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When to See a Fertility Specialist: A Guide for Those Trying to Conceive

Trying to conceive can be an exciting and emotional journey. However, for some couples or individuals, it can take longer than expected. If you’ve been trying to conceive without success, you might be wondering when it’s the right time to see a fertility specialist. A fertility specialist is a medical professional who has specialized knowledge in diagnosing and treating infertility. Here are some key guidelines for when you should consider seeing a fertility specialist:

After One Year of Unsuccessful Trying (or Six Months for Women Over 35)

For most couples, it is normal to take up to a year to conceive. If you have been actively trying to get pregnant for 12 months without success, it’s time to seek help from a fertility specialist. This is the standard recommendation for women under the age of 35.

However, for women who are 35 years or older, fertility can decline more rapidly, so it’s recommended to see a specialist after 6 months of unsuccessful attempts. The biological clock tends to tick faster, and early intervention can help address any age-related fertility concerns.

If You Have Irregular Menstrual Cycles

Regular menstrual cycles are an important part of a woman’s fertility. If your menstrual cycle is irregular (e.g., cycles that are too short, too long, or you have missed periods), it can be difficult to predict ovulation, which affects conception. Conditions such as Polycystic Ovary Syndrome (PCOS) can cause irregular cycles, so seeing a fertility specialist can help identify and manage underlying issues that might be affecting your ability to conceive.

If You Have Been Diagnosed with a Medical Condition That Affects Fertility

Certain medical conditions can affect fertility in both men and women. If you have been diagnosed with one of the following, it is a good idea to see a fertility specialist:

Endometriosis: A condition where tissue similar to the uterine lining grows outside the uterus, causing pain and often infertility.
Pelvic Inflammatory Disease (PID): This condition can cause damage to the fallopian tubes and ovaries, leading to fertility challenges.
Thyroid disorders: Hypothyroidism or hyperthyroidism can interfere with ovulation.
Diabetes or other chronic conditions that can impact reproductive health.
Varicocele (in men): An enlarged vein in the scrotum, which can reduce sperm quality.

If you have any of these conditions or suspect you may, a fertility specialist can provide an evaluation and guide you through potential treatments.

If You Have Experienced Multiple Miscarriages

Having a miscarriage can be a deeply emotional experience, and experiencing more than one can raise concerns about your fertility. If you’ve had two or more consecutive miscarriages, it is important to see a fertility specialist to understand the underlying causes. Possible causes could include genetic issues, immune system problems, or structural abnormalities in the uterus.

If You Have a Family History of Fertility Problems

If there is a family history of infertility or related health conditions (such as early menopause or genetic conditions like Fragile X Syndrome), you might be more prone to similar challenges. A fertility specialist can conduct genetic testing and other evaluations to assess your fertility health and provide guidance based on your personal medical history.

If You Want to Delay Childbearing Due to Lifestyle or Career Choices

Some people may delay having children due to career, education, or lifestyle choices. If you want to delay parenthood to over 35 and have concerns about fertility, a fertility specialist can help assess your reproductive health. With advanced techniques like egg freezing, there are options to preserve fertility for later use.

This is not an exhaustive list, but should act as a guide. If this is overwhelming and you would like to speak to our friendly doctors, then (CLICK HERE TO BOOK AN APPOINTMENT)

Egg Bank Test

You are the queen of your own life, therefore it is important to take these INFORMED decisions. There is never a problem delaying parenthood, but we live in times that we can at least prepare for the delay (if being a mom is on the list at all).

To begin with, women should get a fertility blood test aka egg timer aka ovarian reserve called AMH, anti mullerian hormone. The AMH level test is a simple blood test that measures your ovarian reserve and gives an indication as to the remaining number of eggs in your ovaries. These reserves decrease naturally with age. It does this by measuring your level of anti-mullerian hormone (AMH) that is produced by the small follicles that support the eggs. These reserves decrease naturally with age.

Whilst the AMH test can provide an insight egg number, it does not give any indication about the egg quality, which declines steadily over a woman’s lifetime and by the age of 36 starts to decline rapidly. A low AMH does not mean that the eggs are poor quality and vice versa, it is just a guide to how many remain.

