What to expect in first fertility appointment?

[MindZGap]

Hi everyone

I'm TTC 23 months and finally got a first fertility appointment next month.

Hormone tests and sperm analysis both came back normal and no other concerns or issues. But I've not been pregnant at all in that time.

I'm wondering what to expect in that appointment? Is there anything I should be asking or preparing for?

I know they're going to talk to me about my weight as I have a BMI of 32 which is slowly coming down and my GP said they might refuse treatment as a result...

I'm in Scotland if that makes a difference.

Would love to hear others' experiences and any tips (other than try to lose 3 stone in a month lol)

@MindZGap did you have a transvaginal ultrasound, as that's part of the initial work up and it's likely the first appointment will be to talk about your medical histories and the results of the tests and then to discuss what options are available.

They're likely to ask a lot of questions about your health, things like if you smoke/drink/exercise etc. They'll review the tests you've had so far and maybe book you in for further tests if required. Then they'll likely talk you through what your options are in terms of treatment but to be honest I don't know about in Scotland but in England I think they require you to be under BMI of 30 to get any treatment at all, but the fact the gp referred you when you weren't in that range is hopeful they might have options for you. Well done on your weight loss so far, I know it can be a battle.

Good luck on your TTC journey

@Gardenlady543 No haven't had an ultrasound yet (well I have but was years ago to investigate some mid-cycle bleeding and didn't find anything).

Thank you for the info and @LavenderSweetPea too. I'm preparing myself for them to say I need to lose more before they will do anything, but also hoping they will at least do some more investigations as I'm trying to lose weight sustainably though lifestyle changes rather than strict dieting so taking longer than I have done in the past. I also think an arbitrary cutoff point is ridiculous but that's a rant for another time 😁

Thank you for the well wishes xx

Im just going through this process for the second time (first time ended in doing ovulation induction with letrozole to conceive DD1).

First appt was full history from both of us, height, weight etc. Bloods booked for a certain point in the cycle + transvaginal scan for me. DH sent for sperm analysis (i guess you might be able to skip this if you've already done it). Discussion about whether i would need a hycosy but agreed not as i have carried a child to term. Told to lose weight as NICE guidelines are BMI needs to be under 30. Second appointment booked for 12 weeks later to discuss all the results of the above and agree a plan for next steps.

Ive lost 12kg and our next appointment is Monday. Its been bloody hard work but hoping the second appointment will confirm we can try another round of letrozole.

Good luck with your appointments!

In my first appointment they discussed our history, what investigations we've had etc. booked me in for a hycosy to check fallopian tubes.
However I'm in England and the fertility clinic wouldn't see me unless my BMI was under 30. The GP wouldn't have been able to refer me to the clinic.

Hope everything goes well ttc xx

@MindZGap I definitely think you can push for the tests at least while you reach your goal weight. There's no reason not to get the tests - as PP said they should definitely offer you an internal scan to check for any physical things that might prevent pregnancy - some causes of infertility can be fixed with surgery and that I don't think has any kind of BMI limit. You may also want to ask for a hycosy scan to check that your tubes are unobstructed (I've even heard of people getting pregnant after these because they can kind of 'flush out' any obstructions)

I assume you've been ovulation tracking whilst TTC and have records of your cycles? It would be good to have these to show your doctor at the fertility appointment. If you've not been doing that track it this month so they can see what your lh peak looks like and when it comes in your cycle.

Lastly, obviously I hope you get a really nice doctor who is going to be helpful BUT I know sometimes you can get someone who is just convinced your weight causes your infertility (despite the fact that actually it's the other way round, often underlying problems that cause infertility cause weight gain as well, like PCOS for example). If you think they are dismissing you because of your BMI don't be afraid to insist on further tests - plenty of women with a BMI over 30 get pregnant naturally so you should push to make sure they check for other causes.

Thank you all so much, this has been incredibly helpful - and empowering.

I haven't used OPKs for a while so will do that before the next cycle.

@CrispAppleStrudels I hope your appointment goes well Monday.

Love and strength to all of you xx