Infertility With Dr. Prokop
Gabrielle Prokop, MD from the Department of Obstetrics and Gynecology, shares some important insight into infertility as part of National Women’s Health Week.
Q&A with Gabrielle Prokop, MD
Is infertility a common issue?
Infertility is unfortunately a very common problem that we encounter, affecting up to 15% of couples.
How do we diagnose infertility?
Infertility is defined as the inability to conceive after 12 months of unprotected intercourse if the patient is less than 35 years old, or 6 months if they are 35 years or older.
However, evaluation may be required sooner in women who are not ovulating, have irregular cycles, or are diagnosed with endometriosis.
What are the first steps in evaluating infertility?
The first step for any patient who is concerned about fertility starts with monitoring menstrual cycles. Determining cycle length (from the first day of one period to the first day of the next) can help determine cycle regularity.
Additionally, monitoring ovulation predictor tests (usually cycle days 10-16) to evaluate if she is ovulating.
What are some common causes of infertility?
The most common causes of infertility that we see are anovulation (the failure of an egg to release during a menstrual cycle), tubal factor (blocked fallopian tubes), decreased ovarian reserve or premature menopause, uterine abnormalities, male factor, or an unexplained cause.
Are there any steps a patient can take to prevent infertility?
The best things to help with fertility are maintaining a healthy lifestyle including diet and exercise as well as decreasing alcohol and tobacco use. Otherwise, unfortunately, a lot of people who struggle with infertility have no way of predicting or preventing it.
What treatment plans are available for patients struggling with infertility?
The first steps typically start with an evaluation to determine the actual cause which can include:
- Blood work – looking at ovarian reserve, male hormone levels, thyroid, and other hormones such as prolactin as well as checking if the patient is ovulating
- Semen analysis – evaluating partner’s sperm (up to 40- 50% of infertility is a male factor)
- Ultrasound – looking to see if anything is abnormal with the uterus or ovaries
- Hysterosalpingogram (HSG) – putting dye through the fallopian tubes to see if they are open
From there, management options include medications such as Clomid or Femara to help with ovulation and/or artificial insemination. Occasionally in cases where something is found to be severely abnormal, patients may require an immediate referral to a specialized infertility doctor.
Are there common misconceptions about infertility?
I think the most common misconception is the idea that conditions make it so that someone is never going to be able to have children. I have a lot of patients who have always thought about this or have been told this, and it is very rarely the case. Another misconception is that birth control causes infertility. There is no scientific data proving this association.
It does tend to take a few months after stopping birth control for your body to go back to normal, but this should typically happen in about three months. If you are still not having periods on your own after around three months off of birth control, this is not normal, and you should see your gynecologist for evaluation.
Do you have any health tips for women trying to conceive?
Trying to get pregnant in general is very frustrating, whether you just started trying to conceive or have been trying for a long time. Do not hesitate to talk to your gynecologist if you are seeing irregular cycles or feel like something is wrong – if nothing else we can talk about appropriate timing and can consider labs.
I think it’s also important to realize that it’s common for it to take a few months to get pregnant – 80% of couples will conceive by six months and 85% of couples will conceive by 12 months. When trying to get pregnant, this is also a time to focus on eating a healthy diet, exercising, and cutting out any illicit substances, tobacco, or alcohol for both you and your partner to try to optimize your fertility.
Visit our Department of Obstetrics and Gynecology for more information about our providers, locations, and specialties.
