As a woman, you may be thinking about having children — either in the near or distant future. When we’re young, we tend to assume that our lives will follow a linear plan of graduating from college, establishing a career, getting married, and having children. But the truth is that everyone’s timeline and path to parenthood is different, and so it’s important to be proactive and informed about your reproductive health.
A woman’s fertility declines with age — we’ve heard about our “biological clocks ticking,” right? And, regardless of how much we grow up being told what we can do to prevent pregnancy, not every woman conceives easily or naturally on their own. In fact, approximately one in eight couples will struggle with infertility, which, according to Verywell Family, is “the inability to conceive naturally after one year of unprotected sexual intercourse.”
Contacting a fertility clinic to get information and discuss your options can feel overwhelming and intimidating, and, with it, comes many questions, such as when is the right time to visit a fertility clinic? And what options are right for you? Read on to learn what to expect when visiting a fertility clinic for the first time.
When is the right time to see a fertility specialist?
Multiple reasons exist for reaching out to a fertility clinic for the first time. Getting pregnant may be taking much longer than you’d thought or possibly you’ve had miscarriages. Whatever your situation, it’s clear that there are many reasons for working with a fertility clinic.
However, according to Northwestern Medicine, if you are trying to conceive a baby, the experts typically suggest contacting a fertility specialist if you have been actively trying to get pregnant for a year without success, or if you are over the age of 35 without success after six months. You may also want to contact a fertility specialist if you have a known reproductive issue, such as endometriosis, polycystic ovary syndrome (PCOS), uterine fibroids, or primary ovarian insufficiency. Additionally, if you’re over 40 (regardless of how long you’ve been trying to get pregnant), have an under or overactive thyroid, if you’ve ever had a cancer diagnosis, or if you’ve experienced miscarriages, you may want to visit a fertility clinic.
According to the Southern California Reproductive Center, “the main goal of this first appointment is to build a road map of your fertility journey: where you’ve come from and where you are headed.”
Every fertility clinic is different, so be open to finding the right fit for you
It’s important to keep in mind that, just like every company you’ve worked for and every nail salon you’ve ever visited has a particular culture, every fertility clinic is different as well. As noted by Resolve: The National Infertility Association, there is no one-size-fits-all approach, though some clinics may be more similar than others. For example, some clinics are very large whereas others are smaller and offer a more personalized approach (via The New York Times). Depending on the clinic, you may be assigned a nurse or you may work with different nurses throughout your treatment.
Other differences between clinics? According to Resolve, some might use more of the latest technologies, but others might have fewer “bells and whistles” to provide more affordable treatment. Some may also operate strictly from a medical standpoint, whereas others will consider a more holistic approach, such as the Zita West Clinic in the U.K. that provides fertility medical treatments in addition to services like acupuncture and counseling — all under one roof.
Don’t think that just because you’ve visited one clinic that all clinics and fertility specialists are the same. They’re not. It’s okay (and actually a smart thing!) to do your research and seek a second opinion if there is something you just don’t feel comfortable with, since “you’re in charge,” as Saint Barnabas reproductive endocrinologist Serena Chen disclosed during a webinar for Resolve.
Bring your partner or someone close to you to an initial fertility consultation
Having children is a sensitive topic, so it’s a good idea to not come alone to your initial fertility consultation. If you don’t have a partner or if your partner is unavailable, bring your mom, sister, or friend — anyone whose presence makes you feel comfortable — for the extra support. If you’re not bringing your partner, make sure you bring someone with whom you’ve been very open and honest with regarding your medical history since you’ll be asked all kinds of questions. Plus, the wealth of information you’ll receive can be overwhelming and sometimes it’s just helpful having someone else there to ask a question you may not have thought of on your own, as noted by the Southern California Reproductive Center.
If you do come with your partner, this gives them the opportunity to ask questions, alleviate any fears or misunderstanding they might have, and better understand the options available, especially since many options can be quite costly. Bottom line: It’s helpful to ensure that you and your partner are both on the same page. In fact, WINFertility points out that “in heterosexual couples, infertility is not only a ‘woman’s problem,'” since infertility is actually due to the male partner in almost 40% of cases involving couples experiencing infertility.
