GETTING PREGNANT

Many of us grew up watching the old pregnancy test commercials where the woman surprises their partner with a bright solid line. Well, for some of us, it just isn’t going to be that simple. That does not mean that you will not take home a healthy baby. It just means that it may not happen the way you initially thought it was going to happen. Like most situations in life, we need to switch to plan B.

Our team is experts in helping patients along their journey to parenthood, no matter how long, how far, or in what direction that journey takes you. We will be there with you every step of the way, encouraging and supporting you. We will make sure you have a clear understanding of everything you are facing and all of your treatment options. We fell it is our job to make you as comfortable as possible during this challenging period in your life.

LIFESTYLE CHANGES TO MAKE

Healthy bodies are simply better at establishing and maintaining healthy pregnancies, and it is in your best interest to work creating that healthy body and healthy reproductive system as soon as you decide to get pregnant. Our team is prepared to help you along the way. Some patients have a medical diagnosis that requires medication or hormonal support before they are ready to begin treatment. Some patients have difficulty maintaining a healthy diet or healthy weight. Some patients are struggling to cope psychologically with the painful experience of infertility. Some patients need to quit bad habits like smoking, excessive drinking or recreational drug use prior to conceiving. Our team of experts is here to help you, no matter what your lifestyle issues are. We will make sure your body is as healthy as possible and ready for conception and pregnancy.

WHEN TO TRY

Once you have decided you are ready to raise a child, the time of conception becomes crucial to promote success. Women are most fertile before the age of 26. After this age, their reproductive system begins a steady decline in fertility through menopause (the cessation of ovulation and menstruation). Some men maintain their fertility throughout their lives, but many experience an age-related decline after 45 years of age. Because women over the age of 35 are approaching menopause, it is important that they seek out a fertility specialist early in their journey to parenthood.

Over the counter ovulation kits are a great way to start your journey to conceiving on your own. They are available in any drug store and can help you determine if you are timing intercourse properly. They cannot, however, guarantee that you are ovulating. Our office can run testing and cycle monitoring to ensure that you are ovulating.

WHEN TO SEEK HELP

Women over the age of 35 should wait no longer than six months of trying before discussing their options with a reproductive endocrinologist. Women under 35 can try for one year, or they may elect to speak with a fertility specialist during that year of trying just to make sure they are fertile. Our office provides a full range of testicular and ovarian function testing, and we can help you determine if you are on the right track or not.

Patients who have had any of the following should seek out a reproductive endocrinologist early on:
Patients with painful and/or irregular periods
Patients with more than one miscarriage in the past
Patients who are not in their recommended body mass index (BMI)
Patients and partners who have a history of sexually transmitted disease
Patients and partners who have a history of cancer/chemotherapy/radiation or other treatment likely to cause infertility
Patients and partners who have a history of substance abuse or smoking
Patients and partners who have certain endocrine disorders
Patients who are concerned that their future plans may negatively impact their fertility before they are ready to conceive

FEMALE FACTOR INFERTILITY

Polycystic Ovary Disease (PCOS)
For many years the symptoms and causes of PCOS were poorly understood. It includes a collection of symptoms, some of which may seem unrelated to fertility. These symptoms include excessive follicles visualized on sonogram, hyperandrogenism, anovulation and metabolic irregularities.

Patients with PCOS should only undergo ovulation induction or ovarian stimulation with a board-certified reproductive endocrinologist as they are at an increased risk to over-respond to the medication creating a potentially life-threatening complication called ovarian hyperstimulation syndrome (OHSS).

Anovulation and Ovulatory Disorders
Some patients have a hint to their ovulation disorder by their irregular periods. Some patients, however, may undergo regular periods and still fail to ovulate eggs properly. These disorders are easily diagnosed and usually treatable without in vitro fertilization (IVF) by merely regulating the menstrual cycle with hormones.

Premature Ovarian Failure (maternal age younger than 36 years)
While menopause is a natural process, most women should not expect to undergo menopause until they approach 40 years of age or older. Women under 40, however, can experience a complete cessation of menstruation and ovulation, which is termed premature ovarian failure. The diagnosis is relatively simple with blood work and sonogram. Still, the treatment may require IVF depending on how far advance the decline in ovarian function is when treatment has begun.

Diminished Ovarian Reserve (maternal age 36 years and older)
As you approach menopause, your reproductive system will be in steady decline, and each cycle fewer eggs will be available for recruitment either in the natural menstrual cycle or in a stimulated treatment cycle. For this reason, it is important that women over the age of 35 seek out a fertility specialist early in their journey to parenthood. For these patients, there just simply is not a lot of time to waste.

Uterine Factor
The uterus is a complex organ that must nurture and protect a pregnancy from the very beginning through birth. Many types of disorders can affect the uterus. In some cases, fertility treatment may allow a patient to carry a pregnancy to term even with uterine factor infertility. In more severe cases, the use of a gestational carrier to carry the pregnancy to term will be required.

MALE FACTOR INFERTILITY

Male factor infertility usually involves a decreased amount of motile sperm in the ejaculate. Still, it can range to patients who do not have any sperm in the ejaculate or who are unable to ejaculate. Having zero sperm in the ejaculate does not mean that you are not making sperm; it just means for some reason; it is not making its way into the ejaculate. A urologist who specializes in fertility can help determine why this is happening and how to retrieve the sperm directly from the testicle. Likewise, patients who have little or no ejaculate may be making plenty of sperm. Still, either their accessory glands are dysfunctional, or the sperm may be passing into the bladder during ejaculation. In either case, our team can help determine the cause and recover sperm to use in infertility treatments. In some cases, fertility hormones are not functioning properly, and medication can be prescribed to help regulate their function and production.

UNEXPLAINED INFERTILITY

Because the reproductive system of both men and women is so complex and requires so many other systems of the body to function properly, many patients will experience unexplained infertility. Meaning, even with all of our training, expertise, and access to testing, we still cannot clearly define the exact cause of your infertility. This diagnosis is only used when all other diagnoses have been explored and have been determined inadequate in describing your issues. Many patients end up embarking on treatment without a clear, concise cause of their infertility ever becoming known. Treatment options are still available for these patients and they can still conceive healthy pregnancies.

INHERITED DISEASES AND DISORDERS

Some patients have no trouble conceiving at all but are not able to carry a genetically healthy baby to term. Some patients know or come to know after prenatal genetic testing that they are carrying an inherited gene known to cause disease and wish to not pass along this gene to the next generation. These patients can use IVF to conceive and have the option to test biopsied samples of their embryos for these known gene sequences.

Other patients are not carrying gene sequences that are linked to disease, but rather carry entire chromosomes that are the wrong size, shape or have missing or duplicated information in the wrong places.