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If you have been trying to get pregnant for a year without success, it may be time to see a fertility doctor. This is a big step that requires preparedness and commitment leaving so many women or couples daunted, especially if you are unsure of what to expect. Fortunately, there are several options available in Singapore, and help is readily available.

Here are ten things you should know before attending your first fertility appointment.

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1. Be aware of the types of doctors you can approach for your fertility issues.

The first step in the fertility treatment journey is a visit to your OB/GYN. But in doing so, make it a point to ask exactly how much training, experience, and success he or she has had in treating infertility.

OB/GYNs are trained to diagnose and treat women’s reproductive issues and manage their health and well-being during pregnancy and childbirth. It’s safe to say that gynaecologists have a considerable amount of experience in dealing with fertility issues. But not everyone is formally trained to treat infertility or conduct the necessary procedures (e.g. IVF, IUI, ART).

While there are some OB/GYNs who are equipped to manage infertility issues, there are some who are not. If you’re OB/GYN does not specialise in fertility treatments, your next stop would be a board-certified reproductive endocrinologist. These practitioners have undergone years of additional training to diagnose and treat infertility both in men and women.

While your gynaecologist can offer some preliminary information on fertility, not all of them are experts in the treatment of complex conditions like infertility. These professionals must render additional clinical experience and exams to be duly certified.

Men who struggle with infertility can consult an andrologist. These physicians are urologists who are certified to treat male infertility, impotence, and sexual dysfunctions, just to name a few.


2. Learn if a clinic specialises in the fertility issue you have.

There can be several reasons why a woman or a couple is unable to bear a child. Usually, these reasons are complex, so it requires a fair amount of specialisation to address the issue. There are clinics whose practitioners specialise in specific fertility issues. For instance, there are clinicians who are particularly good at managing PCOS, endometriosis, or diminished ovarian reserve. Getting in touch with a doctor who is trained and experienced on your fertility problem is a step in the right direction.


3. Know when to talk to a gynaecologist about fertility issues

The right time to approach an OB/GYN about your fertility is even before you are aware of any fertility issue. When you see yourself starting a family even if it’s still in the distant future, there’s no time like the present to get into a fertility work-up.

Since this journey takes two to tango, you must also take your partner to a gynaecologist appointment. This will get the two of you in the habit of working with a doctor. If ever fertility management is going to be necessary, visits to the doctor will come more often. Like they say, “it takes a village to raise a child”, and this statement will also apply even while planning for a baby. It will take a team effort. Therefore, it’s important to establish good rapport with your gynaecologist early on.

Learn more about this in the video below, or read more on infertility in this blog.


4. Know the qualities that you should look for in your doctor

It’s important that you feel comfortable with your doctor. Intuition will tell you that a certain doctor is your ally in your journey to conceive. There are several accounts where patients encounter doctors with very poor bedside manners. Instead of being warm and accommodating, there are clinicians who are cold and dismissive.

If you will choose a doctor, find someone who is willing to explain the process to you. It’s not promised that this journey is going to be smooth sailing, and it’s normal to have a lot of questions. So, in your hour of need, it’s good to have someone who will not keep you in the dark which can only raise your anxiety.

Doctors who rush through the consultation or decline to explain options such as surgery or drugs without discussing why is a red flag. Don’t waste critical time with the wrong doctor.

You can check potential doctors through websites that offer evaluations or reviews on OB/GYNs or fertility specialists. You can glean a lot of inside information from online forums or ask friends and families for referrals.


5. Know when to go with a different doctor

The decision to move on from a fertility clinic is never easy. Perhaps you have started the process with a clinic or are currently undergoing infertility treatment. Then you realise that something is off, or you don’t feel comfortable and well-taken care of. Whenever you feel that you’re getting the proper treatment, it is well within your rights to seek help somewhere else.

