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4 Steps to Finding Out Whether You Need Fertility Treatment

April 17th, 2013

4 Steps to Finding Out Whether You Need Fertility Treatment

The ability to conceive is a life event that most couples take for granted and it can be one of the most frustrating and devastating of life’s detours when it doesn’t happen as expected.  For some couples this is the first time that they realize that they are not in control of something important in their lives.  Dr. David Walmer has a few guiding principles to help you decide when and how to get started with fertility treatment.

Step #1: Consider preconception counseling

“Pregnancy is one of the riskiest and most rewarding things that women do in their lives and planning for it is wise,” says Walmer. “Screening tests can help you ward off or anticipate potential problems in pregnancy. It’s not a bad idea to document that you are immune to German measles (Rubella) and Chicken Pox (Varicella). Also, knowing your blood type and having an antibody screen can help your doctor manage your pregnancy. Many autosomal recessive genetic disorders can be predicted and eliminated through screening that is becoming less expensive every day.”

“It’s never wrong to start by having a conversation with your primary care provider,” says Dr. Walmer. Your provider can help you to optimize your reproductive strategy, identify general health problems that might complicate pregnancy and help you assess your fertility potential, which may help you decide when to seek help.” Factors that delay conception or potentially harm a pregnancy include:

  • Delayed childbearing (age of the woman)
  • Medical problems (diabetes, hypertension, etc.)
  • Former surgeries in the abdomen or pelvis
  • Intake of alcohol, caffeine, tobacco, prescription medications or other drugs

In addition, the psychological benefit of talking about these issues can make the decision regarding any potential fertility treatment easier.

Step #2: Get help immediately if you know or suspect that you have a problem

If you know that your menstrual cycles are not regular or you have been diagnosed with a problem that might impact your fertility, there is no reason to wait before being evaluated to find out if you’re a suitable candidate for assisted reproductive technology.

Step #3: Seek help in 6-12 months if infertility is unexplained

If there are no apparent reproductive problems, the American Association of Reproductive Medicine recommends that younger couples seek professional advice if they have been trying for a year without success. The age of the female partner is more important than the age of the male.  For women older than 35 years of age, it is very reasonable to start an evaluation for fertility treatment after trying to conceive for six months.

Step #4: Fertility Screening

In order to try to figure out why you aren’t conceiving, your fertility treatment provider may want to do tests to help identify if there are sperm and eggs, whether they can find each other and if the uterus looks like a good place for a baby to be.  These tests may include a:

  • Semen analysis
  • Ovarian reserve testing (Ultrasound, AMH, FSH, Estradiol, Antral follicle count)
  • Uterine cavity evaluation (HSG or saline ultrasound)
  • Fallopian Tube Testing (HSG or FemVue)
  • Hysteroscopy
  • Laparoscopy
  • Endocrine testing (progesterone, thyroid, prolactin)

Once you have the results of the testing, you can begin to discuss options for enhancing your fertility.  The options will vary with regard to probabilities of success, risks and cost. Some couples will want to do the least invasive, least expensive option first even if it has the lowest probability of success while others will want to invest in fertility treatment to fix every problem that we know how to fix with IVF.

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