Fertility Consultation

Deciding to have a baby is exciting, however, it isn’t always that easy. In fact, many couples experience challenges and difficulties when trying to conceive. Women experiencing fertility concerns often go through a range of emotions, including anxiety, confusion and fear.

At Women’s Specialists of Northside Gwinnett, Dr. Melanie Watkins and Certified Nurse Midwife, Tonya Hemmings, specialize in guiding you and your family through this stressful time to not only help you find answers and get education, but also create a detailed plan to help you grow your family.

What is Infertility and What Are the Common Causes?

Infertility is defined as not being able to get pregnant after one full year of trying (or six months for women 35 and older).

The most common causes of infertility include: sperm issues, hormonal imbalances caused by Polycystic Ovarian Syndrome (PCOS) and thyroid disorders, age, fallopian tube disease, endometriosis, premature ovarian failure, and/or uterine fibroids or endometrial polyps.

What should I expect at my fertility consultation?

During your consultation at Women’s Specialists of Northside Gwinnett, you can expect the following:

  • Review of Detailed Medical History: Dr. Watkins and/or Tonya Hemmings, CNM, will take a detailed and comprehensive medical history. We ask that you download and fill out the Infertility Consult Form prior to your appointment to bring with you.
  • Lab Work: Labs will then be ordered that will help us in uncovering why you and your partner may be struggling with conceiving. These will likely include:
    • Antimullerian hormone (AMH): this lab acts to be a “window” into the age of your ovaries. This is especially important in women whose mothers experienced early menopause (prior to 45) or women who are over 35. This lab can also help to confirm a diagnosis of polycystic ovarian syndrome (PCOS). In general, a level greater than 1.5-2 is reassuring of normal ovarian reserve and good egg quality.
    • PCOS /hormone lab panel: a full lab panel will be drawn to rule out PCOS and other hormonal issues which can be a common cause of infertility. These labs include:
    • Follicle stimulating hormone (FSH)
    • Luteinizing hormone (LH),
    • Thyroid stimulating hormone (TSH)
    • Prolactin
    • DHEAS (dehydroepiandrosterone)
    • Free and Total testosterone
    • Complete metabolic profile
    • Hemoglobin A1c
    • Insulin
  • Semen Analysis: A semen analysis order will then be given to you for your partner. Male factor infertility can be the cause of infertility in 40-50% of couples. A semen analysis can help to make sure your partner has sperm that are normal in number, motility and shape.
  • Ultrasound: We will schedule an ultrasound to evaluate your uterus and ovaries for the presence of fibroids, polyps, and/or ovarian cysts.
  • Femvue: If all other causes of infertility are ruled out or if you have risk factors for scarred or blocked fallopian tubes, a Femvue will be scheduled. A Femvue, also known as a “tube test,” is a simple in-office procedure that will assess your fallopian tubes to make sure they are open and rule out blockages. Tubal blockage or scarring can be the cause of infertility in 25-35% of women. Risk factors for tubal disease include: recent or remote history of chlamydia or gonorrhea, history of endometriosis and/or history of pelvic surgeries.

What To Expect: Post Fertility Consultation

At Women’s Specialists of Northside Gwinnett, we are here to help you and your family overcome fertility issues in the best way possible, including:

  • Removal of polyps and/or fibroids found on ultrasound. This can be done in the comfort of our office or with same-day-surgery at Northside Hospital Gwinnett.
  • If a thyroid disorder is the cause, we can help to start you on thyroid medication and/or refer you to a local endocrinologist.
  • If male factor infertility is diagnosed, we can refer you to a local fertility urologist.
  • If PCOS is diagnosed, we can help you manage this condition and give you education that will help you ovulate. We also can prescribe medications that will help you to ovulate.
  • If decreased ovarian reserve is diagnosed, we will help you to come up with a plan and assist with referrals to local reproductive infertility specialists.
  • If tubal disease is diagnosed, we can assist with referrals to local and amazing reproductive infertility specialists.
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