What to consider when you need a fertility specialist
If you’re trying to start a family and are having trouble getting pregnant, you may want to consider consulting a fertility or reproduction medicine specialist. Fertility specialists also help same sex and trans partners conceive. Fertility issues are more common than many people realize. According to CDC data, 19% of heterosexual women between the ages of 15 and 49 who have never given birth are not able to get pregnant after one year of trying. And in this group of women, 26% have difficulty carrying a pregnancy to term.
A large number of people with fertility issues choose to use assisted reproduction technology (ART) as a path to parenthood. The CDC’s preliminary 2020 ART data found that there were 326,468 ART cycles performed at 449 clinics in the U.S. These cycles resulted in the live birth of 79,942 infants.
ART takes many forms, including:
- intrauterine insemination
- in vitro fertilization-embryo transfer (IVF-ET)
- gamete intrafallopian transfer (GIFT)
- zygote intrafallopian transfer (ZIFT)
- frozen embryo transfer (FET)
- intracytoplasmic sperm injection
- egg donation
- the use of gestational carriers or surrogates
When to see a fertility specialist
In addition to not becoming pregnant after a year of trying, you may want to make an appointment with a fertility specialist if the female partner is 35 or older, you’ve had three or more miscarriages, the female partner has a history of irregular or no periods, endometriosis, fibroids, or polycystic ovarian syndrome (PCOS), or either partner has a chronic medical condition such as diabetes, thyroid disease, kidney disease, heart disease, genetic disorders, or has been treated for cancer. Being overweight or obese can also impact fertility, as can substance use and smoking by either partner.
Types of fertility specialists
Several different types of physicians treat people who need help conceiving. OB/GYNs can perform a wide range of tests for female patients to look for the cause of fertility problems and can provide some treatments to increase fertility.
Andrologists are urologists who have undergone additional medical training in fertility. They work with male patients and explore the possible causes of low or no sperm production and can provide treatments to increase sperm count when appropriate.
Reproductive endocrinologists work with patients to find and treat the underlying causes of fertility issues. These specialists are gynecologists who undergo additional medical training in fertility and treat both male and female patients.
Reproductive immunologists often partner with reproductive endocrinologists. They can help patients with reproductive autoimmune disorders like antiphospholipid syndrome (the immune system produces antibodies that attack the placenta, resulting in miscarriage, second trimester complications, premature delivery, or stillbirth). They also treat patients whose immune systems are interfering with an embryo’s ability to successfully implant.
Ask these questions when choosing a fertility specialist
If you’re considering ART, start by getting data on the clinic’s volume of procedures and success rates from the CDC’s ART reports. You can search by location, patient characteristics, and success rate data.
These questions can help you gather the information you need to make an informed decision about which fertility specialist you want to work:
- Are you board-certified in your specialty?
- What percentage of your patients are in our age range or have the same type of fertility issues we have?
- How many patients do you treat each year?
- Which hospitals are you affiliated with?
- What fertility procedures do you offer? Are there egg or embryo donor or surrogacy options available?
- What is your practice’s success rate for live births for people with the issues we have?
- Do you follow American Society for Reproductive Medicine practice guidelines?
- Do you accept my insurance? What parts of my care are covered under insurance and what is the expected out of pocket cost with and without insurance coverage?
A health advisor can be a valuable resource during your fertility journey. An advisor can connect you with experienced specialists, gather and maintain your complete electronic medical record, arrange second opinions, and provide evidence-based information on your diagnosis and treatment options.