Posts Tagged ‘infertility’

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

One couple’s rocky road to parenthood

Monday, April 25th, 2016

In honor of National Infertility Awareness Week, we are grateful that one mom shared her story with us. We hope that her journey will inspire others who may be on this path.

couple w pregnancy testInfertility is a journey. And every journey looks different. Some end in happiness and some do not.

In early 2015, after 3 years of trying to get pregnant, my husband and I found out that we were expecting. After all of the roadblocks we had hit along the way, hearing, “you’re pregnant” was surreal. The pregnancy was not without challenges, and I was extremely paranoid that we would somehow lose this baby. I am happy to say that my son was born healthy at 38.5 weeks, albeit with a nearly week long NICU stay. But, this happy ending came after a journey of twists and turns and more downs than ups.

I’d wanted to be a mother for as long as I can remember. . . That sounds so cliché, doesn’t it?

We were young and had only been married for a couple of years when we decided to start a family. We were so naïve and full of hope! I went off my birth control and started actively trying to have a baby. I read everything I could about getting pregnant and started charting my cycles.

When my cycles went from the perfectly timed 28 days to 60 and 70 days, I knew something was off. I did some reading and thought I might have polycystic ovarian syndrome (PCOS). (The beauty and danger of the internet!) PCOS happens when you have hormone problems along with cysts on the ovaries. I bought a book, went on a diet and started exercising. I learned everything I could about getting pregnant with PCOS and did my best to take control of my body.

After 6 months of trying to conceive with no luck, my doctor examined me, ran some tests (blood and ultrasound) and confirmed the PCOS diagnosis. She told me that she could write a prescription for Clomid to try and stimulate ovulation. But, she said that before I could start on the Clomid, my husband needed to have a semen analysis. (A large number of infertile couples have both female and male infertility issues, and they don’t want to unnecessarily medicate someone.)

To say that my husband was less than thrilled would be an understatement. It took me a few months to convince him to go for the test. He finally went and when we got the results back we were devastated. His sperm count was very low and the chances of conceiving on our own were basically zero. The doctors told us that they might be able to treat my husband and me, so that we could conceive. Little did we realize that this was just the beginning of years of doctors’ visits, but nevertheless, we jumped in with both feet.

Dealing with infertility can be all-consuming (at least it was for us). I would wake up and go to sleep thinking about it. There was never down time for my brain. I would see a pregnant woman or a couple with a baby and I would feel jealous, angry and sad. Hearing that other couples got pregnant without even trying was overwhelming. . . And the medical bills were never ending. Our insurance didn’t really cover any of our treatments so we paid almost all of it out-of-pocket. We were saving for a down payment on a house when we started trying to have a baby. And after the fertility treatments we were back to square one.

Through all of the doctors’ visits, blood work, ultrasounds and shots, I kept up the hope that someday I would be a mother.

Fast forward…

Now that we’re 6 months into being parents, I can say that I am thankful for my son every day. The first couple of months were incredibly challenging, and the idea that “maybe I wasn’t meant to have kids” crossed my mind frequently. But, I now revel in time spent with my son.

Although at the time, it seemed that the process of trying to conceive was going on and on, with no end in sight, I can say now that it is becoming a distant memory. The intense joy my husband and I feel every time we see the smile on our son’s face or see him hit another milestone, fills me with happiness and pushes the difficult journey of how we got here into the background.

I am sending baby dust to everyone out there struggling with infertility.


Please feel free to share your thoughts or personal story below.


Preconception health for dads

Friday, February 12th, 2016

becoming a dadWe talk a lot about getting a woman’s body ready for pregnancy. But what about men? Dad’s health before pregnancy is important too. Here are a few things men can do if they are thinking about having a baby in the future.

Avoid toxic substances in your workplace and at home

If you and your partner are trying to get pregnant, it may be more difficult if you are exposed to the following substances:

  • Metals (like mercury or lead)
  • Products that contain lots of chemicals (like certain cleaning solutions, pesticides or gases)
  • Radioactive waste, radiation or other dangerous substances (like drugs to treat cancer or X-rays)

Read more about how to protect yourself at work and at home here.

Get to a healthy weight

Obesity is associated with male infertility. And people who are overweight have a higher risk for conditions such as heart disease, type 2 diabetes, and possibly some cancers.

Prevent STDs

A sexually transmitted disease (also called STD) is an infection that you can get from having sex with someone who is infected. You can get an STD from vaginal, anal or oral sex.

Many people with STDs don’t know they’re infected because some STDs have no symptoms. About 19 million people get an STD each year in the United States.

