
Who should I go to for help?
For women 35 and under who have been trying to conceive for up to one year, have regular menstrual cycles (every 21 to 35 days), no history of sexually-transmitted diseases, pelvic pain or pelvic surgery, and whose partners are in good health, the obstetrician gynecologist (OBGYN) doctor can be an excellent first resource to begin to evaluate the causes of infertility. Some well-trained OBGYN doctors are comfortable with treating mild ovulation disorders with oral ovulation induction medications like Clomiphene Citrate or Letrozole. In many cases, infertility is due to causes unrelated to ovulation and a more extensive evaluation of the couple is warranted. OBGYN doctors are experts in managing pregnancies, office gynecology and some pelvic surgery. As OBGYNs, however, receive only a few weeks of training in reproductive endocrinology and fertility, they typically refer couples with infertility to Reproductive Endocrinologists.What is a fertility specialist and when should I see one?
While any physician can state that she or he is fertility specialist, true specialists in fertility and reproductive medicine are called Reproductive Endocrinologists, physicians who are not only fully-trained and board-certified in Obstetrics and Gynecology, but who have also completed two to three years of additional fellowship training in the diagnosis of complex reproductive disorders and their treatment, including assisted reproductive technologies like in vitro fertilization, egg and embryo freezing, egg donation, and reproductive surgery. Reproductive Endocrinologists work closely with reproductive Urologists in cases in which the male partner has significant sperm deficiencies or abnormalities in sexual function. While it is beneficial for all couples with infertility to see a reproductive endocrinologist, the following are conditions in which a woman or couple should see a Reproductive Endocrinologist as soon as possible:- If the couple has tried to conceive for six or more months and the woman is 35 or older
- A couple with a history of two or more miscarriages
- A woman with a mother or sister with menopause at age 45 or younger
- A woman with a history of pelvic surgery or pelvic diseases
- A woman with ovulation dysfunction who has failed to conceive with three cycles of Clomiphene Citrate or Letrozole
- A man with an inability to achieve an erection or ejaculation
- A man with a low sperm count (< 10 Million per ml) or with poor sperm motility (<40%) or morphology (<4 %)
- A woman with significant autoimmune disease (e.g. hypothyroidism, lupus, rheumatoid arthritis)
- A woman or a man who is planning to start chemotherapy for cancer or autoimmune disease
- A woman over 30 who is planning to delay childbearing