If you’re planning a visit with a fertility doctor, be prepared. Discussing issues like egg quality, sperm count, timing sex, treatment options can leave anyone a little dazed and confused. Here are some questions to bring with you along with something to take notes with as you listen to answers.
1. What is your experience with evaluation and treatment of fertility issues?
Not all providers that treat infertility are created equal. In the US, a reproductive endocrinologist has completed medical school, a four-year residency program in Obstetrics and Gynecology, and a three-year fellowship in Reproductive Endocrinology and Infertility. An RE is a true fertility specialist who usually provides all types of fertility treatment options including IVF. Many other primary care providers may provide fertility testing and low tech treatments like ovulation induction with medication and sometimes even intrauterine inseminations. If starting low tech treatment with a primary care provider, get a long term plan and ask when they would consider referring to a specialist if the treatments are not successful.
2. How do I get my questions answered?
Evaluation and treatment for infertility will leave you with many questions about timing, medications, test results, options so find out in the beginning how you will get answers. Do you have a nurse assigned to you to answer questions? What about questions that come up after clinic hours and on weekends
3. Is your clinic open every day (because ovulation does not care if it’s a weekend)?
Ask! What if you need an ultrasound or an intrauterine insemination on a weekend? If the clinic is closed on weekends – you may want to consider finding an alternative or at least be prepared to miss treatments in cycle where you are ovulating on the weekend
4. What tests do you recommend, why, and how will I learn the results?
Fertility tests are pretty standard and involve checking on female anatomy, egg supply, and sperm quality but each patient may need slightly different testing based on their history. Ask about the recommended testing and how you will understand the results once they are completed.
5. What are my options for treatment and chances of success with each one?
Your fertility provider may provide you with a treatment plan that sounds good to you but ask specific questions about chances of success and alternatives for you. Fertility treatment options usually involve trying naturally, ovulation induction with medication with or without an intrauterine insemination, and in vitro fertilization (IVF). If you are planning IVF ask about intracytoplasmic sperm injection (a fertilization method also called ICSI), genetic screening of embryos, and chances of success with donor egg and/or donor sperm. Even if all of those options sound unappealing or scary – educate yourself early in the process so you truly know all of your options and have perspective on the overall chances of success.
6. What is my long term plan?
Ask this early. If you’re planning to start with low tech treatments like ovulation induction or intrauterine inseminations – understand the chances of success (usually 20% or less depending on the couple) and what the long term plan will be – how many inseminations before considering alternative treatment like IVF. Have a plan.
7. What would you do if you were me?
Best question for a doctor ever. This is where you can cut through all the BS and get what they are really thinking. It’s ok if you do not agree with what they say but you’ll hopefully get a clear picture of what they think is best for you.
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Lora Shahine, MD
Dr. Lora Shahine, joined Pacific NW Fertility after completing her fellowship in Reproductive Endocrinology and Infertility at Stanford University. During her time at Stanford, Dr. Shahine served as a Clinical Instructor in the department of Obstetrics and Gynecology, contributed several research publications in women’s health and infertility, and trained in one of the few Centers for Recurrent Pregnancy Loss in the United States.
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