Red Flags & When to Go In Person for Infertility (Initial Telemedicine Counseling)

Audience: pediatric

Infertility can be a challenging experience, especially for young people and their families. Initial telemedicine counseling can help provide education, discuss concerns, and guide next steps. However, some signs and symptoms need urgent in-person evaluation to ensure safety and proper care. This guide explains common warning signs that require a visit to a healthcare facility, what telemedicine can and cannot do for infertility concerns, and how to prepare for your telemedicine visit. Remember, telemedicine is a helpful first step but does not replace hands-on exams or tests that may be needed in person. If you or your child experiences severe pain, bleeding, or other urgent symptoms, seek immediate medical care. This information aims to support families in understanding when to use telemedicine and when to seek in-person care for infertility issues.

Red flags — go in person / ER

• Severe pelvic or abdominal pain requiring emergency care
• Heavy vaginal bleeding or bleeding between periods
• Fever with pelvic pain or foul-smelling discharge indicating possible infection

What telemedicine can do

• Initial history-taking and symptom discussion
• Education about infertility and reproductive health
• Planning and ordering initial tests
• Providing emotional support and counseling

What telemedicine cannot do

• Physical examinations including pelvic exams
• Performing ultrasounds or imaging studies
• Collecting blood or other laboratory samples
• Managing emergency symptoms like severe pain or bleeding

What Is Infertility and How Telemedicine Can Help

Infertility means having trouble getting pregnant after trying for a year or more. In children and teens, it may relate to early health issues or conditions affecting future fertility. Telemedicine allows you to talk with a healthcare provider by video or phone. During this visit, the provider can review medical history, discuss symptoms, and suggest tests or treatments. Telemedicine is a good way to get started, especially if travel or clinic visits are difficult.

When to Seek In-Person Care Immediately

Some symptoms need urgent attention in a clinic or hospital. These include:

If any of these happen, go to the nearest emergency room or urgent care center right away.

Signs That Warrant Prompt In-Person Follow-Up

Other symptoms may not be emergencies but still need timely in-person evaluation:

Your provider may recommend physical exams, blood tests, or imaging to understand these issues better.

What Telemedicine Can and Cannot Do for Infertility

**Telemedicine can:**

**Telemedicine cannot:**

Knowing these limits helps you understand when to follow up in person.

Preparing for Your Telemedicine Visit

To make the most of your telemedicine visit:

This preparation helps your provider give the best advice.

After Your Telemedicine Visit: Next Steps

After your visit, you may be advised to:

Keep track of all recommendations and ask for clarification if needed.

How to prepare for your tele-visit

• Prepare a list of symptoms and questions
• Gather medical history and family fertility history
• Ensure a private, quiet space with reliable internet or phone
• Have a trusted adult present if needed
• Be ready to discuss menstrual and sexual health openly

After your tele-visit

• Schedule recommended in-person tests or exams
• Follow provider instructions on medications or lifestyle
• Monitor symptoms and report any changes
• Attend follow-up telemedicine or in-person visits
• Seek emergency care if red-flag symptoms develop

FAQs

What causes infertility in children or teens?

Infertility in young people can be caused by hormonal imbalances, genetic conditions, infections, or developmental issues affecting reproductive organs. Sometimes, it relates to chronic illnesses or past surgeries. A healthcare provider can help identify possible causes during evaluation.

Can telemedicine diagnose infertility?

Telemedicine helps start the conversation and gather important information but cannot provide a full diagnosis. Physical exams and tests done in person are usually needed to confirm causes of infertility.

When should I take my child to see a fertility specialist?

If your child has signs like delayed puberty, irregular or absent periods by age 15, or other reproductive concerns, your provider may refer you to a specialist. Early evaluation helps address issues sooner.

Is infertility treatment different for children and teens?

Treatment depends on the underlying cause and age. For children and teens, the focus is often on identifying and managing health conditions that may affect future fertility. Treatments are tailored carefully considering growth and development.

What if I cannot visit a clinic for in-person care?

If in-person visits are difficult, discuss this with your provider. They may help arrange local testing or connect you with resources. However, some evaluations require physical exams or tests that cannot be done remotely.

Sources

1. Infertility — MedlinePlus, U.S. National Library of Medicine / National Institutes of Health.
2. Evaluation and Treatment of Infertility — Mayo Clinic.
3. Infertility FAQs — Centers for Disease Control and Prevention (CDC).
4. Pediatric and Adolescent Gynecology — American Academy of Pediatrics.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If you experience any urgent or severe symptoms, seek immediate medical attention.