How To Prepare for Your First Fertility Appointment

Reproductive freedom includes the decision to have children. But biology doesn’t always cooperate. Infertility can be a painful experience for people who want to be parents.

If you are ready to have a child, you can explore your fertility options. Fertility clinics help diagnose and treat medical conditions that inhibit pregnancy.

Yet, visiting a fertility specialist can be harder than anticipated. You’ll need to decide what doctor to trust and which treatment plan is right for you. You’ll also need to understand the estimated costs and what your insurance will cover. The process may involve strong self-advocacy or, in some cases, legal assistance.

Get ready for your first consultation with a fertility doctor with the tips below:

• Consider your fertility and family planning options
• Choose your fertility doctor carefully
• Know your reproductive rights
• Check your insurance coverage
• Gather your medical history
• Talk to a family attorney

Consider Your Fertility and Family Planning Options

If you're unable to conceive naturally, various options may be available to you. These options include using a surrogate or pursuing adoption. Or, you might seek the help of a fertility clinic.

There are multiple options for fertility treatments. Common types include in vitro fertilization (IVF) and medication. But the exact treatment depends on your condition and desired outcome. For example, the IVF cycle can be a complicated process.

Fertility clinics offer a variety of services, including:

• Gestational surrogacy
• Egg donation (including anonymous donor eggs)
• Sperm donors (including anonymous sperm donation) or sperm banks
• Egg retrieval
• Egg freezing for fertility preservation
• Embryo transfer, which involves the implantation of an embryo
• Intrauterine insemination (IUI)

Assisted reproductive technology provides a variety of options for people who cannot have children on their own, whether due to infertility or other obstacles. It's important to consult with your doctor about your care.

Genetic Donor Laws

Treatment options carry legal considerations, too. For example, you may want to consider how parental rights and paternity work for genetic donations. The clinic may provide basic patient resources about these topics. Your attorney can review any potential complications with you and protect your parentage.

State law generally requires that the donor and recipient of sperm or eggs cannot be related. States sometimes make exceptions for those more distantly related than second cousins. Check your state's laws for more information.

Fertility Services for the LGBTQ+ Community

Biological barriers to having children are not only a question of infertility. LGBTQ+ couples experience a different set of obstacles when it comes to reproduction. Yet, couples within the LGBTQ+ community can have biologically related children. They can get assistance from a fertility clinic.

For example, a lesbian couple might choose reciprocal IVF. In this process, one partner donates an egg, which is fertilized with donor sperm. The other partner carries the pregnancy. This allows both partners to share in the biological experience. As another example, same-sex male couples might seek fertility care through surrogacy.

As trans-visibility has grown, so has awareness of the needs of transgender individuals when it comes to having children. Fertility treatment options are legally available to everyone, regardless of their gender identity or whether they are in a same-sex partnership. Transgender people are protected by law in their use of fertility clinics.

Choose Your Fertility Doctor Carefully

Fertility doctors are usually reproductive endocrinologists or OBGYNs. Choosing your doctor is a big decision.

You may wish to ask the following list of questions at your initial appointment:

• How long have you practiced in fertility care?
• Are you or your doctors board-certified? In what specialties and subspecialties?
• What is your overall success rate? How is your success rate calculated?
• What is your success rate for couples experiencing the same problems as ours or undergoing the same treatments?
• How much do these procedures and drugs usually cost?
• Does your clinic accept my insurance?
• Do you offer payment plans for uncovered expenses? Do you know about any resources for possible grants or aid programs?

Picking a trustworthy provider is important for intimate matters like reproductive care. Even if you meet one in person at your first consultation, you can decide whether to proceed with them or seek a second opinion.

Know Your Reproductive Rights

Family planning is a highly sensitive and personal subject. Understanding your basic rights as a patient can help you advocate for yourself in the doctor’s office.

A few of the fundamental rights you’ll have in your fertility journey include:

• The right to informed consent and complete information
• The right to privacy and medical data security
• The right to avoid discrimination

Informed Consent in Fertility Consultations

Making the best choices for your body and your family starts with getting accurate, complete information. At your first visit with a fertility specialist, they should ensure you understand your options. Informed consent laws require them to explain the risks and alternatives.

