Infertility 101: where to start?
You have been TTC1 for a bit, reading on and following every bit of TTC tips you could find, but still no success so far …
You may have been wondering: is it time to ask for help, when to see a fertility doctor?
Deciding to seek medical support to start or to grow your family is a huge and deeply personal step. And yet, it often comes with more questions than answers:
When should I call a doctor? Who should I see? What do I even say?
The answer will depend on your personal situation.
If you are a single woman or man, or an LGBTQ+ couple investigating your options, then you will most likely need to seek a first fertility appointment with a fertility specialist (called reproductive endocrinologist or “RE”) quickly.
As for heterosexual couples, here’s a general rule of thumb to seek your first fertility appointment:
- If you're under 35 and have been trying to conceive for 12 months or more without success
- If you're 35 or older and it's been 6 months or more of trying naturally
- If you have a known medical issue - like blocked tubes, endometriosis, or past cancer treatment – that may affect your fertility
… then it’s time to consider reaching out to your Ob-Gyn or an RE.
As hard as this step may feel, it's a powerful one, and I recognize and praise you for this humbling achievement.
Many of us grew up hearing how easy it was to get pregnant, so when it doesn’t happen, it can feel like something’s wrong with us.
Sometimes, it can also be hard to get or stay pregnant for a second, third … child: secondary infertility is a “real” thing. Even if conceiving the first time was “easy” and uneventful, it doesn’t mean that subsequent pregnancies will be easy to achieve. It can be very hard then to admit that help may be needed, as “it worked fine the first time around”.
Saying out loud, “I need help” is not just brave: it’s a major milestone. You are not broken. You are not alone.
Below are a number of tips on how to prepare for that first appointment and what to expect, so that you can walk in informed, empowered, and ready to take your next steps:
- Educate yourself: understanding your own cycle and fertility basics is key to a good start (see our article “”)
- Prepare your questions for your doctor
- Find the medical professional that works best for you!
1. Educate yourself: understanding your own cycle and fertility basics is key to a good start
Before stepping into a doctor’s office, it will help you immensely to understand the basics of the menstrual cycle and how fertility works. The more you know about your body (or the reproductive system relevant to your fertility journey), the more confident you'll feel communicating with your care team and making informed decisions.
And if you weren’t born with female reproductive anatomy, don’t skip this section!
Understanding these concepts will likely still be key to your fertility journey, even if you're using donor eggs, a surrogate, or supporting a partner through treatment.
Here are some key questions to explore ahead of your first appointment:
- Is your menstrual cycle regular? Is it typically 26, 28, or 30 days? Or is it unpredictable?
- Do you understand the phases of your cycle? Knowing about the follicular phase, ovulation, and luteal phase can help you track your fertility.
- Can you identify your fertile window and ovulation day? Are you using ovulation predictor kits (OPKs), tracking apps, or monitoring cervical mucus or basal body temperature?
- Have your attempts at natural conception aligned with your fertile window? It’s helpful to know whether intercourse occurred during your likely ovulation period.
- Do you have any past gynecological or fertility history your doctor should know about? For example:
- Have you had any live births, and if so, were they via vaginal delivery or C-section?
- Any history of miscarriages, chemical pregnancies, or ectopic pregnancies?
- Any history of surgery such as explorative laparoscopy of the reproductive organs?
- Have you been pregnant with a different partner?
- Have you previously done egg freezing and do you still have some cryopreserved (frozen) eggs?
- Have you ever had a tubal ligation or reversal?
- Any known or suspected infections, STIs2, or pelvic inflammatory disease?
- Have you ever had an IUD3 or used hormonal birth control? For how long?
- Have you been tested for AMH4 or other fertility hormones?
- Any diagnosis of PCOS5, endometriosis, fibroids, polyps or adenomyosis?
- Have some of your family members (sister, cousin, mother, grand-mother, nieces etc.) ever been diagnosed with those conditions, or with uterine or breast cancer?
- If your mother is already in menopause, what age was she when it started?
- Did your mother experience any struggles to conceive and/or to give birth?
Lastly, don’t overlook other health conditions.
