Visiting a fertility specialist (also known as a Reproductive Endocrinologist or RE) for the first time can be daunting and many patients wonder what to expect during their first visit. We understand that no one wants to have to come and see us. Instead of feeling defeated at your first visit because you haven’t been able to conceive on your own, look at the visit as your first step towards improving your odds of having a baby.
Your initial visit is likely to be a long discussion between you and your doctor. There may be some tests performed at this visit, but not always. At the first consultation my goal is to figure out what’s been going on for the past 6 – 12 months. Is there something obvious that will indicate why a couple has not had a natural pregnancy? Often there isn’t, and then it’s a matter of looking at the personal history of both partners and also inquiring about family history. Usually we then get into a conversation about initial tests that can be done to look for reasons why pregnancy has not been achieved. There are 4 basic areas that we test: 1) ovarian reserve (eggs); 2) sperm; 3) tubes; 4) uterus. Of course there are other tests that may be suggested, but these 4 areas make up the basic “infertility work-up.”
To test these 4 areas your doctor may ask you to do some or all of the tests below:
- Ovarian reserve: AMH, antral follicle count, day 2/3 FSH+Estradiol
- Tubes/Uterus: HSG, saline sonogram, pelvic sonogram, pelvic MRI, hysteroscopy
- Sperm: semen analysis
It’s pretty common that patients are torn between wanting all of their test results to be normal, and also hoping to find a cause for their infertility. Towards the end of your initial visit your doctor may briefly discuss treatment options. Recommendations for treatment depend on test results, but if all the testing is essentially normal then every treatment option is a possibility and the decision as to which treatment is best will often come down to age (usually of the woman). For women > 37 years going straight to IVF is the most effective way to become pregnant. That does not mean that every woman over 37 opts to go right into IVF. Together with your doctor you will come up with a treatment plan that feels right for you!