Starting a fertility treatment

Some people compare starting a fertility treatment to a  journey to a new world : new jargon, a new medical environment, new treatment routines …

Its emotionally very exhausting, you risk going from hope to disappointment in matter of weeks or months.

At some point, you may have a good perception of what you are going to go through, but as what lies ahead is unknown, the lack of control  felt by some couples is a perfectly normal phenomenon. It is important to have an open discussion with your partner before starting a treatment program and determine how many treatment cycles you are willing to undergo.

Do not hesitate to ask the medical team assigned to you to clarify any questions you have during your fertility treatment. This will keep you informed, and the more informed you are, the more you will feel reassured and confident in the various stages which await you.

In this post, you will find all the necessary enlightenment needed to help you better prepare for your treatment.

Establish a schedule

Scheduling is the first step in starting a fertility treatment. The goal is to define the number of attempts and the budget available to spend on the treatment.

In addition, opinions and feelings should be openly discussed between partners because infertility is easier to approach with the two people involved. Treatment decisions are simpler when made by partners in line with their goals.

Make sure you have a certain amount of  flexibility on schedule, because one of the things you need to keep in mind during fertility treatment is the  ability  to be able to quickly adapt to changes.  

The first step

By establishing a calendar, couples can ask themselves the following questions:

  • What are the financial limits?
  • Who can help us?
  • How is treatment consistent with our spiritual and moral beliefs?
  • What are our feelings about treatment?
  • How much do we want to follow the process?

Questions to ask during a fertility treatment

Infertility treatments can be so technical (complicated medical jargon) that its easy to feel quickly lost and overwhelmed. The more you are able to understand the treatment, the more sense of control you would have.

Here are some questions to ask your doctor that can enable you understand the whole process better.

General questions about treatment

  • How many cycles are recommended for each treatment option?
  • What is the delay between the different treatment cycles if any?
  • How does age affect our schedule?
  • What are the chances of getting a pregnancy for each treatment option?
  • How much will the different treatment options cost?

Questions about laboratory tests and procedures

If a procedure or test is planned, you should ask the following questions:

  • What is the purpose of this test?
  • Where and when will the test take place?
  • Is the test painful? Is there a medication to take before or after the test to relieve pain?
  • What is the time needed before knowing the test results? How to interpret the results?
  • Does the doctor’s office call patients to tell them about the test results?
  • How much does the test cost?

Questions about drugs

The answers to these questions help couples understand the medications prescribed:

  • What is the purpose of the prescribed drugs?
  • When should I take the prescribed medications and at what dosage?
  • What is the method of administration of the drug? What are the storage conditions of the drug (put in the fridge, away from light ….)?
  • What are the possible side effects?
  • Does the use of this medicine include restrictions related to sport, certain activities, certain foods and beverages? Do you have to respect a specific timing when taking the medication?
  • Are the drugs fully reimbursed or do you have to pay a full or partial supplement? If so, how much is personal participation?

Help the work of the doctors

For effective fertility treatment, doctors need to know as much as possible about the health and history of their patients.

At first, it can be tedious for a patient to always provide the same information that he / she has already given to other physicians. Similarly, some questions asked by doctors can also make couples uncomfortable. These may include questions about past personal behavior that may lead to shame or guilt. The sole purpose of these questions is to highlight very valuable clues that may explain the cause of infertility.

During fertility treatment, physicians are interested in the following antecedents.

Gynecological

  • Menstruation (age of onset of menstruation, duration and frequency of the cycle, intermediate periods, contractions or significant bleeding), painful cycle, painful intercourse?
  • Sexual history
  • Contraceptive use (IUD, pill and other methods)
  • Sexually Transmitted Diseases (STDs) (chlamydia, gonorrhea, genital warts, syphilis)
  • Surgery or lower abdominal therapies (removal of appendicitis, bowel restoration, removal of ovarian cysts, dilatation and curettage, treatment of a malformation of the cervix)
  • Infections, pain in the lower abdomen, feeling of heaviness in the belly
  • Abnormal cervical smears
  • Previous pregnancies / abortions / miscarriages
  • Myomas (type, format and location)

Medical

  • Chronic Diseases (Diabetes, Hypertension, Asthma, Arthritis, Thyroid Disease and Ulcers)
  • Anti-cancer treatment
  • Chronic infections of the bladder or urinary tract
  • Taking medication
  • Medicated allergies

Personal

  • Health and lifestyle (sports, tobacco, alcohol and drugs)
  • Recent weight change
  • Exposure to toxic substances in the environment (lead, irradiation, pesticides)

Family History

  • Fertility problems in the family.
  • Repeated miscarriages or difficult pregnancies.
  • Age of mother / sister at the time of menopause.
  • Chromosome and / or hereditary diseases (sickle cell anemia, muscular dystrophy and hemophilia, trisomy 21, mental retardation).

Previous fertility analysis

If fertility tests have been performed in the past by another doctor, important information and a copy of the results can be sent to the fertility specialist.

The following information, if available, is to be provided to the physician.

  • Sperm analysis (number of spermatozoa, mobility, morphology)
  • Hormonal analyzes (FSH, LH, TSH, estradiol, progesterone, testosterone, prolactin)
  • Buccal ultrasound (report of the results)
  • Hysterosalpingography (HSG) (x-rays and report made during the procedure)
  • Postcoital test (CPT) · Basal body temperature, observation and / or culture of cervical mucus
  • Endometrial biopsy
  • Laparoscopy (report and possible x-rays)
  • Hysteroscopy (report and possible x-rays)

Previous treatments of infertility

If fertility treatments have been used in the past, it is essential for a new doctor to obtain as much information as possible.

The easiest way is to ask your previous doctor to summarize the following results:

  • Information on the cycle with ovulation stimulation drugs (name of the drug (s) and dosage, number of days of taking, possible hormonal levels, number of follicles).
  • Intrauterine inseminations (the same information as above, with the day of the cycle where the IUI occurred, the quality of the sperm original and stimulated, including the percentage and quality of the sperm mobile).
  • IVF (In Vitro Fertilization) or ICSI (Intra Cytoplasmic Sperm Injection) cycle: the same information as above, with the number of eggs obtained, the day of the cycle where the puncture took place, the number of frozen embryos, the type of anesthesia performed for the puncture, the number and quality of embryos put back in place, the time between cycles (resting cycles).
Preparation for treatment
  • Make sure you are available for the duration of your treatment and can arrange flexible hours.
  • Lighten your social life in order to cope with the demands of treatment (frequent check-ups, injection of medication at a time determined by your doctor).
  • Surround yourself with positive people who will help you through the different phases of treatment and who you can count on to support you psychologically.
  • If you have the opportunity, talk to others who have followed the same treatments.
  • Both observe a healthy lifestyle (reduce for example tobacco and alcohol consumption, or better yet, stop them completely).
  • The woman is advised to take folic acid at least 3 months before starting treatment.
  • If you have trouble managing stress, use stress reduction techniques (physical activities such as walking, swimming, relaxation techniques, yoga, acupuncture, participation in a discussion group …).

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