Your initial fertility consultation can be daunting and complex; after months, maybe years of trying to conceive, you’re finally ready to figure out the why. This conversation can be overwhelming, to say the least, particularly if you aren’t familiar with infertility, the medications involved, and the success rates of such processes.
It is completely normal to go into your first appointment blindly. If you don’t know what to expect, don’t fret – you are 100% not alone. However, if you can go in armed with some specific questions, you will get more out of your consultation.
Questions to Ask Your Fertility Doctor
First, it’s important to remember that no question is a bad question. Your fertility doctor has heard it all, as they see dozens and dozens of women like you every week. Second, there should be no fear or wariness when looking for clarification on topics that can and will be a little confusing. You aren’t expected to understand (or remember) every detail that is shared with you off the cuff. Though we would recommend having your partner accompany you to as many appointments as possible – the more ears, the better.
That said, asking the right questions can help you make informed decisions so that when you are ready to proceed with your treatment plan, you can go in confident, informed, and with clarity. Don’t forget to bring a pen and paper – take those notes!
Do you have any insight into why we haven’t conceived?
Your reproductive endocrinologist may be able to speculate or identify possible reasons behind why you have not yet become pregnant. This would be based on you and your partner’s medical history, and any testing you may have already completed. If this meeting is the very first discussion you have had, you may not have undergone any screening yet. In this case, he or she may advise you to take certain tests before making any claims. You may not have a “diagnosis,” so to speak, right away.
However, they may ask questions related to the frequency of your menstrual cycle, if you are a smoker, how frequently you drink, and, if you are overweight, what your diet and lifestyle are like. These are natural and environmental factors that can prevent you from getting pregnant.
What is our diagnosis and how did you come to this conclusion?
After ordering a series of tests, your fertility doctor should be able to conclude whether you are experiencing female factor or male factor infertility. Both parties will likely take a series of blood tests, the female may take an HCG, and the male will provide a semen sample. With these screening methods, your clinic will be able to rule out any non-factors to determine what’s stopping you from conceiving. If your diagnosis is complex, ask your doctor to elaborate on how they came to this conclusion.
Keep in mind that there is a chance your doctor will deem your infertility “unexplained” – which can be hella frustrating. After trying for all this time, you deserve to know why it’s not working! Especially since you don’t want to play a very expensive guessing game when trying to find a solution. Unfortunately, this happens.
What are our treatment options, which do you recommend for me personally, and why?
Like we always say, everybody is different, and every BODY is different. Therefore, it is absolutely crucial to keep in mind that not all treatment plans are created equal. What works for one couple will not work for another.
Your treatment plan will depend entirely on your fertility diagnosis – female factor, male factor (or both), and why. Some may start with an IUI, while others will jump directly to IVF. In severe or high-risk cases, some may require an egg or sperm donor, and others may need to work with a surrogate. No matter which direction your fertility doctor takes you, it’s important to understand why.
What is your success rate and how is it calculated?
There is no shame in wanting to know how good your RE is at his or her job! Especially if you have a more complex case that involves overly invasive protocols. (Who am I kidding, IUI and IVF are nothing BUT invasive, if you catch my drift.) Fertility clinics and REs should be able to provide their success rates, including statistics behind how patients have responded to particular treatments in recent years.
When my husband was diagnosed with non-obstructive azoospermia, my RE referred him to a Urologist who was to perform a micro-TESE (surgical sperm extraction). Being a numbers guy, he naturally wanted to know what this doctor’s success rate was before he agreed to have him be the one to perform this crazy-invasive surgery. After all, men only get one set if you know what I mean, and this was a “do-or-die,” “will we or won’t we,” type of situation.
How will we communicate throughout my treatment? And who can I contact when (not if!) I have questions about my treatment and/or evaluation?
Communication is EVERYTHING during fertility treatment. Everything.
Not only will your hormones be all out of whack (and your mind all over the place), but there will be so much going on. You’ll have multiple visits to the clinic for blood tests and ultrasounds, revisions will be made to your medication dosages based on how your body is responding, and the timing of your IUI or IVF will be contingent on these updates.
Odds are that your RE’s nurse will be the one calling you after your clinic visits to report on behalf of your doctor, and you most likely won’t be speaking directly to him or her all that often. Because of this, you’ll want to understand who you will be speaking with, if you will reach them by phone or email, and how best to get your questions answered as they arise. Responsiveness is key!
IVF Week 1: Stims
If this treatment plan doesn’t work, what are our other options? How long should we try this method before reevaluating and going another route?
Depending on your treatment plan and your fertility doctor’s educated insight, there is a chance they will want to try the same methods more than once before taking another approach (for example, a few IUI attempts before trying IVF). This roadmap will be largely based on which method your RE believes will be most successful for your diagnosis, considering how your body is responding to the medications and the statistics behind such treatment.
This will all also depend on your finances and how much insurance coverage you have. For example, your insurance may cover four IUIs, so you may want to run those attempts dry before making the leap to IVF. At the end of the day, the decision is yours, but your doctor can offer deeper insight into your odds of success.
How much will this treatment cost?
Straightforward. Because there is nothing worse than getting unexpectedly large bills.
Will you be performing the treatments?
Depending on the size of your clinic, your RE may not be present at your treatments. A bit alarming, I know, but very common. If you are going to a large clinic with lots of patients, it’s likely that the fertility doctors work on rotation (kind of like OB/GYNs – sometimes the odds of your own doctor delivering your baby are slim).
If this is the case, you may very well have another (equally qualified) doctor performing your IVF egg retrieval, IVF embryo transfer, or IUI.
I had a doctor I’d never met perform my egg retrieval, but fortunately, found out his name ahead of time, which gave me time to stalk some Facebook groups to get other mamas’ opinions on him. Then, I was very fortunate that my own RE was working on the day that I had my transfer, so he was the one who performed it. It was actually the first time I’d ever even met him in person since everything else had been virtual, thanks to the pandemic.
When can we begin and how long will this treatment cycle last?
You will naturally want to get started as soon as possible. After all, you’ve waited quite some time to finally see those two pink lines. Depending on your diagnosis, your fertility doctor will most likely have you get started with your medications after your next menstrual cycle.
There are SO many questions to ask your fertility doctor, it can definitely be overwhelming. Just enter with your head held high, stay positive, and trust that your body will do what it’s got to do to make you a mama! You got this!
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