It is important to continue to protect yourself and your partner from STDs during pregnancy. STDs can be harmful to pregnant women and their babies and cause problems, such as premature birth, birth defects, miscarriage, and stillbirth.

Stop smoking, using street drugs, and drinking excessive amounts of alcohol

All of these behaviors are harmful to your health. Being around people who smoke is dangerous for pregnant women and babies. Being exposed to secondhand smoke during pregnancy can cause your baby to be born with low birthweight.

Secondhand smoke is dangerous to your baby after birth. Babies who are around secondhand smoke are more likely than babies who aren’t to have health problems, like pneumonia, ear infections, asthma, and bronchitis. They’re also more likely to die of SIDS.

Drinking excessive amounts of alcohol and using street drugs can negatively affect a man’s fertility.

Know your family’s health history

Your family health history is a record of any health conditions and treatments that you, your partner and everyone in both of your families have had. It can help you find out about medical problems that run in your family that may affect your baby. Taking your family health history can help you make important health decisions. Knowing about health conditions before or early in pregnancy can help you and your health care provider decide on treatments and care for your baby.

Be supportive of your partner

Help your partner. If she is trying to quit smoking, make sure you support her efforts—and join her if you need to quit too! If she has a medical condition, encourage her to see her doctor.

Even before pregnancy, dads play an important role in their baby’s lives, so make sure you are planning for the future too.

Have questions? Email us at

Why can’t I get pregnant?

Friday, May 1st, 2015

womann reading HPTOne of the most common questions we get in the Pregnancy and Newborn Health Education Center is about conception. Women want to know when they will get pregnant and why it is taking longer than they thought it would. Often they wonder if something may be wrong and they should seek out a reproductive specialist.

If you’ve been trying to get pregnant for 3 to 4 months, don’t panic, and keep trying. The good news is that most couples will conceive on their own, although it may take longer than expected. Nearly 9 out of 10 couples who try to get pregnant do so within one year.

But if you have been trying to get pregnant for over a year or longer than six months if you are over 35, then you may want to talk to your health care provider. Infertility means that the body’s ability to perform the basic function of reproduction is impaired. According to the Center for Disease Control and Prevention (CDC), approximately 1 in 8 couples of childbearing age have difficulty conceiving or carrying a pregnancy to term.

There are many possible causes of infertility. If your provider does refer you to a specialist, it is important to know that both you and your partner will most likely need to undergo testing. Infertility affects men and women equally. And 25% of infertile couples have more than one factor that contributes to their infertility.

Some lifestyle factors that contribute to infertility are a woman’s weight and whether she or her partner smoke. Women who weigh too much or too little can have difficulty conceiving. Getting to a healthy weight and maintaining it may help to reverse some infertility.

Smoking also reduces fertility for both men and women.  According to the American Society for Reproductive Medicine (ASRM), up to 13% of female infertility is caused by cigarette smoking and women who smoke have an increased risk of miscarriage.

The majority of couples (85-90%) who experience infertility can be treated with surgery or medications. Only a small percentage of couples (less than 3%) will need to undergo advanced procedures, such as in vitro fertilization, to conceive.

Insurance coverage for infertility treatments varies from company to company and state to state. Because treatment can be very costly, be sure to learn more about the costs and your insurance coverage while you are still thinking about treatment options.

If you are concerned about your ability to get pregnant, make sure you talk to your provider. She can guide you and help you determine what the next step is for you and your partner.

Questions?  Send them to

What is endometriosis?

Monday, March 9th, 2015

crampsEndometriosis occurs when the lining of the uterus (the endometrium) grows in places outside of the uterus. This misplaced tissue is found on the ovaries, fallopian tubes, outer surface of the uterus, and sometimes even the bladder or intestines. Endometriosis affects about 5 million women in America and is most common in women in their 30s and 40s. Endometriosis may cause fertility issues for women who want to conceive.


Symptoms of endometriosis

  • Pain: This is the most common symptom of endometriosis. Regardless of where the endometrial tissue is located in the body, it continues to act as if it were part of the uterus. Each month it thickens, breaks down and bleeds. This can make for very heavy and painful menstrual periods. Depending on the degree of extra tissue growth, a woman with endometriosis may also experience sharp pain during ovulation, sex, or bowel movements.
  • Infertility: According to the American Society for Reproductive Medicine, “up to 30-50% of women with endometriosis may experience infertility.”
  • Digestive issues: Women with endometriosis may experience diarrhea or constipation.

