What You May Expect at Your First Fertility Appointment

By Kristyn Hodgdon

Sponsored by Organon.

Kristyn Hodgdon is an IVF mom, current fertility patient, Co-founder and Chief Community Officer of Rescripted. This article is the opinion of the author and reflects the author's views. The author is not a healthcare professional.

Let’s set the stage: You may have been trying to conceive (TTC) for a while now. You may think you’re doing everything right, however, month after month you’re hit with that single pink line or the negative symbol on a pregnancy test. With each month passing, you may feel a little bit more helpless and in search of answers. You have told your gynecologist about your struggles, and he or she has recommended that you see a fertility specialist.  

While you might understand that this is the logical next step, visiting a fertility clinic may seem like a big leap. To relieve some of the anxiety you may be feeling, you’ll want to be as prepared as possible for that first appointment. 

Now let’s go over what you might expect at your initial fertility consultation, in hopes of easing some of your worries.

Once you choose a fertility clinic and doctor, both you and your partner will be asked to provide as much of your medical histories as possible. After your physician completes a thorough review of your medical histories, you may be asked a series of questions to help identify any potential causes for your difficulty conceiving. 

 Questions your physician might cover include:

  • the frequency and regularity of your menstrual cycle

  • if you experience pelvic pain

  • abnormal vaginal discharge or bleeding

  • previous pelvic infections or medical illnesses

  • prior pregnancies or if your partner has fathered children

  • miscarriages

  • prior surgeries

  • methods of contraception 

  • genital injuries, surgeries, or infections

  • prior or current drug and/or medication use

  • how long you’ve been trying to conceive

  • how often you have sexual intercourse

  • use of lubricants

  • family histories of birth defects

  • any pain or difficulty during intercourse

  • exposure to viruses

If your doctor doesn’t ask a specific question that’s on your mind, don’t be afraid to bring it up. This is your opportunity to put forward any concerns about why you haven’t been able to conceive.

The goal of your provider at this point is to ensure you feel comfortable with your care team and their strategy for moving forward. If you’re not comfortable, don’t hesitate to get a second opinion. 

Feel free to discuss any questions or concerns, including any emotional impact that you may be experiencing, with your physician. While this may be your first appointment to address fertility concerns, it’s not theirs, and you should feel comfortable asking any questions or expressing your concerns.

This first appointment may be the time for you and your doctor to discuss a plan for increasing your chances for a healthy pregnancy. You may be advised to begin taking prenatal vitamins if you haven’t already, and your physician might bring up the importance of a well-balanced and healthy lifestyle, as well as any risks associated with alcohol or recreational drug use. At this time, you should feel free to ask any lifestyle-related questions you have, from how much caffeine you can safely consume while TTC to whether you should complement your treatment with alternative approaches such as acupuncture.

After the initial questions and discussion, your doctor will perform a physical examination of you and, in some cases, your partner. Depending on what fertility concerns are identified, your physician may do a further work-up that includes a pelvic ultrasound to get a clear and detailed view of your uterus, ovaries, and fallopian tubes. This will allow your doctor to check your antral follicle count, a marker of your ovarian reserve, and assess for any fibroids or polyps, which could be affecting your fertility. Your physician might order blood tests to measure your reproductive hormone levels and identify anything out of the ordinary that could be contributing to your difficulty getting pregnant.

While each fertility journey is different, you may be advised to set up a genetic carrier screening test to determine whether you or your partner carry any genetic disorders that you could pass on to your future child(ren). A semen analysis for the male partner may be considered as part of the evaluation. To evaluate the uterus and fallopian tubes, a hysterosalpingogram (HSG), which is an X-ray of the uterus and fallopian tubes, may be used to check for blockages that can impact your chances of conception.

What’s Next?

It’s not until all of the diagnostic test results are in that your provider will have a complete picture of what’s going on, so try to remain patient and hopeful as you wait for your follow-up appointment. In that appointment, your doctor will go over your test results as well as a personalized treatment plan for moving forward.  

We know this information is a lot to process, and the thought of your first fertility appointment can feel overwhelming. But being as prepared as possible may help to ease your anxiety as you take one step closer to hopefully some answers and building your family. 

For additional information on how to prepare and what you may expect, visit fertilityjourney.com, and know that you’ve got this!