Trouble Getting Pregnant?
Infertility strikes millions of people annually. The causes of infertility are varied but mainly attributable to ovulation issues, endometriosis, and damage to the fallopian tubes in women. Studies show that in the US, about 9% of men and 11% of women of reproductive age have experienced fertility problems. There are many risk factors for infertility, including abnormal menstrual cycles, autoimmune and blood clotting disorders, sexually transmitted diseases (STDs), and chronic diseases.
Diagnosing infertility
For many individuals or couples, the diagnosis of infertility is not always straightforward. A highly trained specialist, such as a reproductive endocrinologist (RE), can perform a thorough evaluation, including taking a medical history, performing a physical exam, and conducting relevant testing. As infertility can affect both men and women, a series of tests are utilized to find the root cause. Blood tests, including hormone levels, thyroid studies, and semen analysis, are commonly ordered. Ultrasound can help assess pelvic anatomy and estimate egg count. A specific blood test known as the anti-mullerian hormone (AMH) test can be ordered to determine the number of eggs remaining, also known as the ovarian reserve. A high value indicates an individual will respond well to fertility medicine and treatment.
More than a number
Age is a significant factor in fertility, as the reproductive systems undergo natural changes that can impact the ability to conceive. For women, the ovarian reserve starts to decline with age, as does egg quantity and quality. Getting older also increases the chance of chromosomal abnormalities. In men, aging causes gradual changes in the testicles, resulting in a decrease in size and testosterone release. Testosterone has many functions and is primarily responsible for sex drive, sperm production, and muscle mass. After age 30, levels start to decline at a rate of 2% per year. Age can also introduce medical conditions that affect fertility, like obesity, diabetes, scarring from previous surgery, pelvic infections, and cancer treatment.
When to see a RE
Infertility is defined as the inability to conceive after 12 months of unprotected intercourse. A reproductive endocrinologist is an obstetrician/gynecologist (OB/GYN) specializing in the endocrine system. This system consists of tissues and glands that release hormones to regulate many processes, like metabolism, growth and development, sexual function, and the sleep-wake cycle. An RE can evaluate fertility issues and make recommendations on treatment. In addition, an RE can provide further procedures to narrow down the causes of infertility. For instance, a hysterosalpingogram (HSG) is a procedure that uses a combination of x-rays and dye to check the patency of the fallopian tubes and the shape of the uterus. Laparoscopy is a surgical procedure that an RE can perform to evaluate the pelvic organs for conditions like endometriosis or scar tissue that might be affecting pregnancy chances. Furthermore, an RE can initiate assisted reproductive technologies (ART) like in vitro fertilization (IVF) to increase the chances of getting pregnant.
Navigate infertility like an expert
The inability to conceive is a prevalent issue affecting many couples worldwide. A reproductive endocrinologist can help pinpoint the cause of infertility and offer many benefits on the pregnancy journey. From the initial diagnostic workup and evaluation to possible treatment with ART, an RE can provide a full complement of resources to overcome infertility and help people reach the goal of building a family.
