What are the First Steps for Testing/Investigating Whether We Have a Fertility Problem?

[Anonymous]

DH and I have been trying for DC#2 for six months now with no success. I know that's not very long, but we're starting to get anxious.

Any advice on what first steps we should take to test/investigate whether we have a fertility problem that we should address?

Background: I'm 37.5, DH is 40. We conecived DC#1 on month five, which was the same month I did accupuncture/herbs for the first time. (I'll probably try it again this month.) No history of m/c and my FSH is normal (my gyn drew/tested the blood last month because I happened to be there on the right day of the cycle.)

Thanks!

[Anonymous]

If it has been 6 months, I would absolutely make an appointment now with an RE..it takes a couple weeks to get in sometimes. I wouldn't wait much longer. If you get pregnant between now and then, you can always cancel appointment, but at least you have it..

[Anonymous]

Thanks. I'll check with my GYN for a referral.

Can I ask what to expect from the RE appointment? What do they check/test? Should I also encourage my husband to have his sperm count checked? Where would he go for that?

[Anonymous]

The RE can order all of the tests for him as well. It depends where you go, but usually the first appointment is consultation and then testing, and then follow ups and you decide what you will do from there. The testing takes about a month to finish..but generally, if there are no serious issues, they try IUI first with fertility meds.. but this can take a while too, because often it takes more than one cycle, and some cycles may be cancelled.. so just allowing yourself some time really helps! Also, make sure you do your research on your RE, its really important that you like him/her and trust them..AND that they have good reviews from past patients..Hope that helps!

[Anonymous]

For testing, the RE will start with bloodwork and ultrasound on day 3 of your cycle (3rd day of bleeding) to test your estrogen, FSH, TSH, prolactin, and progesterone levels. If you are in the middle of your cycle when you go for the initial consult, then you will just wait until you get your next AF to do the initial b/w and u/s. Some clinics have you do a Clomid Challenge Test where they do b/w and u/s on day 3, then have you take clomid around days 5-10 of your cycle, and do additional b/w and u/s on day 10, but not all clinics do that test.

They will also do an HSG (shoot dye into your uterus/tubes) to check for misshapen uterus or blocked tubes. Saline sonogram is also possible (they add saline to your uterus and do an ultrasound). Both the HSG and saline sono have to be done between days 5-10 of your cycle.

They will also have your DH do a semen analysis. He will need to make a deposit in a cup and they will test the shape, movement and counts of his swimmers. I think that covers the basic testing.

Once all of the testing is done, the RE will have a better picture of your fertility and will have a consult with you to make treatment recommendations. Good luck!

[Anonymous]

Thanks everyone. This is so helpful. Exactly what I was looking for!

[Anonymous]

This is probably obvious, but I'd bring the results of your previous FSH test with you to the appointment.