A fertility specialist is usually a gynecologist or urologist who has received additional training to address reproductive problems in men and women who are trying to conceive.
Your doctor might recommend that you see a fertility specialist for any number of reasons, such as:
- If you are having difficulty conceiving after 6-12 months.
- If you have experienced more than one miscarriage.
- Trying to conceive while having preexisting risk factors or fertility issues, such as irregular periods, genetic conditions or previous sexually transmitted infections (even though they have been treated).
- When considering permanent birth control procedures, such as tubal ligation or vasectomy.
- Patients with cancer who require guidance about how to preserve fertility prior to treatment, or those who want to conceive following treatment.
A primary care physician or gynecologist is usually able to start the process of fertility evaluation, and may even prescribe some basic medical treatment. However, it may be necessary to visit a fertility specialist in order to get more advanced testing and treatment.
Types of Fertility Specialists
There are several types of doctors who specialize in treating fertility. Your medical history and specific needs will determine which doctor is right for you.
When most people talk about fertility specialists, they are usually referring to reproductive endocrinologists. Reproductive endocrinologists, or REs, are gynecologists who have had additional training in treating fertility and infertility in both men and women.
Reproductive endocrinologists oversee, recommend, and perform a wide range of fertility testing and treatments. These include assisted reproductive technologies (ART) such as IUI or IVF. If outside specialists are required for a specific case, the reproductive endocrinologist will normally be the lead consultant.
REs can also help cancer patients preserve their fertility. By coordinating with an oncologist, they will work together to develop a fertility preservation plan before any beginning any cancer treatments that could pose a risk to fertility.
An andrologist is a urologist who has received additional training in male fertility. He or she may assess and prescribe treatment for male fertility issues on their own, or collaborate with a reproductive endocrinologist.
They may also examine more closely to identify the root cause of a sperm count that is below normal, or absent altogether. Ideally this will enable them to treat the issue so that the couple can conceive without the need for IVF.
An andrologist is also able to perform testicular biopsies to retrieve sperm, referred to as testicular sperm extraction, or TESE. They can also treat conditions such as erectile dysfunction, undescended testes, testicular torsion and reproductive infections.
A reproductive surgeon is another type of fertility specialist. Although reproductive endocrinologists can perform surgery, reproductive surgeons are more skilled in surgical procedures.
They may also treat patients reasons other than fertility issues. They may have primary training in urology or gynecology.
Reproductive surgeons can remove fibroids, or treat endometriosis surgically. Also, a reproductive surgeon might perform vasectomies, reverse vasectomies, or tubal ligations.
Reproductive immunologists utilize the studies of both immunology and reproductive medicine. Recurring miscarriages, as well as IVF failures and fertility problems with no apparent causes, are all examples of cases where a reproductive immunologist might be called upon.
If you have been diagnosed with endometriosis, or an autoimmune condition such as rheumatoid arthritis or lupus, a reproductive immunologist may be able to help. Reproductive immunologists can be scientists or physicians, and typically work together with a reproductive endocrinologist in order to help couples who are experiencing fertility issues.
Fertility Clinic Personnel
Fertility clinics are typically overseen by a reproductive endocrinologist, or a team of REs. Some have an andrologist on staff, while others do not.
Although they are less common, reproductive immunologists will still be available to the clinic in certain cases. That said, not all fertility specialists are on up-to-date with the most recent immunology-based treatments.
A fertility clinic may also staff embryologists, sonographers, nurses who are trained in the field of reproductive medicine, or other laboratory technicians. Certain clinics might also have counselors, nutritionists, and even acupuncturists on staff.
Additionally, clinics often have financial advisors that can help you understand your options for payment and with managing your insurance, if necessary.
A good clinic doesn’t have to be staffed with a lot of people, and a clinic that has a large staff isn’t necessarily the best. Consider your fertility situation and specific needs when choosing a fertility clinic.
Certain clinics will not accept women over 40 unless they consent to using donor eggs from the beginning. However, others specialize in treating women over 40.
An andrologist is the best option if it’s known that there are problems with male fertility.