The value of knowing your ovarian reserve as it sits today is so that you can choose to do something about fertility now, soon, or later.

Optimising Egg & Sperm Health

Optimising Egg Health

Women often worry about the number of eggs they have remaining (as indicated in the AMH/AFC tests), however, the key to achieving a successful pregnancy is not so much about the number of eggs but the quality of those eggs.

Egg -quality declines with age, and is a natural part of the ageing process, which makes achieving a pregnancy after age 35 more difficult. Not only are there fewer eggs, but older eggs can have a higher percentage of abnormal DNA.

Leading a healthy lifestyle helps to optimise egg-quality which includes eating a healthy diet (more veggies and fruits), limiting saturated fats, sugars and processed foods.

Soft drinks, energy drinks, chocolate, tea (including green tea) and coffee all contain caffeine, which is linked with lower fertility and increased miscarriage when consumed in high amounts. We recommend limiting caffine to around 200mg a day – or around two cups of coffee. There is no safe amount of alcohol to drink when pregnant or trying to conceive, so it is best to eliminate alcohol if you can.

Smoking can harm an egg’s DNA and should be avoided. We can help you with a quitting program to help support you.

Exposure to chemicals and toxins should also be limited when trying to conceive as these can act as hormone disrupters. You can swap microwaving in plastic for glass, and avoid heavy perfumes and cleaning products.

Vitamins play a huge role in egg health. Anyone trying to conceive or considering freezing their eggs should start taking a pregnancy vitamin or folate supplement. There are several other vitamins which our doctors recommend to improve egg quality which will be discussed with you at your appointment.

Regular exercise can also help to improve natural fertility by encouraging blood flow throughout the body and assist in maintaining a healthy weight, which is optimal for pregnancy.

Prioritising self-care and limiting stress is important during your fertility journey. Stress can produce hormones like prolactin and cortisol which can affect egg quality and production. Self-care activities which can decrease stress include meditation, acupuncture, yoga, spending time with pets and loved ones and prioritising sleep.

Optimising Sperm Quality

Male factor infertility accounts for approximately 40% of all cases of infertility. Whilst age doesn’t impact sperm in the same way as eggs, there is still a decline in the quality of sperm after the age of 45 years.

Common causes of male infertility are often easily diagnosed and can often be effectively managed through IVF treatment options. Lifestyle changes – like eating well, exercising and quitting smoking – can also improve sperm quality. The results of these changes can be seen in as little as 90 days.

To fertilise an egg, the sperm needs to be the right shape and have good motility so it can reach the egg. A healthy diet and lifestyle promotes healthy sperm; prioritise fresh fruit and vegetables, healthy oils and whole grains for healthy sperm. Minimising sugar and highly processed foods is also beneficial. If drinking alcohol, it is best to stick to 1-2 standard drinks once or twice a week only.

Smoking and recreational drugs can damage the DNA of sperm and affect its shape and ability to reach the egg, so should be avoided. Exposure to chemicals and toxins should also be limited where possible.

Regular exercise is important to maintain a healthy body weight as Being overweight can have an impact on the production of sperms. Excess body weight especially around the thighs can create warmth around the testes. An increased body temperature during acute viral illness can also affect sperm production.

There are several vitamins that can improve sperm quality. Your doctor will discuss this with you at your appointment.

What is IVF

Simplifying it at JFMCH. Let’s be Friends!!

Before you even start reading this, know that you are loved, know that things will fall in place and know that you landed on this page for a reason. Smile and read on about InVitroFertilisation, popularly known as IVF.

We all understand that sexual intercourse is the first step needed to have a child. This allows the egg and sperm to meet and form an embryo which then develops into “your baby” inside the uterus.

However, for some couples the egg and sperms are not able to unite or produce a good quality embryo that can actually develop into your healthy child. When these couples seek assistance and the egg is fertilised in the lab, the process is called as IVF- Fertilisation is done in the lab!!!

