Do you know?
Really know?
Or do you just “have a feeling”?
Or maybe you’re in denial? Maybe a confirmation will validate your fear?
Or maybe it’s the process that scares you?
Sometimes the anticipation of the diagnosis is the scariest part, and sometimes it’s the unknown of what the diagnosis process, or the fear of the actual fertility treatments. Last month we addressed the child-free life. This month, we’re talking about what to expect from the diagnosis process through infertility treatments as well as a personal perspective. If you haven’t gone through the diagnosis process, or a round of treatment, these posts are for you.
When to seek help
Generally speaking, if you are under 35 and have been having regular unprotected sex for a whole year and have not been pregnant, you should go seek help. Over 35, give yourself six months. If you have a diagnosed condition that could contribute to difficulty conceiving, get checked out sooner, or ask your OB/GYN how long you should wait before diagnosis.
Who to see
Ask your GP (general practitioner) or your OB/GYN. Both will ask you the same questions. “How long have you been trying for?” “Have you ever had a pregnancy/miscariage/abortion?” “Does your partner have any biological children?” and a few other questions. If you meet the criteria to explore an infertility diagnosis they may run a few tests in their office or they may refer you out to an RE (Reproductive Endocrinologist) right away.
What to expect
The male partner will give a sample, and maybe an STD screening. The female, well, she gets a lot of testing. A pap smear and STD test is just the start. It’s followed by a menu of blood work to test your hormone levels at various parts of your cycle. Estrogen/estradiol and FSH (follicle stimulating hormone) on day 2 or 3 of your cycle. LH (luteinizing hormone) half way through around day 14. Progesterone towards the end of your cycle. AMH (anti-mullerian hormone), androgen, prolactin, and thyroid at any time. Transvagianl ultrasound anyone? Most REs will perform at least one around ovulation, if not twice, doing the other one earlier on in your cycle. A Hysterosalpingogram (HSG) (via water and transvaginal ultrasound or dye and x-ray) is often performed to verify that your tubes are unobstructed.
Most couples go through at least that much. Generally the diagnosis process takes between 1-3 months depending on where you are in your cycle when you first meet with a doctor, and what tests you need. You’ll find yourself going back and forth several times. Get used to it! If you have to do any form of infertility treatment you’ll find yourself visiting your RE as much as you go to work.
There are a whole battery of tests that can be performed for various reasons. If you have any questions on what, or why, a doctor is performing a test, just ask. Ask them why are they doing it, why is it necessary, what information are they hoping to gain from the test results. The better informed you are the more comfortable you will feel during the process.
There is a lot of research that shows stress can hinder your ability to conceive. For most people, the more informed they are, the more in control they feel, the more relaxed they feel.