If it has been a reasonable amount of time trying to conceive (6 months for over 35 years of age and one year for 35 years of age and younger), you may have chosen to seek medical help from your general practitioner. This may be a daunting thought knowing you will need to provide information that was once very private and personal, to someone outside of your close family and friends. What this post aims to accomplish is to ease the anxiety, stigma, and unknown when seeking medical advice to help start or grow your family. 1 in 6 couples in Canada experience infertility. You are not alone and there are amazing healthcare professionals out there to help and support you along the way.
All general practitioners do vary in how they go about assessing their patients. Below are a few things that you might expect out of your first visit:
Questions about you and your partner’s general health
They likely will want to find out more about what you are doing to try to conceive ie. Are you using ovulation predictor kits, how you are timing intercourse, etc.
You may discuss menstrual cycle information – how long are your periods & cycles, ie. Irregular cycles, short bleeds, etc.
They may try to identify aspects of you or your partner’s lifestyle that may be having an impact on fertility (ie. smoking, use of alcohol or drugs, diet and activity, or being exposed to harmful chemicals)
Your practitioner will likely send you and your partner for some common diagnostic tests.
Specifically for women, common diagnostic tests may include:
Blood tests to check hormone levels (ie. Day 3 of your period hormones, thyroid, testosterone etc.)
Screening for sexually transmitted infections (STI)
A pelvic ultrasound to assess your uterus and ovaries. This exam helps to determine your follicle count (gives insight to # of eggs), and check for any abnormalities in the uterus
For women, once you are referred to a fertility specialist the following tests may be ordered:
An x-ray dye test (hysterosalpingogram or HSG) to determine the shape of your uterus and assess for any blockages in your fallopian tubes
A sonohysterogram (SHG), which is a special test involving a pelvic ultrasound that can help to find fibroids, polyps, or endometriosis in your uterus
Each of the above-mentioned tests take less than 5 minutes to perform and do involve some internal (vaginal) contact – the ultrasounds involving a wand-like probe inserted into the vagina, and the HSG involving a speculum and a narrow tube or catheter inserted into your cervix. Depending on where you live, these tests may be completed at a diagnostic imaging center or your nearest hospital.
Specifically for men, common diagnostic tests may include:
Screening for sexually transmitted infections (STI)
Semen analysis – to assess for things such as volume (count), morphology (size and shape), and motility (movement) of the sperm
Genetic testing (if there is reason to suspect a genetic cause)
Do The Tests Hurt?
Unless there is a medical condition ie. Vaginismus (involuntary tensing of the vagina), most women claim that the pelvic ultrasound does not cause pain or discomfort – only pressure. Like most medical procedures, there is varying feedback regarding experience with the HSG and SHG tests – some claim “it was nothing!” and some claim “that was the worst!”. You are urged to take the experience as your own as heightened anxiety prior to the procedure can lead to more discomfort. It is common to have cramping during and following the tests as well as vaginal spotting that may last a couple days.
Can I Get an Infection from These Tests?
Yes. With any insertion of a foreign object into the body, there is a risk of infection. However, many prescribers will include antibiotics (for the HSG/SHG tests) as a prophylactic measure to mitigate this risk. The procedures are done by specialists with a clean-sterile technique to minimize risk of infection.
What Happens After the Tests are Done?
It may have been discussed at your initial appointment, but if it hasn’t yet, after review of you and your partner’s results, your physician will determine next steps. This could be any of the following:
better timing of intercourse (around the woman’s ovulation cycle)
medications to fix hormonal problems or stimulate ovulation
surgery on your reproductive organs
assisted reproductive technology (ART) or fertility treatment
If any of the above tests were not ordered from your general practitioner, your fertility specialist will likely order them during your initial visit.
What Can I Do While I Wait?
With some fertility clinics, you may be waiting several weeks/months to have your first appointment. One thing that you can do while you are waiting to speak with your specialist, is ensure that all the above-mentioned tests are completed and current, within 6 months-1 year of your visit (test dependent). Another thing that you can do while waiting, is if it was determined at your initial visit that there were lifestyle factors that may be impacting your fertility, try to implement some changes. This might include decreasing or quitting smoking/alcohol, improving your diet, increasing activity levels, or making an appointment to see your diabetes specialist to control your HgbA1C levels. You can also learn more about how ovulation predictor kits/timed intercourse may help – visit https://www.warriorcoach.ca/services to learn more.
Hopefully, this has cleared up some of the daunting, anxiety-inducing hesitancy, and concerns that you may have had about seeking medical help. Remember, whether it has been recommended to continue trying at home, or to proceed with fertility treatment, The Warrior Coach is here for you every step of the way!