Many individuals wonder if their obstetrician-gynecologist (OB/GYN) can assist with fertility testing. Fertility concerns are common, affecting about 12% of women aged 15-44 in the United States. Your OB/GYN is often the first point of contact for questions about conception, helping evaluate reproductive health and determine appropriate next steps.
The Role of Your OB/GYN in Fertility Assessment
OB/GYNs are trained in general women’s health, including obstetrics (pregnancy and childbirth) and gynecology (reproductive system care). They provide guidance on preconception health and help identify common factors that might influence fertility. While their scope is broad, they are equipped to initiate basic diagnostic steps and rule out more straightforward issues. Your OB/GYN can evaluate your overall reproductive health, which includes reviewing your medical history, conducting physical examinations, and discussing lifestyle factors. They can offer initial advice on optimizing your chances of conception by tracking ovulation and timing intercourse. If underlying issues are suspected, they can perform preliminary evaluations to determine potential causes of infertility.
Initial Fertility Tests Your OB/GYN Can Perform
Your OB/GYN can perform several initial fertility tests. Blood tests are a common first step, often conducted at specific points in your menstrual cycle. These include follicle-stimulating hormone (FSH) and estradiol levels to assess ovarian reserve, and luteinizing hormone (LH) levels to indicate impending ovulation. Progesterone levels are tested after suspected ovulation to confirm it occurred and to assess uterine lining readiness. Thyroid-stimulating hormone (TSH) and prolactin levels may also be checked, as imbalances can disrupt ovulation.
A transvaginal ultrasound provides detailed views of the uterus and ovaries, identifying structural abnormalities like fibroids, polyps, or ovarian cysts, and assessing antral follicle count. Your OB/GYN can also order a semen analysis for a male partner to evaluate sperm count, motility, and morphology.
When to Seek Fertility Testing and a Specialist Referral
Guidelines suggest seeking fertility evaluation after a certain period of regular, unprotected intercourse without conception. For women under 35, this timeframe is typically one year. If you are 35 or older, it is recommended to seek evaluation after six months of trying to conceive. For individuals over 40, a consultation with a gynecologist or fertility specialist soon after beginning to try for pregnancy is often advised.
Certain medical histories or symptoms may prompt an earlier consultation with your OB/GYN. These include irregular or absent menstrual cycles, painful periods, a history of conditions like polycystic ovary syndrome (PCOS) or endometriosis, or recurrent miscarriages. Concerns about male factor infertility, such as known issues with sperm count or function, also warrant earlier evaluation. If initial tests are inconclusive or more complex issues are suspected, your OB/GYN will recommend a referral to a fertility specialist.
Understanding the Role of a Fertility Specialist
A fertility specialist, also known as a reproductive endocrinologist (REI), is an OB/GYN who has undergone extensive additional training. After completing medical school and an OB/GYN residency, they pursue a three-year fellowship in reproductive endocrinology and infertility. This specialized training equips them with advanced expertise in diagnosing and treating complex fertility issues that go beyond the scope of general gynecological practice.
Fertility specialists offer more specialized diagnostic tools and a wider range of treatment options. They perform advanced imaging, conduct comprehensive semen analyses, and delve into genetic factors affecting fertility. Their treatment arsenal includes advanced reproductive technologies such as intrauterine insemination (IUI) and in vitro fertilization (IVF), as well as surgical interventions to correct reproductive anomalies. A referral to a fertility specialist ensures access to advanced care and personalized treatment plans for complex cases of infertility.