7 Things to Know Before Your First Appointment With a Fertility Doctor

You've been trying to have a baby for some time with no success. Should you see a fertility doctor? If you're under 35 and have been actively trying to conceive for 12 months or more without success, make an appointment with a fertility doctor, or reproductive endocrinologist (sometimes referred to as an RE). If you're over 35, wait only six months before getting help.

Either way, expect to go through an array of evaluations and tests to determine what may be interfering with your efforts to get pregnant. Here's an overview of things it will be useful to know before you see a fertility doctor. 

Are You Ovulating?

Female doctor discussing with patient in clinic
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One of the initial things the doctor will want to know is whether or not you're ovulating (releasing an egg every month). This is something you may be able to figure out on your own before your appointment by charting your basal body temperature (BBT) for several months.

Tracking ovulation can be a very inexpensive way of helping you get pregnant, so it's worth the effort.

You Will Need Fertility Testing

At your first meeting with the fertility specialist, they will go over your medical history and then outline the fertility tests you (and your partner, if you have one) will need to have.

These will include blood work, physical examinations, and a semen analysis. Typically, the doctor will order an ultrasound and a specialized X-ray to examine the uterus, ovaries, and fallopian tubes. 

What to Expect From Semen Analysis

One basic test for infertility is a semen analysis (SA), in which a sample taken after ejaculation is evaluated in a lab. A semen analysis looks at sperm count, semen volume, the shape and movement of sperm cells, the presence of white blood cells, and other factors.

Providing a sperm sample can be anxiety-provoking, but it's a straightforward process and the lab staff is trained on how to help.

The Basics of Fertility Treatment

After all the testing has been completed and you have a diagnosis—a reason you are having trouble conceiving—your infertility doctor can put together a treatment plan.

Even if the results of your tests have been inconclusive, and there's no clear reason you aren't getting pregnant—up to a third of couples never find out why they can't conceive—treatment is still very much available.

In either case, expect to have options ranging from lifestyle modifications to fertility medications to surgical interventions or even intrauterine insemination (IUI) or in vitro fertilization (IVF).

Fertility Drugs Have Side Effects

Medication to stimulate ovulation is integral to most infertility treatments. In some cases, drugs alone are used (at least at first). Fertility drugs also are part of more involved treatments such as IVF. There are certain risks of fertility drugs, which your doctor will go over with you.

So you're prepared, know that they include the possibility of conceiving twins or higher-older multiples, which can lead to complications with the pregnancy. Another side effect associated with fertility drugs is a condition called ovarian hyperstimulation syndrome (OHSS). 

Fertility Treatment Is Expensive

Fertility treatment is expensive. In fact, according to one study, the median per-person costs ranged from more than $24,000 to roughly $38,000 for IVF and IVF with donor eggs.

However, there are ways to get help with financing fertility treatments, including payment plans and even scholarships. A good source for guidance and options is RESOLVE: The National Infertility Association. 

Fertility Treatment Is Challenging

Along with drug side effects, people undergoing fertility treatments face many challenges: the vigilance required for drug treatments, the frequent (sometimes daily) trips to the doctor's office or clinic for blood work and ultrasounds, the expense, and the disappointment if a treatment doesn't work.

It's vital to talk about what you're feeling, whether you are undergoing treatment yourself or supporting a partner who is. If you find this hard to do, consider seeing an infertility counselor who is specially trained to guide people through the emotional minefields of fertility treatment.

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