During your fertility consultation, you'll be asked about your cycle, so start keeping track
Some of us know our menstrual cycles like clockwork (you know, that friend who always knows exactly when her period will come?), whereas others need a little help remembering.
Before your first visit with a fertility specialist, it’s helpful to begin tracking your cycle, and, these days, there are plenty of apps that do just this. Since your doctor will likely ask about approximate timing of ovulation – when your body releases an egg each month from your ovary — it’s good to have an answer ready. For example, do you usually ovulate early, on time, or late? In addition to apps, it can be helpful to track your basal body temperature leading up to your appointment. Verywell Family notes that “tracking ovulation can be a very inexpensive way of helping you get pregnant, so it’s worth the effort.” Knowledge truly is power.
Be prepared to share your medical history and your partner's if you have one
During your initial consultation with a fertility clinic, you’ll meet with the doctor, commonly referred to as a fertility specialist or the technical term reproductive endocrinologist (via Verywell Family), and possibly also a fertility nurse (via RMA). You’ll be asked a variety of questions regarding your medical, gynecologic, and reproductive history and your partner’s medical history (if you have one), and those of close family members. For example, if your mother had a number of miscarriages or had trouble conceiving, this is important genetic information to share. Or if your partner has a chronic illness, this is important to disclose in order to leave no stone unturned. According to director of the Division of Reproductive Endocrinology at Saint Barnabas Medical Center Serena Chen, who spoke during a webinar for Resolve: The National Infertility Association, this is your chance to “tell your story.”
WINFertility notes that it’s likely you’ll be asked to come early to your appointment to fill out the necessary paperwork or to complete the paperwork at home prior to the appointment. You may also be asked to bring copies of your medical records, including your gynecological records. Because of the sensitive nature of sharing your personal medical history, it’s important to disclose private information to your partner (if you have one) before it comes up during the visit, so that neither of you are caught off guard by, say, a past sexually transmitted illness that’s revealed.
Make sure to ask questions and be your own health advocate
You can expect to be asked a variety of questions during your fertility consultation, but you’ll also want to ask plenty of your own. Come prepared with a list of questions to ask on everything from the fertility evaluation, testing, diagnosis, and treatments to questions about the actual clinic itself. To make the most of this first visit, plan for the consultation to last up to 90 minutes, depending on your questions. This way, you won’t feel rushed, and the doctor will have time to learn as much as possible about you.
Questions shouldn’t end with the first visit either. “It’s important that this be a dialogue and not just the doctor directing the patient,” said Serena Chen, reproductive endocrinology division director at Saint Barnabas Medical Center, at a webinar hosted by Resolve: The National Infertility Association. Similarly, the Southern California Reproductive Center advises patients to “remember that [they] are an equal partner and participant in [their] treatment and [they] have the right to be informed and knowledgeable about every phase and stage.”
You should always feel comfortable to address any goals and concerns you have. These might range from logistical questions about how the clinic operates to your own timing to conceive to your own personal preferences regarding treatment, possibly based on your culture or faith, for example (via Resolve).
You'll likely speak with a financial counselor on staff at the fertility clinic
One thing regarding fertility treatment that most people are probably already aware of is the often high cost. Depending on the clinic, during your initial consultation, you may have the opportunity to speak with an on-staff financial counselor regarding treatment costs, payment options, insurance information, financial policies, and additional costs for things like genetic testing and embryo storage, as noted by Verywell Family. Or you may have to speak with a financial counselor during a separate appointment.
According to the Southern California Reproductive Center, it’s helpful to be aware of your insurance coverage regarding fertility treatments prior to meeting with a financial counselor. If open enrollment is around the corner, it may be possible to switch to a plan that provides more comprehensive coverage for fertility treatments.
Keep in mind that there are many options for financing fertility treatments. Community programs provide grants to help couples afford fertility treatments. Some clinics even offer special IVF “shared risk” or refund programs that offer money-back guarantees if treatment is unsuccessful, according to Verywell Family. Also remember that clinics vary in their prices, so compare clinics if cost is a major factor in choosing a practice.
What types of follow-up tests can you expect after your initial fertility consultation?
