A visit to the fertility clinic does not have to be a daunting experience. Many couples think they are responsible for figuring out the reasons for their lack of fertility on their own (or with Dr. Google’s help). A visit to the fertility clinic does not represent a failure in this regard – it’s actually just the opposite! Seeing a fertility doctor can help to ease the stress of trying to conceive by taking the burden of medical expertise off a couple’s shoulders. Ideally, this means you can get back to trying for a baby and spend less time thinking about trying for a baby!
Usually, a family doctor or gynecologist will make the referral to a fertility clinic on your behalf. Fertility doctors are specialists in women’s medicine (Obstetrics & Gynecology) with additional training on top of that (usually two or three years more) in Reproductive Endocrinology and Infertility. If it takes two to make a baby, they why are fertility doctors mainly gynecologists? It is because the female portion of fertility treatment is arguably more complex. There are specialists in male fertility (urologists) who work with fertility clinics when necessary.
Before your first visit each member of the couple will need to undergo some basic testing. Standard protocol dictates that the man and the woman will do basic blood testing for infectious diseases (HIV, hepatitis and syphilis). We also do some additional hormone blood tests for the woman (day 3 FSH and estrogen level) to test her egg number and make sure she is immune to chicken pox and rubella in preparation for pregnancy. Men are also asked to do a sperm test (semen analysis). Collecting a sample for a sperm test can be awkward in some circumstances.
Here are some tips to make things go smoothly.
Sometimes you can produce your sample at home: Our clinic operates in British Columbia and Alberta, in both of these provinces, outpatient laboratory or hospital-based sperm testing is covered by provincial insurance (so you do not have to pay out of pocket). The sperm sample has to be produced on your own (usually off-site) and then dropped off at the lab, ideally, within thirty minutes. Your doctor’s office or the lab should provide you with a sterile plastic cup to collect the sample. You can hold it close to the body on the way to the lab to keep it warm. You may need an appointment before dropping of the sample, so check with your local lab first.
A brief period of abstinence is important: The ideal duration of abstinence before collecting a sperm sample is two to five days, but even a shorter time between ejaculations should not decrease the sperm numbers. Even if you rush to the lab with your sample, it is common that the lab will take over an hour before processing the sample for analysis. This can have an impact on the sperm movement scores (motility), but your fertility doctor can usually tell if this is the case. Our fertility clinics offer the option to collect and analyze the sperm sample on-site at our specialized labs, but unfortunately healthcare does not cover this (cost is $100-250). Results of the sperm test are usually available within a week.
Plan to reserve at least 60 minutes for your visit: When you attend the first visit to the fertility clinic plan to be there for 30 – 60 minutes. It is best if both members of the couple can attend. The fertility doctor will go through a detailed history of the woman’s cycle, any previous pregnancies or miscarriages, past medical problems and medications. The man’s medical history is also important and you will both be asked about any health problems that may run in your families. It is important to disclose any medication, supplement or recreational drug use as these can have an impact on egg and sperm quality. Remember, your doctor is there to help and all information is completely confidential.
You can expect your fertility specialist to review the results of all of the tests you have done so far. He or she may perform an examination of the woman including an ultrasound of the uterus and ovaries. Further testing is often necessary before a final diagnosis can be made. This means that you will leave your first visit with a basic understanding of where you’re at, but you may not have a definitive plan for treatment yet. You should have a chance to ask questions and to describe your goals to your doctor and you should leave feeling like you are on the path to progress in your fertility journey. Sometimes one member of a couple feels really stressed out by trying for a baby and the other does not see things as being urgent.
Don’t worry, we get that. As I said, it takes two to make a baby and we’re here to help you both.