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There are a lot of feelings when you enter your first fertility consultation; that's totally normal. The good news: the first visit will primarily gather information, answer questions and make a clear plan. It's not a pass/fail kind of test, but when you and your care team map out what's most likely to help you grow your family.
Bring a list (or photos) of any relevant medical records: past pregnancies, past surgeries, diagnoses (endometriosis, PCOS, varicocele, for example), chronic conditions and current medications (including supplements). Write down your menstrual cycle information (length, regularity, last period), frequency of intercourse, lifestyle (smoking, alcohol, occupation) and any previous fertility testing. If you have previous test results (ultrasounds, semen analysis, blood tests), bring some of those; they expedite the discussion. Most clinics also ask partners to attend or give relevant history.
Most first fertility consultations include:
Clinics strive to provide you with a clear next step at the end of the visit; whether this is simple testing, changes to your lifestyle or referral for more specialised treatment.
This is usually the first and most important test for men. A lab checks the sperm count, motility (how they swim), shape (morphology) and other features of the semen. You'll typically be asked not to ejaculate for 2-7 days before the sample, and clinics may ask for repeat samples if they get borderline results, since sperm numbers can vary. Results are useful in deciding if additional testing (hormones, ultrasound, genetics) is necessary.
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Blood tests are often performed, such as FSH, LH, thyroid test, prolactin and AMH (Anti-Mullerian Hormone) to assess ovarian reserve. These tests, which are often timed to specific days of the cycle, help predict the number of eggs available and whether hormone issues may be affecting fertility. Your clinician will describe the meaning of results in terms of options and timing.
A pelvic ultrasound (often transvaginal) checks the uterus and ovaries for fibroids, polyps, ovarian cysts or signs of PCOS. If tubal blockage is suspected, a hysterosalpingogram (HSG), an X-ray of the uterine cavity and fallopian tubes, may be recommended. For men, a scrotal ultrasound can be performed to look for varicoceles or for structural problems. Imaging is ordered, depending on history and the results of initial tests.
If basic tests are very low or absent sperm or if there's a relevant family history, then genetic testing (karyotype, Y chromosome testing (microdeletion) or CFR testing) may be discussed. Other specialised tests, such as sperm DNA fragmentation tests, infection screens or immune testing, are used, on a selective basis, when they will alter management.
General advice is to get checked after 12 months of regular unprotected sex if you're under 35 and after 6 months if you're 35 or over. If you have obvious risk factors (previous cancer treatment, known reproductive issues, irregular cycles or absence of a period) then you should see a clinician earlier. Early assessment may sometimes save time and save options.
Note: abnormal results are not a definitive diagnosis; many of the problems are treatable or manageable using assisted conception.
Fertility workups can be emotionally heavy. Good clinics pair medical assessment with counselling, clear explanations, and time to weigh options. Don’t hesitate to ask for written summaries, contact details, or a second opinion if you need it.
If you’re ready to take the first step, Maaeri Fertility and IVF Centre(www.maaeri.co.in) can help you prepare for the consultation, book reliable baseline tests (semen analysis, AMH, hormone panels, ultrasound), and connect you with experienced fertility specialists. Maaeri’s patient navigation aims to reduce the overwhelm, from explaining test prep to helping you understand results and next steps, so you feel supported from appointment one.