Pre-existing medical issues, such as thyroid disorders, immune system problems, blood clotting abnormalities, or medication allergies, can be highly relevant to your fertility journey. These conditions may contribute to infertility or impact how your doctor designs your treatment plan. Be sure to share a full list of your current and complete diagnoses and medications so your care team can make informed, personalized decisions.
Even if you don’t have all the answers right now, starting to gather as much of this information as you can while you wait for your first appointment, will make it much more productive and possibly will save you some time down the road.
Also, it will absolutely give you more confidence walking through the door of the doctor’s office, and help alleviate a bit of the stress you may feel!
2. Questions to ask your RE or doctor: be prepared!
Once you’ve decided to seek medical support, you will get a first in-person or virtual consultation. Oftentimes, clinics offer that consultation for free.
The first one can feel overwhelming: you might be unsure of what to ask, or even where to begin. Below is a list of thoughtful, grounding questions that can help guide your first (and future) appointments.
Remember: you don’t have to know it all. That’s what your doctor is there for, and you should always feel free to ask your doctor any question. There is no “silly” or “dumb” question, and even if it feels so, do ask that question.
Being informed and prepared empowers you to best advocate for your care, understand your options, and make the most of your time with your provider.
As I continue building BabyBloom, I will continue to work on educational content, with a goal to provide pieces of answers to all the below questions. In the meantime, you will find a number of resources below to help you dig into those mind-numbing questions. You can also consult our Resources section, for many very useful websites and community groups.
We’ve grouped possible questions into themes, so you can pick and choose what’s most relevant for you.
General Health & Initial Evaluation
- What tests should we start with to evaluate our fertility?
- Should my partner also be tested now? For what?
- What does a full fertility workup include?
- Are there lifestyle, nutrition, or supplement changes we should consider?
- Do any of my current health conditions or medications affect fertility?
- How long should we continue to try naturally before moving to treatment?
- Should I be screened for ….
- Endometriosis?
- Adenomyosis?
- PCOS?
- Chronic endometritis?
- Hormonal imbalance?
- Fibroid, polyps, or other uterine structural issues?
- What is genetic carrier screening? Is it something we should consider?
- What is your philosophy: do you tailor treatments, or follow a standard protocol?
- What infertility emotional support or mental health support options exist – for individuals or couples?
Male Factor Infertility (MFI)
- What is “male factor infertility”, and how is it diagnosed?
- What does a semen analysis look for, and when should we do one?
- What lifestyle choices or medical factors can impact my partner’s fertility?
- If male factor is involved, what are our options?
- My partner is hesitant to get tested: how can I approach that conversation?
Testing, Timing & Hormones
- What does fertility testing for couples normally entail?
- What is “AMH” or “ovarian reserve” and what does it tell us?
- What do FSH7, LH8, estradiol, and progesterone levels indicate?
- Why would a thyroid test be helpful for fertility purposes?
- Do I need an ultrasound to check my “antral follicle count”? When is that done?
- How do my hormone results reflect egg quality or ovarian reserve?
- Are there hormonal levels that could disrupt an ART6 conception cycle?
Treatment Paths & What’s Ahead
- What are our treatment options: timed intercourse (TI), intra-uterine insemination (IUI), in-vitro fertilization (IVF)? Are there others?
- Based on our case, what path would you recommend? Why?
- Should we do even more testing than what we have done before moving forward?
- What are the success rates for each option, given our situation?
- We’ve read about medications like Clomid or Letrozole that can help get pregnant: are those appropriate for us?
- Should we do “egg freezing” first, or directly fertilize eggs, or both?
- How long do treatment cycles typically take?
- If necessary, do you open the clinic for checks or surgery on the weekend?
- What if treatments don’t work: what are our next steps?
Supplements, Diet, and Lifestyle
- What supplements do you recommend for egg and sperm quality and health?
- How long do we need to take supplements for? When do they start working?
- Is it worth exploring things such as acupuncture, red light therapy, TENS9 unit?
- Are there foods or substances I should avoid while trying to conceive?
- Does alcohol, caffeine, or exercise or other lifestyle choices impact fertility?
Financial & Insurance
- What should I include in my fertility treatment costs?
- Does my health or Rx insurance cover any of the testing, treatment, or medications? Do I have any fertility insurance coverage?
