What to expect from your first reproductive endocrinology & infertility (REI) visit?

Your first visit with an REI provider is focused on collecting your history and that of your partner if you have one. The visit is usually about 45 minutes to one hour. Your REI provider wants to know how long you have been trying to conceive and what that looks like for you. They also want to know if you have ever seen a fertility specialist and any previous workup you have completed. Be sure to bring those records with you if you have seen someone previously.

Other detailed medical history that will be asked by your REI provider during the first visit include:

• Any ongoing or previous medical problems, surgeries, medications you take, medication allergies, and your health habits.

• Details about your periods including age when you first started having periods, how often you have periods (# of days between cycles), how long they last, how heavy your bleeding is, and if you have any pain with periods or intercourse.

• Any history of abnormal pap smears or sexually transmitted infections.

• All pregnancies you have had in the past, including losses and terminations, and any complications you may have had.

• Family history, including any history of cancers, infertility, recurrent miscarriage, early menopause, or babies born with birth defects or genetic abnormalities.

Your REI provider will also review the typical workup for infertility which involves:

• Checking ovarian reserve labs (AMH and day 3 FSH and estradiol)

• Checking for normal uterine cavity and open tubes (HSG or HyCoSy/FemVue)

• Checking a semen analysis on your partner.

• Preconception labs which include blood type, complete blood count, thyroid hormone tests, diabetes screening, immune screening (rubella, varicella, measles), and infectious disease screening (HIV, hepatitis, syphilis).

Other workup that your REI provider may also offer include:

• Expanded carrier screening. This blood tests looks to see if you carry any genetic mutations for dangerous diseases that can be passed to your baby, such as cystic fibrosis. As a carrier, you do not have the disease, but if your partner is also a carrier, your baby has a 25% chance of having that disease. If you test positive for anything, we then check your partner.

• If you have a history of irregular periods, PCOS, recurrent pregnancy loss, or endometriosis then your provider may recommend additional testing.

Next step: You should follow up in 3-4 weeks to review the results and plan for next steps.