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Perhaps you’re in your mid 30’s and you can hear that biological clock ticking…LOUDLY. Or, perhaps you’ve been trying for a while to conceive but have been struggling. Below, Dr. Chantel Roedner discusses common and not-so-common questions pertaining to women, men and infertility.
The definition of infertility is the inability to become pregnant during the last 12 months in a couple that is having regular intercourse without contraception.
Infertility in women can be caused by one of or a combination of problems. Commonly there are issues with ovulation, the structure or functions of the fallopian tube or uterine structures, or hormonal imbalances. Infertility can be age related or due to rare genetic diseases. Often it may be unexplained.
Male infertility is often due to issues with the amount of or health of sperm.
A workup for infertility is fairly exhaustive, meaning we are evaluating a couple with lab tests and imaging to help determine the cause. We typically start with a thorough history and physical examination. Medications, weight, vital signs, and social history are reviewed. This will help to guide our decision-making and recommend additional testing as needed. Certain surgical procedures may also be necessary.
The cost for a workup varies. Lab tests may range on the order of less than $100, whereas more invasive tests to evaluate the uterus and fallopian tubes (such as hysterosalpingogram) may be $400 or more. Surgeries can be several thousand dollars.
Depending on your insurance provider, some of these costs may be covered. We will come up with a treatment plan depending on the perceived cause of infertility. Weight loss, lifestyle changes, medications, surgery or advanced reproductive technologies (ART) may be recommended.
While there is no perfect time to plan a pregnancy, we do know that after the age of 35 there are increased risk factors that make pregnancy more challenging. These include miscarriage, preterm birth, chromosomal disorders, hypertension, and diabetes to name a few. However, many women will have normal, healthy pregnancies and deliveries. We typically offer more testing and monitoring in women of this age category.
There has been an increase in the number of births in older women during the last 50 years. Later age of first marriage, second marriages, use of effective birth control, education and career opportunities have contributed to this trend.
Many women are now having their first children into their mid-30s to early 40s.
As women age, their risks of infertility increase. While it is possible to conceive spontaneously in this age group, many individuals seek out assistance from their OBGYNs. Referral to a fertility specialist, or REI (reproductive endocrinology and infertility) doctor, can help women to understand their pregnancy potential and undergo ART when needed.
Not every couple will need in-vitro fertilization (IVF). Fertility specialists will review one’s information and formulate options for maximizing pregnancy.
Often many people will feel helpless when they receive the diagnosis of infertility. It can be frustrating and overwhelming at times for those who have been trying to get pregnant for so long. Thankfully there are many resources and providers available that can guide these individuals through the work-up and treatment process.
Dr. Chantel Roedner joined WakeMed Physician Practices as an OB/GYN after completing her residency at The University of North Carolina at Chapel Hill and earning her Medical Degree at the Medical University of South Carolina in Charleston. Her clinical interests include high risk obstetrics, infertility, minimally invasive gynecological surgery including robotic surgery, well woman care and contraception.
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Raleigh, NC 27610