Here are some key terms commonly used in IVF (in vitro fertilization):

IVF (In Vitro Fertilization): A process where an egg and sperm are combined outside the body to facilitate fertilization.
ICSI (Intracytoplasmic Sperm Injection): A specialized form of IVF where a single sperm is injected directly into an egg.
Oocyte: An egg cell that is retrieved from the ovaries for fertilization.
Sperm Retrieval: A procedure to collect sperm from the male partner or a sperm donor.
Embryo: A fertilized egg that has begun to divide and develop.
Blastocyst: An embryo that has developed for about 5 to 6 days after fertilization and has formed a hollow structure.
Embryo Transfer: The procedure of placing one or more embryos into the uterus after fertilization.
Cryopreservation: The process of freezing eggs, sperm, or embryos for future use.
Hormonal Stimulation: The use of medications to stimulate the ovaries to produce multiple eggs.
Endometrial Lining: The inner lining of the uterus that thickens in preparation for a potential pregnancy.
FET (Frozen Embryo Transfer): The process of transferring previously frozen embryos into the uterus.
Donor Egg/Sperm: Using eggs or sperm from a donor when the intended parents are unable to use their own.
Preimplantation Genetic Testing (PGT): Testing embryos for genetic abnormalities before transfer. Only done if indicated. This is not a routine procedure.
Luteal Phase Support: Hormonal treatments given after embryo transfer to support the uterine lining and increase the chances of implantation.

What are the common causes of infertility that IVF can address?
IVF can help with:

Female infertility: Blocked fallopian tubes, endometriosis, premature ovarian failure, or advanced maternal age.
Male infertility: Low sperm count, poor sperm motility, or structural issues in the reproductive tract.
Unexplained infertility: When no clear cause is identified after medical evaluation.

What are the steps involved in the IVF process?
The IVF process involves:

Ovarian stimulation: Hormonal medications to stimulate the ovaries to produce multiple eggs.
Egg retrieval: A minor surgical procedure to collect mature eggs.
Fertilization: The eggs are fertilized with sperm in a lab (using IVF or ICSI techniques).
Embryo Development: our doctor will discuss how long they will watch embryo development in the laboratory before performing embryo transfer. It is common for transfer to be done between Day 2 (2–4 cell stage) and Day 5 (blastocyst stage – around 100 cells) of development. This allows assessment of embryo cleavage (the way an embryo divides) and ensures the embryo is still developing so that only embryos capable of resulting in a pregnancy are transferred.
Embryo transfer: A healthy embryo is transferred into the uterus. This is a simple procedure which is done without anesthesia.
A soft tube called catheter is used to transfer the embryos into the uterus via the vaginal opening.
Luteal Phase Support: estrogen and progesterone are given after the embryo transfer to help the uterus prepare for implantation.
Pregnancy test: A blood test is performed 10–14 days after the transfer to confirm pregnancy.

Are there any dietary or lifestyle recommendations during IVF treatment?
Yes, to improve the success of IVF:

Diet: Eat a balanced diet rich in fruits, vegetables, whole grains, and lean proteins.
Lifestyle: Avoid alcohol, smoking, and excessive caffeine. Engage in moderate exercise and maintain a healthy weight. Manage stress through yoga or meditation.

What is ICSI, and how is it difference from IVF?

Intracytoplasmic sperm injection (ICSI) is a procedure where a single sperm is directly injected into an egg to facilitate fertilization. It is often used for severe male infertility or when previous IVF cycles have failed.

IVF and intra-cytoplasmic sperm injection (ICSI) are the two most popular assisted reproductive technologies used for successful fertilisation. The only dierence between the two is the way the egg is fertilised. IVF allows the sperm to penetrate the egg of its own accord whereas ICSI directly inserts the sperm into the egg. This is done under a microscope by highly qualified embryologists using sophisticated tools for micromanipulation. The technique is used when the sperm is unable to penetrate the egg wall. If the egg is fertilised, the embryo is inserted into the uterus in the same way as for IVF.

We are here to help you, at every step of the way

This can seem very confusing and difficult, but remember, you can come and talk to us anytime. At JFMCH, our priority is to make you feel heard and to provide you with the best treatment options. Remember, once a queen, always a queen.