The First Visit To The Reproductive Endocrinologist
The first visit to the reproductive endocrinologist (RE) can be worrisome because the hope and dream of having a baby rides on what this doctor can do for the couple. This appointment is typically scheduled according to where the female is in her menstrual cycle so she possibly had to wait a month or more for an appointment at best. These specialists are so book up that many times it is a wait of four to six months to get in to see one.
At the first visit, the doctor will take a complete history and physical and spend a great deal of time just talking to the couple and getting familiar with their reproductive history. Initially, the doctor will want to do some preliminary tests. He will want to do some hormonal blood tests to check the follicle-stimulating hormone and the luetinizing hormone. The doctor will do a series of blood tests to check for sexually transmitted diseases as well as ask both partners about past history of sexually transmitted diseases. This helps the doctor get a mental picture of anything in the past that could have an impact on current fertility. In addition, the doctor will perform a physical exam. Typically, the doctor will want to perform a semen and urine analysis on the male partner as well.
Another thing that takes place at the first visit is that the RE discusses all of the fertility treatments that are available in that particular clinic and the protocol surrounding those treatments. The doctor will speak with the patient concerning how far they are willing to go in the treatments.
By the end of the first appointment, the couple and the doctor will have a good picture of what will come next and how far the journey will go if necessary. The blood work and semen analysis test results will not be back for about three or four days so at the end of the first visit there probably will not be any answers about the cause of the infertility. Before leaving that first visit, the couple will make a series of appointments for future tests and visits with the doctor. Each clinic typically has a scheduler who works with the local hospitals and will put together the appointment and testing schedule for each couple. It is extremely important for the female to have her menstrual calendar with her at this appointment because other future appointments will need to be made according to what the cycle day is. As a general rule it is not good to have to call back to have the scheduler make the future appointments because the dates fill up quickly and the wait tends to get longer. In addition, at this visit the couple will meet with a financial planner who will go over approximate costs, insurance information, and clinic fees.
Occasionally tests and procedures that need to be performed on certain cycle days will need to be scheduled on weekends or holidays. Most clinics are accustomed to this and are equipped to work on the necessary days. In other cases, waiting one or two days is not significant. However, if at any point the couple feels like timing is everything and they are being asked to wait beyond what they are comfortable with always go straight to the doctor. The couple should never be afraid to talk to the doctor directly with any questions or concerns.
The next appointment will usually be within three to five days after the initial appointment to perform a diagnostic ultrasound to check the production and quality of eggs within the ovaries according to the cycle day.
