Understanding Fertility Assessment Timing

It’s not uncommon to face challenges and complications when trying to conceive. Fortunately, accessing the support and expertise you need starts by answering a single question: “When should I see a fertility doctor?”

Whether you’re wondering about age, reproductive history, or yet unknown factors, we can help you find the answers – and understand the questions you should be asking.

• What is a fertility specialist? 
• When should I see a fertility doctor?
• Fertility Specialist: Additional FAQs

What is a fertility specialist?

A fertility specialist is a physician of obstetrics and gynecology that specializes in reproductive endocrinology and infertility. Also known as reproductive endocrinologists, fertility specialists are experts in hormonal function and the role it plays in male and female fertility and reproductive health. They dedicate their careers and expertise to helping people achieve their dreams of having children.

When should I see a fertility doctor?

The decision of when to see a fertility doctor is different for everyone, but in general, it’s recommended that you see one if you’ve been trying to conceive for a year and haven’t been successful. For women over the age of 35, it’s recommended that you see a fertility specialist after six months of trying. Depending on your personal circumstances, you might want to consider seeing a fertility specialist sooner.

Trouble conceiving after a year of trying

Being over the age of 35

Having a known reproductive issue

Trouble Getting Pregnant

Conception and pregnancy are exceptionally complex biological processes that rely on the perfect synchronization of many factors. First and foremost, a successful conception requires healthy eggs and sperm. You also need unobstructed fallopian tubes and a uterus capable of sustaining a pregnancy. You also need to plan intercourse according to your ovulation cycle so that the sperm can meet the egg at the exact right moment. A wide range of factors can disrupt any of these aspects. 

If you have been trying for a year to actively conceive and haven’t succeeded in getting pregnant, seeing a fertility specialist will explore what the issue is and develop a treatment plan to address it.

Being Over the Age of 35

As you reach your mid-30s, your fertility begins to decline, first gradually and then rapidly. After the age of 35, a woman’s ovarian reserve has naturally depleted in both quantity and quality. This can also be exacerbated by certain medical conditions and lifestyle factors, such as endometriosis and smoking. Because you have fewer eggs, the chances of successfully getting pregnant are lower. Furthermore, as you get older, the eggs that remain are more likely to have structural and chromosomal abnormalities.

For men, the aging process affects their reproductive health a little differently. Men can produce sperm throughout their adult lives, starting from puberty. As such, many people believe that men retain their peak fertility at all ages. However, this is not true. Although men can continue to produce sperm at older ages than women can produce eggs, male fertility also begins to decline after the age of 35. Not only does your sperm count begin to drop, but the sperm also become less motile and more prone to genetic instability and fragmentation.

For individuals who are over the age of 35, it’s often recommended to see a fertility specialist after six months of actively trying to conceive without success. However, there are many factors to consider, and in some cases, you might want to see a fertility specialist sooner.

A Known Reproductive Disorder

There are several female reproductive disorders that can make it more difficult for patients to get pregnant, the most common and well-known being endometriosis, polycystic ovarian syndrome (PCOS), and uterine fibroids.

Endometriosis

Endometriosis is when endometrial tissue (the tissue that lines the inside of the uterus) grows outside the uterus onto other parts of the reproductive system, such as the fallopian tubes, ovaries, and pelvic region. The condition can lead to infertility and can cause a wide range of other symptoms, including painful periods, heavy menstrual bleeding, pain during sex, painful urination and/or bowel movements, and abdominal pain. Every person is different, however, so no two cases of endometriosis are experienced in the same exact way. Some people with endometriosis have very painful, obvious symptoms, while others do not.

Endometriosis is considered to be very common and is thought to affect more than 11% of women in the US of reproductive age. In spite of its prevalence, endometriosis is also commonly underdiagnosed or misdiagnosed. This is because many of the symptoms and signs of endometriosis are common in other conditions. Some of the symptoms are also commonly dismissed as being a normal part of life.

Polycystic Ovarian Syndrome (PCOS)

PCOS is a reproductive condition in which sex hormones are out of balance. In PCOS, the ovaries produce an excessive amount of androgens, which is a group of sex hormones that play a crucial role in growth and reproduction. Androgens are often associated with male reproductive health but are also present in females in small amounts. In PCOS, the androgen levels are elevated, causing several symptoms, including:

• Irregular menstruation (missed, irregular, or very light periods)
• Hirsutism, or excessive hair on the body and face
• Enlarged ovaries
• Growths (cysts) on the ovaries
• Oily skin
• Acne
• Weight gain, especially in the abdomen
• Hair loss or thinning
• Skin tags
• Patches of darkened skin under the armpits, under the breasts, or on the back of the neck

