A reproductive specialist is an expert who helps couples to conceive after years trying without any birth control plans and methods. An obstetrician is a female fertility specialist while an urologist specifically an andrologist is a male fertility specialist. Often they work together to help couples find out their problems and fix them in no time.
Continue reading the article to know more about what a reproductive specialist does as their routine job to help the couples.
Firstly, the specialist will start taking a clear and thorough history from both the husband and wife to get a clearer picture on the problem faced by you. Some common questions which will be normally asked by them are duration of trying to conceive without any birth control plans, frequency of sexual intercouse by the couple, any problems faced by the husband particularly such as premature or delayed ejaculation, any history of pregnancy or miscarriages before. Apart from that, other general questions are such as past medical history like diabetes, hypertension and chronic kidney disease.
It is extremely important to tell your specialist if you or your husband had any health problems before such as any abnormalities in the menstrual cycle, thyroid issues, history of dysmenorrhea and deep dyspareunia. Men’s problems such as testicular torsion, orchiditis, varicocele and others should also be informed to your specialist to help narrow down the infertility diagnosis.
What investigations are normally carried out?
Separate investigations for both men and women are carried out to find the exact cause behind the infertility issue. For instance, seminal fluid analysis is an investigation of choice for men. The seminal fluid is then examined for a few criterias such as volume, liquefaction time, concentration, motility, morphology and total white cell count in the semen. Few other investigations are also carried out to confirm the diagnosis. Such tests are like serum hormone levels and karyotyping to find out genetic causes.
While on the other hand, investigations for females are more complex and expensive. Initially blood hormone levels will be evaluated. Follicular stimulating hormone (FSH) and luteinizing hormone (LH) are evaluated to look for ovulation issues. Mid luteal serum progesterone is often taken if your menstrual is regular in cycle. Other blood tests like thyroid function tests and serum prolactin are taken if you have any associated symptoms.
Further investigations like hysterosalpingography (HSG) is done to demonstrate the outline of the uterine cavity and it is less invasive than tests like diagnostic laparoscopy. It is contraindicated in females with a history of pelvic inflammatory disease, ectopic pregnancy, endometriosis and previous surgery done to the fallopian tube.
Diagnostic laparoscopy is the most sensitive and specific investigation often carried out by reproductive specialists. It is used to have a direct visualization of the female reproductive structure.
What are the treatment options?
After a thorough history, examination and proper investigations, a working diagnosis is made and your reproductive specialist will help you in treating the issue accordingly. Get an appointment in clinic to meet your reproductive specialist and discuss treatment plans. Usually treatment options are given for couples who have been trying to conceive for more than 2 years without any birth control plans and women who are aged less than 35 years old.
Initially, reassurance is given for couples with uncontrolled medical problems to control your blood sugar level, blood pressure and sign yourself up for a quit smoking clinic. Medical treatments are like ovulation induction with clomiphene and dopamine agonists like bromocriptine and cabergoline. Surgical treatments are like tubal surgery and intrauterine insemination after ovulation induction. These options are only reserved for suitable and medically failed patients.
Besides, assisted reproductive techniques can also be tried in couples who are interested. In vitro fertilization and intracytoplasmic sperm injection are common methods used nowadays.