Making a consensus to see a fertility specialist is a very difficult decision for couples with fertility issue. Many find it stressful to seek professional help for such an intimate problem as it may also often put a strain on a relationship. In seeking fertility treatment, the first step is always the hardest one. Most couples are doubtful about what to expect during the initial consultation.
The purpose of the first consultation is for the doctor to have a comprehensive infertility evaluation of the couple. An integral part of evaluation is the history-taking. Over 70% of the medical diagnosis could be obtained just from tracing back on health history. Therefore, a couple should be ready to answer questions to help the fertility specialist to make the diagnosis quickly and proceed with the next step. These are some questions that a couple can anticipate from a doctor.
Questions for the couple
• How long have you been trying to get pregnant? • Are you using any contraception? • What contraceptions have you used before? Any side effect from it? • How frequently do you have intercourse? • Do you find any difficulty during or after intercourse? • Do you both stay together? How frequent do you travel? • Have you sought any fertility treatment before? What treatment has been given? • Do you have any side effect from the treatment? • Have either one of you treated for sexually transmitted disease before? • Do either one of you smoke or drink? How frequently do you smoke or drink? • Do you have miscarriage, ectopic or failed pregnancy before? Any particular cause for that? What was the treatment? • Do you have any live birth before? How long ago? Any complication from the delivery? • How long did you try before you got your previous one? • Do you have any offspring with your previous partner? • Do you have any long term medical illness such as diabetes or hypertension? What medication are you taking now? Any side effects from the treatment? • Have you been exposed to chemotherapy or radiotherapy? • Do you have any surgery before? Was it major or minor? Any complication from it? • How is your working environment? Have you been exposed to heat, radiation, chemical or toxin? Any other occupational hazard? • Are you taking any supplement, traditional herbs, and steroids? • Are you having tremendous stress recently? • How about your family members? Do they have any fertility issue? • Are you happy with your marriage?
Questions for the husband
• Do you have any difficulty getting erection and ejaculation? • When did you attain puberty? • Any injury to reproductive organ before, such as during football and cycling? • Have you had mumps infection before? • Do you experience reduced sexual desire? • Do you experience infections of the testis, epididymis or prostate? • Have you had any surgery done on your reproductive organ or to repair hernia? • Are you using any weight gain regime, bodybuilding powder or anabolic hormone? • Are you using any anti-hair loss medication? • Do you always wear tight pants or love cycling?
Questions for the wife
• When did you first start menstruating ? • Is your menstrual cycle normal? Is it regular? How long is your normal cycle? How many days of bleeding? What is the amount of bleeding? • Do you have painful period? • Do you have painful intercourse? • Do you exercise a lot? • Do you have drastic weight gain or weight loss? • Are you using weight loss products? • Do you experience excessive vaginal discharge? • When was your last Pap smear test and what was was the result?
Dr. Wai Kok Yau is a consultant Obstetrician, Gynaecologist and Fertility Specialist in TMC Fertility and Women’s Specialist Centre, Kota Damansara and Kepong, Malaysia.
Dr. Wai completed his medical training and obtained his MBBS in University of Malaya. He started his specialization in Obstetrics and Gynaecology in 2004. Since then, he has served in various tertiary and district hospitals, providing services in Women’s Health to the communities in need.