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When to Seek Help

How do I know if have infertility?

Traditionally, a fertility specialist will assume infertility is present based on the following definition. When a woman is:

  • Under 35 with regular cycles and no pregnancy after 1 year
  • 35 to 39 with regular cycles and no pregnancy after 6 months
  • 40 or over with regular cycles and no pregnancy after 3 months

Do men have infertility?
and this is why we must test both the male and female for infertility when a couple is having difficulty conceiving. Infertility is often thought of as a female problem. This is a myth.

In 10 percent of cases, sperm are severely compromised and this can be the exclusive reason why couples have failed to conceive. Nearly 40 percent of semen analyses demonstrate abnormal sperm, which may contribute to infertility.

Are there any early warning signs that infertility may be a problem for a woman?
Women of any age with any of the following should proactively talk with a physician about how these conditions could affect their ability to get pregnant:

  • Irregular menstrual cycles (a sign of polycystic ovary syndrome, or PCOS)
  • A history of pelvic surgery (such as the removal of an ovarian cyst, ablation of endometriosis, ectopic pregnancy, tubal surgery, or ruptured appendix)
  • Severely painful periods
  • Diagnosis of endometriosis

For women with any of these conditions, if you’re having difficulty conceiving, we recommend seeking an evaluation even sooner than what we typically recommend.

Menstrual Cycle Infographic

I want to be as proactive as possible. Are there any early warning signs to look out for that may indicate I will have trouble getting pregnant?
Yes, the more proactive you can be and seek intervention early, the better your chances are for success. Early warning signs may include:

  • The absence of a menstrual period on a regular basis is typically the number one indicator that a problem may be present.
  • A woman’s age can raise a red flag. Infertility can occur at any age, but with increasing frequency after age 35.
  • If the male has trouble achieving or maintaining an erection, or is unable to ejaculate in the vagina, this may signal a problem.
  • If a complex medical condition exists, we recommend counseling about the risks of pregnancy prior to conceiving. While the condition may not preclude pregnancy, it’s best to discuss.
  • If the male or female has a family history of a genetic disorder, it may affect the couple’s ability to conceive.
  • Two or more miscarriages increase the likelihood of an underlying fertility problem.

While individuals in a same-sex relationship may not necessarily be infertile, the couple should still have an evaluation and will often need assistance building their families.

When and where should I seek help if I don't get pregnant?
A general obstetrician/gynecologist (OB/GYN) and urologist can conduct basic female and male diagnostic testing, as can a reproductive endocrinologist or reproductive urologist. The choice of where to begin is often dictated by insurance. Success with any intervention is highly dependent on the quality of the egg so the main thing is to get tested and begin treatment with increasing urgency if the female is older than 35.

Female Evaluation by an OB/GYN
A female evaluation by an OB/GYN typically includes:

  • A detailed medical history
  • Ovarian reserve testing with blood test through ReproSource Laboratories to check follicle-stimulating hormone (FSH), estradiol, and anti-Müllerian hormone (AMH) levels
  • A transvaginal ultrasound performed on the second, third, or fourth day of the menstrual cycle to count the number of follicles (egg sacs) in each ovary
  • A hysterosalpingogram (HSG) to evaluate if the Fallopian tubes are open

Male Evaluation

  • A detailed medical history
  • Semen analysis
  • When people meet the definition of infertility (see above)
  • When basic treatment, often clomiphene citrate (Clomid, Serophene) has not resulted in pregnancy after 6 months
  • When severe male factor exists

When should I/we consult a fertility specialist?

  • When people meet the definition of infertility (see above)
  • When basic treatment, often clomiphene citrate (Clomid, Serophene), has not resulted in pregnancy after 6 months
  • When severe male factor exists

Let's get started together. Call us today to learn about the power of what's possible, 1.888.761-1967 or schedule an appointment online.

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