"I’ve spent most of my life making sure I didn’t get pregnant until I was ready. Now, I’m ready and can’t get pregnant! Why is this so hard?"
Few women expect to have trouble becoming pregnant. But the fact is that many do. The Centers for Disease Control and Prevention (CDC) estimates that about 12% of women of childbearing age have trouble conceiving or staying pregnant. That’s more than six million women.
Despite how it may feel, infertility is not just about a woman’s reproductive health. Only about a third of fertility issues are due to a health concern in the woman trying to become pregnant. Another third are caused by reproductive or health concerns in the male partner. The remaining third are either a combination of both male and female partners or due to unknown problems.
HCA Midwest Health offers fertility services at four of our Kansas City area hospitals: Centerpoint Medical Center, Overland Park Regional Medical Center, Menorah Medical Center and Research Medical Center. Our fertility experts offer the following advice to consider if you are having trouble getting pregnant:
Talk to Your Doctor Early
When women are ready to start trying to get pregnant (or even thinking about being ready), they should talk with their primary care physician or gynecologist. Men should talk to their doctor too. There are diet and lifestyle choices you can make well ahead of trying to conceive that will increase your likelihood of success and ultimately lead to a healthier pregnancy for you and your baby.
You also need to make sure that any chronic conditions you may have are under control. Getting medical advice early is simply the smart way to get started.
How Long To Try?
The definition of infertility changes for women at age 35. Before that, a couple trying to get pregnant are only considered infertile after 12 continuous months of trying. After age 35, that drops to six months and at 40 it drops to three months, and at age 40 immediate evaluation is not unreasonable.
For years, the accepted science has been that women are born with all their eggs, releasing the healthiest eggs when they are young each month. It followed that older eggs (and ovaries) are less likely to result in healthy pregnancies. However, some recent research suggests that women may, in fact, continue to produce new eggs as they age. Wherever science eventually lands on this issue, the fact is that women are far more likely to have trouble getting pregnant after age 35 than before.
Women under 35 who have known risk factors for infertility should also talk to their doctor sooner. Risk factors include:
- Irregular or no menstrual periods
- Very painful periods
- Pelvic inflammatory disease (PID)
- Polycystic ovarian syndrome (PCOS)
- More than one previous miscarriage
“At any age, if you are concerned about your reproductive health, talk to your doctor,” said Dr. Celeste M Brabec, an infertility specialist with Overland Park Regional Medical Center and Centerpoint Medical Center. “The reality is that your emotional health is important. Stress and depression can affect your ability to conceive, have an impact on your quality of life, and become a vicious circle. Time is important - by female age 30, pregnancy rates already begin to decline. It’s better to see a Board-Certified Fertility Specialist early to ask questions and start the conversation rather than wait and wonder.”
Consulting a Reproductive Endocrinologist
A reproductive endocrinology and infertility specialist (REI) is a doctor who specializes in infertility diagnosis and treatment. These specialized physicians diagnose fertility issues in both women and men and offer treatments ranging from counseling to medication and/or assisted reproductive procedures (ARTs)—commonly known as IVF.
When you consult a reproductive endocrinologist, you’ll most likely start with an infertility checkup. This includes a physical exam and health history for both partners. One or more tests may be performed, including blood tests, semen analysis and an ultrasound of the ovaries. Additional testing may be needed to diagnose the causes of infertility.
Treatment may include one or more of the following:
- Medication to regulate or enhance ovulation (the growth and release of an egg)
- Surgery to correct issues contributing to infertility, such as blocked fallopian tubes, uterine fibroids or physical problems with the uterus in women and semen blockage or testicular vein problems in men
- Intrauterine insemination (also known as artificial insemination)
- In-vitro fertilization (IVF)—fertilizing the egg outside the body then implanting it in the uterus
- Intracytoplasmic sperm injection (ICSI)—a single sperm is injected into a mature egg (as part of IVF or ZIFT) before being transferred into the woman
- Egg and Embryo cryopreservation—freezing embryos and eggs for later use
“20 years ago, in-vitro had a 20% pregnancy rate,” said Dr. Ryan Riggs, Infertility Specialist at Research Medical Center and Menorah Medical Center. Today, the pregnancy rate is about 70%, so it has really changed in terms of what we have to offer.”
Your fertility specialist can also help guide you through issues like whether to use donor egg, donor sperm or a gestational surrogate to carry your baby. After a pregnancy occurs the reproductive endocrinologist, in addition to your obstetrician and any other care providers you may need (such as a perinatal specialist for high-risk pregnancies), continue to follow the pregnancy for several weeks. Sometime in the first trimester, your fertility specialist will usually transfer your care to an obstetrical provider.
Finding a Doctor
Whether you are looking for a reproductive endocrinologist, ob-gyn or a primary care physician, we can help. Call our free physician referral line at (913) 541-8330. You can also search for a reproductive endocrinologist online at hcamidwest.com.
To learn more about the fertility services offered by HCA Midwest Health hospitals, call (913) 541-8330.
Information & Support
Visit HCAMidwestHealth.com/Fertility for more information or to sign up to receive our email with useful tips about fertility and pregnancy planning.
If you have any health questions along the way, call Nurses On-Call at that same number, (913) 541-8330. This free service lets you speak to a registered nurse anytime, 24 hours a day, 7 days a week.
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