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If I’m Struggling to Conceive, When Should I Seek Help From a Fertility Specialist?

Dr. Jerald Goldstein offers advice for couples looking to expand their family.

What is a fertility specialist?
A fertility specialist, also known as a reproductive endocrinologist and infertility specialist, REI, is an obstetrical/gynecological physician who has undergone three years of additional training in reproductive endocrinology/infertility. REI physicians devote all or most of their practice to the diagnosis and treatment of fertility problems. When choosing a fertility specialist, make sure you select one who is a board-certifi ed reproductive endocrinologist.

When should you seek help from a fertility specialist?
If you are a woman under age 35 trying to conceive for one or more years without success or if you are a woman age 35 and older trying to conceive for six or more months, you should seek the help of a physician. However, if a general fertility evaluation has shown that you or your partner have a fertility issue, such as irregular menstrual cycles, blocked tubes, or a low sperm count, you should consider seeking the care of a fertility specialist right away so it can be addressed.

Infertility has always been an issue, but more women are waiting longer to start their families. Age really does matter when it comes to fertility.

Why do more couples need fertility treatments these days?
Infertility has always been an issue, but more women are waiting longer to start their families. Age really does matter when it comes to fertility. According to the American Society of Reproductive Medicine, fertility starts to decline noticeably as early as the late 20s and early 30s in women. A woman is born with all the eggs she will have in her lifetime, and she loses both the quantity and quality of her eggs as she advances in age. Women of advanced reproductive age can still have successful pregnancy outcomes, but statistically the success rate is lower. Often, these women will require medical assistance to conceive. In addition to waiting later in life to conceive, today there is a higher incidence of male factor, tubal factor, and second marriages following a prior sterilization procedure.

What is in-vitro fertilization (IVF)?
IVF is one of the most effective treatments available for infertility today. Utilizing IVF, eggs are removed from a woman’s body, fertilized, and transferred back into her uterus. IVF offers hope for many couples struggling with infertility. You may be a candidate if you are experiencing ovulation disorders, blocked or damaged fallopian tubes, endometriosis, low sperm count, or sperm motility issues. The age of the woman undergoing IVF is the single most influential factor in success.

Does egg freezing provide more options for women today?
Generally, fertility in women is greatest in their 20s. Many years ago, women had to choose between their careers and planning a family. Today egg freezing allows a woman to finish her advanced degree, work on her career, and wait for the right partner or circumstance in her life to conceive. In the past, egg freezing was considered experimental in the United States. However, in 2012, the American Society for Reproductive Medicine stated that we have enough data showing success with egg freezing and therefore the experimental label was removed. Pregnancy success rates for frozen eggs ultimately depend on the age of the woman when she chooses to freeze them, as well as the overall health of her eggs. Ideally the younger her age, and the better her quantity and quality of eggs at the time of freezing, the more beneficial the egg freezing process will be. Additionally, egg freezing is a great option for women recently diagnosed with cancer who want to freeze their eggs before starting potentially egg toxic chemotherapeutic drugs and radiation.

Founder and medical director of Fertility Specialists of Texas, Dr. Jerald S. Goldstein is a native Texan who received his medical degree from the University of Texas Southwestern Medical School, Dallas. He is board certified in both obstetrics and gynecology and reproductive endocrinology and infertility. Dr. Goldstein was an assistant professor in the division of reproductive endocrinology at Washington University Medical Center, St. Louis. He has presented before numerous medical conferences and published in such peer-reviewed journals as Fertility and Sterility and Obstetrics and Gynecology. Dr. Goldstein is a member of the American Society of Reproductive Medicine, the American College of Obstetrics and Gynecology and the Society of Reproductive Endocrinology and Infertility.


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