After a first visit with a fertility specialist, testing is likely to be done to determine if there’s anything going on that may contribute to infertility. Men sometimes undergo a semen analysis first to determine any abnormalities that may exist. This particular test may be done twice on different days to make sure results are accurate and consistent, according to Verywell Family. Edmund Sabanegh Jr., director of the Center for Male Fertility at the Cleveland Clinic, explained to WebMD why this typically occurs. “Routine semen analysis is quick and relatively inexpensive,” he shared. “Before we put women through invasive, expensive, and painful tests, we better have a pretty good idea that those tests are necessary.” Makes sense to us!
For women, a number of tests may be conducted after the initial visit (although some clinics, such as RMA, for example, will conduct a pelvic exam and vaginal ultrasound during the first visit). Bloodwork will be done to check thyroid levels and other hormone levels to determine if they’re in the healthy range. Vaginal ultrasounds will be conducted to confirm ovulation and to check for follicle count and the presence of cysts or fibroids. A hysterosalpingogram, or HSG, may be arranged in order to look for any potential blockage in the fallopian tubes (via WebMD). Verywell Family notes that other possible, but less commonly used, tests include endometrial biopsy, hysteroscopy, sonohysterogram, and diagnostic laparoscopy.
Be prepared for frequent early appointments at the fertility clinic for cycle monitoring
Because working with a fertility clinic involves close monitoring of your cycle, be prepared for frequent early morning appointments for bloodwork and/or vaginal ultrasounds. Fortunately, it’s totally doable to work these appointments into your schedule since many clinics offer early morning appointments starting at 7 a.m. As noted by The New York Times, it’s common to visit the office “multiple times a month” for testing.
Because of the many appointments involved, convenience can become an important deciding factor in choosing a clinic. “It sounds simplistic, but fertility testing and treatment is like a part-time job on top of people’s already busy lives,” Dr. Elizabeth Ginsburg, medical director of assisted reproductive technologies at Boston’s Brigham and Women’s Hospital, told The New York Times. Frequent appointments for testing and cycle monitoring mean that “if it’s an hour to get to an appointment, that really does add significantly to the stress.”
What are some common fertility treatments?
The type of treatment you receive depends on your reason for meeting with a fertility specialist in the first place. If you are single but looking to preserve your fertility to help build your future family, you may pursue the process of egg freezing. If you’re having trouble conceiving or want to be proactive in case of any potential issues, your team would typically begin by monitoring your natural cycle to get an idea of when you ovulate and then determining when intercourse should take place to have the best chance for pregnancy. Romantic, isn’t it?
WebMD notes that the “first-line infertility treatment” commonly includes fertility drugs, such as Clomid, to stimulate ovulation. They may be used within a natural cycle or in preparation for an IUI, or intrauterine insemination, a procedure in which either your partner’s or a donor’s sperm is inserted into the uterus. IVF, or in vitro fertilization, is commonly, but not always, performed after two or more unsuccessful IUIs, according to the Los Angeles Reproductive Center.
Then there are third-party reproduction techniques, such as donor IVF, a specific type of in vitro fertilization usually performed when those trying for a family have poor egg or sperm quality. Gestational surrogacy is another option.
What can you expect after doing tests?
If you’re not dealing with information overload at this point, what happens next often depends on the clinic, your individual circumstances, and test results. According to an article from The Bump, fertility clinics will schedule a follow-up appointment to discuss treatment options. “Based on the results,” an article for The New York Times explained, “couples can decide whether they want to begin treatment — and what kind of treatment they want.”
It’s also important to take a deep breath and digest the information you’ve learned before determining next steps. The emotional aspect of fertility treatment should also be considered, as it can be a very stressful, uncertain, all-consuming, and expensive process. “Most patients, I think, find the emotional part is much more difficult than the physical,” Dr. Lynn Marie Westphal, a Stanford University professor of reproductive endocrinology, shared with The New York Times.
It’s important to focus on self-care. “Establish self-care routines and practices that are meaningful to you, whether it’s meditation or a long vacation,” The New York Times notes. Because we’ve got to ensure we can take care of ourselves before caring for a tiny human.
Source: Read Full Article