What is Infertility?
Infertility is generally defined as a failure to achieve pregnancy within 6-12 months of trying to conceive, though this can vary depending on each patient. For women aged 35 and older, or with other medical problems, this window is shortened to 6 months. Infertility affects about 15% of couples due to a variety of reasons including decreased or impaired ovarian function, blocked fallopian tubes, history of pelvic infections, abnormal uterine anatomy, or abnormal sperm in one’s reproductive partner. Many times, however, it is unexplained.
Why is Infertility Important?
In some cases, infertility is caused by things that might also affect your overall health, so it’s important to determine the causes for both your sake and your child’s. Additionally, your child’s health might be affected by certain causes of infertility so your gynecologist can direct you to the right experts if your pregnancy becomes high-risk.
How Can My Gynecologist Help?
If you’ve been trying to conceive for 6-12 months without becoming pregnant, you should make an appointment with your gynecologist. This typically begins with a complete history, physical examination, and laboratory tests. We will also review your menstrual calendar to ensure that you’ve been having intercourse at the right time each month to increase your chances of getting pregnant. We can then recommend a variety of tests and a referral to a reproductive endocrinologist and infertility specialist (REI). Effective testing usually includes addressing different factors that both you and your partner might be experiencing.
Male factor infertility is typically related to problems with sperm, such as a low count, slow movement, or abnormal appearance. All of these issues can be evaluated with a test called a semen analysis, where a semen sample is viewed under a microscope. We generally refer you to an REI for this, as they perform this test directly in their own laboratory.
Female causes of infertility are much broader. Testing usually begins with blood tests to check hormone levels and thyroid function. A specialized imaging test called a hysterosalpingogram, or HSG, may also be done. During this test, a radiologist puts dye through the cervix into the uterus and fallopian tubes, which lets us see that the fallopian tubes are open. This also lets us see if the shape of the womb is abnormal. For insurance reasons, you may need this test ordered by an REI.
Based on all of these findings, your REI will make recommendations and provide treatments for infertility. Once you are pregnant, your gynecologist can recommend your next steps to ensure a healthy, successful pregnancy.
How Can Infertility Be Treated?
Depending on the results of your initial workup, additional testing or procedures may be your best options. Alternatively, certain medications can sometimes be prescribed to help optimize your chances of achieving pregnancy. Ultimately, you may be referred to a specialist in the field for further management. REIs are trained in special methods of achieving pregnancy, including the use of hormonal medications, intrauterine insemination, or in vitro fertilization. Each of these topics can be discussed with your gynecologist who can recommend whether you might benefit from specialized care.
Schedule an Appointment
Infertility can be a long and difficult journey, but our expert team can help. To learn more about your options and get started, contact our New York City office by calling or filling out our online form.