Onward Babe
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Let's get you ready

You're getting a fertility workup · no details given · change answers
Email me my appointment questions We'll email you a link to your Fertility workup questions — plus what to bring and which tests to ask about — so they're on your phone in the exam room. You'll also get What's Next, our monthly email. Unsubscribe any time.

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Questions to ask

  • Which of these has been done, and which haven't: ovulation, ovarian reserve, uterine cavity, tubal patency, semen analysis, thyroid?
    Ask for the list out loud. A complete workup should cover all of these.
  • Has my partner had a semen analysis? If not, can we order one now?
    Male factors contribute in roughly 40–50% of cases, and the test is simple. It's the most commonly skipped part of an evaluation.
  • What does each of my results mean, in plain language, and which ones change what we do next?
  • Is there any test you'd consider for me based on my history that isn't on the standard list?
    For example, after a pregnancy loss, or with a history of pelvic infection or endometriosis, additional tests may be reasonable.
  • If everything comes back normal, what would you look at next, and when?
    'Everything looks normal' should be the start of a plan, not the end of the conversation.
  • Can I get copies of all my results and notes? (You're entitled to them.)
  • Who do I contact with questions between appointments, and how quickly should I expect a reply?
  • Which of these tests and treatments are typically covered, and can your office help me check my benefits before we start?

Things to bring

  • All results so far, including from other doctors
  • Your cycle history and how long you've been trying
  • Any prior pregnancies or losses, with dates
  • A list of medications and supplements for both partners
  • Your questions, written down. You will forget them in the room.

Tests to ask about

  • Ovulation. Confirmed by regular cycles, a mid-luteal progesterone level, or ultrasound tracking.
  • Ovarian reserve. AMH, antral follicle count, day 2–4 FSH and estradiol. Useful for planning treatment; not a prediction of whether you can conceive.
  • Uterine cavity. Transvaginal ultrasound first; a saline sonogram is more sensitive for polyps and fibroids.
  • Tubal patency. An HSG (X-ray with contrast) or a contrast ultrasound (HyCoSy) shows whether the tubes are open.
  • Semen analysis. Volume, concentration, motility, and morphology. Often needs to be repeated once if abnormal.
  • Thyroid (TSH). Commonly included. Ask if it's part of your panel.

Nail this down before you leave

  • Which tests are complete and which are still pending
  • What 'normal' means for each of your results and what range you're in
  • What the leading explanation is, if any, and what the next step will be
  • When your follow-up is and who to contact before then

Questions that work in any appointment

These four apply to any test, any treatment, any recommendation — and they're the ones that turn a pronouncement into a decision you're part of.

  • Does this evidence apply to my situation specifically?
  • What would this test change about our plan?
  • What are the benefits, the risks, and the alternatives?
  • What would make you recommend a different approach?

If they say everything looks normal

  • Which of the standard tests have actually been done, and which haven't?
  • If everything is normal, what would you look at next, and when?
  • Is there anything in my history that would make you consider additional testing?
  • What's the plan from here, and at what point would you change it?

What happens next

The results that usually decide what comes next: ovulation status, tubal patency, ovarian reserve range, and semen parameters.

If a clear cause is found (for example, blocked tubes, no ovulation, a significant sperm issue), the next conversation is about the treatment that fits it. Move to I'm considering treatment.

If everything is normal, the label is 'unexplained infertility.' Guidelines recommend a defined plan for it, usually starting with ovulation medication plus IUI for a few cycles before IVF. That's a next step, not a shrug.

Notes from the appointment

Onward Babe is educational, not medical advice. Everything here is built from published research and professional guidelines so you can have a better conversation with the doctor who actually knows your situation.