Posts Tagged ‘fertility treatment’

When do you need a reproductive endocrinologist?

Friday, April 29th, 2016

preconception healthWe get a lot of questions from women wondering how long it will take them to get pregnant. If you have been trying to conceive for a few months, you may just need more time. Most couples who try to get pregnant do so within one year. It may not happen immediately, but the odds are it will happen soon.

However, if you have been trying to get pregnant for more than a year (or six months if you are 35 or over) and have not conceived, talk to your health care provider. She may suggest you consult a reproductive endocrinologist. A reproductive endocrinologist is an obstetrician/gynecologist who specializes in diagnosing and treating infertility. They complete 4 years of medical school and a 4-year residency in Obstetrics and Gynecology. They then receive an additional 3 years of specialized training in Reproductive Endocrinology.

At your first visit, your reproductive endocrinologist will review your:

  • Medical history, including menstrual cycle, pregnancy/loss history, birth control use, & any other medical conditions
  • Family health history
  • Lifestyle and work environment

After a complete physical exam, your doctor will discuss with you any additional tests that may be ordered. These may include ovulation testing, looking at the anatomy of the uterus and fallopian tubes, determining the quality and quantity of eggs, testing hormone levels, and a pelvic ultrasound. Your partner may be referred for additional testing as well.

There are several kinds of fertility treatment. You, your partner, and your reproductive endocrinologist can decide which treatment gives you the best chance of getting pregnant and having a healthy pregnancy. Treatments include:

  • Surgery to repair parts of your or your partner’s reproductive system. For example, you may need surgery on your fallopian tubes to help your eggs travel from your ovaries to your uterus.
  • Controlled ovarian stimulation (also called COS). COS uses certain medicines to help your body ovulate and make healthier eggs.
  • In vitro fertilization (also called IVF). IVF is the most common kind of assisted reproductive technology (ART). In IVF, an egg and sperm are combined in a lab to create an embryo which is then transferred to the uterus.

Some couples may be concerned that consulting a reproductive endocrinologist means they will need IVF.  But this is typically not the case. In fact, 85-90% of infertility cases are treated with conventional therapies.

If you have been struggling to conceive, talk to your health care provider and see if consulting a reproductive endocrinologist is the right choice for you.

Have questions? Email us at AskUs@marchofdimes.org.

IVF, triplets and more

Monday, April 21st, 2014

In this video, Dr. Siobhan Dolan talks with a woman about fertility treatment and how to lower one’s chances of getting pregnant with twins, triplets or more.

Pregnant at 46

Thursday, April 18th, 2013

pregnant2Most of us have heard that Halle Berry is pregnant at the age of 46. Wow, you go girl!  And did you see the recent episode of Call the Midwife where a first-time pregnant woman (a twin) in her 40s gave birth to twins of her own? Some women are asking us “If they can, why can’t I?”  Good question, complicated answer.

Women over age 35 may be less fertile than younger women because they tend to ovulate (release an egg from the ovaries) less frequently. Certain health conditions that are more common in this age group also may interfere with conception. These include endometriosis, blocked fallopian tubes and fibroids.

If you are over 35 and haven’t conceived after 6 months of trying, make an appointment to see your health care provider. Studies suggest that about one-third of women between 35 and 39 and about half of those over age 40 have fertility problems.  At age 47, most babies are conceived with some form of fertility treatment.  This can be time consuming and expensive and there is no guarantee the treatment will work.

Most miscarriages occur in the first trimester for women of all ages, but the risk of miscarriage increases with age. Studies suggest that about 10 percent of recognized pregnancies for women in their 20s end in miscarriage. The risk rises to about 35 percent at ages 40 to 44 and more than 50 percent by age 45. The age-related increased risk of miscarriage is caused, at least in part, by increases in chromosomal abnormalities.

The good news is that women in their late 30s and 40s are very likely to have a healthy baby. However, they may face more complications along the way than younger women. Some complications that are more common in women over 35 include: gestational diabetes, high blood pressure, placental problems, premature birth, stillbirth.  About 47% of women over age 40 give birth via cesarean section. You can see why it’s so important to keep all appointments with your health care provider.

All these things taken into consideration, many women who do conceive in their late 40s, either on their own (unlikely but not impossible) or with some fertility treatment, do manage to have healthy babies.  The important thing to remember is to have a preconception checkup and early and regular prenatal care. Know the signs of preterm labor, and give your doc or midwife a call whenever you have a question or concern.

We are proud to be partners in the Show Your Love national campaign designed to improve the health of women and babies by promoting preconception health and healthcare.