You'll likely have a consult first, where doc will go over health histories, what you've all tried, how long etc. From there they'll determine what testing might be helpful to start with. For us it went like this:
- three day bloodwook (third day after period starts) and both abdominal and transvaginal ultrasound (after reviewing my fertility friend charts she agreed to start me on clomid then, monitored cycles so she could see what it did to my lining and how many additional follies I was producing....she helped us to nail down bd timing)
- when nothing happened the following three months of that doc ordered bloodwork on dh and a SA (because everything looked fine on ultrasounds, I was ovulating regularly, we were doing everything right, and I had two children from a previous marriage she moved onto investigating things on his end a bit sooner - showed low count, morph and motility).
- she moved me onto femara because the clomid had awful side effects for me and was absolutely obliterating my lining and we attempted our first monitored IUI. When it didn't work she then ordered an HSG to check that my tubes were still open (kids were born 9 and 10 years ago at that point so it was possible, one was mucky and they were able to clear it by simply pushing more dye through)
- second SA were very similar so we were referred to a reproductive urologist to determine what was causing the poor results. He ran bloodwork to check hormone levels, did a physical exam and did a testicular ultrasound. We sorted out then that the issue was a congenital one and nothing we could fix via meds or corrective surgery.
- two more unsuccessful monitored IUI's and many additional months of femara we were eventually referred to a reproductive endocrinologist who ran another SA and agreed that our chances of conception even using IUI were less than 2% each time. Our only real shot would be IVF and it (VERY THANKFULLY) ended up working for us the first time. They did do a saline sonogram before we began to make sure I had no endo, adhesion, fibroids or whatever else could effect implantation before we started the cycle.
We were lucky in that our insurance covered infertility diagnostics to a certain degree. After we'd met our annual deductible they covered 100% of *diagnostics* up to a lifetime $5000 cap. Same went for our IVF meds....policy said NO coverage for fertility treatment meds, but once we med a certain prescription deductible, ANY prescription meds we needed for anything, were 100% covered. Most people assume they have no coverage because policies are often times worded that infertility is excluded, period. But if you have coverage call and really pick apart if there are loopholes for your testing especially. Even something as simple as insurance coding - going in under the premise of having pain while ttc instead of just going in as unexplained could save you an insane amount of money throughout the process. Not saying you should lie by any means, but if you have an understanding doc that doesn't mind being flexible when submitting things to insurance it can make all the difference.
Our first clinic, and then the RE's office were more than a half hour away from our home so we didn't have the option of dh collecting his sample at home (I want to say they capped the time frame at a half hour otherwise the sample can be compromised). I do know it would have been an option though if that wasn't the case. I think it largely depends on the individual preferences, but most that I've heard of are more than willing to offer that option.
Depending on what kind of doctor you're planning on seeing, if you're hoping for a June appointment you should probably schedule it now. The good ones tend to fill up so sooooo fast and if you wait you could be looking at fall before being able to get in to be seen. You can always cancel if you end up not needing it.
I'm wishing you loads of luck so you don't have to go down this path!
. The process for me is a little different. I can't even make an appointment to see the RE until all tests are done. I had 13 vials of blood taken on 2nd day of AF. I was told that I could go anytime between 2nd and 3rd day of AF. DH had his SA already since he didn't have to wait for anything. And tomorrow, I am going to have HSG procedure. Then, I can make an appointment with the RE. I have the test results for my bloodwork and SA already but they all look gibberish at this point. So hopefully I can get an appointment to see RE soon. 
I will have lingerie ready. 
