FIRST DOCTORS APPOINTMENT
If you have been to the nurse appointment then your paperwork and test results will be ready for review with the doctor. If you have not been to a nurse appointment then we encourage you to bring along reports of all tests or treatment you have had previously.
What to expect at your first appointment
We encourage both partners to attend your first doctor’s appointment so that you can both be involved in the discussions and decision-making. On the day of your appointment you should plan on spending at least one hour at our office. Please make sure that you are on time for your appointment and allow plenty of time for parking and traffic problems.
We require all new patients to complete our new patient data form, provide photo ID and bring along all previous medical tests and treatment reports. If you would like to complete your form before, then this will save time in the clinic. If you have already attended the nurse appointment, then this form will already have been completed.
The new patient data form includes information on all medical conditions, past surgery, family members medical history, drug use (medicines and any other drugs) all pregnancies and all the tests or treatments you may have completed previously.
The doctor will review this information and usually will request to examine the female partner and perform a transvaginal pelvic ultrasound scan. Sometimes the female partner may choose to delay this examination to your second visit. Any remaining tests will then be organised and the doctor will give you some information on possible treatment options.
Most blood tests will be perfomed by the nurses in clinic at your appointment, however sometimes the female partner will need to wait for a period to do hormone blood tests. For other tests, such as tube x-rays you will need to make an appointment at a recommended x-ray centre.
What are the initial tests that will be suggested?
- Women will be given blood tests (see Basic Tests for Women) to check the numbers of eggs they have (AMH), whether they are making and releasing eggs (ovulating) and to check the levels of hormones that control their fertility and menstrual cycle. They will also need a detailed pelvic ultrasound to check the health of the womb, ovaries and pelvic area. Sometimes a woman will be asked to have a tube x-ray (HSG).
- For men a detailed semen analysis, from a qualified professional, is essential. This sperm test checks the number of sperm you are producing, how well they swim, whether they are healthy and other possible problems such as antibodies, infection, other cells and problems with the semen fluid. In our clinic all sperm tests are performed by qualified andrologists and embryologists. Sperm tests from other clinics and laboratories performed by untrained personnel with inadequate microscopes are not detailed enough to make the important (and sometimes) expensive decisions on your fertility treatment plan. For this reason you will be asked to undertake a sperm test in our clinic or provide results from an accredited andrology centre.
WHAT ARE THE NEXT STEPS?
If the results of these tests show that the female partner is not ovulating but the sperms are healthy, then your doctor may be able to prescribe a medication that will stimulate ovulation (ovulation induction treatment), such as clomiphene citrate. However, the use of these fertility drugs must be carefully monitored with ultrasound scans. Good medical practice means that only doctors who have specialist fertility training and protocols for monitoring your cycle should be offering this treatment.
If the test results are normal and you have been trying to conceive for less than 12 months you are likely to be advised to continue trying a while longer (Royal College of Obstetricians and Gynaecologists guidelines). If the timespan is longer than this, or you are aged over 35, or if any results are abnormal, you should be either having further tests or starting fertility treatment.
Often some further tests are required before the doctor can help you choose your treatment plan, and provide you with the success rates and treatment options for you both as a couple.