Common Infertility Questions Answered By OB-GYN & Infertility Expert
Thanks to AdventHealth for Women for sponsoring today’s video. As always, all stated opinions are my honest thoughts. I value your opinion and only partner with companies that I truly love.
In honor of National Infertility Awareness Week, I hosted a Facebook Live with AdventHealth for Women to get common infertility questions answered by an OB-GYN and infertility expert. Dr. Samuel E. Brown from Brown Fertility provided such great information in the video (shown below), so I knew I wanted to document everything in a blog post for easy reference.
Whether you’re a couple currently experiencing infertility, worrying about future infertility, or simply wondering about the best family planning options, I think you will learn SO much from Dr. Brown’s advice! Keep reading to learn more about common infertility conditions, treatments, and family planning.
Common Infertility Questions Answered By OB-GYN & Infertility Expert
How long should a couple try to conceive before seeking the support of a fertility expert?
According to Dr. Brown, women under 35 should seek fertility support if they do not have a successful pregnancy within one year of random unprotected intercourse. When they see a fertility doctor, they’ll be able to get a diagnosis and receive appropriate diagnostic testing that will help the doctor and couple work together to develop a treatment plan.
For couples where the woman is between the ages of 35-40, the time period adjusts to six months of random unprotected intercourse. For couples where the woman is 40 and above, it is recommended for the couple to immediately begin fertility consultations before trying to conceive.
What role does age play in fertility?
Dr. Brown emphasized that while both genders can have fertility issues, the woman’s age is the main factor. The age of a woman’s uterus isn’t a concern, but the age of the woman’s eggs is of utmost importance. He mentioned that the American Society Reproductive Medicine currently recommends for women to get pregnant under the age of 55, but women may experience increasing issues with fertility as their age progresses.
For women between under the age of 33, it is fairly easy to get pregnant with or without fertility assistance. Women between the ages of 33-37 can also generally conceive fairly easily; however, women between the ages of 38-41 need to act quickly. Dr. Brown mentioned 99.9% of women will not be able to conceive with their own eggs (unless they previously froze their eggs) after the age of 44.
Dr. Brown mentioned that the man’s age and age of the sperm isn’t as significant of an issue. Most men can produce sperm into their 60s and 70s without issues.
How common is infertility?
Dr. Brown said that in the U.S., approximately 10% of couples in the population could experience fertility issues(more accurate for couples where woman is 35 or under), but it may be up to 1 in 8 couples who experience infertility.
While those numbers are averages for the entire population, infertility rates vary by age. In couples where the woman is closer to 40, it can be up to 25%. When the woman is over 40, infertility rates rise up to 50%. He emphasized infertility is a very common issue. You very likely have a neighbor, family member, or friend experiencing infertility. While infertility may be common, with treatment, there is a very high rate of success in conceiving.
What are the most common causes of infertility?
As we previously discussed, Dr. Brown mentioned the most common cause of fertility is age. He also pointed out that infertility can be due to issues with one or both partners. With the couples he sees in his practice, he mentioned that 40% of the time, the cause of infertility is due to sperm issues from the male partner. 40% of the time, infertility issues are caused by various reasons from the female partner. 20% of the time, both partners have infertility issues.
In females, a few other common causes of infertility are endometriosis (about 25% of his patients), tubal occlusion (fallopian tubes are blocked), ovulation issues like PCOS (Polycystic Ovarian Syndrome), or the woman no longer has viable eggs. For more information on endometriosis, check out this Q&A I did with an advanced gynecological surgeon and board-certified OB-GYN answering common questions about endometriosis.
If a woman suspects they may have infertility issues but isn’t ready to try to conceive, should they seek the support of a fertility expert?
If you are worried about diagnosed or potential fertility issues, Dr. Brown recommends seeking a consultation with an infertility specialist – no matter where you are in the process of building a family. They can do whatever you’re comfortable with – proactive testing, planning for the future, discussing options, and helping you to create a plan.
If you’re worried about a potential undiagnosed issue, diagnosis testing could should that there isn’t actually be a problem, so that could resolve anxiety. And if there is an issue that pops up, they’ll be there to offer assistance and help you develop a plan for when you’re ready so that you can make informed decisions. Either way, it’s a positive situation!
Another option is fertility preservation. Women under 37 are able to freeze their eggs, which your doctor may suggest as a potential option if you are not ready to start a family but are concerned with future potential infertility.
Even if you don’t have suspected or known fertility issues, it’s still completely fine to see a fertility specialist for your family planning or your OB-GYN. Dr. Brown said they love speaking to couples regardless of if they have an infertility diagnosis or not. It certainly never hurts to have an expert help you develop a plan that’s optimal for your family!
