Infertility is a fear for most couples when attempting to conceive, but for some it is a shocking reality. For any couple wanting to bring a little one into the world there are the ups and downs both emotionally and physically when each month her menstrual cycle comes or the pregnancy test is negative. The initial excitement becomes wearing and turns into a stressful and sometimes emotionally unbearable task.
There are many things to consider when conception is challenging. When I assess fertility with my female patients I determine whether someone is ovulating regularly first by evaluating their cycle history and symptoms as well as hormone testing in individuals where this doesn’t seem likely. Initial labs that I consider running are based on the individual, but may include: FSH, estradiol, progesterone, testosterone, thyroid, prolactin, glucose and insulin. I may instruct my patients who have regular cycles to determine if they are ovulating by purchasing urine ovulation predictor kits by First Response. The kits can be picked up at any Target, Walmart, CVS, etc. This helps me determine when in the month they need to have intercourse if the test shows up positive.
I also like to evaluate the reproductive tract’s structure, meaning are the tubes open, do the ovaries have many follicles present and lack ovarian cysts and if there are any fibroids present (benign tumors in the uterus). Where the ultrasound can determine the quantity of eggs, checking the hormone levels like FSH and estradiol as mentioned earlier, can help determined the quality of eggs.
Now with all that said the male partner must ALWAYS be evaluated. Men are truly 50% of the equation in more ways than one. I recommend having the male partner complete a semen analysis to check the quantity and quality of sperm. My female patients are often pre-occupied with getting themselves healthy that they forget the other half of the equation is just as important. Having their partners evaluated can be of significant value because there are many natural solutions in improving sperm count and morphology.
Treatments are individualized and vary based on the findings from labs and imaging, but can include nutritional counseling, hormone balancing herbs, acupuncture, various vitamins and even nutrient IV therapy for both women and men.
When there are no clear answers from the labs and imaging than often couples are labeled as “unexplained infertility” and this can bring confusion and be heart breaking news for many. Traditionally infertility specialists will recommend In Vitro Fertilization at this point. My goal when speaking with any infertile couple is to get my patient’s as healthy as possible by digging even deeper to determine other underlying causes to infertility. Other potential underlying causes will be discussed in more detail in my next blog. My philosophy is that it is important to get my patients as healthy as they can be so that they will be able to carry the pregnancy full term without any complications whether they go through with In Vitro or not. For patients who decide to do In Vitro Fertilization I recommend combining it with acupuncture and IV therapy. I feel that it really improves the odds for conception at least that is what I have seen with my patient population.
Please keep your eyes open for the second part of this blog where I will discuss more about the unexplained category of infertility as well as miscarrying.