Knowing When to Move on When You’re Trying to Conceive

Tuesday, April 16, 2019 | 7:41 pm

If you are having trouble getting pregnant, chances are one of the first steps you will take is to schedule an appointment with your obstetrician-gynecologist (OB-GYN).

Like many women, you might have a rapport and an established relationship with your OB-GYN. Your physician has performed pap smears and prescribed birth control. Perhaps he or she delivered your children, and you are now having difficulty expanding your family. Or maybe your insurance carrier requires you to visit an OB-GYN before it pays for a specialized infertility consultation.

Not every OB-GYN treats infertility. However, many are experienced in preliminary care, such as providing diagnostic evaluations and prescribing medications. They also may conduct intrauterine inseminations, where the doctor places washed and concentrated sperm into a woman’s uterus. They have the expertise to successfully guide patients with mild endometriosis, problems with ovulation, mild male infertility, and cervical infertility.

Guidelines for a transition

Often women who have been struggling to conceive are unsure about the right time to transition to an infertility specialist to receive more advanced treatment. If you are wondering when to move on from your OB-GYN or even bypass your current women’s health provider, here are some guidelines to help inform your decision:

• Your gynecologist has performed six to twelve cycles of basic procedures like medicated ovulation induction or intrauterine inseminations that have not resulted in a successful pregnancy. Age is an important consideration. Women under the age of 35 are not advised to have more than twelve cycles, while women over 35 have an upper limit of six cycles.

• You’ve experienced multiple miscarriages.

• You already have been diagnosed with or have a family history of PCOS, endometriosis or another known fertility issue, and now are ready to start a family.

• A doctor has diagnosed your partner with a severe male factor issue that may require the services of a urologist as well as a reproductive endocrinologist.

• You have been diagnosed with a condition that requires in vitro fertilization (IVF), such as blocked fallopian tubes, severe male infertility or a genetic disorder, and know you will need the services of a clinic that offers advanced assisted reproductive technologies and genetic analysis.

• You or your partner have been diagnosed with cancer and need to freeze eggs, embryos or sperm.

• You want a second opinion, even though you adore your OB-Gyn.

• You are a woman who is older than 35 and realizes that time is not on your side.

• Your OB-GYN wants to refer you to a reproductive endocrinologist.

Making the move to a fertility clinic

When you schedule your initial consultation with a reproductive endocrinologist, prepare for this appointment by obtaining your medical records, learning about your insurance coverage, summarizing your medical and reproductive history, and creating a list of questions. Many patients get recommendations for specialists from their OB-GYN, insurance carrier, friends and family, and by researching the Internet.

Fertility specialists have a unique relationship with obstetrician-gynecologists. Before becoming reproductive endocrinologists, which is the reproductive medicine discipline for infertility, they first must become board-certified in obstetrics and gynecology. Many worked in this field before deciding to focus exclusively on fertility issues.

HRC Fertility works with many OB-GYNs who refer their patients when they have exhausted all options to help them get pregnant. They want to see their patients succeed at parenthood and, conversely, HRC refer these women back to their OB-GYNs when they become pregnant. So the strong connection between OB-GYNs and reproductive endocrinologists is beneficial to both types of physicians and, most importantly, for their mutual patients.

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