When to See a Fertility Specialist (Reproductive Endocrinologist)

• • Overview (jump to topic):  In general, if the couple or individual has been trying to get pregnant for 12 months without success, they should see a fertility specialist.
  • Other considerations: When the female partner is older than 35, or if the couple has known risk factors for infertility, they should see a specialist after six months of no success.
  • Infertility is relatively common and can be traced to both female and male reproductive issues, so both partners should see the fertility doctor at the initial visit.
  • Who to see: Our fertility doctors (reproductive endocrinologists) are double board certified in OB/GYN and reproductive endocrinology & infertility (REI) and are highly focused on all aspects of infertility.
  • First appointment: The initial meeting will involve discussions on general health and reproductive history, infertility testing & exams (sometimes conducted at this visit), and treatment options.
  • Come prepared: Knowing the right questions to ask of a fertility specialist helps couples or individuals make informed decisions.

When to see a fertility specialist

It can be difficult for couples or individuals to know when to seek an infertility specialist’s help getting pregnant. Should they just keep trying? Do they really need help for something that comes so naturally to so many others?

The general rule of thumb is that couples in which the female is 35 or younger should see a reproductive endocrinologist if they have been unable to get pregnant after a year of regular, unprotected sex. For women older than 35, the recommendation is to seek help after six months of trying; women over 40 should seek help immediately.

It’s also important to see a reproductive endocrinologist sooner than six months to a year without pregnancy success if:

• Either partner has a history of sexually transmitted diseases.
• Either partner has had cancer treatments.
• The female partner has irregular or no periods.
• The female partner has a history of pelvic infections or previous abdominal surgeries.
• The female has strong menstrual pain or has been diagnosed with endometriosis.
• The female partner has had recurrent miscarriages.
• The male partner has sexual problems (difficulty with erections).
• The male partner’s semen analysis shows poor-quality sperm.

The sooner people who suspect they have infertility reach out for help, the better. The sooner we can diagnose possible issues, the earlier we can suggest treatments and help patients conceive. If there are lifestyle factors such as obesity that are preventing pregnancy, we can help reduce those risks best by addressing them early on.

Some patients may need treatments that are known as assisted reproductive technology (ART), which are those involving the handling of eggs or embryos as with in vitro fertilization (IVF). Preparing for those treatments can take time and effort, so getting started sooner is important in those cases.

The causes of fertility issues are roughly related a third of the time to male factors, a third to female factors and a third to a combination of the two. Because of this, we recommend both partners come to the initial appointment.

Highlight: We don’t try to prove our expertise, we work to build relationships.

What is infertility?

Infertility is the inability to conceive or carry a baby to term. It can be frustrating and scary.

But couples having trouble trying to get pregnant should know they’re not alone. Studies show that about 15% of couples are unable to conceive after a year of trying. Nearly seven million American women have trouble conceiving or carrying a healthy baby to term, according to the U.S. Centers for Disease Control and Prevention. But infertility doesn’t just affect women. About a third of infertility cases can be traced to reproductive issues in men.

What causes infertility? A host of issues, and they’re different for each couple or individual.

 Learn more about the causes of female and male infertility.

What is a reproductive endocrinologist (fertility specialist)?

We want to be sure that couples understand what a fertility specialist does. Many people first look to their OB/GYN (for women or transgender men) or urologist (for men or transgender women) when they have trouble getting pregnant. These physicians will often refer their patients to a fertility specialist immediately or if some initial workup and treatment has not resulted in a pregnancy.

Fertility specialists, or reproductive endocrinologists, are the most qualified and highly trained physicians who diagnose and treat infertility. After medical school, they complete a four-year residency in Obstetrics and Gynecology (OB/GYN) and then a three-year fellowship in Reproductive Endocrinology and Infertility (REI).

During their fellowships, they work with other fertility specialists and learn how to perform infertility treatments such as IVF, the most effective, and complex, infertility treatment to help women become pregnant. But we treat about 85% of infertility cases with therapies involving medication or surgery, not the more involved ART treatments.

The fertility specialist will partner with a couple or individual throughout their journey from diagnosis of infertility to the objective of a successful birth.

Questions to ask our fertility specialists

Our fertility doctors welcome questions. We want to help patients make informed decisions by having a good understanding of infertility issues, our clinic’s practices and the treatment options available. The following questions may help patients determine during their initial visit if our clinic is a good fit for their needs.

• Does FINO offer all fertility treatments?
• How do the patients and doctor decide together what treatment to pursue?
• How many IVF procedures does the clinic perform annually and what are FINO’s success rates from IVF treatment?
• How much do particular treatments cost? How much is covered by insurance?
• How long has the clinic existed? How long has the doctor been there?

Learn more about what to expect at your first appointment with a reproductive endocrinologist