Fertility FAQs

Fertility specialists help people have children through assisted reproductive technology. They are experts at fertility diagnostic testing and creating personalized treatment plans that address each unique patient that walks through their fertility doors. 

An OB/GYN is a type of doctor that specializes in the medical and surgical care of female reproductive health, pregnancy, and newborns. They are the doctors that monitor pregnancies from conception to childbirth to postpartum. Reproductive endocrinologist, or fertility doctors, are a type of OB/GYN that has received additional training in order to diagnose and treat infertility and other reproductive issues. So, while all fertility doctors are OB/GYNs, not all OB/GYNs are fertility specialists.

Deciding whether to see an OB/GYN or a fertility specialist depends on several factors. If you are under the age of 35 and have been trying to conceive for less than a year, consulting with an OB/GYN or getting a preliminary fertility assessment from one should be sufficient. However, if you have been trying to conceive for over a year, are over the age of 35, or have reason to suspect that you or your partner are experiencing a fertility issue, seeing a fertility specialist will be more likely to give you the answers you are looking for.

Most people who decide to go to a fertility clinic do so after trying to have a child for at least a year. People who are over the age of 35 typically go after six months of trying to conceive. If you haven’t conceived after six months to a year of actively trying to get pregnant, it doesn’t mean that it won’t happen for you naturally. However, this is considered to be a good timeframe for you to get your fertility assessed and make sure that everything is in good shape.

On the other side of the spectrum, people sometimes see a fertility specialist because they’re not quite ready to have children now but want to have the option available later. These individuals visit fertility clinics so that they can pursue their family-building goals on their own timeline through fertility preservation. It is more common for women to freeze their eggs, but some men also choose to freeze their sperm. Aside from electing to freeze eggs and sperm, some people choose fertility preservation because they are facing a medical situation that may harm their fertility, such as the need for cancer treatment, which can cause damage to the reproductive system.

Fertility clinics are medical facilities where the diagnosis and treatment for the full spectrum of fertility issues are performed. Fertility clinics are typically staffed with reproductive endocrinologists, nurses, lab technicians, embryologists, and other trained personnel, all of whom specialize in fertility care. They generally offer diagnostic tests for both men and women, such as bloodwork, hormone panels, ultrasounds, and semen analysis. They also perform fertility treatment procedures such as intrauterine insemination (IUI), in vitro fertilization (IVF), fertility preservation, and third-party reproduction (e.g. egg donation, surrogacy, sperm donation, etc.).

A fertility evaluation is a series of diagnostics that assess your overall reproductive health. For women, these tests are focused primarily on evaluating ovarian reserve (i.e. the number and quantity of egg follicles present in the ovaries), hormone levels, and structural efficacy of the fallopian tubes and uterus. A fertility evaluation for a female patient typically involves bloodwork, transvaginal ultrasounds, and pelvic exams. For men, a fertility evaluation mainly focuses on sperm count, motility, (i.e. ability to swim), and morphology (i.e. the shape of the sperm). Learn more about fertility evaluation for women and men.

The decision of whether to get your fertility tested is different for everyone. While many people decide to get their fertility checked after six months to a year of trying, others may have good reasons to get their fertility evaluated sooner. For example, women who have been diagnosed with endometriosis or polycystic ovary syndrome (PCOS), both of which are known to have an impact on fertility. Another example is if you’re interested in fertility preservation or have a family history of early menopause. In all of these scenarios, getting your fertility tested is definitely worth it, especially if you do it sooner rather than later.

The first fertility consultation is the starting point for you and your doctor to map out your potential treatment options. This first appointment is all about gathering your personal information, including your medical history, and performing some preliminary tests. Your doctor or a nurse will conduct an in-depth review of your medical details, including any information about ovulation, menstruation, pain during intercourse, pre-existing medical conditions, lifestyle, family medical history, vitals, and past reproductive history. There will also be questions about how long you’ve been trying to conceive as well as the frequency and timing of intercourse. You will also have a chance to get to know your fertility doctor and ask them all the questions you have on your mind.

During this consultation, your fertility doctor will take blood to be analyzed, perform a pelvic exam, and assess your ovarian reserve using a transvaginal ultrasound. They will explain their findings and answer all of your questions.

Being prepared for your first fertility appointment will help make the entire process easier and more streamlined. Be sure to bring the following:

• Copies of your medical records, including general health, gynecological, and any previous fertility care
• A list of all your medications and supplements, including vitamins and herbs
• Your family’s medical history
• Details about your ovulation and menstrual cycles, including how old you were when you first got your period
• A record of your basal body temperature (BBT), if you have been recording it
• Details about how you’ve tried to get pregnant in the past (frequency of intercourse, etc.)
• A list of all your questions
• A notebook to write down thoughts, instructions, or details.

