Fertility clinics can often help people who haven't been able to conceive.
Fertility Doctors
In most cases, an obstetrician-gynecologist (OB/GYN) is the only pregnancy doctor you'll need. Most women are able to conceive within one year of deciding to have a baby. But, what if you're still not pregnant? What if you already know that you or your partner have a fertility problem? That's when fertility clinics can be helpful.
The doctors who work at these clinics are often Reproductive Endocrinologists. These doctors have extensive training in endocrinology, obstetrics, and gynecology. That means they specialize in both hormonal pathways and in fertility issues. Having a hormonal problem, such as too much estrogen or an underactive thyroid, can interfere with fertility. So can a physical problem like an improperly formed uterus or incorrectly formed sperm.
If you want to make sure that a doctor was specifically trained as a Reproductive Endocrinologist, ask if they are Board Certified. That means they have completed a fellowship and taken a special exam to prove that they are qualified.
First Steps
Before your doctor starts talking to you about fertility clinics, he or she will probably do some basic fertility tests. If you're a woman, your OB/GYN should begin by getting a full health history from you, including information about your menstrual cycle, any surgeries or serious illnesses, and any prior pregnancies. You can also expect a physical exam and several hormone tests to make sure that you are ovulating normally.
Men will usually start by seeing a urologist, a doctor who specializes in the urinary and reproductive tracts. The urologist will do a physical exam and will probably check testosterone levels. He or she can also test a man's semen to make sure that there are enough sperm and that they are formed properly.
Referrals to Fertility Clinics
If the urologist or OB/GYN has gathered the appropriate information and finds that he or she can't help, the next step is a referral to a fertility clinic. Your doctor may be able to recommend one; if the office is part of a large hospital system, there may even be a clinic on site.
If you're looking for a clinic on your own, check the Assisted Reproductive Technology Report from the national Centers for Disease Control. These charts show success rates for fertility clinics throughout the country. The data is a little difficult to understand, but in general you want to make sure that the clinic's success rate is average or better.
Procedures
Expect the fertility doctor to work with both you and your partner, to get a clear picture of why you haven't been able to conceive. Depending on the reason for your infertility, you may receive medical treatment or you may be offered a form of assisted reproductive technology (ART).
ART includes:
- In vitro fertilization-embryo transfer (IVF-ET)
- Gamete intrafallopian transfer (GIFT)
- Zygote intrafallopian transfer (ZIFT)
- Tubal embryo transfer (TET)
- Frozen embryo transfer (FET).
All of these are methods of assisting egg fertilization. In most of them, the sperm and egg are combined outside the woman's body. If fertilization is successful, the very tiny embryo is then placed into her uterus or fallopian tubes. In GIFT, the sperm and egg are both placed into the woman's fallopian tube, where fertilization hopefully will occur. Your fertility specialist can explain all these procedures in detail and help you understand which one is right for you.
Tests
Fertility clinics do a number of tests to make sure that a couple does not have any medical problems that could affect a developing baby. In addition to fertility tests, you and your partner will probably be checked for:
- HIV
- Hepatitis B and C
- Syphilis
Other tests for women include:
- A Pap smear
- Blood type
- Gonorrhea and chlamydia
- Immunity to rubella (German measles) and chickenpox
The doctor may also recommend genetic testing to see if your baby would be at risk for diseases like cystic fibrosis, Tay-Sachs, and sickle-cell anemia.
Making the Decision
Fertility treatments and ART are expensive and are not usually covered by insurance. The process can be very stressful for both the man and the woman. And, even with the best science, the treatments don't always work. Fertility specialists recommend talking the decision over very carefully before embarking on any form of assisted reproduction.
In addition, there are some fertility clinics which do not have patients' best interests at heart. Most really do care about helping couples conceive and will take good care of mother, father, and baby. However, a few are only interested in making money. If you feel that the clinic is trying to sell you expensive services without explaining them fully, if the doctor doesn't listen to your concerns, or if anything else happens to make you uncomfortable, find a different clinic.