Causes and treatment of endometriosis
Unfortunately, we don’t know what causes endometriosis. While there is no cure, treatment options include:

  • Medications
    Pain medication: Over-the-counter pain medicines can help provide relief. If you are trying to become pregnant, ask your health care provider which ones are OK for you to take.
  • Hormonal birth control: If you are NOT trying to get pregnant, hormonal birth control such as an extended cycle (you only have a few periods each year) or continuous cycle (no periods) pill or shot can reduce the number of periods you have each year.  There are other medications that may be appropriate as well. Your health care provider can advise you depending on your symptoms and your reproductive plans.
  • Surgery
    When hormones are not helping or you want to get pregnant, surgery may be an option. The doctor will locate any areas of endometriosis and remove them. This procedure may improve the chance for conception.

Can I get pregnant if I have endometriosis?
Most women with a mild to moderate case of endometriosis are able to conceive, eventually.  But, it may be more difficult to get pregnant. If you have endometriosis and are thinking about getting pregnant, make sure you talk to your health care provider. He or she will be able to advise you of treatment options that may work for you.

Considering fertility treatment

Tuesday, February 4th, 2014

coupleIf you’ve been trying to get pregnant for three or four months, keep trying. It may just take more time, even longer than you think it could. But, you may want to think about fertility treatment if you’re younger than 35 and have been trying to get pregnant for at least a year, or you’re 35 or older and have been trying to get pregnant for at least six months.

Here are some things you and your partner can do to find out if you need treatment:
• Talk to your health care provider about whether or not you need treatment.
• Learn about how things like smoking and weight affect fertility. It’s possible that you may be able to make changes in your life that will help you get pregnant without fertility treatment. Talk to your health care provider about what you can do on your own, without fertility treatment.
• Tell your health care provider about diseases and other health problems in your family.
• Keep a monthly diary of your periods. Write down the date you start and end your period each month. This will help you figure out when you ovulate.
• Have your partner get his sperm tested to make sure it’s healthy.
• Have a test to make sure your fallopian tubes are open and your uterus is a normal shape. (When your ovary releases an egg, it travels down the fallopian tube to your uterus.)

If you’ve tried various options and think it’s time to speak to a fertility specialist, read our information on when and how to find a fertility specialist and center. You’ll find information on risks and benefits, who pays for it, and more.

Polycystic ovary syndrome

Tuesday, October 1st, 2013

sad-womanPolycystic ovary syndrome (PCOS) is a condition that affects a woman’s hormones and ovaries. PCOS affects up to 7 percent of women of childbearing age and is the leading cause of female infertility. Some women learn they have PCOS when they have problems becoming pregnant.

Women with PCOS have high levels of male hormones (androgens), which may interfere with normal ovarian function. Affected women often do not ovulate regularly. PCOS also affects other bodily systems, increasing a woman’s risk for diabetes and heart disease. Signs and symptoms of PCOS include:
• Irregular or absent menstrual periods
• Ovaries containing many small cysts (fluid-filled sacs)
• Increased facial hair
• Acne
• Weight gain or obesity
• Male-pattern baldness
• Abnormal blood sugar levels or diabetes
• High blood pressure

The exact cause of PCOS is not known.  However, there are quite a few factors that may play a role:
• Genetics:  Women who have a mother or sister with PCOS, are more likely to develop PCOS.
• Hormonal imbalance: Women who have PCOS seem to make more androgens (male hormones) than women who do not have PCOS.  All women produce some male hormones, but levels that are too high may affect egg development and ovulation.
• Insulin: Insulin is a hormone that allows cells to convert sugar (glucose) to energy.  Women with PCOS tend to have too much insulin.  And excess insulin seems to result in increased androgen production.

There is no specific diagnostic test for PCOS. Diagnosis is usually based on:
• Signs and symptoms, including menstrual irregularities
• Physical examination
• Blood tests to check androgen and blood sugar levels
• Ultrasound of the ovaries

There is no cure for PCOS so the goal of treatment is to manage symptoms and prevent complications.  There are a number of ways that this can be accomplished.  Women with PCOS who are overweight or obese should attempt to lose weight. Women who lose even 10 percent of their body weight can improve menstrual irregularities, lower androgen levels and reduce their risk of diabetes. Weight loss can improve fertility, as well.

Women who do not wish to become pregnant right away can take birth control pills. Birth control pills help to regulate the menstrual cycle and reduce androgen levels. In some cases, metformin (Glucophage), an oral diabetes drug, may be used instead of or in addition to birth control pills. Metformin also helps reduce androgen levels and may help with weight loss.

Women who want to get pregnant and are having difficulty conceiving can be treated with medications that stimulate ovulation. If those medications are not successful, other fertility treatments can be considered.

