First Steps After a Fertility Consultation: What to Expect

Introduction

"I feel like I left with more questions than I went in with..."

This is perfectly normal after your first fertility consultation. Between unfamiliar medical terms, prescribed tests, and decisions to make, it’s easy to feel overwhelmed. Understanding what lies ahead will help you approach the next steps with greater confidence and prepare effectively.

The Initial Workup: Your Roadmap

Essential Tests for Her

Your specialist has probably ordered:

Blood tests (to be done on cycle days 2–5):

• Anti-Müllerian hormone (AMH)

• Follicle-stimulating hormone (FSH)

• Luteinizing hormone (LH)

• Estradiol

• Prolactin

• Thyroid-stimulating hormone (TSH)

• Infectious serologies (rubella, toxoplasmosis, CMV, HIV, hepatitis)

Pelvic ultrasound:

• Antral follicle count

• Assessment of uterine and ovarian anatomy

• Screening for structural abnormalities

Hysterosalpingogram (HSG) or HyFoSy (hysterosalpingo-foam sonography):

• Evaluation of Fallopian tube patency

• Visualization of the uterine cavity

• Considered a first-line procedure

💡 Pro Tip: Book your blood draw on Day 2 of your period. Labs are generally less busy first thing in the morning.

Essential Tests for Him

Semen analysis (including sperm culture):

• Sperm concentration, motility, morphology

• Infection screening

• Semen volume and pH

Blood tests:

• Infectious serologies

• Occasionally hormone panels (FSH, LH, testosterone)

Preparing for your semen sample:

• Abstain from ejaculation for 3–5 days before collection

• Avoid alcohol, tobacco, and excessive heat

• Sample can be produced at home or in the clinic, per lab protocol

Timing & Organization: Planning Efficiently

Scheduling Your Tests

Most workups fit into one or two menstrual cycles:

Cycle 1:

• Blood tests (days 2–5)

• Pelvic ultrasound (days 2–5)

• Semen analysis (any time)

Cycle 2 (if needed):

• HSG or HyFoSy (days 7–12)

• Additional tests based on initial results

🌟 Did you know? Lab results usually return in 48 hours to one week. Some centers email securely; others require you to pick up results in person.

Managing Practical Constraints

Work obligations:

• Employers must allow medical leave for prescribed tests

• Request a medical certificate from your clinic to justify absences

• Opt for morning appointment slots when possible

• Some facilities offer weekend testing

Financial considerations:

• Verify coverage with your insurance or benefits plan

• Keep all invoices and receipts

• Inquire about fees before each test

Results & Interpretation: Understanding to Act

Receiving Your Results

Typical turnaround times:

• Blood tests: 24–48 hours

• Semen analysis: 3–7 days

• Ultrasound: immediate findings

• HSG/HyFoSy: immediate imaging, full report in 48 hours

“I got my results by email on a Friday night, then spent the weekend Googling and worrying. Now I always ask to review results in person to avoid that stress.”

— Sophie, 32

Preparing for the Results Appointment

Key questions to bring:

• What do my results specifically show?

• What are the recommended next steps?

• What timelines should I expect?

• Are there any lifestyle changes I should make?

💡 Pro Tip: Write down your questions in advance. It’s easy to forget once you’re in the doctor’s office.

Possible Scenarios: What to Expect

Normal Workup: Maximizing Natural Chances

If all tests are normal, your doctor may suggest:

• Continuing natural attempts with cycle monitoring

• Timing intercourse to coincide with ovulation

• Nutritional supplements (folic acid, vitamin D)

• Stress management and healthy lifestyle tweaks

Recommended duration: 3–6 more months, depending on your age

Mild Abnormalities: First-Line Treatments

Ovulation issues:

• Simplified ovarian stimulation (e.g., clomiphene or letrozole)

• Ultrasound monitoring

• Ovulation induction trigger (hCG or GnRH agonist)

Minor male-factor findings:

• Antioxidant supplements

• Lifestyle modifications (diet, exercise, stress reduction)

• Re-evaluation after 3 months

More Complex Situations: Referral to ART

Common indications:

• Blocked or damaged tubes

• Severe endometriosis

• Significant male factors

• Failure of simpler treatments

Next steps:

• Registration at an ART (assisted reproductive technology) center

• Additional diagnostic tests

• Counseling on IVF, ICSI, or other advanced techniques

Additional Diagnostic Tests: When to Go Deeper

Pelvic MRI

Indications:

• Suspected endometriosis with significant symptoms

• Ultrasound findings that need further characterization

• Preoperative lesion mapping

Preparation:

• No special prep required

• Exam lasts 30–45 minutes

• IV contrast injection may be used

Recurrent Pregnancy Loss Workup

When to consider:

• After two consecutive miscarriages

• Family history of recurrent loss

• Suspected uterine abnormalities

Typical tests include:

• Karyotype analysis of both partners

• Thrombophilia panel

• Autoimmune screening

• Diagnostic hysteroscopy

Diagnostic Hysteroscopy

Indications:

• Uterine abnormalities seen on ultrasound

• Irregular menstrual cycles

• Repeated implantation failure

• To complement HSG findings

Procedure:

• Outpatient, office-based

• Lasts 10–15 minutes

• Mild discomfort possible

Support & Guidance: You Are Not Alone

Available Resources

Your care team:

• Fertility specialist (REI physician)

• Reproductive endocrinologist or biologist

• Fertility counselor/psychologist

• Nurse coordinator

Support networks:

• Online forums and communities

• Local support groups

• Fertility tracking and support apps

Involving Your Partner

Communication:

• Share feelings and concerns

• Make decisions as a team

• Divide practical tasks

Clinic visits:

• Encourage your partner to attend appointments

• Prepare joint questions

• Share the emotional load

Emotional Well-Being: Take Care of Yourself

Anticipating Your Reactions

Common emotions:

• Relief at having answers

• Anxiety about what they mean

• Impatience to move forward

• Fear of upcoming treatments

“Those first tests made everything feel real. I was relieved to be taking action but terrified of what we’d find. Learning to accept that mixed feeling was a huge step.”

— Céline, 35

Coping Strategies

While waiting for results:

• Keep up your normal routines

• Avoid excessive online research

• Practice relaxation or meditation

• Lean on supportive friends and family

💡 Pro Tip: Establish a small post-test ritual—take a walk, enjoy a cup of tea, or practice deep breathing—to help release stress.

Building Your Journey: Staying in Control

Asking the Right Questions

About proposed treatments:

• What are the success rates?

• What side effects should I expect?

• Are there alternatives?

• What is the timeline?

About your situation:

• How long until we see results?

• When should we re-evaluate?

• How can I optimize my chances in the meantime?

Taking Time to Decide

You have the right to:

• Request time to reflect

• Seek a second opinion

• Decline specific tests or treatments

• Change your decision at any point

🔑 Key Learnings

• The initial workup spans 1–2 cycles and offers a comprehensive fertility snapshot, including first-line HSG/HyFoSy

• Plan your tests around cycle timing and secure medical certificates for work absences

• Prepare for your results appointment by listing key questions in advance

• Multiple pathways exist: from continued natural efforts to referral for ART

• Additional diagnostics (pelvic MRI, recurrent loss workup) may be needed based on your findings

• You remain in charge: take time to understand every step and make informed decisions

💝 Every step brings you closer to your goal

These early weeks after your consultation can feel intense, but each test provides valuable insights to personalize your journey. Don’t hesitate to lean on your medical team for answers—your active participation is key to achieving your dream.