The First Visit To The Reproductive Endocrinologist

The first visit to the reproductive endocrinologist (RE) can be worrisome because the hope and dream of having a baby rides on what this doctor can do for the couple. This appointment is typically scheduled according to where the female is in her menstrual cycle so she possibly had to wait a month or more for an appointment at best. These specialists are so book up that many times it is a wait of four to six months to get in to see one.

At the first visit, the doctor will take a complete history and physical and spend a great deal of time just talking to the couple and getting familiar with their reproductive history. Initially, the doctor will want to do some preliminary tests. He will want to do some hormonal blood tests to check the follicle-stimulating hormone and the luetinizing hormone. The doctor will do a series of blood tests to check for sexually transmitted diseases as well as ask both partners about past history of sexually transmitted diseases. This helps the doctor get a mental picture of anything in the past that could have an impact on current fertility. In addition, the doctor will perform a physical exam. Typically, the doctor will want to perform a semen and urine analysis on the male partner as well.

Another thing that takes place at the first visit is that the RE discusses all of the fertility treatments that are available in that particular clinic and the protocol surrounding those treatments. The doctor will speak with the patient concerning how far they are willing to go in the treatments.

By the end of the first appointment, the couple and the doctor will have a good picture of what will come next and how far the journey will go if necessary. The blood work and semen analysis test results will not be back for about three or four days so at the end of the first visit there probably will not be any answers about the cause of the infertility. Before leaving that first visit, the couple will make a series of appointments for future tests and visits with the doctor. Each clinic typically has a scheduler who works with the local hospitals and will put together the appointment and testing schedule for each couple. It is extremely important for the female to have her menstrual calendar with her at this appointment because other future appointments will need to be made according to what the cycle day is. As a general rule it is not good to have to call back to have the scheduler make the future appointments because the dates fill up quickly and the wait tends to get longer. In addition, at this visit the couple will meet with a financial planner who will go over approximate costs, insurance information, and clinic fees.

Occasionally tests and procedures that need to be performed on certain cycle days will need to be scheduled on weekends or holidays. Most clinics are accustomed to this and are equipped to work on the necessary days. In other cases, waiting one or two days is not significant. However, if at any point the couple feels like timing is everything and they are being asked to wait beyond what they are comfortable with always go straight to the doctor. The couple should never be afraid to talk to the doctor directly with any questions or concerns.

The next appointment will usually be within three to five days after the initial appointment to perform a diagnostic ultrasound to check the production and quality of eggs within the ovaries according to the cycle day.

Male Infertility Testing
Male infertility accounts for approximately one-third of all cases of infertility and is related in some way to about half of all infertility cases. After one year of unsuccessful attempts at pregnancy, it is important for both people to seek treatment. This can be distressing for most men and it is good for men to know that the male infertility testing is relatively simple and routine.

The first and most common test for the male is the semen analysis. For this test, the sperm is collected into a sterile specimen jar and sent to an on-sight lab. The technician will look at the semen under a microscope to check the sperm for shape, appearance, and ability to swim quickly and efficiently. At this time, the technician will also count the number of sperm in order to assess the effectiveness at which the male body makes sperm. For the sperm count, the technician will check to see if the concentration of sperm is above or below 20 million sperm cells per milliliter of ejaculation fluid.

The second test that is usually done is a urine analysis. The urine is checked for infection because any kind of infection in that area can kill sperm or greatly affect their ability to fertilize an egg. The urine is also checked for sperm. If there is, sperm in the urine this can signify retrograde ejaculation, which is also a common cause of male infertility.

At this point if the semen analysis and urine analysis tests are both normal, the testing typically turns to the female and further male testing is not necessary. However, if the female turns out to have no fertility issues and the doctor feels it is necessary to go back to testing the male there are a few other tests that can be done.
1. Sperm agglutination is a laboratory test that checks to see if the sperm are clumping together. Clumping of the sperm inhibits their ability to swim through the female cervical mucus.
2. Sperm penetration assay is a rarely used test that uses hamster eggs to determine the sperms ability to penetrate an egg.
3. Hemizona assay is a test that uses a non-usable female egg to determine the sperm capabilities of penetrating the outer layer of the egg.
4. Acrosome reaction is another laboratory test that determines whether or not the sperm head is capable of going through the chemical changes necessary to penetrate the female egg.
5. Hypo-osmotic swelling is a laboratory test that determines the ability of the sperm tail in penetrating the female egg. In a solution of a special sugar and salt, a healthy sperm tail will swell while a dead or non-healthy sperm tail will not respond.
6. Testicular biopsy is a test that determines how well the sperm are being produced by removing a small piece of tissue from the tubules in the testes.
7. Vasography is a type of x-ray exam that will show whether there is blockage or leakage of sperm within the vas deferens.
8. Ultrasonography is a type of ultrasound that examines the entire male reproductive system to identify blockages or other types of damage that could be a cause of infertility.


