When most people talk about fertility specialists, they are usually referring to Reproductive Endocrinologists & Infertility (REI) doctors. These REI’s are gynecologists who have had additional training in treating infertility in both men and women.

Reproductive endocrinologists will recommend an evaluation of a patient/couple’s fertility, and may perform a variety of treatments depending on each individual case. REI’s can also help patients preserve their future fertility with treatments like egg freezing, embryo freezing, or sperm freezing.

For more information, be sure to check out my YouTube channel.

If you are seeing a Board Certified Fertility Specialist, like myself, then this is a Doctor that has gone through extensive medical education to specialize in Reproductive Health. Requirements include, but are not limited to:

• Medical school degree

• ObGyn Residency training (4 years in the US)

• REI Fellowship training (3 years in the US) *REI stands for Reproductive Endocrinology & Infertility

• Written exams in BOTH ObGyn and REI

• Oral exams in BOTH ObGyn and REI

• Ongoing yearly maintenance of certification (MOC) with article review and questions.

Your doctor might refer you to an REI if you are having trouble conceiving after either 6 or 12 months, depending on the woman’s age, if you have a history of miscarriages, or a known risk factor for infertility such as previous surgeries in your pelvis. They may also consider referral if your periods are very irregular or extremely painful.

There are many reasons why a patient, or couple, should see a Fertility Specialist. Ask your doctor if you think you would be a good candidate.

*Please note, that a referral is NOT always required and if you desire to see a Fertility Specialist, most insurance plans will allow you to schedule this appointment without a referral from your healthcare provider.

Every REI will be different, so it is important to ask when you make your appointment, what you should expect. With that said, most fertility specialists will spend time reviewing your medical history, and that of your partner if you have one. They are trying to identify risk factors for infertility. They will likely also discuss which tests they would like for you to complete as part of your fertility evaluation. An overview of treatment options may be provided, though these are typically discussed in more details after all the testing has been completed.

Some REI’s may do a physical exam and/or a transvaginal ultrasound during your New Patient consultation, so make sure to inquire before the day of your appointment so that you go prepared.

There are several tests that may be ordered during an evaluation and these will depend on your individual case. These may include:

1. A Physical Exam with a Pap and/or Gonorrhea-Chlamydia testing

2. Transvaginal ultrasound assessment typically during your menses for a baseline assessment of your uterus and ovaries, including a follicle count. (See my Blog post on ovarian reserve for more info)

3. Hysterosalpingogram (HSG) or Sonohysterosalpingogram: This is a study of the inside of your uterus and fallopian tubes, making sure that both are open. The HSG is more commonly ordered, but both may be used for assessment.

4. Blood tests to check your hormones and other pre-pregnancy markers that may be warranted prior to conception such as a blood type or your sugar level, depending on the individual case and the particular REI.

5. Semen Analysis, if there is a male partner involved.

6. Genetic screening tests. There are a few different types, so if you are planning on proceeding with genetic testing I encourage you to check with your REI regarding what type of test is being done.

Treatment for Infertility needs to be individualized and should be tailored depending on several factors including both what is medically reasonable as well as the patient’s wishes. Treatment options for infertility may include the use of oral and/or injectable medications, timed intercourser, intrauterine insemination (IUI), or in-vitro fertilization (IVF).

In addition, you may hear other terms along with IVF such as: ICSI (intracytosplasmic sperm injection, which is the micro-injection of one sperm into one egg), AH (assisted hatching, aka, poking a small hole in the outer shell of the embryo to facilitate its development), and PGT (preimplantation genetic testing, where the genetic material of the embryo is checked).

May patients have been trying for a long time before they ever see an REI. However, there are many things you can do well before that initial visit to optimize your chances of success. Check out my worksheet on 5 ways you can optimize your fertility today.

A Fertility Coach is someone who will support a person, or couple, through their fertility journey by providing both education as well as emotional support. Some fertility coaches offer detailed nutritional and lifestyle advice, but the style of coaching generally depends on the coach's training and background. They are an added layer of support through your journey. Fertility coaches cannot guarantee an outcome of conception, and if they do… stay away.

Regardless of whether you decide to incorporate a Fertility Coach onto your team, please note that working with your ObGyn, or with an REI, is still vital in your TTC journey.

*TTC = trying to conceive