- What are the out-of-pocket costs for fertility evaluations, treatments and medications?
- Where can I get those costly medications for better prices?
- How much will a cycle cost? How do we even afford it?
- What exactly is included in a fertility cycle package …. and what isn’t?
- Are there discount programs or fertility grants available?
- Are there discounts for multiple cycles? Refund or guarantee programs?
- Are there payment plans, grants, or nonprofit assistance available?
Tip: write down the answers during your visit, or bring someone with you to help listen or take notes! Depending on where you are located, you may legally have the possibility to record your consultation: but make sure to check on this with your doctor before!
Use your BabyBloom app to track all your medical provider questions and their answers!
You’re not alone. You’re asking the right questions. And every question you ask, brings you one step closer to the clarity and support you deserve. 💛
3. How to choose a fertility clinic?
Choosing the right fertility doctor or clinic can feel overwhelming, but it’s one of the most important steps in your journey.
And the key is to find the medical professional that works best for you!
While many people start with recommendations or local options, finding the right fit is deeply personal. The clinic that helped your friend might not be the right one for you – and that’s okay. Here are a few tips to guide your search.
Start with Your Ob-Gyn
If you already have a trusted Ob-Gyn, they can be a great starting point. They may run basic fertility tests, help track your cycle, and refer you to an RE if needed. Some Ob-Gyns are also part of larger health systems that also include fertility practices, making coordination easier.
Tip: not all Ob-Gyns are fertility specialists, and not all Ob-Gyns will even be willing to help. If you’ve been trying for a while, have known complications, or if you feel your Ob-Gyn doesn’t seem very eager to help, it may be time to move directly to an RE/fertility clinic.
Use Online Resources (with a critical eye)
Websites like FertilityIQ.com, SART.org, RESOLVE.org, and Healthgrades.com can help you explore fertility clinics by location, specialty, or IVF success rates. These can be helpful for getting a sense of what’s available near you.
Tip: don’t choose a clinic based solely on success rates. These numbers can be misleading. Some clinics selectively accept patients with higher chances of success (e.g., younger age, lower BMI, or no complex health issues) to protect their stats. That means a clinic with “perfect” scores may not be open to helping people with more complicated fertility challenges – while a clinic with more modest numbers might actually be more flexible and personalized in their care.
[See our upcoming article “Should I trust the SART success scores to select my clinic?”]
You can – and should – also check public reviews on Google Maps, Apple Maps, Yelp, search the clinic in Facebook fertility-related groups, or even Reddit to get a sense of how people describe their experience with a specific clinic or RE.
Tip: keep in mind that reviews are often emotional and highly personal. A glowing review could be based on bedside manner solely, or a lucky “first time first cycle and got pregnant” story, while a scathing one might stem from disappointment after an unsuccessful outcome. Try to spot patterns across multiple reviews, not just one-off impressions.
Word-of-Mouth & Community Groups
Fertility support groups (those are abundant on Facebook), forums (like Reddit’s r/Infertility), and local or online communities can offer honest insights into different providers, and often recommend those clinics that stand out.
Hearing from people who’ve been through it can help you learn what to ask and what to expect.
Tip: remember, someone else’s great experience (or bad one) doesn’t guarantee yours will be the same. Your body, your needs, and your situation are unique.
Look at the Clinic’s Website & Team
Once you’ve identified a few possible clinics, take a look at their website. A clinic’s website often gives you a sense of their approach, available services, and the backgrounds of their doctors. A lot of them will also post some of their prices – just be cognizant of what these prices include and exclude.
Look for a team that includes board-certified REs, that offers services that match your needs (e.g., IUI, IVF, egg freezing, donor/surrogacy, LGBTQ+ family building, immune protocols, etc.), and that will be convenient for you to travel to – as appointments during cycles can be every day or every other day and eat up a lot of your time.
Tip: Many clinics offer free seminars or nurse consults: these can be a no-pressure way to learn and ask questions. Some will also showcase a large range of educational information in terms of options available, protocols, and so on. Reading these as well as their FAQs will give you an idea of what type of practice they have, and what they do or do not offer.
Don’t rush your choice!
