During an initial consultation, the patient discusses past fertility experiences and goals with Dr. Elassar to identify potential treatment options. Whether the goal is family building or fertility preservation (egg and embryo freezing), the Doctor will explain treatment options in depth, determine a timeline, and answer any questions. Consultation includes an ultrasound to determine the ovarian reserve and detect any uterine abnormalities. Blood is drawn onsite to evaluate hormone levels depending on your case.
When Should You Come In For A Consultation?
There is no harm in checking with a reproductive endocrinologist and at any stage of your reproductive life but such a consultation can have great benefits. If you are concerned about your reproductive age (ovarian reserve), effects of polycystic ovaries, fibroids, endometriosis, or any fertility issue, you should seek consultation. In addition, preconception counseling and labs may reveal significant abnormality that could be treated in the mother or prevented from reaching the baby.
- Couples are not able to conceive after one year of regular unprotected intercourse with a female aged less than 35 and six months if the female age is older than 35. You are attempting to conceive if you are not using birth control pills or condom.
- Women with known or possible fertility factors: these could include women with no menses or irregular cycles, women diagnosed with PID, prior pelvic surgery, endometriosis or PCOS (polycystic ovary).
- Men with known or possible fertility factor: erectile or ejaculatory dysfunction, retrograde ejaculation, reduced libido, prior vasectomy, deformities or abnormalities of the penis and abnormalities in sperm analysis.
- Women interested in extending their fertility using egg freezing or couples interested in extending their fertility using embryo freezing.
- Women and men at risk for reduced fertility due to a disease or disease treatment. This includes women and men diagnosed with cancer, those diagnosed with lupus and requiring chemotherapy, women requiring surgery for ovarian cysts or endometriomas and men requiring genital surgery.
- Women or men carrying or at risk for carrying a genetic disease, individuals with strong family history for a genetic problem, or those who conceived a child diagnosed with birth defect.
- Women with recurrent pregnancy loss: repeated first or second trimester abortion or recurrent preterm delivery.
- Individuals seeking pregnancy through donor sperm or donor eggs or using a gestational carrier (surrogate).
- Same sex couples.
- Women desiring pregnancy with a specified sex for family balancing.
Always remember that consulting with a reproductive endocrinologist is an important safety measure and prevents the transmission of genetic problems to your baby in addition to helping you with your specific fertility issues. The vast majority do not require any intervention.
What To Expect At Your First Visit At NYCIVF
Prior To Your First Fertility Consultation
We want you to feel fully informed and prepared when you first come to see us. We know that good preparation can help you get the most from your fertility consultation—and help us better understand your needs. That’s why we’re available to you at any time prior to your first visit to answer any questions by phone or email.
When preparing for your visit, please plan on spending about 90 minutes with the doctor. This will allow us the time we need to do a thorough exam and address all of your needs, questions, and concerns. We encourage you to write down any questions you may have and bring them with you to your visit.
To help us fully evaluate your needs—and provide more accurate, personalized advice—we also encourage you to bring a record of any previous testing or treatment, including:
- Sperm analysis
- Hysterosalpingogram (HSG) report and films (if available)
- Lab test results
- Results of any previous genetic consultations
- Medical reports from your physician about any significant disease or health condition
- Operative reports of any abdominal or pelvic surgery
- Records of any prior fertility treatment, including ovarian stimulation (cycle sheets), embryology records indicating sperm quality, number of eggs retrieved, number of mature eggs, number of eggs fertilized, quality of embryos, number of embryos transferred, and number and stage of embryos frozen
During Your Fertility Consultation
When you arrive for your appointment, you’ll be taken back to a private consultation room as soon as possible—usually right away. The first fertility consultation typically takes about 90 minutes.
During your visit we will conduct:
- A thorough medical and personal history to review information related to ovarian, tubal and male factors of infertility as well as medical, surgical, and personal issues. A detailed family and genetic history is essential to identifying and possibly testing for the risk factors of genetic disease. We also want to know any relevant information about your daily activities, work, and relationship—and anything else that’s on your mind.
- A physical examination, including a general, abdominal, and pelvic exam.
- A pelvic ultrasound to detect any abnormalities in the uterus, ovaries, or pelvis. Ultrasound is also an excellent tool to estimate ovarian reserve.
- Blood work will also be done at your initial visit, if needed.
We’ll then talk about the possible issues that may reduce your fertility, any required tests needed to investigate ovarian reserve and male and tubal factors as well as prenatal tests needed before conception.
Finally, we’ll work together to outline a provisional plan for finding out the cause of your infertility—and deciding on the right treatment option. We’’ll go through each likely scenario—and the treatment options for each—as well as your expected success rate and overall prognosis. We’ll also discuss possible treatment risks, including the risk of multiple pregnancies.
After Your Fertility Consultation
Before making any treatment decisions, we’ll need to complete all required testing, including sperm analysis, testing for tubal patency (HSG), and tests for ovarian reserve. Additional prenatal tests, including reproductive hormone assay, infectious disease profile, and genetic screening, should also be completed before attempting to conceive.
All required testing can be completed within 2 to 3 weeks of your first fertility consultation—allowing you to make a prompt decision about the next step in your treatment plan. We’ll call you to set up a follow-up consultation—by phone or in person—to discuss the results, our recommended treatment plan, and your chances of success.
Points To Consider Before Starting Treatment
- Time commitment: Fertility treatment may require multiple visits over several weeks. We tailor these visits around your schedule to ensure minimal disruption to your work schedule or other activities.
- Cost: You’ll need to consider the full cost of treatments at the fertility center you are using. We believe in making fertility treatment affordable to all women and men.
- Risks—including multiple pregnancies: You should consider not only the pregnancy rate but also the risk of multiple pregnancies. We make every effort to minimize potential undesired outcomes, especially multiple pregnancies. If you desire a singleton pregnancy, we encourage you to lean towards IVF with single embryo transfer rather than ovulation induction with gonadotropin injections. Before treatment, we’ll also discuss your level of acceptance for possible fetal reduction if needed.
- Surgery: If any surgery—such as the removal of uterine polyps or fibroids—is required before fertility treatment, you’ll also need to consider the risks and benefits of such procedures.