Uterine Fibroids

Uterine fibroids are a condition in which noncancerous growths develop on the uterus. This can impact fertility by creating blockages in the uterus and fallopian tubes. Not only can uterine fibroids make it more difficult to conceive, but they can also make it more difficult to sustain a pregnancy. Some of the most common signs of uterine fibroids include:

• Periods that last longer than seven days
• Heavy menstrual bleeding
• Pain or pressure in the pelvic region
• Frequent urination
• Constipation
• Pain in the back or legs

Although endometriosis, PCOS, and uterine fibroids are some of the most common causes of infertility in women, they are often treatable, especially with the help of a fertility specialist. If you have already been diagnosed with or strongly suspect that you have a known reproductive disorder, connecting with a fertility specialist may help you improve your chances of successfully having a child.

A History of Recurrent Pregnancy Loss

Recurrent pregnancy loss, also known as recurrent miscarriage, is a reproductive condition defined by having two or more pregnancy losses before the 20th week of gestation. The most common cause of recurrent pregnancy loss is abnormal embryonic development, which often occurs randomly. This is typically caused by some type of chromosomal abnormality, usually in relation to the number of chromosomes present in the embryo. The average human has 23 pairs of chromosomes, inheriting a set from each parent for a total of 46 individual chromosomes. If there are too many or too few chromosomes, the embryo cannot develop correctly.

If you’ve lost two or more pregnancies, seeing a fertility specialist can help understand what is happening and take steps towards helping you have a successful pregnancy.

Connect with a fertility specialist today about recurrent pregnancy loss.

Irregular Menstruation or Ovulation Symptoms

Having trouble conceiving is sometimes caused by ovulation irregularities. This often happens because of issues with hormone regulation, either by the hypothalamus, the pituitary gland, or the ovaries themselves. Aside from trouble conceiving, there are several other signs that can indicate an ovulation-related condition, the most obvious being irregular or no periods. Other signs can include:

• Irregular hair growth on the face or body
• Hair loss or thinning
• Acne
• Weight gain

If you have these symptoms, seeing a fertility specialist can help find out what the issue is and develop a treatment plan to circumvent them. Fertility specialists perform extensive diagnostic assessments to get an understanding of what is going on with your reproductive system.

Family History of Early Menopause

Menopause refers to the time in a woman’s life when she permanently ceases to menstruate. It is typically defined as when a woman hasn’t gotten her period for a year. Once you have reached menopause, you stop ovulating and can no longer conceive without fertility care. Menopause typically happens to women when they reach their 40s or 50s, but can also happen to younger women. This is known as early or premature menopause.

The cause of early menopause is not always understood and, in some cases, can happen without a clear reason. However, genetics often play a role. 

Early menopause can also be caused or exacerbated by certain lifestyle factors, such as smoking. The toxic chemicals contained in cigarettes (nicotine, carbon monoxide, cyanide, etc.) cause damage to eggs and increase their rate of loss. The more quickly your egg supply depletes from smoking, the more likely you are to go through menopause early. This is especially true if you have a family history of early menopause.

If early menopause runs in your family, talking to a fertility specialist about treatment can help you figure out your family-building options.

A History of STIs

Sexually transmitted infections (STIs), such as chlamydia and gonorrhea, can cause infertility in both men and women, especially if the STI goes untreated. For women, STIs can cause damage, inflammation, and scarring in reproductive organs, such as the fallopian tubes. This can make it difficult for eggs and sperm to meet in the fallopian tubes. It also can increase the likelihood of having an ectopic pregnancy, a potentially fatal condition in which an embryo implants into tissue outside of the womb.

Men are less likely to have fertility issues related to STIs than women, but are not immune. Untreated STIs can contribute to male factor infertility when they cause damage and inflammation to the epididymis and urethra, both of which play an important role in the transportation of sperm.

Part of the issue with STIs and infertility is that many patients do not experience symptoms and may not realize that they even have an infection that needs treating. Women are more likely to be asymptomatic than men. If detected early enough, many STIs can be treated successfully and fertility can be protected.

If you have a history of untreated STIs and believe that it is a contributing factor in your fertility, talking to a fertility specialist can help develop a course of treatment that makes it possible for you to still have a child.

Fertility Preservation

Another reason to see a fertility specialist is if you are interested in fertility preservation. Fertility preservation involves the cryogenic freezing of eggs, sperm, or embryos. These genetic materials are flash-frozen through a process known as vitrification, which helps to stabilize the tissues and prevent damage during freezing and thawing. Frozen reproductive tissues are then stored long-term in liquid nitrogen in a cryogenic center.

