What to Know Before You See a Fertility Doctor

How Prepare For That First Appointment

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, have been actively trying to conceive, and have not been using birth control for 12 months or more, 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. 

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 can figure out on your own before your appointment, by charting your basal body temperature (BBT) for several months. This can be a very inexpensive way of helping you get pregnant, so it's worth the effort.

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Blood Draw in Lab
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At your first meeting with the fertility specialist, he'll go over your medical history and then outline the fertility tests you and your partner will need to have. These will include blood work and physical examinations (for both of you), semen analysis (for men), and ultrasounds to look at the lining of the uterus and to check for ovarian cysts and fibroids (for women). 

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A semen analysis is something to help you determine the cause of infertility. Photo © iStockPhoto

For men, the basic test for infertility is a semen analysis (SA), in which a sample of ejaculate is evaluated in a lab. The sperm in the sample is counted and observed for problems with motility—the ability of the sperm to move through the female reproductive tract. Providing a sperm sample can be anxiety-provoking, but it's truly a straightforward process.

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IVF treatment
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After all testing has been completed and you have a diagnosis—a reason you and your partner 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, you can be treated. In either case, expect to have options ranging from infertility medications to in vitro fertilization (IVF).

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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. These drugs do carry certain risks, which your infertility doctor will go over with you. So you're prepared, know that they include the possibility that if you conceive there will be more than one embryo which can lead to complications with the pregnancy. Another side effect associated with fertility drugs is a condition called ovarian hyperstimulation syndrome (OHSS)

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Fertility treatment is expensive. In 2014, the average cost of IVF was $12,000, for example. There are ways to get help with financing fertility treatments, however, including payment plans and even scholarships. A good source for guidance and options is the RESOLVE: The National Infertility Association

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Fertility drugs can have unpleasant side effects, and the vigilance required when taking them, the frequent (sometimes daily) trips to the infertility doctor's office or clinic for blood work and ultrasounds, and the shared disappointment if a treatment doesn't work the first time are just some of the factors that can take a toll on a couple undergoing fertility treatment. It's vital that both partners talk about what they're feeling. If you find this hard to do, consider seeing an infertility counselor who is specially trained to guide couples undergoing fertility treatments through the emotional minefields of the fertility treatment. 

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