i have been ttc for about 2 years now and have been unable to get pregnant. I recently had a HSG test which revealed that my fallopian tubes are both blocked. The doctor that preformed my test did not go into detail about the severity of the blockage or if it is fixable. He just said that it looked like both were blocked because even though they both filled up there was no spillage into the uterus. my regular ob suggested i makea an appointment with an IVF specialist. I have an appointment friday and would like to know what type of questions i should be asking on my first appointment. any suggestions?

The specialist should be well versed in explaining the basics of the process. You'll want to ask about the clinic's success rates for various treatments (not just successful implants, but live births). You'll also want to get a full description of the costs and you should call your insurance company to find out what, if anything, they will cover. Find out if the clinic has experience with people with UC/j-pouches/ostomies, etc... I know it sounds unlikely but my clinic actually tracks data on people with IBD.

Find out what the standards for protocol are - does the clinic use progesterone post transfer? (there is some evidence that progesterone can help prevent miscarriages, esp when IVF is done) Do they use suppositories/gel or the progesterone in oil that requires intramuscular shots? How long do they recommend the progesterone treatment?

Depending on your particular situation, they'll tell you what drugs you would be taking and in waht amounts. My personal belief is that clinics should support producing a reasonable number of eggs (say up to 20) but not push women to produce more. Ovarian Hyper STimulation is a real risk of IVF and for us a big one as one of the major issues is dehydration.

Find out what your clinic's feeling is on how many embryos to transfer. New studies are showing that transferring one or two embryos has the same success rate as transferring more without all the risks (to mother and babies) of a high multiple birth.

That should get you started. your head will spin after the first visit, so take a little time to let it sink in. Let me know if you have questions.

thank you so much this gives me a good idea of what to expect and ask