What are the current recommendations for getting the COVID vaccine for women who are trying to conceive or women with suspected or known fertility issues?
Dr. Brown says that his practice as well as the American College of OB-GYN recommends that anyone who wants the vaccine should get it. He reports no concerns with getting the vaccine pre-pregnancy, during pregnancy, or in the postpartum and lacation stage. He didn’t see any negative part of getting the vaccine, so he recommends getting vaccinated if you’d like to.
Is there anything you can do to increase your fertility?
Dr. Brown recommended taking a prenatal vitamin two to three months BEFORE trying to conceive to ensure your body has the right balance of vitamins – especially folic acid/folate.
He also recommended tracking your ovulation cycle with urine ovulation predictor kits. They’re very inexpensive and easy to use. Simply check urine with the kit every single day starting on day 9 of the woman’s menstrual cycle (day 1 would be the first day of your period / the first day you have to use a tampon or pad).
If you get a positive ovulation result, stop testing and have unprotected intercourse that day or every other day for two or three events. He said that’s all that’s necessary per cycle. Whenever the ovulation test turned positive, you’ll need to wait at least 16 days later to take a pregnancy test and see a potential positive result. If you get a positive, schedule an appointment with your OB-GYN or fertility doctor immediately for next steps.
Is there anything that can negatively affect fertility?
Dr. Brown said there are a few things that can negatively affect fertility. He always recommends lowering alochol consumption and says it is not wise to continue drinking after ovulation occurs. Lowering caffeine consumption to 1-2 caffeinated beverages a day is another common recommendation.
Of course we all know that smoking is very bad for our bodies, but Dr. Brown says it is important to take whatever steps or medications necessary to stop smoking as soon as possible. Marijuana also isn’t recommended, but it the effects are not quite as bad as nicotine – but still bad to discontinue use.
As always, a healthy diet and exercise regimen is recommended; however, it isn’t a good time to start a new high-intensity program if that’s not what you’re used to doing. When you’re trying to conceive, continue what you’ve already been doing if you’re starting a fertility plan and don’t start anything new or begin an extreme weight loss plan.
How do fertility doctors work together with a woman’s OB-GYN team?
Roughly half of Dr. Brown’s patients come in from a referral from OB-GYN, family practitioner, or urologist, and half come in without a referral. Either option is fine. Fertility doctors conduct testing (simple and usually covered by insurance), to figure out what the problem is, and then they find the most cost-effective course of treatment for the couple. Dr. Brown said most couples only require the least-expensive treatments to get pregnant.
When the couple gets pregnant, the fertility practice will complete the first ultrasound to make sure it’s a sustainable pregnancy, and then they will hand the patient over to a OB-GYN team around the 6-8 week mark. The patient will experience a normal obstetrical experience from there.
What is the difference between IVF and IUI?
IUI is intrauterine insemination. Dr. Brown said it is very affordable (costs a few hundred dollars), and the process involves concentrating sperm and placing it into the uterus. They make sure the woman is ovulating and place the sperm into the uterus at the right time. He said it’s a very simple and affordable procedure.
Most of Dr. Brown’s patients get pregnant through IUI, but more serious cases may require IVF or in-vitro fertilization. With IVF, the doctors use a needle to extract woman’s eggs, fertilize them outside the body with the partner’s sperm, and then a few days later, place them back inside the womb. For women under thirty, IVF has a success rate of up to 80% per try when one embryo is implanted. IVF has become more and more affordable over time.
Dr. Brown encourages everyone to check your insurance and work benefits because many offer coverage for infertility treatments.
Is fertility preservation common? How do you know if freezing your eggs is the right choice for your situation?
Dr. Brown said that as of 2014, fertility preservation is the standard of care for all OB-GYN by the American College of OB-GYN. It is a standard procedure and not experimental.
Freezing eggs is recommended for women under the age of 38. It begins with an IVF process: a few days of medication, IV sedation so patient won’t feel things, extracting the eggs from the ovary with a needle, and then freezing the eggs. The eggs don’t age when frozen. You can freeze your eggs under the age 38 and use them in the future. As Dr. Brown mentioned previously, the age of the uterus is far less important than the age of the eggs.
Thanks again to AdventHealth for Women, Brown Fertility, and Dr. Samuel E. Brown for making this important conversation about infertility causes and treatments possible! If you’re in the central Florida area, be sure to use AdventHealth’s FREE service – Women’s Health Navigator, to help you find the right care for your needs. They have a team of nurses available to answer your healthcare questions and direct you to a medical team that’s the perfect fit for your situation, and it’s 100% complimentary! You can watch a full Q&A about this service and how to find the right healthcare for your family here.
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