Keep an eye out of the following warning signs:

  • You can’t ask questions freely.
  • Your doctor dismisses your concerns.
  • Your OB/GYN or fertility specialist suggests you continue a course of treatment even though you’ve been through several cycles without success.
  • You have to remind the doctor constantly about your treatment plan.
  • Pregnancy drug treatments are not carefully monitored with blood tests and ultrasound exams.

When you finally decide to make the switch, the primary criteria you should seek are the same as with your first clinic. These include board-certification, success rates, reputation, compassion from the entire staff, and ease of access to the physician.

Change can be intimidating, but it can also be equally rewarding when you feel that you are given the care you deserve. Decide what is best for you and do so without regrets.


6. Know your ovulatory cycle

One of the basic information that the doctor will want to find out is whether or not you are ovulating. You can find out for yourself prior to your appointment by keeping track of your basal body temperature (BBT), which is your temperature when you’re fully at rest. You need to keep monitoring for a few months.

Ovulation may slightly increase your basal body temperature. Take note that you are most fertile during two or three days before your temperature increases. By tracking it daily, you are able to predict when you will ovulate. While it may not be a hundred percent accurate, the information that you can glean by keeping tabs will be helpful during your evaluation.


7. Expect a battery of tests to achieve a diagnosis

Infertiltiy is complex, that is why it usually requires several tests to arrive at a diagnosis. While it may sound frustrating, you need to keep your eye on the ball. These are all necessary steps that are designed to look into essential factors for successful conception, such as, hormone balance, ovarian status, ovulation, sperm quality  and quantity, and male/female reproductive factors affecting fertilisation.

This may sound like a lot, but you don’t necessarily have to go through all of them. Your fertility doctor or care team will be able to tell you exactly what tests are involved in your case.


8. There can be several treatment options available for your particular concern

After you’ve completed all the necessary testing, your doctor can provide you with a diagnosis. Even if yours fall under “unexplained infertility”, there are treatment options that can help you conceive.

The diagnostic phase may not be an easy ride, but this level of thoroughness will be crucial in narrowing down the treatment options suitable for you. The goal here is to find a treatment that will be tailored to the unique needs of each patient to ensure a safe pregnancy that will run its full course.


9. Check your insurance coverage

Your budget is an important consideration when you’re considering fertility treatment. So it would be wise to  check into your insurance coverage before you see your doctor. Be sure that you’re well informed and find out what existing government subsidies in Singapore and your private medical insurance plans will cover. If you have health insurance, you can choose a specialist included in your health plan’s network of specialists.


10. Do your own research and prepare your questions

Some people are shy about asking questions, but you shouldn’t be. A good doctor will welcome these questions to make sure you understand your diagnosis and treatment options. If you don’t understand the answers, don’t hesitate to seek clarifications. If you’re still not sure what to ask, below are some good questions that you can start with.

While at the clinic, get as many facts as you need by asking all the necessary questions. It may be helpful to request fact sheets or literature about each of the options discussed so you can review them later. Take advantage of the knowledge, experience, and expertise your doctor has to get a good grasp of the situation. Remember that you’re not in this alone, and help is available.

We understand that there is a lot of anticipation and fear around making your first appointment, but we are here to help you every step of the way. At the Dr Pamela Tan Clinic, we are all active participants in helping you grow your family.  Making your appointment is an important step in starting your fertility journey, and we are here to help you in this exciting time in your life. You can make an appointment with us today by calling +65 6254 2878 or send a message here.

Dr Pamela Tan

About Dr Pamela Tan

Dr Pamela Tan is a board certified obstetrician and gynecologist in Singapore. She finished her undergraduate studies at the National University of Singapore and earned her post-graduate degree at the Royal College of Obstetricians and Gynaecologists in the UK. She is an accredited specialist by the Specialist Accreditation Board (Ministry of Health), and a fellow of the Academy of Medicine, Singapore. She subspecialises in colposcopy and is certified to perform Level 3 minimally invasive keyhole surgeries such as laparoscopic hysterectomy, myomectomy and cystectomy. Dr Pam also supports the natural birthing method and she strives to provide a personalised care and treatment for each patient.