Frequently Asked Questions

At what point should I see a reproductive endocrinologist?

*You are 35 years of age or older;

*You have been trying to get pregnant for at least one year;

*You have been receiving infertility medical treatment for approximately one year and have not gotten pregnant;

*You have a history of irregular menstrual cycles, sexually transmitted disease, pelvic infection, hormone problems, excessive weight gain, endometriosis, fibroids, chronic pelvic pain, DES exposure, excessive facial or body hair, adult acne, or your male partner has been diagnosed with infertility issues;

*You have had two or more miscarriages;

*You are about to start injectable infertility medications;

*The doctor you are seeing does not offer holiday or weekend office hours for ultrasounds, blood work and inseminations;

*The doctor you are seeing is only using abdominal ultrasound and not transvaginal ultrasound scans;

*The doctor you are seeing does not check your ovaries and hormone levels while on clomiphene (clomid) to monitor the size of your ovaries, your response to the medication and to determine when or if ovulation occurs;

*You have been on clomiphene (clomid) for several months and have not gotten pregnant, and there is no change in your future treatment plan;

*You have been on clomiphene (clomid) for several months and your dosage is simply being increased without any monitoring to determine how your body is responding to the increased doses;

*Intrauterine insemination is not an option at your present doctor's office;

*You are considering a laparotomy or laparoscopy;

*You have pain, prolonged bleeding and/or bowel or bladder symptoms around the time of your period and your doctor doesn't suggest having a hysterosalpingogram (HSG), a hysteroscopy or a laparoscopy to determine the cause of the symptoms;

*A fibroid, polyp, uterine anomoly or tubal blockage has been noted on a hysterosalpingogram (HSG)--ideally, you want to see the film yourself with the doctor showing you the exact problem noted.

*You or your male partner have been diagnosed with a significant infertility issue (consistently abnormal semen analyses, severe endometriosis, blocked fallopian tubes, etc.) and in vitro fertilization is not offered as a treatment option by your doctor.

What is a Reproductive Endocrinologist?

A reproductive endocrinologist is a subspecialist physician who has received residency training in Obstetrics and Gynecology and advanced training, a fellowship, in the treatment of infertility, recurrent miscarriages and hormonal disorders in women. A typical Ob/Gyn resident receives between 5 and 12 weeks of training in Reproductive Endocrinology and Infertility, while a fellow has that initial residency experience and then dedicates 2-3 years to the field after completing that residency. Reproductive Endocrine fellows are trained in advanced procedures necessary for difficult infertility surgeries, with a focus on minimally invasive laser surgery that allows the woman to return to her regular schedule quickly and can save precious months of fertility that would have been spent recovering, procedures to reverse tubal ligation, injectable fertility drugs and Assisted Reproductive Technologies such as in vitro fertilization (IVF).  Although the emphasis of most Reproductive Endocrinology  and Infertility fellowships emphasize infertility, training also focuses on hormonal problems associated with menopause, abnormal menstrual cycles, polycystic ovary syndrome, endometriosis, pelvic pain and recurrent pregnancy loss.  During the course of their training, reproductive endocrinologists gain a comprehensive exposure to diagnostic tests, learn to manage ovulation induction, receive training in surgical techniques relevant to reproductive endocrinology and infertility, and are trained to provide the assisted reproductive technologies (ART), including in vitro fertilization.  Most importantly, they are trained to manage potential side effects and complications that may result from these treatments and procedures. To obtain Board Certification, Reproductive Endocrinologists must publish a thesis and pass separate written and oral examinations. Prior to taking the Reproductive Endocrinology and Infertility examinations, they must successfully pass the written and oral examinations to earn Board Certification in Obstetrics and Gynecology. Most Reproductive Endocrinologists are equipped and capable of caring for the problems of over 95% of the patients seen. For the patient who has an unusual problem requiring special care, the Reproductive Endocrinologist is likely to know where to find unique treatment and expertise, and can facilitate seamless coordination of care.

What is the "official" definition of infertility?

In general, infertility is defined as one year of unprotected intercourse without conception.  For women over 35, it is six months of unprotected intercourse without conception.