By Dr Andy Stamatiou, specialist at City Fertility Centre Brisbane.
Are you having trouble conceiving? Have you made the decision to seek fertility advice and don’t know where to start or what to ask? Here is a list of five areas that will be discussed in your first fertility consultation with a specialist.
Fertility history and examination
At your first consultation, your specialist will take a thorough medical history from you and your partner (if applicable) and perform any relevant examinations. This information will direct the specialist towards specific treatments that will help to enhance your fertility.
Your specialist will want to discuss things such as your menstrual cycle, how long you have been trying to conceive, lifestyle factors, and whether you have had any previous fertility treatment. Both partners are encouraged to attend this appointment.
Investigations
If you have had investigations ordered by your GP, it is important to make it known to your specialist before the first consultation so that these can be accessed. Most of them do not need to be repeated. Some tests are ordered to ensure you are ready for pregnancy, while others assess the specific cause of your fertility problem. These tests may include:
Female Fertility Tests
- Common blood tests include follicular phase (early cycle) sex hormones (estrogen, luteinising hormone (LH), follicle stimulating hormone (FSH) and thyroid stimulating hormone).
- Tests to predict ovarian reserve, such as anti-Mullerian hormone (AMH), which is a blood test, and/or an antral follicle count (AFC), which is done via an ultrasound scan. The AMH is a hormone produced by ovarian follicles that contain eggs. The amount of AMH gives an indication of the number of eggs being produced (or ovarian reserve).
- A pelvic ultrasound scan is performed to check the pelvic anatomy and exclude ovarian cysts. A hysterosalpingogram (HSG) is an X-ray dye study that will check the uterine cavity and exclude blockage of the fallopian tubes. This can also be done with a saline sonohysterogram, which is a specialised type of ultrasound scan.
Male Fertility Tests
- A sperm count is also known as a seminal fluid analysis. It looks at the sperm concentration, motility (ability to swim) and morphology (shape).
- An abnormal blood count may require blood tests such as FSH, LH and testosterone.
- Depending on your history and the results of the initial tests, your treating doctor may request a sperm DNA fragmentation test or a testicular biopsy. For more information about these tests, please visit our page on Sperm Test and Semen Analysis.
Treatment options
Depending on your history, examination and available results of investigations, your fertility specialist may be able to discuss treatment options at your first visit. Your fertility problem may be obvious and may require laparoscopic surgery or other specific fertility treatments. More commonly, your specialist will not be able to give you definite answers until all the test results are back. A detailed treatment plan is usually established at the second meeting.
At the first consultation, your specialist may be able to touch on the likely treatments available to you. Treatments range from ovulation induction, alone or with artificial insemination, to the various types of IVF treatments.
Where to from here?
After your initial consultation, you should have an understanding of what the specialist is doing to diagnose the cause of your specific fertility issues and the various treatment options available.
A follow-up appointment will be scheduled to discuss the results of your fertility tests and to submit a tailored treatment plan specific to your needs.
Learn more about the clinic
It is normal to find out about the clinic’s practices, reputation and success rates. The financial cost of the fertility treatment should also be explained. More accurate costing of your treatment is only possible once a tailored plan has been submitted.
You should also be aware of other services encouraged at City Fertility Centre for your emotional and physical wellbeing, such as counselling services and complementary therapies.
At City Fertility Centre, after your consultation with your specialist you will attend an information session and meet members of the nursing team, a patient services administrator and lab staff to discuss your treatment plan. This is a great opportunity to ask any questions you may have about your treatment.
From the outset, we will strive to provide clear and comprehensive information so you feel you can take part in, and make well-informed decisions about, your journey towards parenthood.
When to Seek Fertility Advice
At City Fertility Centre, we recommend you seek medical advice from your GP or a specialist if you have not conceived after 12 months of trying, or after six months of trying if you are over 35 years old.
There are also other instances where you might want to seek earlier fertility advice. These include: early menopause; polycystic ovaries; irregular or non-existent menstruation; history of endometriosis; when either you are or your partner is a current or past cancer patient; or when the male partner has had a vasectomy.
You and your partner will require a referral from your GP to see one of City Fertility Centre’s specialists.
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