Studies suggest that women with PCOS who become pregnant are at increased risk of gestational diabetes, preeclampsia (a pregnancy-related form of high blood pressure) and premature birth. Women with PCOS should see their health care provider before pregnancy to make sure any health problems, such as diabetes, are under control, and that any medications they take are safe. When they become pregnant, they should go to all their prenatal appointments so that any complications can be diagnosed and managed before they become serious.

Chat on pregnancy after age 35

Monday, May 13th, 2013

texting21How old were you when you had your baby? Today, 1 in 5 women in the US has her 1st child after age 35. Halle Barry currently is pregnant at age 46! The good news is most have healthy pregnancies & healthy babies. There are, however, a number of challenges and concerns. 

Join us on Twitter Tuesday May 14th at 1 PM ET for our next pregnancy chat. Learn about these issues and things you can do to help start a family when you’re no longer in your 20s. Join in the conversation by using #pregnancychat.

Lose the weight before pregnancy

Wednesday, January 2nd, 2013

Advertisements abound these days for weight loss programs and quick fix diets. Did you eat all your favorite traditional treats over the holidays and have a cup or two of cheer? I certainly did and am now feeling like it’s time to behave – time to swap the cookies for carrots, the fruitcake for fruit.

For those of you thinking about pregnancy, it’s especially important to get your weight under control before you conceive. To know if you’re overweight or obese, find out your body mass index (BMI) before you get pregnant.  BMI is a calculation based on your weight and height.

If you’re overweight, your BMI is 25.0 to 29.9 before pregnancy. Two in 3 women (66 percent) of reproductive age (15 to 44 years) in the United States is overweight.  If you’re obese, your BMI is 30.0 or higher before pregnancy. About 1 in 4 women (25 percent) is obese.

If you’re overweight or obese, you’re more likely than pregnant women at a healthy weight to have certain medical problems during pregnancy. The more overweight you are, the higher are the risks for problems. These problems include:
• Infertility (not being able to get pregnant)
• miscarriage (when a baby dies in the womb before 20 weeks of pregnancy)
• stillbirth (when a baby dies in the womb before birth but after 20 weeks of pregnancy)
• high blood pressure and preeclampsia (a form of high blood pressure that only pregnant women get). It can cause serious problems for mom and baby.
• gestational diabetes
• complications during labor and birth, including having a really big baby (called large-for-gestational-age) or needing a cesarean section (c-section).

Some of these problems, like preeclampsia, can increase your chances of preterm birth, birth before 37 completed weeks of pregnancy. This is too soon and can cause serious health problems for your baby. (We’ll talk about how mom’s weight issues can affect her baby’s health in tomorrow’s post.)

For those women who are severely overweight, some are turning to surgery. New studies suggest that weight-loss surgery may help protect obese women and their babies from gestational diabetes, high blood pressure, overly large babies and cesarean delivery during pregnancy.

So think about staying healthy and shedding those unwanted pounds before you get pregnant. Talk with your health care provider, find a plan that’s good for you and stick to it. You’ll have a healthier and more comfortable pregnancy when the time comes.

Amenorrhea – missed periods

Thursday, October 20th, 2011

There can be many reasons why a woman might not get her period. For women who are sexually active and in their 20s or 30s, pregnancy is the first thing that pops to mind. If you’re in your 40s or 50s, it could be the beginning of the transition leading to menopause, or perimenopause. Whatever the reason, it’s important to find out why.

Extreme exercise can be a cause. Did you know that between 5% and 25% of female athletes work out so hard that they stop getting their periods? This is called exercise-induced amenorrhea. I had two friends, both avid runners, who were unable to conceive while they were in training and running marathons. Their intense exercise altered the manufacturing and releasing of reproductive hormones involved in the menstrual cycle. While still remaining active, my friends had to significantly dial back their exercise routines before they were able to have children. But both of them went on to have kids.

Another substantial body stressor that can affect the operation of reproductive hormones is a severely changed eating pattern. Women with eating disorders like anorexia nervosa are greatly altering their hormonal balance by depriving their body of nutrition. This can shut down a normal reproductive cycle.

Women who breastfeed often do not see the return of a normal period for many months. This lack of a period does not necessarily mean you’re not ovulating and it is possible to get pregnant during this time.

Medical conditions like problems with your uterus, polycystic ovary syndrome (PCOS)thyroid conditions or pituitary gland disorders, or problems with the hypothalamus can cause amenorrhea. Women who are extremely overweight or obese can lose their period.

If you miss your period for an extended period of time and aren’t sure why, check into it with your health care provider.