The decision to see a fertility specialist is a major step for anyone that’s trying to conceive, and it can come with a powerful mix of hope and anxiety. Hopefully, your fertility consultation will provide answers to many of the questions that have been building up since you first started trying to get pregnant. However, it’s perfectly normal to feel nervous about discussing your fertility with a new doctor. Let’s take a look at what you can expect from that first visit and how you can prepare to make the most of your time with your fertility specialist.
Finding the right fertility specialist
If you’ve been trying to get pregnant for more than a year (or 6 months, if you’re over 35), it may be time to set up an appointment with a fertility specialist, also called a reproductive endocrinologist (1). When you’re ready to start looking for a doctor, take a minute to think about what is important to you. Do you prefer if your doctor is a male or female? Are you more comfortable in a large hospital environment or a smaller office setting? Do you need to find a clinic close to your home or work? What kind of fertility coverage (if any) does your health insurance offer?
Different doctors and clinics will offer different experiences, and it’s important to find someone that you and your partner are comfortable with. (Remember, you’re going to be discussing some pretty intimate stuff with them.) For example, some clinics may prioritize using advanced technology to increase success rates, while others may focus on providing more affordable services to patients (2, 3).
For some assistance in your search, you can check out the Centers for Disease Control and Prevention’s database of fertility clinic success rates. You can also read about different physicians online, usually on their clinic’s website, and even call to request a quick meeting with a specialist before you commit to an official consultation (2, 4).
How should you prepare for your appointment?
During your first meeting with your fertility specialist, you’ll start to work with them to help them understand why you and your partner haven’t conceived and discuss what your options are moving forward (1). To get the most out of this appointment, you should start preparing during the days or weeks leading up to your visit. First, you’ll want to get your medical records organized and sent over to the fertility clinic. Your current doctors may be able to send them electronically or via fax, or you may need to request a paper copy and bring it with you to your appointment.
Also check your health insurance coverage before your appointment so you can have an idea of what you’ll be expected to pay out-of-pocket for the consultation. Some—but not all—states have laws requiring insurers to offer some sort of fertility coverage. Click here to see if your state is on the list (5, 6).
Before your visit, write down any family or medical history that may not be in your medical records already. Your doctor will want to know how old you were when you got your first period, how long you’ve been trying to conceive, how often you’re having unprotected sex, and whether you’ve already done any fertility tests or treatments. If you’ve been tracking your cycles, basal body temperature (BBT), and cervical mucus, bring this information with you as well. On your list of things to share with your doctor, also jot down any questions and concerns you have about your health and your treatment options.
For your first appointment, your fertility specialist will focus on two main goals: learning your medical history and giving you the information you need to move forward with the process. You’ll go over the information that we discussed in the previous section. Your doctor will also ask you questions about your lifestyle, activity level, and drug, alcohol, and tobacco use. The more your doctor knows about your health, the better they’ll be able to help you conceive (1, 3).
This appointment is your chance to learn more about your fertility and treatment options. It’s your physician’s responsibility to educate you and address any concerns you may have, so don’t be shy about pulling out that list of questions you made and making sure you didn’t forget to go over anything. It’s best to bring your partner or someone you trust with you to the appointment so you have two sets of ears catching everything your specialist says.
Pro tip: Bring a notepad with you so you can record what your doctor tells you during the appointment. There will be a lot to take in, and you’ll want to be able to go back over the information later.
Your reproductive endocrinologist may request that you and your partner get some diagnostic tests run before your first appointment or recommend testing during your first visit. Common tests include blood tests for hormone levels, infectious disease testing, genetic testing, ovarian reserve testing, semen analysis, and ultrasound scans of your reproductive organs (2, 3). If you’ve already had some fertility testing done, your doctor will review and discuss the results with you during this appointment.
Once your doctor has a good picture of your situation, they’ll go over your treatment options with you, which may include fertility drugs, intrauterine insemination (IUI), in vitro fertilization (IVF), or surgery, depending on your specific situation (3). The more you provide your doctor with historical data about your cycles, the more likely you will get the right treatment for your situation. The next section will explain more.
How to be best prepared for the right treatment for YOUR situation
Before your doctor recommends treatment, such as fertility drugs, intrauterine insemination (IUI), or IVF, you’ll want to make sure they have the information they need to figure out the best way to help you conceive. If you’re not already, you should start tracking your menstrual cycles before your first appointment with your fertility specialist. If possible, try to bring two to three months’ worth of tracking data with you to your visit (1).
Each cycle, you should track your temperature (either your basal body temperature or your continuous core body temperature), the start and end dates of your periods, the heaviness of your flow, and your daily cervical mucus (think: dry, watery, egg white, sticky, or creamy). When you have that kind of detailed information about your menstrual cycles, it can clue your doctor into trends or symptoms that you may not recognize or even think to talk about during your appointment.
If your specialist won’t look at your charts, don’t be afraid to advocate for yourself! There are doctors out there that will use the data on your charts to make an informed decision about what your next steps should be.
To learn more about tracking your cycles while you’re trying to conceive, read Caitlin’s story about how using fertility awareness-based methods of family planning (FABMs), along with Kindara, helped her to get pregnant after nearly a year and a half of trying.
What should you ask your fertility specialist?
When you’re visiting a reproductive endocrinologist for the first time, trying to think of everything you want to ask your doctor can be a little overwhelming. The list below is by no means exhaustive, but it should help you start thinking about the kind of information you need to make informed decisions about your fertility treatment.
How will we diagnose my infertility? Which tests would you recommend?
When will I get the test results back? When can I expect a diagnosis?
What are my treatment options? What are the success rates for those treatment options (both country-wide and at this specific clinic)? Are there any associated risks or side effects?
Do you have experience treating people my age? What about people with medical histories similar to mine? What were their success rates?
Where will any testing and treatments take place (at the clinic or somewhere else)?
What are the costs associated with any recommended tests or treatments? What out-of-pocket expenses should I expect? Does your clinic have a financial counselor?
What are your office hours? Are there any office policies I should be aware of?
Aside from your questions, it’s also important to talk to your specialist about the expectations, hopes, and concerns you have about trying to conceive. Don’t be afraid to bring up any faith-based or cultural preferences that you have about your treatment. Additionally, you should be honest about how much time and money you’re willing and able to commit to this process because that may affect your doctor’s recommendations (3).
The decision to see a fertility specialist can be life-changing, but it doesn’t need to be overwhelming. Remember, it’s your doctor’s job to give you the information and support you need to make informed decisions about your fertility care. By preparing for your appointment and communicating honestly with your physician, you can put your best foot forward as you set out on the next phase of your fertility journey.