What is infertility?
A revision in the definition of infertility was released in 2008 by the American Society of Reproductive Medicine in wherein infertility was defined as the failure to achieve pregnancy after 12 months or greater despite regular intercourse without protection.
The medical history and physical findings warrants evaluation and treatment and earlier treatment is warranted after 6 months for women over age 35.
Testing for fertility – how do I choose a fertility specialist?
It is appropriate to begin by consulting a reputable general gynecologist or alternatively a reputed infertility specialist – who may also be referred to as a reproductive endocrinologist. Initial evaluation of fertility and basic treatment of infertility can also be done by some general gynecologists who are trained and have the experience. Simply thinking that the doctor is a specialist of fertility or a fertility specialist trained by a fellowship is not the way to go about it and one should ask whether he/she did a fellowship in Reproductive Endocrinology and Infertility. After completion of 4 years of residency training in Obstetrics and Gynecology by the doctor, a fellowship is 3 additional years of specialized infertility training is required. A general gynecologist will refer you to a specialist in infertility and it is a good idea to check with the doctor when this will happen. After up to 6-12 months of treatment with the gynecologist, you should be referred to a fertility specialist and this also depends on the woman’s age and the infertility cause.
When to see a specialist in fertility?
Several things that need to be considered for immediately referring one to a specialist of fertility, also referred to as Reproductive Endocrinology and Infertility specialists are:
- Woman’s age -greater than or equal to 38
- Blockage in fallopian tubes
- Other problems with tubes
- Endometriosis (moderate or severe)
- Sperm count or sperm motility
- Problems with ovulation
- Abnormality of reserve tests on the ovaries
To be treated by a specialist in infertility, it does not have to be an expensive problem and based on the treatment needed is the cost.
With a consideration for in vitro fertilization (IVF), ask the IVF doctor for:
- Success rates with IVF pregnancy
- What kind are these – initial pregnancy rates, rates for ongoing pregnancy rates or for live birth?
- Getting IVF success rates written on paper, ask them about the CDC and/or SART IVF success statistics that are the most recent
- individual success rate over the past year for all IVF procedures performed
- individual success rate for cases with fertility problems similar to yours
Cost of Fertility Treatment
Fertility treatment costs vary considerably and making sure of the cost of the treatment and the insurance coverage is essential. Make sure that you address the issues below:
All physician fees
- ultrasound costs and blood monitoring costs
- include all the costs of the facility?
- include all fees of anesthesia?
- any additional costs that are separate from the price for an IVF cycle?
- copy of schedule of fees for services in IVF
These details are necessary, else pick a different specialist. The idea is to find a clinic dealing with fertility that has high rate of success in pregnancy and fees that are reasonable.