Curious about fertility
Under 35 and trying to get pregnant
Ready to talk to a fertility specialist
Getting ready for your first visit to a fertility clinic
If you've made an appointment with a fertility specialist, congratulations on taking the next step towards getting pregnant! Here you'll learn how a doctor can help, how to talk to your doctor, questions to ask, and what to expect at a fertility clinic.
In high school, teachers hammered home the message of how easy it was to get pregnant. Having probably spent your younger years focusing on contraception, now you're actively pursuing pregnancy - but nothing is happening. What should you do?
It may be time to see what your doctor can do for you. A fertility specialist can address your particular concerns about fertility, provide information on fertility, and advise you on the next steps, including treatment options, on your journey to becoming pregnant.
When to see a fertility specialist
If you have been having regular, unprotected sex for a year (6 months if you're a woman over age 35) and you still aren't pregnant, it may mean you are infertile, since this is generally how infertility is defined. It's time to see your family doctor. Women over 37 do not need to wait 6 months before seeing a doctor, because waiting too long to seek help could harm their chances of conceiving.
You'll also want to see your doctor sooner if you have a history of irregular or painful periods, pelvic pain, endometriosis, pelvic inflammatory disease (PID), repeated miscarriages, or if your partner has a low sperm count or a history of testicular, prostate, or sexual problems.
Preparing for your appointment
Although you may feel a bit embarrassed or nervous talking about the subject, talking to a fertility specialist is an important first step. You may find it easier to talk about your fertility if you prepare for the visit in advance. Find out how to get ready for your visit to a fertility specialist.
Don't forget to bring a pen and paper to take notes.
Referrals to fertility specialists
Your family doctor is an important gateway to other specialists, such as an obstetrician/gynecologist (OB/GYN) or a fertility specialist, also called a reproductive endocrinologist (REI). Or maybe you've already see an OB/GYN for your routine Pap tests and you may find it easier to start the conversation with them. Either way, it's important to discuss your concerns about fertility with your doctor and explore the option of seeing a fertility specialist. Depending on your age and health history, your doctor may recommend a medical evaluation. This may be through a referral to either an OB/GYN or a fertility clinic. Some fertility clinics allow for self-referrals so you don't have to go through an OB/GYN or family doctor.
Your family doctor or OB/GYN may be able to review what to expect at a fertility clinic and various treatment options that may be right for you. Seeking help from a specialist, especially a fertility specialist, is that all-important first step required to start the process towards figuring out your fertility.
Perhaps you and your partner fit the criteria of couples who should see a fertility specialist about fertility difficulties:
Yet it's hard to make that first appointment. You keep putting it off.
Does this sound like you? Your hesitation is understandable. It's common for people to find reasons to avoid going to see a doctor. In many cases a person has a fear of the outcome or diagnosis. You're concerned about how much it might cost. You think the procedures are too involved or too time consuming or painful.
You should know that many people are in a similar position. It is normal to feel overwhelmed, uncertain, or stressed. Consider some facts:
Check into your insurance coverage before you see your doctor. Be sure that you're well informed and find out what your provincial and private medical insurance plans will cover. Your policy will outline the coverage available to you. Read "Cost of fertility treatments" to learn more.
Preparing for your visit will help reduce anxieties. If this is your first step toward addressing your fertility concerns, take a few minutes to complete the doctor discussion guide and print a copy to take to your doctor.
Knowing what to ask your fertility specialist ahead of time will help ensure you get the most out of your visit. It helps a lot if you write everything down in advance. That includes medical histories and questions you want answered. I'm sure we've all left a doctor's office only to remember a question we meant to ask but forgot! To see which questions your fertility specialist is likely to ask, and which questions you may want to consider asking, see the "Suggested questions to ask your reproductive endocrinologist (REI) or fertility nurse".
Many people are shy about asking questions, but you shouldn't be. Your doctors want to make sure you understand your diagnosis and treatment options too! And if you don't understand the answers, don't hesitate to ask your doctor to repeat them.
Here are some suggested questions to print and take with you.
Your first visit to a fertility specialist or fertility clinic can be an overwhelming experience. On top of dealing with the emotional issues that may arise with infertility, you now find yourself confronting a new and sometimes scary world of treatment options. Bringing this list of questions to your first visit may help you to keep track of your thoughts and increase your comfort level.
There are a variety of potential measures that can be used to evaluate clinic success rates of assisted reproductive technology (ART). To learn more, read "Understanding fertility clinic success rates."
The workup demystified
Your doctor will also conduct an exam. Depending on your medical and lifestyle history, they will then conduct some tests, beginning with the simplest and least invasive ones. At a later point, you may need to undergo more advanced evaluation.
What happens during the female exam
What happens during the male exam
What your fertility specialist is looking for
If you're preparing to visit a fertility clinic, you probably have hundreds of questions - they likely didn't cover this topic in health class in high school! And it may not be a topic that comes up often among your friends or at cocktail parties. Even in our tell-all society, it can still be challenging to discuss fertility issues and treatment openly.
Find a clinic
Maybe you're still in the investigation and fact-finding stage - you think you want to visit a clinic but aren't sure where to start, or how to even find a clinic. You can start by using the fertility clinic locator to find a fertility clinic near you.
What clinics can do
Often, the reason you are not getting pregnant is treatable. Problems conceiving may be due to a single cause or a combination of factors that may prevent a pregnancy from occurring or continuing. A fertility specialist may be able to determine what the cause is.
At the fertility clinic, you will be presented with different treatment options suitable for your condition. There are many safe and effective therapies that can help you become pregnant. When women of past generations were trying to get pregnant, fertility conversations, if they happened at all, were confined to the family doctor. There was no proper fertility care available to those in need. Now there are modern fertility clinics in most major cities and hospitals in Canada and around the world. Use the fertility clinic locator to find a fertility clinic near you.
What to expect from a clinic
When you first visit a fertility clinic, you may be able to sign up for a free information session. You will also be able to set up personal consultation meetings where staff will be able to answer your questions about the steps of fertility evaluation (testing), diagnosis, treatment, and costs. Often, both partners are encouraged to attend these meetings. They'll provide you with information on the factors that are important when trying to conceive and show you how to maximize your chances of success. You will also have the opportunity to talk with a fertility specialist who can discuss the various treatment options available to you, the specifics of each, and their advantages and disadvantages. Many fertility clinics also recommend or require a consultation with a psychologist or a fertility counselor, who may also be on staff at the clinic.
Testing and diagnosis
In the testing and diagnosis stage, the doctors at the clinic may need to do tests to diagnose the possible cause of your difficulty in conceiving. There may be several tests but they are all important and designed to look at four key factors in successful conception:
Your fertility care team will be able to tell you exactly what tests are involved in your case. You can refer to the Fertility workup section for more information.
After testing and diagnosis, you will have a variety of treatments to choose from depending on your results and particular situation. You'll want to learn about a variety of factors for each treatment option [link to "Fertility treatment options" section, section 5 of this segment], including:
While at the clinic, ask as many questions as you like. It may be helpful to request fact sheets or literature about each of the options discussed so you can review them later. Remember, everyone at the fertility clinic is there to help you, so take advantage of their knowledge, experience, and expertise - you're not in this alone.
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