Some common questions for those just starting with infertility:

After how many unsuccessful months should I begin to wonder?

Many couples have a hard time admitting that there may be an infertility problem. After each menstrual period, they hope that next cycle will be the one that works. When these hopes fail each month, a woman will often turn to her regular ob/gyn or clinic.

Generally after six months of trying, you might consider making an appointment to have a general workup. Most physicians advise you not to be concerned unless you have been trying to conceive for at least one year. However, if you are over 30 years old, have a history of pelvic inflammatory disease, painful periods, miscarriage, irregular cycles, or if your partner has a known low sperm count, you may want to seek help sooner.

Should I see my gynecologist?

For your basic work up, that would be fine. However, a Reproductive Endocrinologist really is the pro to seek help from. Infertility is their specialty.

What should I expect from my first appointment?

The doctor will first get a history, including how long you have been trying. They will want to know if you have been keeping track of your morning temps and using any ovulation predictor kits. They will conduct a pelvic exam and migh also do a basic hormone blood workup, depending on what cycle day you are on.

For the most part, the first appointment is for getting a game plan together. You will find it very helpful to bring a list of questions you might have to your first appointment.

Questions to ask at your first specialist appointment:

Remember it is important to bring along with you are your medical records from your gynecologist, including any testing you have had regarding infertility, abdominal/gynecological surgery, and any testing done for your partner. This will help save time spent on performing tests that have been recently done for you.

The following questions are not related to specific diagnosis, but are to be used in helping to assess how happy you are likely to be with the office and doctor you are meeting with.

. What are your office hours?

You want to know that the office can accomodate your work schedule regarding bloodwork and ultrasounds. There may be times you need to have repeated bloodwork and ultrasounds done, and you want to be able to have them done so as not to interfere with work or school.

Another important reason for asking that is for procedures such as IUI and IVF. A doctor who is closed on weekends or does not provide an alternate means of having those procedures done, is likely to be working more on his schedule than on yours. IF you need an IUI done on a Sunday, and pushes it off to a Monday because of his hours.....is not working in your best interests.

How many times will you try a certain treatment before moving on to another game plan?

While the answer to that can be hard to give because of so many variables, it gives you an idea of just how aggressive your doctor is.

Do you perform all the major procedures in your office?

It is good to know that upfront. Some patients are wildly suprised to get to their IUI and find the office nurse or nurse practioner is performing it.

If I have a question, how available are you to speak to?

It can be very frustrating to have a question mid treatment only to be confronted by an office worker who is not answering your question, or providing comfort to you. You want to hear it from the doctor that it is okay to call the office and ask to speak directly to him.

I want to ask you about your charges.......

You should know up front if they charge for things like office visits when you come in for monitoring during a treatment cycle. These office visits can add up, especially when you are not covered by insurance. Many offices will not charge this office visit, as it is part of the treatment process.

Once we come to a treatment game plan, can I be cycled right in?

Clinics vary as to if they will cycle a patient in at any time, especially once you get to something like IVF. They may only treat a certain amount of patients per cycle, and you may be dissappointed to find out that you can't have your IUI, or IVF when you thought you could.

Does your lab/office close during certain months.

If you are a teacher for example, and the lab closes every July to refresh.....you could run into some problems.

Tell me about your lab.......

You want to know that the office has a full and updated lab. If your game plan calls for IVF, you want to be sure that they have a trained embryologist on hand who is current on the newer technology. If they do not do such procedures as assisted hatching and blastocyst transfers for IVF.....move on. The doctor should be proud of his lab facility.

What are your success rates?

While many people suggest asking this, it is often hard to verify how truthful the numbers actually are. On this topic, you may want to rely more on word of mouth about this clinic....through friends, support groups and your gynocologist. Offices that have lots of NEW thank you letters and baby pictures hanging up is often an encouraging sign.

Remember that you should walk away from that appointment excited about a game plan taking place. If you have any bad feelings, or doubts it is worth while to seek another opinion. Having doubts about the doctor now may only lead to doubt during treament, which is not good. If the RE you have met with seems put off by your questions, chances are good that he will be even more put off as you question him during treatment. You and your doctor should be partners in this process.

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