Infertility specialists, who are board certified in reproductive endocrinology and infertility, must first complete an OB/GYN residency in the same manner as general obstetrician gynecologists. Like general Ob/Gyn’s, they take and must pass written and oral board examinations in obstetrics and gynecology.
The infertility specialist must enter an approved fellowship program in reproductive endocrinology and infertility and complete three additional years of training. The fellowship involves training under the tutelage of leaders in reproductive medicine. The infertility specialists at Baystate’s fertility clinic are all board certified in reproductive endocrinology and infertility.
Infertility specialist training ranges from infertility evaluations, managing assisted reproductive technology cycles to advanced laparoscopic and hysteroscopic surgery. Infertility specialists manage hundreds of IUI and IVF cycles during their fellowship training. In addition, infertility specialists must learn to manage complex disorders in endocrinology, including ovulation problems, and abnormalities of other glands such as pituitary, thyroid and adrenal that affect reproduction.
The reproductive endocrinology and infertility specialist must finally pass both written and oral board examinations to become board certified. These exams are difficult and often require more than one attempt to pass, meaning that those who complete the process are considered experts and consultants to general obstetricians and gynecologists.The average OB/GYN practice is primarily devoted to obstetrics. Usually, less than 15 percent of their patient populations are infertility patients.
Infertility specialist training is similar to other sub-specialties, such as cardiology. If your general medicine physician told you that you needed a cardiac catheterization, you would consult a specialist rather than have the generalist perform the procedure.
In the same manner, if you are told you are infertile, you should seek the care of an infertility specialist to achieve an optimal outcome with the least wasted time. This is especially true if you have been trying to conceive without success for a year or longer, or six months if you are aged 35 or older.
Infertility specialists spend the time necessary to stay current on fast-breaking clinical and research developments in infertility. They study specialty journals and attend meetings and conferences with their peers. Many studies have found that infertility specialist care results in higher pregnancy rates in shorter times, usually at lower cost.
Infertility specialists are keenly aware of women’s “reproductive time clocks”. They are able to offer appropriate advanced treatment options rather than continuing to repeat first-line treatments that have been unsuccessful. This is especially important for older women who may have very little time left to achieve pregnancy. Fertility can decline rapidly as women age beyond 35, making time of the essence. Infertility specialists understand this and move these patients through the evaluation and treatment processes rapidly.
Dependent upon the couples cause(s) of infertility, IUI may be considered as a first-line treatment. If pregnancy does not result, the next step is usually IVF.
Stimulated IUI (using FSH to stimulate the ovaries) should only be conducted by an infertility specialist. The package inserts for FSH products all carry strong cautions that physicians must be properly trained to administer these fertility drugs. Improper use can cause serious side effects, such as ovarian hyperstimulation syndrome, and can result in high order multiple births.
Many of the multiple births (quadruplets and above) seen in the media are the result of improperly managed IUI cycles. Infertility specialists have the training to minimize the potential adverse effects of fertility drugs. Also, if needed based on cycle evaluation, the infertility specialist can often convert the IUI cycle to an IVF cycle.
Of course side effects can occur regardless of who administers fertility drugs; however, the incidences are much lower when the drug is managed by an infertility specialist. These drugs are considered safe when administration is properly managed.
Infertility specialists and their staff are attuned to the special challenges faced by infertile couples. They spend every day caring for the special needs of infertility patients and provide compassionate, individualized care. Infertility specialists make every effort to ensure that patients understand their treatment options and have all of their questions answered before beginning therapy.