Ask Dr. Marc: When to See a RE

Dear Dr. Marc,

I am trying anything right now, any thing to have a child. We have tried for what feels like eternity, and been tested. We have had blood work done, they say that’s normal, my husband has had his sperm count checked, and that came back normal. They say everything is normal……I am 28, my husband is 32…..but we both are losing hope, and I don’t want that!!!

We have tried diets, changes, exercise, and nothing is working. We have cut back on sweets, drinking, and bettered our diets…we have tried this for a year now.  I was on YAZ for 4 years before stopping. Last night we went and got a belly rub done, trying anything out there!

Is there anything else I am missing?

L.

 

Hi L,

First of all, don’t give up hope!  From the information provided, it sounds to me like you stand an excellent chance to conceive!  With that being said, it is probably time for you to take some specific steps towards your goal.

First, you should meet with a fertility specialist, otherwise known as a reproductive endocrinologist (“RE” for short).  To find a good one, you may want to ask your primary OB/GYN for a referral, or consult with friends, or look to Google and review practices in your area.  In addition, the Society of Assisted Reproductive Technologies (www.SART.org) is an excellent resource to compare fertility doctors and review their success rates.

Once you meet with the RE, they will review the tests you have already had, and ask you and your partner about medical, environmental, pubertal and surgical history.  You should be sure to come prepared with all of your old records and a calendar of your past few menstrual cycles (including the day they began and ended). The doctor will likely want to evaluate factors such as your fallopian tubes, your uterus, the environment, ovulation timing and more.  If all of your tests come back as “normal” then you would be classified as having “unexplained infertility.”  This diagnosis is given to approximately 30% of couples with infertility.  While it is highly frustrating to not know the exact reason you are not conceiving, couples with unexplained infertility stand a very good chance of conceiving with fertility treatments.

On another note, it is wonderful that you and your husband are watching your diet and have started exercising.  These steps will certainly help you lead a healthier and longer life.  Unfortunately, things like diet and lifestyle change have less of an impact on fertility than many people would like to believe.  This is especially true when there if there is a physical impediment such as blocked fallopian tubes or uterine fibroids.  So while I encourage you to continue your healthy lifestyle choices, I caution you against waiting very long to see if they impact your fertility.  In general, it is better to be evaluated by a doctor and then make the decision on what your next step will be.

Good Luck,

Dr. Marc