After your first fertility consultation: what happens next?

"I feel like I left with more questions than when I came in..."

This feeling is normal after your first fertility consultation. Between the new medical terms, the prescribed tests, and the decisions to make, it's easy to feel overwhelmed. Understanding what to expect will allow you to approach the next steps with more peace of mind and prepare effectively.

The initial assessment: Your roadmap

Essential tests for women

Your specialist has likely prescribed:

Blood tests (to be done between days 2 and 5 of your cycle):

• AMH (anti-Müllerian hormone)
• FSH
• LH
• Estradiol
• Prolactin
• TSH (thyroid)
• Serology tests (rubella, toxoplasmosis, CMV, HIV, hepatitis)

Pelvic ultrasound:

• Antral follicle count
• Evaluation of the uterus and ovaries
• Screening for structural abnormalities

Hysterosalpingography (HSG) or HyFoSy:

• Evaluation of Fallopian tube patency
• Visualization of the uterine cavity
• Part of the initial examinations

💡 Pro Tip: Schedule your blood test on the first day of your period to make sure you stay within the Day 2-Day 5 window. Laboratories are often less busy in the morning.

Essential tests for him

Spermogram and spermocytogram:

• Analysis of concentration, motility, and morphology
• Screening for infections
• Evaluation of volume and pH

Blood tests:

• Infectious disease screenings
• Sometimes hormone level measurements (FSH, LH, testosterone)

Spermogram preparation:

• Abstinence of 3 to 5 days before collection
• Avoid alcohol, tobacco, and heat sources
• Collection at the laboratory or at home, depending on the arrangements

Deadlines and organization: plan effectively

Timing of examinations

Most tests can be performed over 1 to 2 cycles:

Cycle 1:

• Blood tests (D2-D5)
• Pelvic ultrasound (D2-D5)
• Sperm analysis (whenever you want)

Cycle 2 if needed:

• Hysterosalpingography or HyFoSy (Day 7-Day 12)
• Additional tests based on initial results

🌟 Did you know: Test results are generally available within 48 hours to 1 week. Some centers send results via secure email, while others require pickup at the lab.

Managing practical constraints

Professional planning:

• Employers are legally required to accept absences for medical reasons
• Request a certificate of attendance from the medical center to justify your absence
• Opt for morning appointments
• Some tests can be done on weekends

Financial aspects:

• Check coverage with your health insurance provider
• Keep all receipts
• Inquire about fees before tests

Results and interpretation: understand to take better action

Receiving results

Typical turnaround times:

• Blood tests: 24-48 hours
• Sperm analysis: 3-7 days
• Ultrasound: Immediate results
• HSG/HyFoSy: Immediate results with report in 48 hours

Testimonial: "I received my results by email on a Friday night. I spent the weekend searching the internet and worrying. Now, I always ask to have the results in consultation to avoid the stress." - Sophie, 32 years old

Preparing for the results consultation

Questions to ask:

• What exactly do my results reveal?
• What are the recommended next steps?
• What are the expected timeframes?
• Are there any lifestyle changes to make?

💡 Pro Tip: Write down your questions in advance. The emotion of the moment can make you forget important points.

Possible scenarios: anticipating directions

Normal assessment: optimizing natural chances

If your tests are normal, your doctor may recommend:

• Continuing natural attempts with monitoring
• Optimizing the timing of intercourse
• Nutritional supplements (folic acid, vitamin D)
• Stress management and lifestyle improvements

Recommended duration: 3 to 6 additional months depending on your age

Slight anomalies: first-line treatments

Ovulation disorders:

• Simple ovarian stimulation
• Ultrasound monitoring
• Ovulation triggering

Minor male factors:

• Antioxidant supplements
• Lifestyle changes
• Re-evaluation in 3 months

More complex problems: referral to ART

Frequent indications:

• Blocked fallopian tubes
• Severe endometriosis
• Significant male factors
• Unsuccessful simpler treatments

Next steps:

• Registration at a fertility center
• Additional tests
• Information on available techniques

Additional tests: when to investigate further

Pelvic MRI

When to prescribe it:

• Suspected endometriosis with associated symptoms
• Presence of suggestive ultrasound signs
• Precise evaluation of lesions before surgery

Preparation:

• No special preparation required
• Duration: 30-45 minutes
• Possible injection of contrast agent

Recurrent miscarriage assessment

When to perform it:

• After 2 consecutive spontaneous miscarriages
• Family history of miscarriages
• Suspected uterine abnormalities

Tests included:

• Karyotypes of both partners
• Thrombophilia screening
• Autoimmune screening
• Diagnostic hysteroscopy

Diagnostic hysteroscopy

Indications:

• Uterine abnormalities on ultrasound
• Irregular cycles
• Repeated implantation failures
• Complementary to HSG if necessary

Procedure:

• Outpatient examination
• Duration: 10-15 minutes
• Possible slight discomfort

Support and guidance: you are not alone

Available resources

Medical team:

• Fertility specialist gynecologist
• Reproductive biologist
• Specialized psychologist
• Nurse coordinator

Associations and support groups:

• Specialized forums
• Support groups
• Dedicated apps

Involve your partner

Communication within the couple:

• Share your feelings
• Make decisions together
• Divide practical tasks

Attending appointments:

• Encourage your partner to come along
• Prepare questions together
• Share the mental load

Emotional management: taking care of yourself

Anticipate reactions

Common emotions:

• Relief at having answers
• Anxiety about the results
• Eagerness to take action
• Fear of upcoming treatments

Testimonial: "The initial tests made me realize that it had really started. I was both relieved to be taking action and terrified of what we were going to discover. I learned to accept this ambivalence." - Céline, 35 years old

Coping strategies

While waiting for results:

• Maintain your usual activities
• Avoid excessive internet research
• Practice relaxation or meditation
• Surround yourself with supportive loved ones

💡 Pro Tip: Create a relaxation ritual for yourself after each medical exam. This will help you release stress and reconnect with your well-being.

Shaping your journey: remain in control of your decisions

Asking the right questions

About the proposed treatments:

• What are the success rates?
• What are the side effects?
• Are there any alternatives?
• What is the expected timeline?

Regarding your situation:

• How long before I see results?
• When should we reassess the situation?
• How can I optimize my chances?

Take time to decide

You have the right to:

• Request a cooling-off period
• Seek a second opinion
• Refuse certain tests or treatments
• Change your decision along the way

🔑 Key Learnings

• Initial examinations are spread over 1-2 cycles and provide a complete picture of your fertility, including HSG/HyFoSy as a first step
• Schedule your tests taking into account cycle constraints, and request certificates of attendance to justify your professional absences
• Prepare for the results consultation by noting your important questions in advance
• Several scenarios are possible: from continuing to try naturally to being referred to an ART center
• Additional tests may be necessary depending on your situation (pelvic MRI, miscarriage assessment)
• You remain in control of your journey: take the time to understand and decide

💝 Each step brings you closer to your goal

These first few weeks after the consultation may seem intense, but each examination gives you valuable information to personalize your journey. Don't hesitate to ask your medical team if you have any questions. You have the right to understand and actively participate in your decisions.

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