Even if you have a strong preference right away – and that’s totally normal – it’s a good idea to schedule initial consultations with 2 or 3 different clinics or doctors. Comparing their approaches, communication styles, and recommendations can help you make a more confident and informed decision.
Tip: Come prepared with the same set of questions for each consult. Pay close attention to how they respond:
- Do they actively listen to your concerns and take your history seriously?
- Do they give clear, thoughtful answers, or brush past what matters to you?
- Do you feel respected and heard, or talked down to?
- Are they going off on tangents (about religion, specific diets, or ideologies) that don’t sit right with you?
- Did they reassure you in a way that felt real – not just hopeful promises, but a plan that made sense?
In the end …. trust your gut! If something feels off during that first visit – even if you can’t quite put your finger on it – it’s okay to move on. First instincts are usually spot on.
It’s OK to change your mind!
Sometimes, things just don’t go as planned - and that’s okay. You may realize that the clinic you chose isn’t the right fit after all, for a whole variety of reasons.
And if you’ve convinced yourself it was your fault … it was quite likely not your fault. Not all fertility clinics are solely centered on providing the best care they can. The sad reality of things is, fertility care is still very much a money-maker, and abusive practices can regretfully be found, even in the best rated clinics.
Even if you’re already mid-treatment, if you feel something is wrong or you are not listened to, you are 100% entitled to seek care elsewhere.
You are the patient. You are paying for a medical service around one of the most emotional and life-changing journeys you’ll ever face. If you don’t feel supported, respected, or safe — it’s absolutely okay to leave.
While switching clinics mid-process isn’t ideal, it’s often better than losing precious time, money, or emotional energy on a team that isn’t meeting your needs. And the good news? Your next clinic can usually pick up where the last one left off (for the most part): they’ll review your records, tests, and treatment history to help move things forward faster.
Tip: There are many reasons someone might change clinics, and they’re all valid. Here are a few real-life examples. Remember: if something feels off, it is off — no matter what the “something” is.
- The clinic gave you a diagnosis before running full tests. It might seem efficient or reassuring, like they really know what they are doing … or it might be a red flag. Some clinics may assign a diagnosis quickly just to move you into treatment (and billing cycles), rather than truly investigating your case.
- You’re not getting clear answers. Doctors and staff are busy, but persistent delays or dismissive attitudes aren’t okay: especially when your body and health are involved. If you’ve followed up and still feel unheard, it may be worth consulting elsewhere.
- You’re told to lose weight before beginning treatment. Some clinics have strict BMI cutoffs. While there are medical reasons for this in some cases, it can also feel discriminatory or overly rigid. If you feel shamed or stereotyped, trust your instincts and consider a second opinion. Not all clinics will require you to be under a certain BMI to help you.
- Your protocol doesn’t feel right, and no one is explaining why. Maybe your hormone levels are unusual and your protocol isn’t being adjusted. Maybe a sonographer made an odd comment and your team shrugged it off. If you feel uneasy, ask questions; and if those questions aren’t answered, get another opinion.
- Your timing is being compromised. If your clinic schedules your trigger shot (or egg retrieval) based on convenience instead of optimal timing, that’s a serious concern. This isn’t just about a weekend: it’s your body, your money, your shot at success to get pregnant.
There’s no “perfect” doctor, but the right one for you will help you feel informed, heard, and respected.
Notes
- TTC — Trying to conceive ↩
- STIs — Sexually transmissible infections, such as gonorrhea, chlamydia, herpes, HIV etc. ↩
- IUD — Intra-uterine device, a contraception device inserted in the uterus ↩
- AMH — Anti-Müllerian hormone ↩
- PCOS — Polycystic ovaries syndrome ↩
- ART — Assistive reproductive technology ↩
- FSH — Follicle-stimulating hormone ↩
- LH — Luteinizing hormone ↩
- TENS — Transcutaneous electrical nerve stimulation ↩
Your fertility journey is yours: and you deserve to walk into every appointment feeling prepared, not panicked.
That's exactly why we built BabyBloom: to help you track your cycle, log your questions, organize your medical history, and feel in control of your journey - one step at a time.
Download BabyBloom and start preparing for your first appointment today!
Have a question we didn't cover? Reach out to us: we're building this for you, with you. 💜