When to See an Infertility Specialist
Fertility specialists overview
- Infertility is defined as the inability to conceive after 12 months of regular, unprotected intercourse.
- Woman older than 35 having trouble conceiving for six months or longer should see a fertility specialist as soon as possible.
- Reproductive endocrinologists and infertility specialists (REIs) are the most extensively trained fertility specialists in healthcare and can help diagnose infertility and identify treatment options.
- If treatment is needed, questions to ask a fertility specialist include how much treatment costs, which treatments are covered by insurance, what are the clinic’s pregnancy and live-birth success rates, and how many in vitro fertilization (IVF) procedures the clinic performs annually.
Who should see a fertility specialist?
It can be tough to decide when to see a fertility specialist. Couples trying to get pregnant may say to each other, “Let’s just give it a little more time. It will happen if we keep trying.”
Meanwhile, they often struggle with a sense of personal failure and may even feel a sense of social stigma. But none are alone.
According to the U.S. Centers for Disease Control, nearly seven million American women have trouble conceiving or carrying a healthy baby to term. And infertility is not just a women’s problem. Infertility affects men as often as women, with about one-third of infertility cases stemming from a problem with the male partner exclusively.
So how should someone decide it’s time to visit a specialist? Timing has a lot to do with the decision. Generally, fertility doctors define infertility as the inability to conceive after one year of unprotected intercourse.
However, older women have less flexibility. The American Society for Reproductive Medicine recommends that a woman over the age of 35 who has been trying unsuccessfully to conceive for more than six months should make an appointment to see a fertility specialist.
Other reasons to see a fertility specialist
- At least one partner has a history of sexually transmitted diseases (chlamydia or gonorrhea)
- The female partner has irregular or no menstruation
- The female partner has a history of pelvic infections or previous abdominal surgeries
- The male partner has sexual problems such as difficulty with erection
- The female partner has severe pain during menstruation (a symptom of endometriosis)
- The female partner has a history of three or more miscarriages
- The male partner has had a semen analysis showing a poor quality of sperm
It’s important for both partners to see a fertility specialist for testing, as the cause for a couple’s infertility can be due to either or both partners.
What is a fertility specialist?
For some women, an OB/GYN doctor can help identify and treat infertility problems. Similarly, urologists are specialized in the male reproductive system.
The most qualified and trained medical specialist for infertility, however, is a reproductive endocrinologist and infertility physician (REI).
An REI is a doctor who has graduated from medical school, gone through a two-year residency in obstetrics and gynecology, and usually has also served a two- or three-year REI fellowship at a university hospital.
In a fellowship an REI learns how to perform in vitro fertilization (IVF), the most advanced and effective infertility treatment available.
These days, more and more REIs have also passed a rigorous exam administered by the American Board of Medical Specialties (ABMS).
This extra training – plus an ABMS board certification – ensures patients that each REI has experience and expertise in infertility found nowhere else in healthcare. Moreover, an REI is trained in both female and male fertility, an important factor given that infertility is a shared problem between both female and male partners.
What does a fertility specialist do?
A fertility specialist usually starts the process of diagnosing and treating infertility with an initial examination and consultation with both partners. The first exam and consultation may last an hour or longer.
During the first appointment, the fertility doctor will review the couple’s history, discuss options for treatment, determine what testing may be needed, and possibly map out a treatment plan.
A couple seeing a fertility specialist should take care to bring medical records to the first appointment.
Many fertility clinics also employ a financial counselor. Because insurance does not always cover fertility treatments, this staff member can be extremely helpful in finding financial help. Often a couple meets with the counselor on the first visit after seeing the doctor.
What should I ask a fertility doctor?
A few questions may help you decide during your first appointment if the doctor and clinic you’ve chosen initially are right for you:
- What procedures does the clinic do, and what is the doctor’s philosophy and approach toward which procedures to recommend to different patients?
- What does treatment cost? How much is covered by my insurance?
- What are the clinic’s pregnancy and live-birth success rates from IVF treatment? Fertility specialists and IVF clinics must report these statistics to the federal government annually. Although it’s difficult to compare statistics accurately from clinic to clinic, an IVF center’s track record can be a gauge of its clinical abilities. LLU Fertility Clinic publishes its success rates for patients to review. Learn more about understanding success rates
- Does the clinic have an age limit for treatment? This question can reveal indicators of the clinic’s ethics – be wary of doctors who will treat any age woman. This may be a tip-off that the clinic is more driven by money than patients’ well-being, as the chances of older women getting pregnant can be very small.
- How long has the clinic been in existence? How long has your doctor been there? What is the rate of staff turnover? Answers to these kinds of questions can indicate how well the fertility practice is run and the quality of care you’re likely to receive.
Is it time to see a doctor?
With frequent unprotected sexual intercourse, most healthy couples conceive within a year. If a couple has been trying for longer (or if the woman is over age 35 and the couple has been trying for more than six months), they should speak to a fertility specialist about infertility testing.