know is the status of your impending ovulation (i.e. what are the chances that you are releasing an egg every month?). The easiest way to determine this is by using ovulation kits.
Ovulation kits work by detecting the LH (luteinizing hormone) levels in your urine. LH is a hormone made by your pituitary gland, within your brain, to talk to your ovaries. LH levels spike, as ovulation approaches, in order to push the egg into the final stages of maturity and that’s a required step because only a mature egg will be fertilized by sperm. Ovulation occurs somewhere between 28 to 36 hours after the LH peak.
If you can afford it, I recommend starting your ovulation testing around day 10 or 11 of your menstrual cycle and then performing the test twice daily: when you first wake up in the morning and again at around 6PM in the evening, so as to catch the peak at the earliest possible sign of it.
If you’ve been tracking your ovulation, using other methods (e.g. if you’ve been using a phone application), bring its results with you, as well.
2. Fertility Testing
At your first appointment, you will sit down with your fertility specialist to review you and your partner’s medical history and then, they will outline the fertility tests which you will need to have done. You will talk through things like your current wellbeing, your family health history including both sides of your parents’ families when available, and health details about your partner. During this chat, you’ll also want to share that you have been charting and explain what is going on with your cycle.
The specialist may ask you to get a series of physical examinations including weight, height, blood testing, blood pressure, and semen analysis (for men). You will most likely, at some point, undergo an ultrasound to examine the lining of your uterus and to check for possible ovarian cysts and fibroids to see if there could be any physical issues in the womb that prohibit you from conceiving. In addition, you will most likely be ordered for a hysterosalpingogram (HSG) which is a specialized X-ray test, used to evaluate the fallopian tubes — the place in your body where sperm and egg meet to start a baby.
If these tests have already been done, your fertility specialist will review and discuss the results with you at that first visit.
3. Semen Analysis
This point is a continuation of the previous one, but let me expound a bit about semen analysis. For men, semen analysis (SA) is the basic examination for infertility. This is done by taking an ejaculated semen sample and evaluating it in the laboratory.
The sperm in the sample is observed and counted for probable problems with motility (the ability of sperm to move independently through the female reproductive tract), concentration (total number of sperm) and morphology (how the sperm look, overall). I know providing a sperm sample can be an anxiety-inducing process for most men. However, this is truly a straightforward process and it helps the couples move forward to the next step. Fifty to sixty percent of all couples struggling with infertility have something going on with both the male partner, as well as the female partner. So, it is imperative that the sperm are checked as part of the initial evaluation.
4. Fertility Treatment
After a series of testing and diagnosis, your fertility specialist can put together a treatment plan tailored to your condition. Even if some or all of the results of the tests show no definite reason why you can’t conceive (i.e getting a diagnosis of unexplained infertility), you can still be treated for infertility! Once your fertility specialist finalizes your treatment plan, you will want to learn about a variety of factors for the treatment. With this, it is crucial for you to ask questions such as its duration, possible side effects, chance of conception success, and the cost.
5. Insurance Coverage
It is your responsibility to check your insurance coverage before visiting the clinic. Make sure you’re well informed about what your provincial, state, federal or private medical insurance plans will cover. Oftentimes, the clinic’s billing department will have contacted your insurance provider to determine how much, if any, you need to pay out-of-pocket for your initial consultation but this is not a requirement of them.
The cost of infertility treatment and associated medication can be daunting for some couples. You may be introduced to financial support to ensure you get the assistance you need and deserve. At my clinics, we may discuss information about discounts, insurance coverage, financing plans, and loans.
After your initial appointment, a follow-up may is usually scheduled to discuss your results and all treatment options. For some patients, treatment plans may be started during this follow up visit or scheduled for the next appointment, depending on the duration of your initial meeting and whether other tests or surgeries are needed.
Infertility can be a struggle, but your fertility specialist is there to help you overcome this hurdle and help you achieve your pregnancy goal.
While at the clinic, make the most of your appointment. Ask as many questions as you like, to ensure you have clarifications for your concerns. Remember, everyone at the fertility clinic is there to guide you and cheer you. You are not alone in this!
Authored by Dr Cindy Duke