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One in six couples will struggle with infertility. Of these, some will know that there is a problem before they ever tried to pursue parenthood because of a medical problem such as Polycystic Ovary Syndrome, for example.

Most will, however, spend a considerable time trying to get pregnant naturally before seeing either their family doctor or an OB/GYN. What is a reproductive endocrinologist, and where do they enter the picture for infertile couples?

Reproductive endocrinology explained

A reproductive endocrinologist may also be described as an infertility specialist, which means they specialize in treating reproductive problems. Reproductive endocrinology is a sub-specialty of obstetrics and gynecology. That means that a reproductive endocrinologist first qualified as an obstetrician/gynecologist and then moved on to specialize in reproductive endocrinology involving a three year fellowship and subsequent certification. Reproductive endocrinologists specialize in treating infertility and especially hormonal causes of that, but can also assess hormonal function not related to infertility in both men and women. Besides diagnostic testing to find out the cause of a couple's infertility and counseling them on possible options, reproductive endocrinologists supervise cycles of of intrauterine insemination (IUI), invitro fertilization (IVF), and prescribing certain fertility medications.

Who should see a reproductive endocrinologist?

Many couples who are in fact perfectly healthy are worried about infertility for a time, when they are trying to conceive and do not succeed. Infertility is defined as the inability to achieve pregnancy after actively trying for a year. It is best to either engage in regular sex throughout the menstrual cycle (every two or three days), or to opt to use some kind of ovulation detection method. Among the various way to find out when a woman ovulates are ovulation predictor kits, ovulation calendars, and fertility charting using basal body temperature.

Couples seeking to get pregnant should live as healthy as life as possible, and exercising regularly and eating a balanced diet should be integral parts of that. Those couples who did not get pregnant after a year of regular intercourse can take their first steps toward fertility testing. Your choice of medical professional will depend on the area in which you live. In some places, you may need to start off with a family doctor and get a referral. In others, you will first see an OB/GYN for basic fertility testing or discussions, and perhaps the prescription of Clomid (clomiphene citrate/serophene).

If these initial efforts do not result in a pregnancy, seeing a reproductive endocrinologist would then be a good next option. Some couples or individuals may see a reproductive endocrinologist as their first step in fertility testing. Depending on where you live, infertility specialists will be available at hospitals as well as at private fertility clinics. Using a private facility may cut the diagnostic process short and enable you to pursue any fertility treatments that you need more quickly (possibly increasing your chances of success, since age does play a role in fertility treatment success rates).

Not everyone should try to get pregnant for one year before seeking help from a specialist, and in some cases trying to get pregnant naturally can even be dangerous. If you know that you suffer from blocked fallopian tubes, you know both that natural pregnancy is unlikely and that you have an increased risk of an ectopic pregnancy if you do conceive. Seeing a reproductive endocrinologist is a good option in this case. Women who were diagnosed with endometriosis or Polycystic Ovary Syndrme (PCOS), or who were found to have abnormal ovarian reserves, should also consult a reproductive endocrinologist.

Couples in which the male partner was found to have severe sperm issues should also see a reproductive endocrinologist as soon as they can. We're talking about a very low sperm count or low motility here. You may need to have intracytoplasmic sperm injection (ICSI), a sub-form of IVF, in order to achieve pregnancy. If you are in doubt about the kind of professional you should see about your failure to get pregnant after trying to conceive, you could always consult a gynecologist/obstetrician initially, and ask advice on whether to see an infertility specialist immediately or whether to undergo some kind of diagnostic process first. You may also benefit from checking the details of what your insurance policy covers before making a decision.

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