What to Expect During Fertility Treatment

Dr. Warren Huber explains what to expect during fertility treatment at The Fertility Institute of New Orleans.

What to expect during your first appointment

Here at The Fertility Institute, we welcome new patient consults. Prior to your visit we’ll ask you to fill out much of the needed medical history, fertility history, workup and such in our new patient portal. This will assist in streamlining your appointment so that we can get down to the reason why you’re coming to see us.

Once you present to the office, big deep breath – you made it! First visits are usually very laid back. We typically do not do any imaging, any bloodwork or any exams at a first visit. It’s somewhat of a meet-and-greet where we talk a little bit about where you have been, where you are and then ultimately where do we want to go?

During your new patient visit, we will delve into some of the information that you have provided to us before the appointment. We will look through all of your history and some of the previous treatments if you have had them and we’ll discuss some of the details to make sure that they are accurate. We’ll also talk a little about your medical history, your surgical history, some of your gynecological history, history of menstrual cycles and your partner’s history – partner history is very important to us.

We welcome partners at the first visit, but we are realistic in the fact that sometimes it’s very difficult to get two adults, working adults at that, in the same room at the same time. If your partner is not available for the first visit, we welcome the opportunity to either conference your partner in on the first visit, whether it’s on the phone or via Zoom. Alternatively, we welcome you to take meticulous notes or even have a follow-up phone call for your partner.

What to expect during fertility testing

So, there are multiple different types of imaging procedures in the world of fertility medicine. One of which is a hysterosalpingogram (HSG), where we shoot dye into the uterine cavity to look at the uterus fill up and then the fallopian tubes spill out with dye.

The second is called the saline infused sonohysterogram, also called an ultrasound installation, where we use ultrasound to look at the inside lining of the uterus with salt water inside the uterine cavity.

And the third is called hysteroscopy. All three of these procedures are performed while awake in the office and in general are very, very well-tolerated.

For the hysterosalpingogram we’ll have the patient present to the office, and then downstairs we have an imaging suite where we will place a speculum with a catheter. The catheter goes directly into the uterine cavity, and then we slowly infuse radio opaque dye that shows up on X-ray. We do it all under real time, you get real time results as we’re doing the procedure.

Same with the saline infused sonohysterogram; we actually do an ultrasound prior to the procedure then place a small little catheter into the uterus, instill salt water into the uterine cavity and then do a 3-D sweep through the uterine cavity and reconstruct the uterine cavity to show us any structural defects such as polyps, fibroids, uterine septums.

The hysteroscopy is very similar to the HSG, but instead of putting a small little catheter into the uterus we actually put a scope – a hysteroscope where we can look in with a camera to make sure all is well.

What to expect during an egg retrieval

So today’s your egg retrieval. We will have you present to the office about an hour before the scheduled case, so that we can make sure that all of the paperwork is completed, we can start an IV, and we can confirm that you are who you say you are. The physician will then show up with an anesthesiologist who will get you nice and sleepy. We’ll then use an ultrasound probe to guide our needle into the ovary where we use a pump to take eggs out of the ovary and hand them back to our embryologist.

Once the embryologists have the eggs, they give us a real time count so that when you wake up from your sleep, we’ll be able to tell you how many eggs we’ve gotten.

Typically, patients recover for about an hour in our center. A little bit groggy, maybe a little bit of discomfort but we’ve got a wonderful nursing staff to make sure that your pain is well controlled. When you are ready for discharge, we get you up out of the bed into the car and we give you a call the next day with your fertilization report.

What to expect during IUI

So, you made it! Today’s IUI (intrauterine insemination) day. First things first, we need sperm collection. So, we’ll provide your partner with a collection cup, and sperm goes into the cup. Once the sperm gets to our office, we typically let it sit for about an hour just to liquify. From there we’ll spin it down to collect the best swimming sperm and then we’ll re-suspend it in a very small volume that will then ultimately be put back into the uterine cavity.

From your end, pretty straight forward. You’ll present to the office, and we’ll get you checked in. We’ll bring you back to the exam room when the specimen is ready. It typically takes about an hour to an hour and a half to prepare the sperm specimen. Once you’re in the exam room, we’ll ask you to undress, bottoms off and then covered up with a sheet. We’ll place a speculum once we’re able to bring the sperm specimen into a small syringe utilizing a very small, flexible plastic catheter. We’ll place that little catheter directly into the cervix, we’ll drop the sperm off and we’ll take everything out. You hang with us for about five to ten minutes.

It’s a pretty straight forward process. You’re going to do great!

What to expect during an embryo transfer

So today’s embryo transfer day – the culmination of everything that you’ve been through. Today what we’ll have you do is present to our office downstairs in our IVF center, and what to expect is we will bring you into the IVF center, get you checked in. We will be asking you to fill your bladder, and I tell you why in just a second.

So, once we get everyone checked in and confirm you are who you say you are, we will then alert the embryologist that we are a “go” for the embryo transfer. We bring you back into our transfer suite and while you are wide awake under ultrasound guidance, we will use the ultrasound probe to check to make sure that we will put the embryo directly into the uterine cavity where it belongs.

Again, our embryologist will confirm who you are and how many embryos we are transferring. Once we confirm everything, we will make sure that we can get into the endometrial cavity or the uterine cavity very easily. When we give the embryologist the thumbs up, they will load your beautiful embryo or embryos into the catheter, and then we’ll do an embryo transfer under ultrasound guidance that we can see because of your beautiful bladder.

After the embryo transfer, the embryologists, like us, are perfectionists and they’ll make sure that the embryo didn’t stick to the inside lining of the catheter. Once they flush the catheter multiple times, they will give us the all clear. Once we have the all clear, we’ll take the speculum out, we’ll walk you back to your room, you can empty your full bladder and then we let you go about your day.

Learn about infertility

Are you trying to grow your family? The Fertility Institute of New Orleans can help you understand your options and what to expect during treatment.