After describing your treatment plan, the clinic may also ask you to sign a care consent form. This document records your permission to receive a fertility treatment or procedure. It can also offer more information about the benefits and risks of the treatment. Read it carefully and ask any questions about the plan before signing or giving verbal consent.

Patient Privacy at Fertility Clinics

Patient privacy laws like HIPPA ensure that you get to decide who knows about your reproductive health and fertility goals. Your medical providers and clinic staff must protect your confidentiality. They can’t share your health information with your employer, relatives, or anyone else without your authorization. They must also keep your medical records secure.

Protections Against Discrimination

People who hope to become pregnant may worry about unfair treatment. Rest assured; the law protects you against discrimination during your fertility plan and beyond.

Fertility centers can’t turn away patients based on protected factors. Discriminatory medical practices create barriers to access, which affects who can reproduce. Access to reproductive care has a long civil rights history. Concerns of discrimination and eugenics have shaped modern legal protections. Denying fertility care due to factors like race or disability is illegal.

You also have legal protection in the workplace. Title VII of the Civil Rights Act prohibits sex and pregnancy discrimination at work. The Supreme Court has ruled that the basis of sex discrimination includes the ability to become pregnant (United Automobile Workers v. Johnson Controls, Inc.). Other courts used this ruling to decide cases like Hall v. Nalco Co., which concerned a woman’s time off work to get fertility treatments.

Check Your Insurance Coverage for Fertility Services

Fertility treatments, pregnancy, and newborn care can be expensive. For example, one cycle of IVF could cost around $15,000 to over $30,000, according to the U.S. Department of Health and Human Services. Many IVF patients need multiple cycles to get results.

Insurance coverage can help people access fertility services and grow their families. Certain plans offer health insurance coverage for treatments using assisted reproductive technology.

However, fertility coverage is usually optional for insurers. Many insurers do not cover fertility treatments and don’t view them as medically necessary. Even with some coverage, patients may face out-of-pocket costs.

Review your specific policy to see whether it covers fertility services and related care, such as:

• Initial fertility testing, evaluation, and semen analysis
• Diagnostic testing and treatment for other conditions that may affect the likelihood of pregnancy, such as fibroids and polycystic ovary syndrome (PCOS)
• Fertility preservation services, such as sperm or egg freezing
• Ultrasound imaging
• Fertility drugs and hormones
• IVF or IUI under limited circumstances

After an effective fertility treatment, follow-up care is essential. Your policy may offer coverage for ultrasounds, bloodwork, and other pregnancy care. Consider your coverage and potential costs for all services you might need for your family goals.

State Laws for Fertility Insurance Coverage

Your coverage partially depends on your state and employer. State laws set mandatory coverage for private insurers and Medicaid programs. Some states require insurers to offer some fertility coverage — but only for a few services.

State laws often define a narrow set of circumstances that affect required coverage, such as:

• How long the infertility has lasted
• What underlying condition or injury caused infertility
• Whether the chosen fertility clinic is licensed by the state
• Whether alternative fertility treatment options are available
• Your marital status
• Your age
• How long your eggs or sperm have been stored for fertility preservation

Coverage requirements vary by state. Insurers and employers may be exempt depending on their size and religious affiliation. If you believe your insurer wrongfully denied your claim for fertility care, speak with a lawyer.

Gather Your Medical History

Your medical history can help the fertility specialist treat you appropriately. They can use it to diagnose causes of infertility and identify the best treatment plan.

If you are a new patient at the clinic, you may want to request a medical record transfer before your first appointment. You can contact your primary care provider and any other specialists to sign a medical records release form. Many health care providers have an option to do so through an online patient portal. It’s smart to complete this step early so the transfer can be ready before your fertility consultation.

Also, bring a list of your medications. Include any over-the-counter drugs or supplements you use.

Talk to a Family Attorney Before Your Appointment

Whether by IVF or a gestational carrier, modern medicine offers many solutions for a growing family. But it’s wise to start the process with a clear perspective.

In certain surrogacy arrangements, a legal dispute around parental rights may be more likely. Before the child's birth, it's important to prevent such disputes as much as possible. You may also consider legal matters like your family’s privacy and the safety of your care.

A skilled lawyer can help protect your family’s legal rights. If you have questions about fertility clinics, parentage, or other concerns, consider contacting an experienced family law attorney. They can help you prepare for your initial consultation with the doctor.