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Infertility and its treatment - I
Infertility is a medical problem that results in the inability to conceive a child or carry a pregnancy to full term. A couple is usually diagnosed as infertile after one year of frequent, unprotected, sexual intercourse. If you have been trying to get pregnant on your own and are concerned that you might have fertility problems, it is good to start off by seeing a general gynaecologist.

You should talk to your general gynaecologist about your concerns, discuss your medical history, and ask him at what point he would refer you to a fertility specialist. If you are under 35 and have been trying to get pregnant for a year or more, your doctor may refer you to a fertility specialist. If you are 35 or older, your doctor may refer you for fertility treatment after just six months of trying.

Infertile couples start losing hope, fearing continual disappointment on failure of not being able to conceive. If you've been working with your family doctor or OB/GYN while trying to get pregnant but haven't had success, it may be time so see a fertility specialist or fertility doctor.That’s why it’s important to know when to see a fertility specialist and how this doctor can help you.

Fear of failure, concerns about cost and stories you have heard about other couples difficulties in conceiving can be discouraging. The majority of couples – 65% - who seek fertility treatment succeed in having children after being treated with fertility medication or surgical repair of reproductive organs. More than 95% of infertile couples in treatment do not require in vitro fertilization (IVF).

When looking for an IVF doctor, a good place to start is to ask your OB/GYN for his/her opinion of doctors in your area. Because fertility treatment usually requires several office visits, you will probably not want to travel too far for testing and treatment. Other sources are friends or relatives you know who have had an experience with a fertility doctor. Because there is a wide range of IVF clinics, it is helpful to know the ins and outs of how to select an IVF specialist and an IVF clinic. 

Though some OB/GYNs do provide limited infertility treatment, they are not trained in the more advanced reproductive technologies like IVF. You will want to find a doctor who has been trained to do IVF.

Fertility specialists are doctors that focus on diagnosing and treating male and female infertility. Fertility doctors study Reproductive endocrinology and infertility (REI), a branch of medicine that identifies and treats infertility in both men and women. Fertility doctors are gynecologists who have received advanced, specialized training and certification in fertility problems and solutions. These fertility specialists have undergone the extensive advanced medical training necessary to accurately diagnose and treat the many complex conditions that can cause infertility.

Fertility specialists specialises from the initial diagnosis in the male and female to the most complex assisted reproductive technology procedures. Fertility specialist are actively involved in the management of in vitro fertilization cycles and master the administration of FSH, cycle monitoring, retrieval, culture and transfer. Reproductive Endocrinologists (RE) represents a subspecialty of obstetrics/gynaecology devoted specifically to treating infertility.

When it’s time to see a fertility specialist?

If you've been working with your family doctor or OB/GYN while trying to get pregnant but haven't had success, it may be time so see a fertility specialist. One might want to see a fertility doctor sooner if you have a history of irregular or painful periods, pelvic pain, endometriosis, pelvic inflammatory disease (PID), repeated miscarriages, or if your partner has a low sperm count or a history of testicular, prostate, or sexual problems. If age is a concern then also it is better to seek assistance of fertility specialist earlier.

What is the role of a fertility specialist?

A fertility specialist diagnoses and treats problems related to infertility. If you have been trying to get pregnant for a year (or six months if you are over 35) and natural conception is not working, a fertility specialist can diagnose and treat the infertility problems like Endometriosis, Problems with ovulation, Polycystic ovarian syndrome (PCOS), Abnormalities of the ovaries, fallopian tubes and/or uterus.

Also, if you have had two or more miscarriages, a fertility specialist may diagnose the cause of the miscarriages. The specialist would then guide you in selecting procedures that may help prevent miscarriage so you carry the baby to term.

If you are over 35 or if you want to benefit from assisted reproductive technologies (ART), like in vitro fertilization (IVF), a fertility specialist can guide you in using the ART process, along with other high-tech procedures. A fertility specialist may be the most qualified doctor to help you overcome infertility and finally get pregnant.

Once you have made the decision to consult a fertility doctor and have narrowed down your option on fertility specialist, you should make an appointment to meet with, and interview, the doctor of your choice. It is always better that you pay visit along with your partner. Your partner should attend the appointments with you.

When selecting a fertility clinic and doctor, it is wise that you do your own research in advance of visiting a clinic. Doctors report that IVF patients these days are typically well-informed and knowledgeable when visiting a clinic for the first time. It is to your benefit to be an educated consumer and to know what to look for.

Prepare list of questions you would like to talk to your fertility specialist

The list may include few of the following questions:


1)  For how long have you been treating infertility?
2)  Do you have a treatment specialty?
3)  How long have you been in this practice?
4)  How long has the fertility clinic's medical director been there? How long have the doctors and technicians been there?
5)  Which procedures do you do and how often? Be sure the clinic has a wide range of infertility remedies available and is familiar with the latest technologies, such as something called blastocyst transfer.
6)  Do you have age limits for treatment? If so, it's a good sign that the clinic is concerned about ethical issues.
7)  What specific tests would you recommend to diagnose my infertility? How much do they cost?
8)  Based on the results of those tests, what are my fertility treatment options, and how much do they cost?
9)  How many ovulation induction (OI) cycles do you recommend before moving to in vitro fertilization (IVF)?
10) How many embryos do you transfer per cycle?
11) What is the success rate for IVF in terms of live births per embryo transfer for this facility?
12) If necessary, can you help me access donor egg, embryo or sperm donor?
13) How will I communicate with you during this whole process?
14) Does your clinic provide emotional counseling, or can you refer me to a counselor who deals with fertility problems?
15) What can I expect in terms of time commitments and how many visits do you anticipate will be necessary?

You should also find out if you can speak with any former patients willing to share their success stories. Beyond getting information about the doctor and the practice, you can have an opportunity to connect with people who've been there. Trust your gut. After visiting and narrowing on the fertility specialist or an IVF specialist it's up to you (and your gut) to make your final decision. If something feels off, pay attention.

On the flip side, if you feel a connection, you should listen to that, too. Your comfort level with the doctor is a very important aspect that should not be ignored. Make sure you and your spouse are comfortable with the specialist and there clinic. You should develop a trust in him. Then only proceed.

However, you need to do some homework first. Before you step foot into the fertility clinic, find out what kind of invasive tests or procedures might lie in wait for you. And give some thought ahead of time to how far you're willing to go with this process. Advanced reproductive technology can cost many thousands of rupees, can involve strong drugs or hormones, and can be an emotional roller coaster. Knowing your limits will keep you from being talked into some nifty new procedure that you really don't want and can't afford.

Lastly, follow your own instincts. You know your body, and if you are trying month after month and can’t get pregnant, go ahead and make an appointment to see a fertility specialist. Remember, if you're under 35 and have been trying for more than a year, or are 35 or older and have been trying for 6 months or more, then you should see a fertility specialist right away. This can give you a peace of mind immediately - and hopefully a baby in the near future.

With today's advanced reproductive technology, you can always find a solution to all the fertility problems. You must meet an expert in the infertility field

Dr. Gautam Allahbadia an IVF Fertility specialist is leading Infertility specialist in India running fertility centre named Rotunda – The Center For Human Reproduction.


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