When do you need a reproductive endocrinologist?

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.

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