Definition and overview

An infertility consultation is an appointment with a doctor or a fertility specialist to discuss the diagnosis and possible treatment of infertility. This is an option for couples who are having difficulty conceiving. The appointment will give them an idea of what treatments are available so they can decide whether to seek treatment.

Who Should Undergo and Expected Results

Couples who are having problems conceiving a child will benefit from an infertility consultation. However, most fertility specialists encourage couples to try natural methods of conception first for at least one year before seeking treatment. Thus, it is best to schedule an infertility consultation several months or even years after the couple started trying to conceive. For these couples, the consultation may be their first step towards parenthood. At the end of the appointment, they should be equipped with enough information about their specific condition and their existing options so that they can make an informed decision.

Seeking treatment for fertility is a big step for couples who are unable to conceive. This is because the process is very unpredictable. There is no way to guarantee how long the process will take, and how far it might to go. Some couples are able to conceive on their first attempt, while some require repeated attempts before achieving a successful pregnancy. Thus, couples are also encouraged to take advantage of the first infertility consultation to gauge whether they are willing to commit to the entire process.

How the Procedure Works

An infertility consultation is provided by fertility specialists and reproductive endocrinologists, and is performed at the doctor’s office or clinic. The meeting typically at least an hour. The following will be discussed during the consultation:

  • Medical history
  • Goals as a family
  • How long the couple has been trying to get pregnant
  • How aggressive the treatment can go
  • The couple’s financial plans regarding treatment
  • Timeline based on work schedule or vacation plans, if any

Couples who seek infertility consultation should also be prepared to answer the following questions:

For the male partner:

  • Do you experience sexual problems, such as erectile dysfunction, lack of sexual appetite, premature ejaculation, and so on?
  • Have you previously conceived a child with a different partner?
  • Do your male siblings have infertility issues?
  • Do you experience medical issues affecting your testicles or scrotum, such as swelling or infections?
  • Have you undergone surgery on the testicles or other pelvic organs?
  • At what age did you hit puberty?

For the female partner:

  • What is your typical menstrual period like?
  • Is your menstrual cycle irregular?
  • Have you had a baby or been pregnant in the past?
  • What is your diet like?
  • What are your stress levels?
  • How much exercise do you get on a regular basis?

After the consultation, the couple will undergo diagnostic testing under the physician’s request. Routine fertility testing will determine the quality and condition of eggs, sperm, and the reproductive structures of both partners. For the women, the focus will be on the uterus and the fallopian tubes. Gender-specific tests include:

For the male partner:

  • Semen analysis
  • Transrectal and scrotal ultrasound scan
  • Testicular biopsy
  • Genetic exam

For the female partner:

  • Ovulation test
  • Ovarian reserve test
  • Pelvic ultrasound
  • Hysterosalpingography

Both partners may also be asked to undergo:

  • Genetic testing
  • Hormone testing

During the process of diagnosing the cause of infertility, the process may involve the expertise of a gynecologist (for the female patient) and a urologist (for the male patient). These specialists can provide more information about potential infertility causes affecting the patient.

The results of the fertility tests will help the fertility specialist formulate his recommendations regarding the case, which should include treatment options.

Possible Risks and Complications

As an initial appointment, an infertility consultation does not come with serious risks or complications. Perhaps the only risk faced in such an appointment is an inaccurate diagnosis, which may be caused by the patients’ failure to disclose all information the doctor needs to make an assessment. Thus, in order to have an optimal chance of success, it is important to provide the consulting physician or fertility specialist complete and accurate information.

References:

  • American Society for Reproductive Medicine. Diagnostic evaluation of the infertile female: a committee opinion. Fertil Steril. 2012;98:302-307. PMID: 22698637 www.ncbi.nlm.nih.gov/pubmed/22698637.

  • American Society for Reproductive Medicine. Diagnostic evaluation of the infertile male: a committee opinion. Fertil Steril. 2015;103:18-25. PMID: 25597249 www.ncbi.nlm.nih.gov/pubmed/25597249.

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