Infertility: What to Expect at Your First Doctor Visit

Infertility What to Expect at Your First Doctor Visit

Many couples feel nervous about going for a fertility workup. Knowing what to expect may make it less daunting.

Making a baby is supposed to be fun and exciting. But for many couples it can be frustrating when months drag by with no results. If you’ve been trying to conceive for a year (or six months if you’re 35 or older), it may be time to see an infertility doctor.

Although you may see your gynecologist or family doctor for your first visit, he or she may then refer you to a reproductive endocrinologist, who is an infertility specialist. If you are 35 or older or have a history of fertility problems, such as miscarriages, your doctor may make this referral right away.

It’s common to be nervous about going for your first fertility checkup. Having an idea of what to expect may help you feel more at ease during this process.

What happens at the first visit?

The first doctor visit will give you a chance to talk and ask questions. The doctor can help you understand what problems can cause infertility and what treatments are available to increase your chances of becoming pregnant.
It takes two to make a baby, so both partners need to attend this visit. A fertility problem is about equally likely to be caused by male factors as female factors. In some cases, both partners have problems that can prevent pregnancy.

Be prepared for lots of very personal questions about your past and your lifestyle. Your doctor will need honest answers to all these questions to get to the bottom of your fertility problem. For example, you both will likely be asked:

  • How long you’ve been trying to conceive
  • How often you have sex
  • Whether you smoke, drink or use illegal drugs
  • How much you exercise
  • What your diet is like
  • Whether you have gained or lost weight in recent years
  • What medications you take regularly (including over-the-counter drugs, supplements and herbs)
  • What kind of work you do and what chemicals you use at home (to look for possible exposure to toxic materials)
  • What your ethnic background is (to look for genetic diseases)

The woman’s initial workup

The woman will complete a medical history that includes questions about:

  • Her periods, such as how often she has them and how regular they are
  • Whether she’s had abnormal vaginal bleeding, pelvic pain or pelvic infections
  • Any previous pregnancies or miscarriages
  • Her mother’s age at menopause
  • Previous surgeries
  • History of sexually transmitted infections
  • Types of birth control she has used
  • Any current health problems

Next, she may have a physical examination. This will likely include:

  • A thyroid exam. The doctor will feel the front of the neck to check for any growths or swelling of the thyroid.
  • Checking for unusual hair growth on the face or body. This can be a sign of hormone imbalance.
  • A breast exam. The doctor may squeeze the nipples to see if anything comes out. If it does, this may point to a high level of prolactin, which can prevent ovulation.
  • A pelvic exam to check for discharge, sores, growths or other signs of infection. The doctor may also do a Pap test to look for cancer or infections of the cervix.

The woman may also have some blood tests done, such as a complete blood count (CBC) and Rh factor test. Some blood tests have to be done at a certain point in the menstrual cycle. If it’s not the right time, these may be scheduled at a later date.

The man’s initial workup

The man will complete a medical history and may have a physical exam. A man’s medical history will include questions about:

  • Any genital injuries or surgeries
  • History of urinary tract or prostate infection
  • History of sexually transmitted infections
  • Whether he has fathered children in the past
  • Any ejaculation problems
  • Any current health problems 

A semen analysis is usually the first test done to check a man’s fertility. The man gives a semen sample, which is sent to a lab. A doctor will check the number and shape (count and morphology) of the sperm, how well they move (motility) and whether they show signs of infection. This test may be done more than once.

If the semen analysis shows problems, the man may be referred to an andrologist. This is a doctor who specializes in treating male infertility.

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