As you start your medical journey through the world of infertility and treatments, you may work with several types of reproductive specialists along the way. The question is this… What is their specialty and how will they help you?
Reproductive/Fertility specialists are typically gynecologists or urologists who have had further training to identify and treat any issues surrounding the reproductive organs. There are a number of different reasons why your primary care physician or gynecologist may refer you to a reproductive specialist, including the following:
- Failure to conceive for more than six months if you are 35 or older. Or, if you are younger than 35, failure to conceive for more than a year.
- Attempting to conceive with known risk factors or symptoms of infertility, such as irregular cycles, prior sexually transmitted infections (even if already treated), or specific genetic conditions.
- Having a medical history that includes two or more miscarriages.
- Men or women interested in permanent birth control options, like vasectomy or tubal ligation.
- Women or men with a cancer diagnosis needing advice on how to preserve fertility before treatments or who are ready to conceive after treatments.
Although your gynecologist or your primary care physician may begin the initial fertility evaluation, you will most likely need to see a reproductive specialist for anything beyond the basic testing and treatment.
Types of Reproductive Specialists
Reproductive Endocrinologists (sometimes referred to as REs) are what most people think of as reproductive (fertility) specialists. A reproductive endocrinologist is a gynecologist who has extra training in infertility and fertility treatment; REs can treat both male and female fertility issues.
Reproductive endocrinologists generally manage, carry out, and prescribe different types of fertility tests and treatments, including IUI and IVF. When a patient needs a specialist, the reproductive endocrinologist is usually the primary consultant. REs also have training to help cancer patients with fertility preservation; they will work with an oncologist to coordinate fertility preservation before the beginning of cancer treatments that so often threaten fertility.
Andrologists are medical doctors or licensed physicians who provide diagnostic and treatment services to men with reproductive health issues. As the counterpart to gynecology, andrology is the medical specialty that deals with male health, particularly relating to the problems of the male reproductive system and urological problems that are unique to men. These professionals help patients who have hormonal disorders, fertility issues, and erectile dysfunction, among other problems.
The main focus of any andrologist is male reproductive health. He or she is usually considered an expert in impotence, low sperm count, and prostate problems. Andrologists may evaluate and treat male fertility issues alone, or together with a reproductive endocrinologist. Their work includes looking to find the cause of low or no sperm count in a male partner and treating issues, when possible, so the couple can conceive without IVF.
Reproductive Immunologists bring together a knowledge of immunology and reproductive medicine. A reproductive immunologist is often called upon in cases of unexplained infertility, recurrent miscarriage, or unexplained repeated IVF failure. They may also be consulted if the woman has endometriosis or an autoimmune disease, such as rheumatoid arthritis or lupus. Reproductive immunologists may be scientists or physicians, and they typically work together with a reproductive endocrinologist to treat infertile couples.
Reproductive Surgeons are another type of fertility specialist. While reproductive endocrinologists can perform surgery, reproductive surgeons have even more training in surgical procedures, and often treat patients for problems above and beyond trying to have a baby. Reproductive surgeons can remove fibroids and they often treat endometriosis via surgical procedures. In addition, a reproductive surgeon is often called upon to perform or reverse vasectomies and tubal ligations.
Fertility Specialists and Fertility Clinics
Most fertility clinics are staffed with one or more reproductive endocrinologists. Larger fertility clinics may also have an andrologist on staff. Reproductive immunologists are not likely to be on staff at an individual clinic; they often collaborate, however, with fertility clinic staff on special cases.
In addition to reproductive specialists, most fertility clinics have additional staff with specialty training, including nurses trained and experienced with reproductive medicine, sonographers, embryologists, and reproductive psychologists/counselors. Besides medical specialists, most clinics have a billing or financial specialist who will help you understand your insurance plan and deal with your insurance company, when necessary. They can also help you determine any payment options that are available for you to help make your fertility treatments more affordable.
Having a large staff does not necessarily make a fertility clinic exceptional. When choosing a fertility clinic, you should consider your own specific needs and fertility situation. There are some fertility clinics that refuse to work with women over 40 unless they agree to use donor eggs from the beginning; other clinics, however, specialize in helping women over 40 to conceive using their own eggs. If you are dealing with male factor infertility issues, you may want to choose a clinic with an andrologist on staff. Talk to several different fertility clinics to determine upfront if they can meet your needs and if you are comfortable with the doctors and staff.
If you have additional questions about reproductive/fertility specialists, or if you are looking for more information regarding infertility or fertility treatment, the reproductive specialists and professional staff at the Center of Reproductive Medicine (CORM) would be happy to help you. They are dedicated to helping patients sort through all the information available and providing compassionate guidance for families that wish to grow. If you are located in the greater Houston or southeast Texas area and would like to speak with a reproductive specialist, please contact the Center of Reproductive Medicine today!