Start of fertility journey - questions to ask consultant

[Suzaphone]

Hi, I’ve just joined the forum and can see this is a really supportive network so glad to have found you all!

We’re in our early 30s and have been TTC for 18 months. After initial appointment at clinic in February where I had vaginal ultrasound and basic bloods tested, yesterday the clinic finally called me with a date in a few weeks for my follow up phone call (only 6 months after the last appointment!). I have yet to speak with any fertility consultant, so am wondering whether anyone has any tips for how I get the most out of the time I have with the consultant in my first phone consultation? What questions should I be asking?

Additional info: I have hypothyroidism which has been managed for the past 6 months now, but if anyone knows anything around this I should be asking in particular, that would be really helpful.

My partner has had one semen sample which was normal. As this was now 7 months ago, is it reasonable to ask them to do another semen test?

Any pearls of wisdom much appreciated. Thanks in advance.

Suz x

[Elsidee11]

Hi Suz! Welcome 🫶🏻 this group really is the most wonderfully supportive bunch of humans!

Might be worth another semen analysis - I think we had to do another after our second round and you want to make sure everything is optimal.

It’s difficult to know what to ask a consultant before your first round, and it wasn’t really until I fully understood the process and different protocols that I knew what to ask next. And everyone is so different - I’d say just trust your doctor, and use this support group for questions along the way, if you have any.

Good luck with your first round, its never easy but I hope you get your miracle! X

[Suzaphone in reply to Elsidee11]

Thanks 💛 There is really limited information for anyone before it gets to the point of considering IVF.

[Kittykat198]

Hi! I think I would start with what do they recommend you do? Our consultant was good and quite straight talking about our chances and what he recommended.

Oh and definitely how will they monitor any treatment you have to check it’s working! And what they might do if you aren’t responding as expected?

You could ask about Ivf protocols and which would suit you best? I would ask what they think you could expect from any treatment? (I had a very disappointing first round) For example, I have pcos so produce a lot of eggs but they are duff. Should you expect a good response to medications and are there risks from this (overstimulation can make you unwell). If you don’t respond will they put your dose up, add another drug or try something new?

You could also ask about Ivf eligibility in your area and wait times for Ivf because they vary - even if you aren’t ready for that and hopefully won’t need it. I was just under the cut off for treatment by age when we started treatment but the clinic (who also do nhs treatment) warned me that it is taking a long time to get approved for nhs treatment here. I was also above their bmi limits so had to self fund. If you have to self fund, definitely ask what they estimate the total to be.

You could ask if it worth trying medications like clomid or lentrazole to boost ovulation before Ivf? Are they checking your tubes aren’t blocked? No point pushing for meds or iui with blocked tubes. Or do they think Ivf is the way forwards?

I asked about supplements and was advised about cq10 by our consultant so you could ask what they recommend for you and your partner?

I would definitely ask to repeat the sperm analysis because my partner had two good ones but the one before our first round was rather shockingly bad and we ended up with icsi.

I would also ask whether your thyroid levels are ok for fertility if you haven’t already. My tsh was 3 or 4 which the nhs say is normal but I was given levothyroxine because you are more fertile with a level under 2.5. My t4 was normal if I remember.

Hope that helps!

[Suzaphone in reply to Kittykat198]

Thank you! This is so helpful!

[Eloquentia]

Hi! I have hypothyroidism too. It is worth asking for a full check of the thyroid hormones (TSH, FSH) and very importantly the thyroid antibodies. The thyroid can affect implantation so clinics tend to have specific levels they want to see before they start treatment and any change in the dose of the drugs can take a month or more to take effect. Very best of luck!

[DinaG1971]

Hello Ask to examine very well Husband's sperm (especially DNA fragmentation) because if there is an issue there, you will be having difficulties. Then test for TSH, Vitamin D3, and Vit B12, and homocysteine. Best wishes. all the best