	The First Visit To The Reproductive Endocrinologist The first visit to the reproductive endocrinologist (RE) can be worrisome because the hope and dream of having a baby rides on what this doctor can do for the couple. This appointment is typically scheduled according to where the female is in her menstrual cycle so she possibly had to wait a month or more for an appointment at best. These specialists are so book up that many times it is a wait of four to six months to get in to see one. At the first visit, the doctor will take a complete history and physical and spend a great deal of time just talking to the couple and getting familiar with their reproductive history. Initially, the doctor will want to do some preliminary tests. He will want to do some hormonal blood tests to check the follicle-stimulating hormone and the luetinizing hormone. The doctor will do a series of blood tests to check for sexually transmitted diseases as well as ask both partners about past history of sexually transmitted diseases. This helps the doctor get a mental picture of anything in the past that could have an impact on current fertility. In addition, the doctor will perform a physical exam. Typically, the doctor will want to perform a semen and urine analysis on the male partner as well. Another thing that takes place at the first visit is that the RE discusses all of the fertility treatments that are available in that particular clinic and the protocol surrounding those treatments. The doctor will speak with the patient concerning how far they are willing to go in the treatments. By the end of the first appointment, the couple and the doctor will have a good picture of what will come next and how far the journey will go if necessary. The blood work and semen analysis test results will not be back for about three or four days so at the end of the first visit there probably will not be any answers about the cause of the infertility. Before leaving that first visit, the couple will make a series of appointments for future tests and visits with the doctor. Each clinic typically has a scheduler who works with the local hospitals and will put together the appointment and testing schedule for each couple. It is extremely important for the female to have her menstrual calendar with her at this appointment because other future appointments will need to be made according to what the cycle day is. As a general rule it is not good to have to call back to have the scheduler make the future appointments because the dates fill up quickly and the wait tends to get longer. In addition, at this visit the couple will meet with a financial planner who will go over approximate costs, insurance information, and clinic fees. Occasionally tests and procedures that need to be performed on certain cycle days will need to be scheduled on weekends or holidays. Most clinics are accustomed to this and are equipped to work on the necessary days. In other cases, waiting one or two days is not significant. However, if at any point the couple feels like timing is everything and they are being asked to wait beyond what they are comfortable with always go straight to the doctor. The couple should never be afraid to talk to the doctor directly with any questions or concerns. The next appointment will usually be within three to five days after the initial appointment to perform a diagnostic ultrasound to check the production and quality of eggs within the ovaries according to the cycle day. Male Infertility Testing Male infertility accounts for approximately one-third of all cases of infertility and is related in some way to about half of all infertility cases. After one year of unsuccessful attempts at pregnancy, it is important for both people to seek treatment. This can be distressing for most men and it is good for men to know that the male infertility testing is relatively simple and routine. The first and most common test for the male is the semen analysis. For this test, the sperm is collected into a sterile specimen jar and sent to an on-sight lab. The technician will look at the semen under a microscope to check the sperm for shape, appearance, and ability to swim quickly and efficiently. At this time, the technician will also count the number of sperm in order to assess the effectiveness at which the male body makes sperm. For the sperm count, the technician will check to see if the concentration of sperm is above or below 20 million sperm cells per milliliter of ejaculation fluid. The second test that is usually done is a urine analysis. The urine is checked for infection because any kind of infection in that area can kill sperm or greatly affect their ability to fertilize an egg. The urine is also checked for sperm. If there is, sperm in the urine this can signify retrograde ejaculation, which is also a common cause of male infertility. At this point if the semen analysis and urine analysis tests are both normal, the testing typically turns to the female and further male testing is not necessary. However, if the female turns out to have no fertility issues and the doctor feels it is necessary to go back to testing the male there are a few other tests that can be done. 1. Sperm agglutination is a laboratory test that checks to see if the sperm are clumping together. Clumping of the sperm inhibits their ability to swim through the female cervical mucus. 2. Sperm penetration assay is a rarely used test that uses hamster eggs to determine the sperms ability to penetrate an egg. 3. Hemizona assay is a test that uses a non-usable female egg to determine the sperm capabilities of penetrating the outer layer of the egg. 4. Acrosome reaction is another laboratory test that determines whether or not the sperm head is capable of going through the chemical changes necessary to penetrate the female egg. 5. Hypo-osmotic swelling is a laboratory test that determines the ability of the sperm tail in penetrating the female egg. In a solution of a special sugar and salt, a healthy sperm tail will swell while a dead or non-healthy sperm tail will not respond. 6. Testicular biopsy is a test that determines how well the sperm are being produced by removing a small piece of tissue from the tubules in the testes. 7. Vasography is a type of x-ray exam that will show whether there is blockage or leakage of sperm within the vas deferens. 8. Ultrasonography is a type of ultrasound that examines the entire male reproductive system to identify blockages or other types of damage that could be a cause of infertility. All About Intrauterine Insemination Breakdown Of The Causes Of Female Infertility Causes Of Female Infertility Causes Of Infertility – An Overview Commonly Asked Questions Regarding Female Fertility Commonly Asked Questions About Male Infertility Conceiving After 35 Coping With Infertility Donor Insemination For The Unsuccessful Attempts To Cure Male Infertility Eating A High Quality Diet To Help With Infertility Embryo Transfer – Why Is It Necessary? Female Infertility Testing Female Treatments – An Overview Fertility Drugs – Bromocriptine Fertility Drugs - Clomiphene Fertility Drugs – Gonadotropins Getting Pregnant Without Intervention Gift – Is It Really A Gift? 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