Trying to conceive can be a deeply personal journey, and for some, it may involve seeking assistance from a fertility specialist. These medical professionals, often called reproductive endocrinologists, possess specialized knowledge of the reproductive system and hormonal balance in both men and women. Their role is to diagnose and provide treatment for various conditions that can affect the ability to achieve pregnancy. Consulting a specialist is a common step many take toward parenthood.
General Guidelines for Seeking Help
The timeline for seeking a fertility specialist depends on age and the duration of unprotected intercourse. For individuals under 35, it is recommended to consider a consultation after 12 months of regular, unprotected intercourse without conception. This timeframe allows for a reasonable period of natural attempts, as the average couple may take between 5 to 7 months to conceive.
For those aged 35 or older, the recommendation for seeking help is sooner, after six months of regular, unprotected intercourse. This expedited timeline is due to the natural decline in female fertility with advancing age. Women are born with all the eggs they will ever have, and both the quantity and quality of these eggs decrease over time.
The decline in egg quality becomes more pronounced in the mid to late 30s. Eggs accumulate errors in their DNA during cell division as they age, leading to a higher percentage of genetically abnormal eggs. For women aged 40 or older, an even more immediate evaluation, possibly within three months of trying, is warranted due to the accelerated decline in egg viability at this age.
Specific Medical Conditions Warranting Earlier Consultation
Some medical conditions in women indicate a need for earlier consultation with a fertility specialist, irrespective of age or the duration of trying to conceive. Irregular or absent menstrual cycles can suggest ovulatory disorders, which are a common cause of infertility. Conditions like Polycystic Ovary Syndrome (PCOS), a hormonal imbalance affecting ovulation, fall into this category.
A history of multiple miscarriages, defined as two or more consecutive pregnancy losses, also warrants earlier evaluation. Structural issues within the female reproductive system, such as endometriosis, uterine fibroids, or pelvic inflammatory disease (PID), can impede conception. Endometriosis involves the growth of uterine-like tissue outside the uterus, while fibroids are benign growths in the uterus that can block fallopian tubes or interfere with implantation.
Previous sexually transmitted infections (STIs) like chlamydia or gonorrhea can lead to pelvic inflammatory disease, potentially causing damage or blockages in the fallopian tubes. Individuals who have undergone previous cancer treatments, such as chemotherapy or radiation, should seek early consultation as these can impact ovarian function and egg quality.
Male Fertility Considerations
Male fertility factors contribute to roughly half of all infertility cases, making the male partner’s evaluation equally important. Situations warranting a male partner to see a fertility specialist include issues such as low sperm count (oligospermia), poor sperm movement (motility), or abnormal sperm shape (morphology). These factors can significantly hinder the sperm’s ability to reach and fertilize an egg.
A history of testicular surgery or trauma can affect sperm production or transport, necessitating a specialist’s assessment. Mumps contracted after puberty can lead to inflammation of the testicles, potentially impacting fertility. Erectile dysfunction or other sexual health concerns that interfere with sperm delivery also warrant a consultation.
Previous cancer treatments, including chemotherapy or radiation, can damage sperm cells or other parts of the male reproductive system. In such instances, a fertility specialist can discuss options like sperm freezing prior to treatment to preserve future fertility. Varicoceles, which are abnormally swollen veins in the testicles, are another cause of male infertility requiring specialist attention.
What to Expect During Your First Visit
The initial consultation with a fertility specialist involves a comprehensive review of both partners’ medical histories. The specialist will inquire about menstrual cycle details, any previous pregnancies, surgeries, or chronic health conditions for the female partner. For the male partner, questions will cover similar aspects, including past fertility evaluations or treatments.
A physical examination of the female partner is performed to assess general health and evaluate for potential causes of infertility, such as thyroid issues or uterine abnormalities. This may include a transvaginal ultrasound to visualize the uterus, ovaries, and surrounding pelvic structures. The specialist will also discuss diagnostic tests that may be ordered.
These tests can include blood tests to evaluate hormone levels and ovarian reserve for the female partner, and a semen analysis for the male partner to assess sperm count, motility, and morphology. Imaging tests like a hysterosalpingogram (HSG), an X-ray to check the uterine cavity and fallopian tubes, may also be discussed. The first visit is designed to gather information, explain next steps, and begin developing a personalized plan for diagnosis and treatment.