Hi everybody - I have my first appointment with a reproductive endocrinologist on Friday, after 15 cycles of NTNP and TTC.
I am wondering what I should expect at this first appointment? What kinds of questions will I be asked? What should I ask the doctor?
What are the very first steps in the infertility journey?
pear / 1881 posts
I want to wish you good luck and will try to type more later or tonight once I have time (super busy at work right now). I just had to recommend checking out the podcast Beat Infertility, along with their website. There are a ton of resources on the podcast that might answer your questions and provide you with an idea of what to ask. Also, on the website, you can ask this question there and receive a TON of support and ideas.
The community website:
https://beatinfertility.mightybell.com/home
For the podcasts or you can download on any podcast app:
pear / 1767 posts
The first steps will be to do some diagnostic testing to try to figure why you are having trouble. They will likely ask questions about your cycle, family history / genetic conditions, etc. For my first appointment, we went in with blood test results that my OB had ordered so we were able to jump into the specifics of my issue right away. However, normally the task is to determine what the issues are so they will likely order diagnostic blood tests to check hormone levels on certain days of your cycle and a semen analysis to determine what your partner's issues might be. Once you have a picture of what is going on, then you will likely go back and discuss treatment options, etc. I wouldn't worry about asking all of the right questions this time. I'd just try to have a good sense of family history (like when did your family members go through menopause, etc.). Once you have a sense as to why you've struggled, you will be able to ask more pointed questions of the doctor and questions relating to treatment options.
pear / 1553 posts
@Shantuck: Should I be bringing my husband? 1) I didn't want him to have to take off work if there isn't any testing happening that day (he gets paid hourly) and 2) He has a different insurance company and I'm not sure this clinic takes his insurance.
pear / 1881 posts
@bizwitch: I would call them and ask if he should be there. Either way, you will want him tested as if it is a male issue, that will help determine the course of action going forward. Plus, him doing his test is very easy in the general scheme of things. He might be able to swing by another day, if the day of your actual appointment isn't an option.
honeydew / 7463 posts
100% what @Shantuck: said. The first appointment won't be too much of you asking questions, more of being prepared with family history and your history TTC (months trying, losses, etc). They'll ask how long your cycles are, stuff like that.
They may also want to do a transvaginal ultrasound. I know that I wasn't prepared for that the one day I went in. I thought it would be all talking and then they told me to take everything off from waist down. It's no big deal, but better to be prepared for it!
Good luck!
pear / 1986 posts
@bizwitch: I would say it is unlikely that he would have to give a sample during your initial consult since there is usually a period of abstinence suggested beforehand/specific instructions. I'm sure he will be asked to either drop it off or go in on another day.
That being said, I think it would be good for your husband to go with you if possible. There is a so much information covered and sometimes having two sets of ears to listen and discuss things after is really helpful.
Wishing you all the best!!
pear / 1558 posts
I'm sorry you've had to take this next step. We saw an RE & they sent paperwork with a very thorough questionaire for each of us to complete before the appointment. The Dr went through every item with us in office & also did an ultrasound/exam on me (I just happened to be approaching mid-cycle, so a good time to check my follicles). She recommended an HSG (dye flush of uterus to look for blockages) & blood tests (hormone levels & genetic screening) for me & sperm analysis for DH. It took another month for us to get those scheduled/completed, and then we met the Dr again for her analysis & recommendation of a plan. We were just about to start me on a medicated cycle for 1 IUI as we mentally prepared for ivf (which the Dr recommended b/c of my age & 1 partially blocked tube & the other one pointing away from the ovary) when I tested & found out I had actually gotten pregnant on our own the cycle after my HSG! Wishing you so much luck for success! 
honeydew / 7463 posts
@bizwitch: I personally would make sure he is there. They will also be asking family history type questions about his family. There are definitely things I wouldn't have known about my husband's family.
Plus, it's a ton of info and it's good to have two sets of ears. And he may think of questions you wouldn't have.
I don't think they would do any tests on him that day. They usually schedule the sperm analysis for later if you want to proceed. And in all the times I went, my husband wasn't there as a "patient", even if they asked him questions. Meaning they didn't take 2 copays or anything like that. Especially if it's just a consult.
cherry / 174 posts
Your RE will definitely ask your husband to make an appointment to get tested. You are only half the picture. Most RE's will require testing your husband's sperm before going ahead with treatment.
If you've charted your cycles over the past several months, bring that information. They may not look at it, but it can help you answer questions that come up.
Like a PP said, they will most likely start with diagnostic testing of both you and your husband. At your first appointment, this will mean scheduling when you will do these tests (it's rare they will do tests right then and there). Your testing will probably wait until you start a new cycle but your husband can go in anytime. It's not until the results of these tests are read that you will be able to come up with a game plan, so be ready to be patient!
At your first appointment, they will also probably discuss with you the prices of these tests, the prices of likely possible treatments, and your available payment options.
Also, check to see that the lab your clinic uses accepts your husband's insurance. Even if the clinic doesn't, the lab might.
pear / 1767 posts
@bizwitch: I went solo to my first appointment because my husband was traveling for work and I had gotten an appointment from a cancellation. At my RE's office, my husband had to call and schedule to come in for a semen analysis and like @GreenThumb said, they will want to make sure certain instructions are followed. From an emotional standpoint, it would have been nice had my husband been able to join me for that appointment (but TTC made me a bit of an emotional mess) but he was there for the follow-up appointment and it was definitely helpful to have him there to ask questions about treatment options, etc. If he can't make it to the first appointment, it's probably not the end of the world but I would definitely recommend his coming when you are ready to talk treatment options.
pear / 1767 posts
Also, my husband and I had different insurance and my husband's didn't cover much. Most of the charges will be under your insurance so in the ideal world, your insurance has the better coverage.
pear / 1553 posts
JK JK we do have the same insurance! Forgot he switched companies. I'm going to see if he can come in a couple hours late so he can come with me.
persimmon / 1132 posts
@bizwitch: Nothing new to add that hasn't been said! Just wanted to say GL!!! I hope your time in IF land is short!
persimmon / 1272 posts
@magnoliamama42: I second bringing in any charts/records of your cycles...my RE found that to be helpful. Glad to hear you're going to try to get DH to come too. Will be good to have him with you for step one in this chapter of your journey. Best wishes for a short stay in RE land.
pomegranate / 3355 posts
At my first RE apt it was just a bunch of questions and going over possible treatments but not too much bc nothing can really be determined until you get the testing done. So we were basically informed of all the testing we needed to complete. DH had to do blood work and SA, but it wasn't really necessary for him to be at the first apt but it was nice for moral support and to have 2 sets of ears listening instead of just one (I tend to forget some things).
Once we left we had a list of "tests" and who to call and where to go to get them. This included blood work, semen analysis, HSG for me.... once everything was done we made our f/up apt to discuss treatment.
Good luck!!!
ETA: I had my charts and logs regarding my cycles but they didn't even want to see them! All that tracking for nothing...
persimmon / 1165 posts
Good luck!!
Make sure you are absolutely clear on what your insurance does and does not cover for infertility. I didn't know that infertility was the one thing my insurance didn't cover and my first RE appointment ended up costing us over $5K for the ultrasound and all the blood work.
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