What to Expect on Your First Visit with a Fertility Specialist
If you’re like me then you sometimes push off going to a new doctor’s visit due to the fear of the unknown. Will they have me do a ton of tests? I’m a hard stick and so blood draws are not my favorite. Will I be made to feel ashamed for my choices? How much will it cost? Will they tell me something I don’t want to hear?
It is my hope that this post will demystify your first fertility doctor visit and make the experience less daunting.
Before the Fertility Visit
One of the keys to a productive first visit is being prepared. Preparing for your new patient visit will make the visit go smoothly and ensure that you get the most out of the time you have.
Set Your Goals and Questions
Prior to the visit, I recommend you spend some time thinking about your goals for your visit. While this may expand or change during your visit, it is important to have a starting point. Your goals can be as broad as I want to learn more about my fertility or as specific as I want to know the steps involved in IVF. I also recommend writing down any pressing questions that you have prior to the appointment so that you don’t forget to ask them. It is okay to let your doctor know you have some questions at the beginning of the visit, but wait until closer to the end to ask, as they may be answered over the course of your visit.
Medical History
Your doctor will definitely want to learn about your medical history and having this information readily available makes your appointment move more efficiently and allows you to get more out of your time with your physician. If you have a spouse, your doctor will need your spouse’s medical history as well, even if you feel it may not be relevant to the process.
Your medical history includes any medical conditions you currently have or have had in the past (such as a previous cancer diagnosis) and any medications or supplements you take. You also want to mention any prior surgeries especially and the year they occurred. They will also need information about prior pregnancies, drug allergies, as well as tobacco, alcohol or nicotine consumption. For sperm producing individuals, it is important to know of any previous pregnancies including miscarriages that may be attributed to you.
Previous Tests or Treatments
Lastly, if you have had previous tests done by another physician or healthcare provider, it is ideal to have those records sent to your physician’s office or you can upload them to your patient chart (if this is an option) prior to your appointment. This makes it easier for your doctor to access the necessary information for your appointment.
During the Visit
Your first appointment may be in-person or virtual and especially in our post-COVID works, virtual appointments have become more commonplace.
For a virtual visit, it helps to ensure that you have a good connection and that you the app that you need for the appointment downloaded on your phone or laptop. I also recommend taking virtual appointments from a quiet and private place so that you can discuss freely with your healthcare provider and ask any questions you have without being concerned about being overheard.
Most visits will begin with a discussion with your fertility specialist. During this time, they will ask questions to better understand you, your medical history, your goals e.t.c.
For in-person appointments, this is usually followed by a pelvic ultrasound. This provides information about your egg count (also known as your ovarian reserve) and also about your uterus. Doing this ultrasound before discussing next steps is helpful because it may provide additional information which may affect your next steps.
This ultrasound is usually followed by a discussion of your ultrasound findings and next steps to complete the evaluation.
For both virtual and in-person appointments, the visit usually wraps up followed by a discussion of recommendations and treatment options. The discussion about treatment options is usually quite high level at the first visit, since the evaluation has not been completed. However, if enough information is available at the first visit, you may have a more complete plan following your first visit.
I will go into details about the work up for both male and female infertility in a future blog post, but in summary the next steps will include;
For the egg producing partner:
Blood tests to evaluate egg count and readiness for pregnancy
SIS or HSG to evaluate the cavity of the uterus and patency the fallopian tubes
For the sperm producing partner:
Semen analysis to evaluate sperm count, movement, and shape.
Blood tests
Other tests including genetic tests may be offered based on your history, goals and ultrasound findings. Some of these follow up tests need to be done at a specific time relative to the start of your period.
After the Visit
Following your visit, it is important to understand what the plans are for follow up. For example, do you need to call the clinic on the first day of your next period? When will you have your follow up appointment and what tests need to be completed before the follow up.
In summary, most of your new patient visit is having a conversation with your doctor, where you get to know them a little and they get to know you +/- your partner and understand your unique situation. It is also a time to learn about the treatment options available. It should basically taking you from roaming around blindfolded in a maze, to giving you a map on the necessary next steps to make it towards the exit.