Short answer, yes. The longer answer is that it depends. There are many factors that can cause or influence infertility, some of which can have an effect on menstruation and some of which don’t. While menstruation is an important aspect of understanding fertility, it does not represent the full picture.

To successfully conceive, a woman needs just one viable egg. With IVF, fertility doctors typically retrieve between 10 to 20 eggs. This makes it more likely that there will be at least one viable egg to choose from.

Female infertility is typically caused by ovulation issues, and the most common source of ovulation issues is age. As women get older, their ovarian reserve diminishes until eventually they no longer ovulate (menopause). However, ovulation issues can also occur in younger women, especially if they have certain reproductive conditions (e.g. endometriosis, PCOS, etc.) or certain lifestyle habits that can be damaging to fertility (e.g. excessive alcohol consumption, tobacco use, etc.).

In the vast majority of cases, using birth control does not affect your ability to have a child in the long term. This is true regardless of the type of birth control you use, whether it be oral contraceptives, an intrauterine device (IUD), implants, injections (e.g. Depo-Provera), or patches. That being said, some forms of birth control can delay fertility for longer periods of time. For example, women who discontinue the use of birth control pills may experience a fertility delay of two to six months, while women who discontinue Depo-Provera may have to wait between 10 to 31 weeks to conceive.

There is a wide range of factors that can cause or contribute to male infertility, the most common being issues with sperm count, motility, and shape. Some other causes of male infertility include hormonal imbalances, tumors, varicocele, structural abnormalities, and genetic conditions. Male infertility has also been associated with obesity, smoking, excessive alcohol usage, overheating of the testicles, substance abuse, and extreme physical activity.

A doctor who specializes in male fertility is known as an andrologist. Similar to how reproductive endocrinologists are OB/GYNs with extra training, andrologists are urologists that have received additional training and education in the diagnosis, management, and treatment of male infertility.

With the help of medical intervention and/or lifestyle changes, many men who have experienced infertility may be able have a child. There are many options available to improve or support sperm function.

Infertility is quite common; in the US, approximately 10% to 15% of heterosexual couples experience infertility. About one-third of these cases are caused by only female fertility issues, while another third are caused by only male fertility issues. The remaining cases are either caused by a combination of both male and female fertility issues or unknown factors. Because these statistics do not reflect single individuals or LGBTQ+ families, the rate of infertility is possibly higher than we realize.

For women, fertility starts to decline more rapidly in their mid-30s due to having fewer available eggs. Men, on the other hand, are able to produce sperm well into older ages. That being said, male fertility can also start to decrease around the mid-30s. As a general rule of thumb, men and women who are aged 35 and older should consider undergoing a fertility evaluation if they are planning to have children.

Secondary infertility is when an individual or couple is unable to conceive naturally in spite of having successfully had a child in the past. This condition affects approximately 10% of heterosexual couples.

Just like primary infertility, there are many factors that can cause or contribute to secondary infertility, the most common being advanced maternal age, reproductive conditions, and sperm disorders.

The two most common types of fertility treatment are intrauterine insemination (IUI) and IVF. IUI is a form of artificial insemination in which semen is placed directly into the uterus, thereby making the sperm’s journey to the egg a little shorter. IVF involves retrieving eggs and fertilizing them with sperm in a embryology lab. Once an embryo develops, it is transferred into the recipient’s uterus with the goal of implantation.

In the vast majority of cases, egg freezing is a safe procedure that poses little to no risk to your reproductive health or your ability to get pregnant naturally. However, some women experience a condition known as ovarian hyperstimulation syndrome (OHSS), which is when the ovaries have an exaggerated response to the hormonal medications used in ovulation induction. This causes the ovaries to become temporarily swollen and painful. Most cases of OHSS are mild and go away after a short period of time. However, severe cases can require hospitalization and aggressive treatment. Before undergoing any procedure that involves fertility injections, your doctor will talk to you about the signs and symptoms of OHSS.

Freezing your eggs makes it possible for you to pursue your family-building goals on your own timeline. For women who want to accomplish other goals before having a family or simply aren’t ready to have a child, egg freezing is a great way to keep your options open for the future.

Sperm freezing is a very effective way for men to preserve their fertility. Some men choose to freeze their sperm when they are younger just to make sure they have a bank of healthy sperm for later in life. Others choose to freeze their sperm before undergoing a vasectomy.

At this time, it is not possible for you to freeze your sperm yourself at home. For sperm freezing to be successful, cryopreservation must happen in a laboratory. When sperm is frozen in a laboratory, it is first specially prepared so that only the healthiest, strongest sperm are preserved. Next, the sample is treated with cryoprotectants that help the sperm retain their structural integrity during the freezing and thawing processes. Finally, sperm are frozen and maintained in liquid nitrogen. These storage facilities are also properly equipped to keep all tissues preserved in the event of a power outage or natural disaster.