We know it can be incredibly confusing to begin your fertility journey. From selecting the right clinic to figuring out what sort of information you’re looking for, it’s rarely a walk in the park.
How do I pick a fertility clinic?
One of the most important considerations in picking a fertility practice is to ensure you feel comfortable with and have a good rapport with your physician. Undergoing fertility treatment can often be an anxiety-provoking journey, so you want to ensure you feel supported by your doctor throughout. Additionally, it is important to identify what style of practice may be the best fit for you. In some practices, you will see your own physician for the majority of your ultrasounds and procedures (egg retrieval, embryo transfer, etc), and, in others, some or most of your ultrasounds and procedures may be performed by an ultrasound technician or one of the other providers in the practice, so I encourage patients to ask about how the practice functions from this standpoint if it is important to you.
Additionally, and as I discuss in more detail below, I recommend picking a fertility practice that has a lot of experience in treating patients who have similar fertility struggles to your own. For example, if you are found to have a very low egg count, it’s helpful to be at a practice that has a lot of experience in this setting in order to optimize your outcome.
What happens at an initial fertility consult?
At an initial fertility consultation, the physician you meet with will generally ask you a variety of questions to get to know you better and to best understand your reproductive goals. If you have been actively trying to conceive for a while, we will often want to know specifics about your menstrual cycle, your medical and surgical history, medications you are taking, and whether you have had any fertility testing so far. We will also gather similar information about your partner. This way, we can get a better sense of what may be causing difficulty conceiving.
We will then generally discuss testing that we recommend to get a better sense of your current fertility and what treatment options are possible. This testing often involves doing an internal ultrasound to look at the uterus and ovaries, some blood work to assess egg count and other hormones important in fertility and pregnancy, and a semen analysis to look at your partner’s sperm count. Often, this initial ultrasound and blood work may be done at your initial visit.
If you are not actively trying to conceive but are interested in learning more about fertility preservation through egg or embryo freezing, your physician will want to learn more about how many children you’d like to have in the future and how old you think you will be when you do start trying to conceive. Similar tests to look at egg reserve through blood work and an internal ultrasound will be performed. We will also discuss in detail the steps involved in doing an egg-freezing cycle.
What is important to bring to your initial consult?
I generally recommend bringing information related to your menstrual cycles to the visit if you track it in an app or via another method. It is also helpful to bring results from any other fertility testing or treatments you have done in the past if you did not submit this information online ahead of your appointment. This may include prior blood work results, ultrasounds or a prior semen analysis if your partner has had that test done. If you have completed fertility treatment at another center prior to your visit, your physician will certainly want to review this information in detail as well.
It is always helpful to bring a list of specific questions you have to ensure your physician addresses them all during the visit. Finally, if you are someone who likes to take notes to review later, bringing a pen and a notepad to write on can be helpful. However, in my practice, our patient navigators will also regroup with you after the appointment with your doctor and provide a very comprehensive written summary of next steps, so it is certainly not necessary to take a lot of notes yourself! We recognize that it can be a little overwhelming to digest a lot of information at once, so we like to make it as easy as possible on our patients.
What are the important questions to ask during your initial fertility consult?
I would encourage women to ask about the practice’s experience in treating patients who have a similar situation to your own. For example, if you are in your 40s and/or have a very low egg count, it is helpful to know how many patients your practice treats in similar situations and what their outcomes are. It is also helpful to know if your practice has specific protocols to help optimize your outcome based on your situation. For example, if the egg count is very low, some practices may offer a type of cycle called “minimal stimulation” to help save on costs so that potentially more cycles can be done to optimize the chance for pregnancy.
Furthermore, some practices may place restrictions on trying IVF with your own eggs over a certain age or if the egg count if very low, so this is helpful information to ask about at the onset.
Finally, if you are interested in considering fertility preservation through egg freezing to optimize your chances of having the family you want in the future, I would encourage women to ask about the practice’s experience with egg-freezing and what their outcomes have been when they’ve thawed eggs they’ve previously frozen to attempt pregnancy. Since egg-freezing is a newer technique, not all practices may have comparable experience in optimizing pregnancy outcomes through the use of frozen eggs.