Infertility

Family definitions are wide and varied. Sometimes when people look to expand their families with children there can be struggles, questions, frustration, tears and joy. If you are struggling to add to your family, we at Southdale Ob/Gyn would like to help you identify issues, treat and thereby increase your chances of adding a child.

There are many facets to the definition of infertility. Normally a woman under the age of 35 that is with regular monthly cycles and seeks pregnancy will conceive in a year. If it is longer than a year, couples are encouraged to seek assistance. If a woman does not cycle regularly, then waiting for only 3-6 months to seek evaluation is encouraged.

Generally, two step process of evaluation and then treatment gets us closer to the answers and options that contribute to frustration. Sometimes the issue can be identified with the woman, with the man, a combination of both or sometimes there can be multiple factors that play together to prolong a chance of conception. The smartest approach to seeking adding children to your family is to evaluate completely, identify treatable issues, treat smartly and succinctly.  Prior to any treatment decision, we will thoroughly review them with you so you know each option's limitations and benefits, risks and rewards.

Often the process of gathering information is compared to putting together a puzzle. The pieces of this puzzle will include and evaluation of a woman’s history of her menstrual cycles, past illnesses or problems, hormonal status and ovarian reserve. The male evaluation also includes some testing of sperm, a physical exam and sometimes some blood testing.

When the puzzle or picture seems clear, we can move to the treatment phase of seeking a child. At Southdale Ob/Gyn, we are very happy to assist with the evaluation and basic treatment options. We have the skills, expertise and compassion to assist you to achieving your family goals.

Evaluation:

Female
  • Blood Testing –
    • Estradiol
    • Follicle Stimulating Hormone
    • Lutenizing Hormone
    • DHEAS
    • Testosterone
      • Free and Total
    • Thyroid Stimulating Hormone
    • Prolactin
    • Glucose
    • Insulin
    • HIV
    • Hep B
    • Hep C
    • Rubella
    • Blood typing
    • Cystic Fibrosis
    • Progesterone
  • Uterine testing
    • Ultrasound
    • Hysterosalpingogram
  • Vaginal testing
    • GC/CT
    • Ureaplasma/mycoplasma
Male
  • Semen analysis
  • GC/CT
  • Ureaplasma/Mycoplasma

Treatment options

Ovulation testing – LH tests
Best to start testing around cycle day 10 or 11, continue until positive test

Timed intercourse
Start to have intercourse every other day from around cycle day 10 or 11

Ultrasound
A baseline US is done cycle day 1-5, to determine that a woman’s ovaries are ‘quiet’ or have no cyst maintained from previous cycles. Then an US every 2-3 days, starting about cycle day 11

Clomiphene citrate
This medication is to be used for 5 days, normally starting on cycle day 3, 4 or 5.

Progesterone supplementation
An initial evaluation is done about 7 days after ovulation. If the value is low, then a supplementation can be initiated after the initial evaluation, and then in subsequent cycles starting two days after ovulation.

Artificial insemination
Occasionally sperm parameters indicate a need for artificial insemination. Sometime artificial insemination is used empirically to improve pregnancy rates. Same sex female couples can initiate insemination cycles, or be assisted with medication.