The first visit: what actually happens

A first appointment at a fertility centre is not a decision-making session. It is a fact-finding one. Its purpose is to give the physician a complete picture of both partners, not to choose a treatment that same day. Couples who know this in advance usually leave the room calmer than those who do not.

What to bring

Every test, ultrasound and treatment report you already have, even old ones, even ones you assume are irrelevant. A record of any surgery, the medications both of you take — supplements included — and, if you have had fertility treatment before, the notes from that cycle. The result of an unsuccessful cycle is one of the most valuable pieces of information a new physician can have.

What the physician asks

How long you have been trying, the regularity and length of the menstrual cycle, any history of pregnancy or miscarriage, underlying conditions such as diabetes, hypertension, thyroid disorders or autoimmune disease, and any history of chemotherapy or radiotherapy in either partner. These questions are for both of you, not only for the woman; male-factor causes are involved in a substantial share of cases.

What tests are ordered

Usually an ultrasound to assess the uterus and count antral follicles, hormone tests including AMH to estimate ovarian reserve, an assessment of tubal patency, and a semen analysis. The exact list differs from person to person, and the physician decides which are needed on the basis of that first conversation.

What is clear by the end

Usually which pathways are on the table and what has to be established in order to choose between them. What is not clear at the end of a first visit is the final choice of treatment. IVF is not always the first recommendation; simpler routes such as ovulation induction or IUI are sometimes enough, and the choice between them is made after the test results, not before.