If you are having trouble trying to conceive or suspect you have infertility, you might be wondering which doctor is right for you: OB-GYN or Reproductive Endocrinologist (fertility doctor). As a former fertility patient myself and huge fan of my OB-GYN, I went through a thought process before I made the call to my fertility doctor: “Why can’t I just work with my OB-GYN and take Clomid?”
Current medical guidelines state that women over the age of 35 who have been trying to conceive for 6 months with regular intercourse (every 2 days) but have not gotten pregnant OR women under the age of 35 who have been trying to conceive for one year with regular intercourse but still have not gotten pregnant should consult a fertility doctor.
Truthfully you are better off seeing a fertility doctor, finding out that your reproductive organs are in working order, and sent home with a prescription for well-timed intercourse than to stick it out with your OB-GYN for months or years wondering “When is it going to be my time to conceive?”
You might still be skeptical, but here’s the reasoning behind seeing a fertility doctor instead of your OB-GYN:
A fertility doctor will provide a comprehensive fertility workup. Complete with blood work, ultrasound, semen analysis for your partner, medical history, and fertility tests like hysterosalpingogram (HSG) to make sure your fallopian tubes are open. The fertility doctor will assess your likelihood of conceiving at your age with your respective male factor or female factor infertility diagnosis. Your OB-GYN (and this is coming from someone who seriously loves their OB-GYN) does not have the capacity to test all of these things and has not completed additional training in reproductive endocrinology and infertility to guide you on these appropriately.
Your fertility doctor will closely monitor you throughout your fertility treatment cycle via blood work and ultrasound every few days or daily as your cycle progresses. Your OB-GYN, no matter how skilled he or she is in writing out a prescription for Clomid or even doing an in-office IUI, is most likely not going to monitor you on a daily basis. If you can’t see your ovaries responding to the fertility drugs each day and don’t know your blood estrogen and progesterone levels, how do you know if you are responding appropriately (or overstimulating) in that cycle? Even worse, if your OB-GYN does not order a semen analysis for your partner (and most don’t since they treat female issues), how will you know if male factor infertility is the reason you’re not getting pregnant?
A fertility doctor will look at your fertility tests and your partner’s semen analysis to devise the treatment plan that’s right for you. He or she will use the semen analysis as a guide to determine the need for doing IVF with intracytoplasmic sperm injection (ICSI) to bypass severe male factor infertility. The most your OB-GYN can do with a semen analysis is recommend an IUI or refer you out to a fertility doctor anyway. See…saving you time AND money here, peeps!
In larger fertility clinics, you will probably work with a doctor on rotation and will have one designated nurse for answering your fertility treatment-related questions. In smaller fertility clinics, you may only see one fertility doctor and one nurse. Given the time sensitivity of fertility treatment, you are extremely likely to be given a list of phone numbers to contact with questions, emergencies, and specific instructions on what to do when you get your period, a positive ovulation test, or a positive home pregnancy test. Your OB-GYN will certainly have an on-call phone number to dial after hours, but chances are you will be waiting until the next business day to hear back from someone. You wouldn’t want to miss that window of opportunity during ovulation, would you?
While the thought of seeing a fertility doctor is definitely tough to process, it will save you time, money, and heartache in the long run. So, leave the pap smears up to your OB-GYN and the fertility treatments to your fertility doctor. You won’t regret it!!
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