Are you 35 and over?

Women 35 years of age and older are at higher risk of diminished ovarian reserve. Treatments may include superovulation with oral/injectable medications, intrauterine insemination (IUI), or in vitro fertilization (IVF). Protocols may be modified to include certain supplements and medications which can boost fertility potential.

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Do you have painful periods or endometriosis?

Some women with painful periods have a condition called endometriosis. Endometriosis can impact fertility in a multitude of ways, including through effects on ovarian reserve, the fallopian tubes, and embryo implantation. Treatment may include surgery, medications, or fertility treatments such intrauterine insemination (IUI) or in vitro fertilization (IVF).

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Do you have a history of pelvic infection or tubal disease?

Some women with a history of pelvic infection and/or scarring from endometriosis may have blocked fallopian tubes. The best test to diagnose this issue is a hysterosalpingogram (HSG). Treatment is usually through in vitro fertilization (IVF). In some instances, surgery may be an option.

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Does your partner have a sperm abnormality, a history testicular surgery, testicular trauma, or testicular infection?

Male factor is a common cause of infertility. Initial testing for a male factor issue usually includes a semen analysis and possibly bloodwork. Depending on the severity of the sperm issue, treatments may include intrauterine insemination (IUI) and in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI). If no sperm are present in the ejaculate, a testicular sperm extraction can be attempted.

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Do you have irregular periods or polycystic ovary syndrome (PCOS)?

The most common (but not only) cause of irregular cycles in premenopausal women is polycystic ovary syndrome (PCOS). Ultrasound, bloodwork, and clinical history are used to diagnose this condition. First line therapy usually includes oral medication to induce ovulation and help with timing intercourse.

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Do you have heavy periods, fibroids, uterine polyps, or an abnormal uterine shape?

Uterine factors can impact your ability to conceive and carry a pregnancy. Diagnosing a uterine condition may include a saline infusion sonohysterogram (SIS) and/or a 3D transvaginal ultrasound. Treatment for uterine factors usually involves surgery, but therapies such as intrauterine insemination (IUI) or in vitro fertilization (IVF) may also be recommended.

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Have you had more than one or multiple miscarriages?

Unfortunately, miscarriages are relatively common occurring in 15-20% of recognized pregnancies. However, having recurrent or multiple miscarriage is not very common occurring in 2% to 3% of women. There are many etiologies for recurrent miscarriages to include: age, genetic issues with the sperm or eggs, uterine abnormalities, infections, and hormonal abnormalities. A thorough evaluation can be accomplished during one menstrual cycle. The evaluation includes a clinical history, bloodwork, saline infusion sonohysterogram (SIS) and/or a 3D transvaginal ultrasound, and hysterosalpingogram (HSG). The male partner will require a semen analysis and bloodwork. Treatment will depend on the results of the evaluation.

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Are you desiring to freeze eggs in order to preserve your fertility until you are ready to have a family?

Vitrifying (freezing) eggs is a popular treatment since many women may not be ready to start a family when they are most fertile. Fertility for women declines with age -starting to decrease significantly in a woman’s 30s. Vitrifying eggs preserves the current fertility status until the eggs are thawed and fertilized. For instance, a 45-year-old woman who vitrified her eggs at the age of 32 and is now thawing and fertilizing her eggs will have an excellent pregnancy rate consistent with a 32-year-old (not a 45-year-old). A simple ultrasound and bloodwork can help to determine your current fertility status and ability to preserve your current fertility.

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Are you still unsure of what to do?

If none of the previous options were pertinent to your fertility concern, please schedule a consultation to discuss and evaluate your concerns.