There are many reasons why someone might choose to pursue fertility preservation. One of the most common reasons is that you simply aren’t ready to have a child now but wish to keep the option open. By freezing eggs or sperm during your peak fertility years, you are more likely to successfully have a baby later in life than you would if you were using your regular-aged eggs or sperm. Some individuals choose to preserve their genetic materials before undergoing a procedure for permanent contraception, such as a vasectomy or tubal ligation.

Another reason patients pursue fertility preservation is that they have a disease, such as cancer, which requires treatment that will damage their reproductive systems. While treatments such as radiation and chemotherapy are life-saving therapies, they also can have a detrimental impact on the reproductive system as well as on sperm or eggs. 

Fertility preservation is also a great option for transgender and non-binary patients who wish to save their genetic materials before undergoing gender-affirming therapies or surgeries that will impact their reproductive Fertility preservation makes it possible to save your eggs and sperm while they are still healthy so that you don’t have to choose between life-saving care and your future family-building dreams. Most fertility specialists that offer oncofertility and fertility preservation give preferential treatment to those facing a diagnosis of cancer. When it comes to fertility preservation before receiving cancer treatment, time is of the essence, which fertility specialists understand implicitly.

Fertility preservation is also a great option for transgender and non-binary patients who wish to save their genetic materials before undergoing gender-affirming therapies or surgeries that will impact their reproductive health. 

No matter what your reason or need for fertility preservation is, connecting with a compassionate fertility specialist that takes an interest in you as a person, including your goals, hopes, and dreams is an important part of your journey.

Connect with a fertility specialist today for a fertility preservation consultation.

Third-Party Reproduction

Thanks to advanced technology and modern medicine, many people are able to have a child in situations where only a few decades ago they wouldn’t have been able to. There are many different types of fertility journeys, and no two paths are exactly the same. For some, the path to parenthood requires a little bit of help from a third-party individual, such as an egg donor, sperm donor, or gestational surrogate. This can be because of infertility or medical reasons, LGBTQ+ family-building, or the desire to become a parent without a partner.

In recent years, it’s become increasingly common for people to seek out third-party reproduction on their own using social media to advertise their need for an egg donor, sperm donor, or gestational surrogate. While it may be tempting to go along with this trend, informal arrangements can turn out badly for at least one involved In recent years, it has become increasingly common for people to seek out third-party reproduction on their own using social media to advertise their need for an egg donor, sperm donor, or gestational surrogate. While it may be tempting to go along with this trend, informal arrangements can turn out badly for at least one involved party. Whether you need an egg donor, sperm donor, or surrogate, it is always best to explore third-party reproduction options with the help of a fertility specialist. A fertility specialist will make sure that the experience is healthy, safe, and ethical for all parties involved.

Fertility Specialist FAQ: Learn with Prelude

What do you call a doctor that specializes in fertility?

Doctors who specialize in fertility are often referred to as fertility doctors or fertility specialists. They are more officially referred to as reproductive endocrinologists.

What is the difference between a reproductive endocrinologist and an ob-gyn?

OB-GYN refers to a type of doctor that specializes in obstetrics (medical care for pregnant women and babies during pregnancy and childbirth) and gynecology (medical care for female reproductive health). They provide care for all aspects of reproductive health, pregnancy, and childbirth. 

Reproductive endocrinologists are a type of OB-GYN physician that has had additional training, education, and experience in the treatment of hormonal function as it relates to fertility.

Should I see a fertility specialist before trying to conceive?

While most people see a fertility specialist only after trying to conceive for six months to a year, there are several scenarios in which someone would consider seeing a fertility specialist sooner rather than later, including if you have a known reproductive disorder (endometriosis, PCOS, etc.), a family history of early menopause, or wish to undergo fertility preservation.

How do I talk to my doctor about fertility?

Talking about fertility with your doctor can feel like an overwhelming experience, but it doesn’t have to be. Before discussing with your doctor, gather together your questions so that you know ahead of time what you want to ask. It can be helpful to write these questions down and bring a notebook. Keeping track of your menstrual cycles and noting any symptoms is also highly recommended, as your period often holds vital clues to your reproductive health.

Can my OB-GYN check my egg count?

Some OB-GYN physicians provide basic fertility testing, but for a truly comprehensive fertility diagnostic assessment, it’s best to see a fertility specialist. Fertility specialists review all factors that can have an impact on your fertility and will have a greater understanding of the bigger picture beyond egg count.

Connect With a Prelude Fertility Specialist

No matter where you are in your fertility journey, The Prelude Network™ is here to help you figure out the path that’s best for you. The fertility specialists who run our fertility clinics are not only experts in their field, but also profoundly sympathetic to the needs and hopes of their patients. From physicians to administrative staff, each member of the Prelude family is dedicated to supporting you and your family as you learn more about fertility.

If you’re ready to take the first step on your path to parenthood, our fertility clinics are ready to help. Connect with The Prelude Network™today.