The Mighty Fertility Checklist

The first time we step into the place that would hopefully help us in procreating our first child was on July 10th 2020. We were barely married having done an at-home officiation of our own little ceremony with family on Zoom just weeks earlier! With giddy nerves, we drove up to Columbia Fertility Associates (CFA) and met our reproductive endocrinologist, Dr. Preston Sacks, who approached us in a gentle manner and welcomed us into his office. Sitting in two seats across from his desk, Maya and I locked hands between our seats, eager to learn what options we had with fertility treatments and next steps. I kept reciting in my head, “go with an open mind and expect the unexpected.”

During our initial consultation with Dr. Sacks, Maya and I had a chance to share about our background, our relationship, and hopes to become parents. Dr. Sacks asked Maya a bit about her background such as her age, period regularities, general health, and if she’s been pregnant before. After getting to know about our options and Dr. Sacks answering our (million!) questions, we were provided with a Donor Sperm Recipient Cycling Checklist. This checklist included the different components we would need to check off before beginning Maya’s first artificial insemination treatment cycle. This checklist may be similar to what you could anticipate from other fertility clinics in preparing you for starting an artificial insemination procedure. As we expected, there were parts of this process that we didn’t know about yet that were on the checklist in progressing with fertility treatment.

1. Schedule a financial consult with CFA’s billing counselors. We were required to have financial clearance before beginning the treatment cycle. This may also be the case for other fertility clinics. Our billing consultation was on August 3rd, about three weeks after our initial consultation.
   
2. Submit Pap smear results (within three years), current cultures for gonorrhea and chlamydia (within one year), and provide immunity status of rubella and varicella. She worked with her primary care physician to obtain this information. If you don’t have a recent Pap smear, you can make an appointment with your gynecologist to get new results.
   
3. Go through bloodwork to provide information regarding Blood Group/Rh, HIV, Hepatitis B, and C, and VDRL, and CMV (within one year). Sometimes, a clinic will ask for you to come in to provide more bloodwork during the fertility treatment process to continue to assess one’s health and levels.
   
4. If it was recommended by our physician (which it was), we needed to schedule for a Hysterosalpingogram (HSG X-ray test). We called CFA on Day 1 of Maya’s period to schedule this procedure, which was done during the first half of her cycle. This is an x-ray procedure that evaluates your uterus and Fallopian tubes. Basically, dye is injected into your uterus so it can be visualized through x-ray technology as it fills the uterus and travels through the Fallopian tubes and spills freely into the abdominal cavity. This procedure allows for a doctor to evaluate the shape of one’s uterine activity and to identify any potential abnormalities such as polyps, fibroid tumors, scar tissue, or congenital defects. The HSG also evaluates the shape of the Fallopian tubes and whether or not they are open. All of this information from an HSG can help your RE determine your fertility along with the bloodwork that is done so to communicate the likelihood the patient has of conceiving successfully. Fun stuff. It is uncomfortable or even painful for some people. Maya says it went well for her.
   
5. Sign all consent forms which included one for which fertility treatment we chose to try first, Guidelines for Therapeutic Donor Insemination (TDI) Program, Donor Sperm Recipient, IUI/IVF Semen Thaw Consent, and HIV Consent (if applicable).
   
6. Finally, we were instructed by the checklist to call the office’s recommended counselor to schedule for a psychological consult. We won’t get into this part today, but this is one of the most controversial, most talked about components to a queer person’s fertility treatments. Our checklist did not specify that this is only a recommendation for our clinic.

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