Leaving your first fertility clinic appointment you may feel like a deer in the headlights. This is not the fault of the clinic or your own. You just entered a whole new world of knowledge, expertise, and information that is completely foreign. All you want to know is “why aren’t we getting pregnant?” and “how can you help us?” and you were just provided years of specialized, technical, medical, information. Fertility is a specialty area and unless you work in the industry, give yourself grace and time to absorb and understand the information. This post aims to better prepare you for that first clinic appointment and to make you feel confident enough to have your questions answered, learn more, and know what steps you need to take next to continue your journey.
Get Your Testing Done
The first two things that you want to hear from your physician when you attend your first appointment is “why aren’t we conceiving?” and “what can we do about it? “. The most efficient way to have these questions answered is to complete your testing. Your tests allow the physicians to better understand what is happening inside your body based on hormone levels and assessments of your pelvis and ovaries. Another benefit to completing your tests prior to your appointment is to avoid delays. Some tests such as a hysterosalpingogram (HSG) can take several months to complete. You just went from waiting a month to see your specialist, to now adding on 2 more months to complete a test. Get your testing done ahead of time!
One thing to note is fertility clinics prefer your testing to be complete and up to date. This means that even though you’ve completed a test at some point in the past, if it is outdated you will need to update results prior to proceeding with treatment. Many clinics want bloodwork that is completed within the year, and an ultrasound completed within the 6 months prior to treatment. This is to ensure the most appropriate treatment plan. Check with your fertility clinic to see what their treatment pre-screening test requirements are.
Below, you can review a list of recommended topics that you may consider learning about prior to your first fertility appointment. Please note: Dr. Google can be both a blessing and a curse. When completing your online research, you are encouraged to read unbiased articles from reputable sources and peer-reviewed journals. Blogs and chat forums can be helpful for learning about other’s experiences but should be taken with a grain of salt. Not everyone’s diagnoses, bodies, and therefore fertility journeys are the same! Some recommended topics include:
· Reproduction 101 –female anatomy ie. cervix, fallopian tubes, follicles, eggs
· Menstruation cycles – ovulation, luteal phase, period vs. cycle
· Common fertility hormones ie. estrogen, progesterone, luteinizing hormone, anti-mullerian hormone
· Common fertility tests ie. sonohysterogram, hysterosalpingogram, pelvic ultrasound, hysteroscopy
· Fertility treatments ie. Intrauterine Insemination (IUI), Superovulation IUI (HMG/IUI), In-Vitro Fertilization (IVF)
We have all been there; you have all these questions prepared in your head that you are going to ask your specialist. By the time you finally sit down in their office to answer their questions and absorb the information that they are providing to you, you forget to ask the questions you were dying to have answered! To help ensure all your questions are answered, prepare your questions ahead of time by writing them down either on your phone or a piece of paper. Trust this - you will not regret it. After your physician has completed their consult with you and asks you if you have any questions, you can review anything that they haven’t already answered.
You have been referred to and have waited several weeks or months to see this specific physician for a reason – they specialize in this area- they are VERY good at what they do. Naturally, physicians vary in their knowledge, opinions, statistics they choose to provide, and their own personal patient experiences. The one thing that does remain constant is that they all have the tools to provide you with high quality, evidence-based information, and treatment recommendations. Listen to what they have to say. It is natural to question certain pieces of information or recommendations and there is no harm in a second opinion, however, questioning your physician(s) at every stage can add emotional, unnecessary turmoil to an already stressful experience. Contrary to some patient’s beliefs, it is not about “taking your money”. Fertility specialists spend countless hours outside of their own clinic hours, having patient case meetings, attending multiple conferences, and working from home, to ensure that you receive the best, most appropriate care. They are on your side and really do want the best outcome for you. For some, caring for you is their life’s purpose.
As mentioned previously, this is a whole new world of knowledge. Even with a ton of preparation, research, and education, your physician or nurse is bound to teach you something new. You may remember most of the information for a day, a week, maybe a month, but when you want to refer to information such as your LH levels on day 3 of your cycle, or how many follicles were counted on your pelvic ultrasound 4 months ago, having notes to look back on will always be useful. Rule of thumb: write down more than what you think you will need.
Actively Participate/Take Initiative
It cannot be stressed enough - actively participate in your care. Do NOT rely solely on your healthcare providers to ensure that your testing is complete, you are ready for treatment, and you have all the knowledge that you need to proceed with the next steps in your journey. This means that as you enter the world of fertility care, get your notebook out, get your binder dividers out, and start writing your checklists now. Between absorbing information, tests, consent forms, and the to-do lists that your clinic will have you completing prior and during treatment, it is only human to forget or misplace information. Here are a few things for you to stay organized and actively involved in your appointments and treatment:
· Take notes (see above)
· Create a checklist for everything that your clinic advises you to complete during each stage and tick them off as completed along with the date of completion
· Create a binder with separate sections for things such as notes, test requisitions to complete (with notes of when they should be completed by/renewed), prescriptions, and information pages that your clinic may provide you
· Have somewhere to write all of your results and physician orders and changes to treatment for each cycle (if you have completed a Warrior Coach workshop, virtual session or treatment concierge support, you may have received your FREE Fillable Template to help you along the way)
Advocate for Yourself
Before you get to the dollar store to create your fertility binder and start getting organized, a reminder to advocate for yourself. As much as your healthcare team wants the best outcome for you and to support you in all ways possible, no one knows your situation better than you. For example, if your physician has recommended for you to do an IUI cycle with ovulation predictor kits, and you know that for the last six months of OPK testing, you haven’t been able to detect your surge (ovulation), tell them that. No comment/question is a silly one. As much as healthcare providers know what they are talking about, there is always a possibility of human error. Trust them, but always, ALWAYS, advocate for yourself. You know your fertility journey best.