Q: Should I write down my history of infertility?
A: Yes, it will definitely stream line your First Fertility Consultation. Focus on documenting your menstrual cycle including the number of days between your periods, ovulation pain, the presence of mid-cycle mucous, menstrual pain.
List all the operations you and your partner have had.
Q: Can I use the results from previous tests and the outcome of previous procedures such as a laparoscopy?
A: It is important to use all the information that you have on yourselves including blood tests, semen analysis results and reports of all previous procedures.
Q: What should I expect with my first consultation?
A: Your fertility specialist will go through a detailed history of your medical background and your past attempts at pregnancy. They will review all your previous records, and then talk about infertility causes in general before specifically addressing your problems. The 3 main areas of concern are egg quality, sperm quality, and determining if the egg and sperm can meet. The latter involves fallopian tube function, and ruling out other pelvic conditions such as endometriosis.
Q: Will I have a pelvic scan?
A: A vaginal pelvic ultrasound will be done to assess your uterus, ovaries and pelvis (this is not a painful procedure). This scan will provide enormous information regarding your uterus and ovaries. The uterine scan will be able to diagnose uterine fibroids, adenomyosis and possible hormonal and physical problems with the endometrium (lining of the uterus)
The scan of the ovaries will measure ovarian size (this is a measure of the number of eggs in the ovary), check for the presence of Polycystic Ovaries and look for possible endometriosis in the ovaries.
Q: Will I be given a diagnosis on my First Visit?
A: Your Fertility specialist will summarise his findings based on your history, previous tests and your vaginal ultrasound findings. This will often lead to a preliminary diagnosis. If you are a first time fertility patient you will need to have further investigations.
Q: If I have had investigations before will they need to be repeated?
A: This will depend on how old the results are and what laboratory was used.
Q: What investigations would we be expected to have?
A: Typically, for first time couples, this will involve a semen analysis, blood work on the male and female and a cycle assessment.
Q: What is a cycle assessment?
A: This includes a vaginal pelvic scan on day 12 of your cycle.
If you are ovulating a post coital (post intercourse) test is done. You will need to have intercourse on the morning that you are ovulating. You will then visit your fertility doctor and a sample of mucous will be taken. This is to check if your mucous is hostile to the sperm.
Q: What Treatment options are available?
A: Treatment options can be as simple as the use of mild fertility medications with ultrasound monitoring and timed intercourse, or may entail the use of intrauterine insemination (IUI) or in vitro fertilisation (IVF). IUI involves placing “washed” sperm in the uterus at or around the time of ovulation. IVF involves extracting eggs through a painless process and injecting them with sperm to create embryos that are developed in the laboratory for about 5 days before placing them back into the uterus. IVF carries with it the highest pregnancy rates, but is also the most involved type of treatment.
– with thanks to Dr Antonio Rodrigues, Medfem
(To learn more about Medfem and their services, contact them at +27 (11) 463 2244, or by e-mailing them at firstname.lastname@example.org)