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So, we have an appointment. Now what?

 Art by: Carol Roque
source last part of text:
We're stoked and excited to finally have an appointment next monday. I've done my research and I feel really prepared. For those of you that are thinking about seeing a fertility specialist, here's what you can expect at your first and second appointment

First consultation:
The first time you meet your specialist it's going to be all talk basically. He/she will either ask you about your family history of infertility or will give you a form to fill out. Make sure you and your partner ask your relatives about it if you have the opportunity and feel comfortable doing so. Some other questions you can expect to be asked are in regard of your overall health, how long you've been TTC, gynecological problems you're experiencing, about your cycle and if you've ever had STD's or stomach surgery. He or she will also like to know if you already have children and how long it took you to get pregnant with them. He/she is going to ask your partner about the descent of the testes, if he's ever had inflamation of the testes or an STD. Your man may have to bring a sperm sample to the next appointment. Or the appointment after that. Either way, it's going to happen.

Now that the talk is out of the way, it's time to get physical.

Second consultation:
He or she will probably make you step on a scale (hooray...not),  measure your height, examine your facial hair growth pattern, breasts and thyroid gland. They'll do a pap and your cervix will be checked. It's most likely that they'll do an ultrasound to check the condition of your ovaries and uterus.

If the thing that's standing between you and your baby still can't be determined, the doctor might reccomend these tests:

  • Post-coital test – Similar to a pap smear that takes place shortly after intercourse, this test can determine if the sperm can penetrate and survive in the cervical mucous. It's best to do this just before ovulation or you may get a false result.
  • Ultrasound exams – To help rule out hormonal problems, fibroid tumors, ovarian cysts and, in some cases, endometriosis, this should be performed on the day of the LH surge. A second ultrasound a few days later can confirm that an egg was actually released, ruling out luteinized unruptured follicle (LUF) syndrome.
  • Blood tests – Including follicle stimulating hormone (FSH), prolactin, progesterone, testosterone, luteinizing hormone and estradol tests, these help rule out infertility causes such as polycystic ovarian disease, premature ovarian failure and thyroid problems.
  • Hysterosalpingogram – This is essentially an X-ray procedure in which dye is injected through the cervix and into the uterus and fallopian tubes to check for abnormalities such as tumors, scar tissue or blockage.
  • Endometrial biopsy – A quick in-office procedure, this will assess the quality of the woman's uterine lining and also determine whether she is ovulating. 
  • Laparoscopy – In this procedure, a narrow fiber optic telescope is inserted through the woman's abdomen to evaluate the ovaries and look for signs of endometriosis.
Depending on the diagnosis the doctor might reccomend oral fertility drugs or some kind of surgery to correct a problem. If this doesn't help you conceive, more powerful injectable fertility drugs are sometimes tried, followed by artificial insemination and finally in vitro fertilization.

And here I was, thinking sex made babies.

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