Your First Fertility Consultation

Being prepared makes your first consultation more productive:

Information to gather:

Your medical history:

• Previous pregnancies and outcomes
• Menstrual cycle details (length, regularity)
• Previous surgeries (especially pelvic)
• Current medications and supplements
• Known conditions (PCOS, endometriosis, thyroid, etc.)
• Previous STIs or pelvic infections
• Family history of early menopause or fertility issues

Your partner's history:

• Previous children (with any partner)
• Known conditions affecting fertility
• Previous surgeries (especially groin/testicular)
• Medications
• Lifestyle factors

Cycle tracking data (if you have it):

• Record of recent cycles
• BBT charts
• OPK results
• Any tracking app data

Documents to bring:

• Referral letter (if applicable)
• Previous test results
• Previous scan reports
• List of medications

Both partners should attend:

• Fertility affects both
• Both will have questions and input
• Shows commitment to process
• Some clinics require both present

Questions to prepare:

• Write down your main concerns
• List specific questions
• Note anything you want to understand

A typical first consultation includes:

Welcome and history taking:

The doctor will ask detailed questions about:

• How long you've been trying
• Your menstrual cycles
• Sexual health history
• Past pregnancies and outcomes
• Medical history for both partners
• Lifestyle factors (smoking, alcohol, weight)
• Occupational factors
• Family history

Physical examination (sometimes):

• May be deferred to a separate appointment
• For women: may include pelvic exam
• For men: usually just general health check

Explanation and education:

• Discussion of fertility basics
• What might be affecting you
• Overview of investigation process
• What happens next

Answering your questions:

• Opportunity to ask anything
• Clarify points you don't understand
• Discuss concerns

Plan for investigations:

• Blood tests needed
• Semen analysis referral
• Scans or other imaging
• Timing of tests

Discussion of next steps:

• When to schedule follow-up
• How results will be communicated
• What to do while waiting

Duration:

Expect 30-60 minutes for a first consultation. NHS appointments may be shorter; private may be longer.

Standard initial investigations include:

Blood tests for her:

Hormone profile (usually day 2-5):

• FSH (ovarian function)
• LH (ovulation)
• Estradiol
• AMH (ovarian reserve - any day)
• Prolactin
• Thyroid function

Day 21 progesterone:

• Confirms ovulation
• Timed to 7 days before expected period

Other possible tests:

• Full blood count
• Rubella immunity
• Blood type
• HIV, hepatitis (screening)

For him:

Semen analysis:

• Sperm count
• Motility (movement)
• Morphology (shape)
• Volume

Usually done at the lab:

• 2-5 days abstinence before
• Sample collected on site or at home if lab nearby
• Results in days to weeks

Imaging for her:

Ultrasound scan:

• Antral follicle count (AFC)
• Ovarian appearance
• Uterine assessment
• Best done day 2-5 of cycle

Sometimes ordered:

• HSG (fallopian tube check) - may be later
• Hysteroscopy (camera in uterus) - if indicated
• Laparoscopy (keyhole surgery) - if indicated

Timing considerations:

Different tests happen at different cycle phases. You may need multiple appointments over one or two cycles to complete all tests.

Make the most of your consultation by asking:

About your situation:

• What do you think might be causing our difficulty?
• What tests do you recommend and why?
• How long will the investigation process take?
• Is there anything we should change while waiting?

About any findings:

• What does this result mean?
• Does this require treatment?
• Is this something that can be treated?
• What are our chances given what you know?

About treatment options:

• What treatment do you recommend?
• What are the success rates for us?
• What are the risks and side effects?
• Are there alternatives?
• What happens if this doesn't work?

About practical aspects:

• What will this cost?
• Are we eligible for NHS funding?
• How many appointments will we need?
• What's the waiting time?
• Who do we contact with questions?

About lifestyle:

• Is there anything we should be doing or avoiding?
• Do you recommend any supplements?
• Should we change anything about timing or frequency of sex?
• Is our weight, exercise, or diet a factor?

About next steps:

• When will we hear about results?
• When should we schedule a follow-up?
• What happens next?
• How do we contact you if we have questions?

Making the most of what you learned:

Immediately after:

• Compare notes with your partner
• Write down what you remember while fresh
• Note any questions that came up
• Review any paperwork or instructions given

Completing tests:

• Book tests promptly (some need specific timing)
• Follow any instructions (fasting, cycle day, abstinence)
• Note where and when to go
• Bring referral letters if needed

While waiting:

• Continue trying if appropriate
• Maintain healthy lifestyle
• Take recommended supplements
• Try not to obsess about results
• Reach out if you have urgent questions

When results come:

• Make sure you understand them
• Ask questions if anything is unclear
• Book follow-up to discuss
• Write down implications and next steps

Emotionally:

• First consultations can bring up a lot of feelings
• It may feel more "real" now
• Talk to your partner about how you're feeling
• Consider support resources if needed
• It's okay to feel anxious, sad, or overwhelmed

Practical tips:

• Keep a folder of all fertility documents
• Write down important dates and appointments
• Track expenses if relevant
• Note names of staff and specialists you meet
• Take someone with you to appointments if helpful

Remember:

This is the beginning of getting answers and help. Taking this step is positive, even when it feels scary.