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What to Expect with a Fertility Work-Up and Evaluation

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a blog by Traci Shahan, RN, WHNP-BC, Doctor of Nursing, Albrecht Women’s Care: A Center for Reproductive Endocrinology and Infertility, March 7, 2011

In my last blog, Five Easy Tips for Your Basic Fertility Work-Up, I looked at tips for making your first visit with a fertility doctor (reproductive endocrinologist or RE) efficient, productive, self-advocating and intentional. This week, let’s look at what you might experience during a fertility work-up cycle, also known as a fertility evaluation cycle.

(By the way, many thanks to those of you who took the time to personally thank me for that blog. It is a joy to receive correspondence from you.)

Everyone Is Different

All of us are different with unique ways that our bodies might be assessed, so everyone's fertility evaluation cycle may not be the same.

If you feel confused or believe that you need additional information to increase your comfort level, YOU DO! You are in the driver’s seat as far as gathering resources to help you understand your fertility challenges. After all, you have hired a group of professionals to help you create a family, and you should be accorded time, respect and as much explanation as you need to feel relatively comfortable in proceeding with fertility treatment.

Remember that most people are anxious to one degree or another. Whatever your anxiety level, you deserve to be treated with patience and respect.

What Does a Fertility Evaluation Cycle Look Like?

A fertility evaulation cycle generally includes:

  • ultrasounds and other imaging such as sonohystograms or hysterosalpingograms,
  • blood tests,
  • possibly oral medications, and
  • return trips to your fertility clinic.

You should expect phone calls when lab tests return. During these calls, your fertility clinic will review with you all results and how any abnormal findings may affect your fertility or your fertility treatment.


Ultrasounds provide a robust source of information. The vast majority of the time, these ultrasounds — also called sonograms or scans — will be performed transvaginally.

Having had scads of them myself over the years, and having performed them many times over, I think I’m a pretty good judge of what an ultrasound feels like. Most people know about the pressure and goop from the ultrasound gel that we use to clarify our pictures, but there is an additional feeling that can occur shortly after and during the scan that is best described as an achy sensation.

Most people do not report this feeling, but those of us who have felt it know that it is real. It is not harmful, as we are simply bouncing sound waves off of your body’s tissue, like a dolphin does with echolocation. But it is an odd feeling that always dissipates in the hours after the scan. You will probably learn to really look forward to your ultrasound appointments to see the progress that you are making. I did.

Blood Tests

Yep, we all know that there will be a pinch, then an ache and maybe a little bruise. Nope, none of us likes having our blood drawn, but hormones are what we in the field of reproductive endocrinology are rooted in, so we have to have them.

If you are a person who gets lightheaded, ask to have your blood drawn while lying down. Drink a lot of water and breathe in through you mouth and out through your nose — gently — as your blood is drawn. Then eat a little snack and drink something afterward. And yes, you can wear that bandage for as long afterward as you wish to garner a little sympathy from family and friends. Or as soon as the puncture site stops oozing, you can remove it. (I always favor the sympathy-gig myself!)

Return trips to your fertility clinic will almost always be in order. Although you will be apprised of findings throughout the cycle, a follow-up consultation with your fertility doctor and his or her team is essential for congruence of care, for your questions to be answered and so that you can continue to understand how the office can best meet your needs.

In my next blog, we’ll continue learning about a typical fertility patient’s first few months of care.

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