A first fertility appointment typically lasts 60-90 minutes and involves: paperwork and medical history review, a conversation with the reproductive endocrinologist (RE), a transvaginal ultrasound, blood draw orders, a semen analysis referral for your partner, and discussion of next steps. It’s diagnostic — no one will pressure you into treatment at this visit. You’ll leave with more information than you had walking in, and that alone is worth the trip.
Before the Day: How to Prepare
Completing these before your appointment saves time and ensures your RE has what they need to make the most of your visit:
- Complete intake forms early. Most clinics email these 1-2 weeks before. They’re long — budget 30-45 minutes. Include both partners’ medical history.
- Export your cycle tracking data. 3-6 months of BBT charts, OPK results, or app data. Screenshot or PDF your Clue, Flo, or Fertility Friend charts.
- List all medications and supplements. Everything — including prenatals, herbal supplements, and OTC meds. Doses matter.
- Gather prior test results. If your OB-GYN ran any bloodwork (AMH, FSH, TSH, Day 3 labs) or imaging (HSG, pelvic ultrasound), bring copies or have them faxed.
- Check insurance coverage. Call your insurance company and ask: Does my plan cover fertility diagnostic testing? Do I need a referral? Is there a lifetime maximum for fertility treatment?
- Write down your questions. You will forget them in the moment. Guaranteed. Write them on your phone or a card. Prioritize your top 5.
The Visit: A Minute-by-Minute Walkthrough
Arrival & Check-In (0-10 minutes)
Arrive 15 minutes early. You’ll check in at reception, confirm insurance details, and sign any remaining consent forms. The waiting room will likely have other couples — everyone is nervous, and everyone is pretending they’re not. Pro tip: bring headphones or a book. Wait times vary.
Vitals & Nursing Intake (10-20 minutes)
A nurse or medical assistant will take your vitals (blood pressure, weight) and confirm your medical history. They may ask about your menstrual cycle, sexual history, previous pregnancies, and any medications or supplements. This is a safe space — be completely honest. Nothing you say will shock them; they’ve heard it all.
The RE Consultation (20-50 minutes)
This is the main event. Your reproductive endocrinologist will review your history, ask detailed questions about your TTC timeline, discuss any known conditions, and outline what they think is going on. This is your time to ask questions — don’t hold back.
Common questions the RE will ask you:
- How long have you been trying to conceive?
- Are your periods regular? How long is your cycle?
- Have you ever been pregnant before (including losses)?
- Any diagnosed conditions? (PMOS, endometriosis, thyroid issues, etc.)
- Have you used ovulation predictor kits? What did they show?
- Any family history of infertility, early menopause, or genetic conditions?
Transvaginal Ultrasound (50-60 minutes)
Almost always done at the first visit. A small ultrasound wand is inserted vaginally to visualize your uterus and ovaries. The RE is looking for: antral follicle count (AFC) — the small resting follicles visible on each ovary, which estimate your ovarian reserve; uterine shape and lining thickness; any fibroids, polyps, or cysts; and signs of endometriosis or PMOS (string-of-pearls follicle pattern).
This takes about 5-10 minutes. Mild discomfort is normal. The RE will often point out what they’re seeing on screen and explain it in real time.
Blood Draw (60-70 minutes)
Bloodwork is typically drawn at this visit or scheduled for a specific cycle day. Common tests include:
- AMH (Anti-Müllerian Hormone) — can be drawn any day
- FSH & Estradiol — Day 2-4 of your cycle
- TSH — thyroid function
- Prolactin — elevated levels can suppress ovulation
- Progesterone — drawn 7 days post-ovulation to confirm ovulation occurred
If today isn’t the right cycle day for certain tests, they’ll schedule you to come back.
Partner’s Semen Analysis (referral given)
Your partner will typically be given a lab order for a semen analysis, either at the clinic or at a local lab. This can be done at a separate appointment. The analysis measures count, motility, morphology, and volume. It’s one of the simplest and most informative fertility tests available. If your partner is hesitant, at-home sperm tests can be a starting point — though a full lab analysis is still recommended.
Wrap-Up & Next Steps (70-90 minutes)
The RE (or a nurse coordinator) will outline the plan. This typically includes: when you’ll get bloodwork results (usually 3-7 days), any additional testing needed (HSG, hysteroscopy, genetic screening), a preliminary assessment based on what they’ve seen, and — if appropriate — a discussion of initial treatment options (timed intercourse, ovulation induction, IUI, or IVF).
You are not committing to anything at this visit. Take the information home, process it, discuss with your partner, and follow up when you’re ready.
Common Questions to Ask Your RE
Don’t leave without asking the questions that matter most to you. Here are some good ones to have in your pocket:
After the Visit: What to Expect
Most clinics have a patient portal where results are posted as they come in. Bloodwork results typically take 3-7 business days. Once all results are in, you’ll have a follow-up consultation (often by phone or video) to review findings and finalize the plan.
The gap between your first visit and getting all results back can feel agonizing. Continue tracking your cycles, taking your prenatals, and timing intercourse normally. The diagnostic process doesn’t pause your natural chances of conceiving. Some couples get pregnant during the workup — and that’s a great outcome.
What If the News Isn’t What You Hoped?
Sometimes the first visit reveals unexpected challenges — low AMH, a blocked tube, a semen analysis that needs attention. This is hard to hear, but remember: a diagnosis is the starting point of a plan, not the end of a journey. Most fertility conditions are treatable. Having clear information allows your RE to match you with the approach that gives you the best odds.
It’s also okay to be upset. It’s okay to cry in the car on the way home. It’s okay to need a day before you talk about it. And it’s okay to get a second opinion if something doesn’t feel right.
Ready to Find a Clinic?
Our guide to fertility benefits by employer can help you understand your coverage options before you book.
Check Your Benefits →Frequently Asked Questions
Yes, absolutely. Many people go to the initial consultation solo and bring their partner to follow-up visits. However, if your partner can attend, it’s helpful — they’ll hear the information firsthand, can ask their own questions, and can provide their medical history directly.
Comfortable clothing you can easily change out of for the ultrasound. You’ll be given a gown or drape for the transvaginal ultrasound portion. No special preparation needed otherwise.
Almost always, yes — a transvaginal ultrasound is standard at the first visit. It takes about 5-10 minutes and involves mild pressure but shouldn’t be painful. Let your provider know if you experience any discomfort.
Look for board-certified reproductive endocrinologists, check SART (Society for Assisted Reproductive Technology) data for their success rates, read patient reviews, and ask about their approach during the consultation. A good clinic will answer your questions openly and not pressure you into immediate treatment.
Absolutely. The testing process takes 2-6 weeks to complete, and you should continue timing intercourse around ovulation during this time. A workup and natural conception are not mutually exclusive.
Medical Disclaimer: This content is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider for personalized guidance.