It can be confusing knowing exactly when you should seek the assistance of a fertility doctor when you’re trying to conceive. You don’t want to feel you’re overreacting but you also don’t want to have a pang of regret that comes from waiting too long to get help.
When we first are educated about “the birds and the bees”, we’re often taught how to avoid getting pregnant so it’s logical to be unclear on exactly how things should work when it’s time to get pregnant. Below, we’re going to walk you through the basics and when you should consider seeking the services of a reproductive endocrinologist like Dr. Wilcox and his clinical teams.
The most fertile time is when the female is ovulating. This is why determining when your most fertile days are is key to conceiving. There are several ways you can do this. You can chart your daily basal body temperature (BBT), which means keeping track of your temperature every morning. You can also use an ovulation prediction kit. Both of these techniques look at when your luteinizing hormone (LH) surges as this means your ovaries are about to release an egg.
A woman’s egg lives for approximately 12 to 24 hours. When you have sex while ovulating, the hope is that the sperm (which can live around 5 to 7 days within the body) will fertilize the egg. This is why knowing when you’re ovulating is important as when it comes to conceiving, timing really is everything.
According to the American Society of Reproductive Medicine, if you’ve been trying to conceive around the time you ovulate regularly for over a year and the female partner is under the age of 35, or if the female partner is over 35 and you have been trying to conceive for at least six months without success, that is when you should schedule a fertility consultation with a reproductive endocrinologist (RE).
There are some exceptions to the above however. If any of the below describe you or your situation, you should schedule your appointment sooner. They are:
- You do not seem to be ovulating at all
- You have missed or irregular periods
- You have a history of pelvic infection, such as pelvic inflammatory disease
- You have needed treatment for tubal damage or endometriosis
- You have had two or more miscarriages
A consultation will include a physical examination and a review of your and your partner’s health histories, including looking at any factors that might be causing issues (smoking, weight, etc.)
For women, this includes blood tests to look at your FSH (follicle-stimulating hormone), LH (as mentioned earlier), and your AMH (anti-mullerian hormone) levels. These three hormones can provide an overview into your ovulation, ovarian reserve, and egg quality. An ultrasound may also be included to make sure you do not have any cysts, polyps or any detectable anatomical issues.
For men, a semen analysis and infectious disease screening test (HIV, Hepatitis B, Hepatitis C, etc.) will be scheduled. A semen analysis is used to evaluate sperm count, shape of the sperm (sperm morphology) and how well the sperm swim (sperm motility).
Some common causes for fertility issues in women can be:
- Irregular or missed periods, as mentioned above
- Pelvic Inflammatory Disease (PID) which is an infection of the female reproductive organs.
- STD’s such as chlamydia and/or gonorrhea if untreated can cause PID. If left untreated, it can cause permanent damage to the fallopian tubes, uterus, and surrounding tissues, which can lead to infertility.
- Diminished Ovarian Reserve (DOR), Premature Ovarian Failure (POF) or menopause which all create a significant decline in egg quality and greatly impact your chances of conceiving.
- Hypothalamic Amenorrhea (Marathon Runners) which is a condition in which menstruation stops completely due to a problem involving the ‘hypothalamus’, which is located in your brain, that stops sending “it’s time to reproduce!” signals to your pituitary gland. This problem results in infertility and a loss of a menstrual cycle.
- Unexplained Infertility.
For men, they may have semen that shows low motility, a low count, or poor morphology.
Based on the tests Dr. Wilcox prescribes, and what the results find, our team will recommend the best course of action to grow your family.
What we hope is a comfort to you is knowing you have many family building options available. Dr. Wilcox and his medical team are ready to support you as you take your first step down the path to parenthood!