First consultation appointment
Investigations
Welfare of the child
Downloads
First consultation appointment
A referral to the Regional Fertility Centre will be in one person’s name, although the consultation is for both you and your partner. It is essential that you attend the appointment together, unless you are attending as a single woman.
Before your appointment with the consultant, you will need to fill in some forms. You should arrive 15 minutes before your appointment to do this.
During your initial consultation with the doctor, they will take a detailed history from both you and your partner. It’s important to get as much background information as possible.
At this first appointment, a transvaginal ultrasound (internal) scan of the pelvis is usually carried out to assess the womb and ovaries. However, this is not always the case.
Other investigations that may be arranged are:
- detailed semen analysis
- FSH and oestradiol levels – taken on day two or three of the cycle
- BMI measurement (female)
Investigations that may be requested by your consultant during your fertility assessment
After meeting with you and discussing your history, your consultant may request some further investigations to ascertain the nature of what is happening.
The investigations below are the more common fertility investigations that may be requested by your consultant after your initial assessment in the Regional Fertility Centre.
Body Mass Index – BMI
We assess everyone’s BMI at the initial consultation. BMI can affect fertility therefore if there are concerns regarding your BMI, your consultant can advise as appropriate.
The NHS has BMI cut off points (funding criteria) for certain fertility treatments as per the NICE guidance.
Transvaginal Ultrasound Scan
Your consultant may perform a transvaginal ultrasound scan during your consultation. This a small probe that is inserted into the vagina and allows the visualisation of the uterus, ovaries and pelvis. The scan can identify certain gynaecological conditions which contribute towards fertility problems.
Anti-Mullerian Hormone – AMH
Anti-mullerian hormone is a hormone that is made by the eggs in your ovaries. This gives us an overall idea of your egg reserve and how you might respond to certain fertility treatments. Anti-mullerian hormone is important in helping to plan treatments, but it is not normally an indicator or predictor of natural fertility.
Thyroid
Thyroid function is routinely tested in the Regional Fertility Centre if this has not already been done by your GP.
Approximately one in twenty patients will have an issue with their thyroid.
By assessing your thyroid hormones, we will then be able to make a judgment on whether it is normal or needs treatment. Correcting thyroid dysfunction if present can assist in increasing the chance of spontaneous pregnancy and also the overall success in fertility treatments if required.
Rubella
We assess a patient’s immunity to Rubella otherwise known as German measles. If you are non-immune to Rubella and you contract the infection in the early stages of pregnancy it could lead to serious consequences for the pregnancy. Therefore it is an opportune time to seek out vaccination if not immune.
Semen Analysis
If not already requested by the GP, your consultant will request a semen analysis for the male partner. This is to assess any potential sperm problems contributing to the couple’s subfertility.
Tubal Assessment
Depending on your history and what your other investigations show, your consultant may request an investigation of your fallopian tubes.
This test assesses whether your tubes are open or closed. In a very small minority of patients there may be tubal blockage.
This is best performed in either the form of: a Hysterosalpingogram (HSG) or Laparoscopy and dye test. HSG is an X-ray and dye test to assess if the tubes are open. In certain situations, a Laparoscopy and dye test maybe suggested which is a surgical procedure where a camera is inserted into the abdomen to visualise the tubes and then dye is flushed through the fallopian tubes via the uterus to assess if the tubes are patent.
Welfare of the child
The Regional Fertility Centre is required to take account of the welfare of any child born as a result of fertility treatment in a licensed centre or any other child who may be affected by the birth.
All patients attending their initial consultation will therefore be asked to complete a short questionnaire. See the Human Fertilisation and Embryology Authority (HFEA) website for more details.
Please note: If you request a female member of staff, we will make every effort to accommodate the request. However, we can’t guarantee that a female member of staff will be available for any specific appointment.
Downloads
You may find this information useful before your first appointment: