Age: If you have been trying to get pregnant for one year and are under 35, or for six months and you're over 35, you should consult a Fertility Specialist. Age>35 warrants prompt evaluation and referral after 6 months of trying naturally. One of the basic tenets of reproduction is that loss of eggs (oocytes) accelerates over the age of 35 and particularly over 37, causing age-related infertility. A family history of early menopause especially below 40 is another reason to refer to a fertility specialist sooner as there is a hereditary component to age-related infertility.
If you have had In Vitro Fertilization Cycles that have failed, a Fertility Specialist should be able to help.
Moderate to severe male factor infertility: An abnormal semen analysis showing low counts, motility, or morphology can require further evaluation or treatment with a Reproductive Endocrinologist with experience in male infertility, intrauterine insemination (IUI: placing washed sperm in the uterus),FSP: fallopian tube sperm perfusion, or IVF with ICSI (fertilizing eggs and sperm in the laboratory).
You are a young single woman or couple who is involved in your career and do not want to put it on hold while you have a baby. We can preserve your eggs or your embryos and save them for later when you decide the time is right for you.
Tubal abnormalities on HSG: Any evidence of tubal blockage may warrant surgical evaluation by laparoscopy or in vitro fertilization.
You have just been diagnosed with cancer and your oncologist recommends that you speak with a specialist about fertility preservation.
Recurrent miscarriage: Two or more first trimester miscarriages (in first 12 weeks) or one second trimester (after 13 weeks) miscarriage are reasons for further evaluation. There are certain genetic, immune and blood clotting disorders that can be tested for and treated to prevent future miscarriages./li>
History of genetic disorder: A strong family history of any genetic disorder (i.e. thalassemia, sickle cell anemia, familial breast cancer) can mean that the genes responsible can be passed on to children. With the advent of IVF with preimplantation genetic diagnosis (PGD), embryos can be created and tested for specific genes to avoid pregnancy with an embryo with the abnormal gene.
Pelvic pain/endometriosis/fibroids/irregular cycles: Menstrual cycle irregularities and pain can indicate the presence of PCOS, endometriosis, or fibroids, all of which can contribute to infertility.
Chronic medical problems: A significant medical history such as hypertension, obesity, diabetes, autoimmune conditions, or blood clotting disorders can lead to pregnancy complications and contribute to infertility. When the initial infertility evaluation is performed in a timely fashion and a prompt referral is made when abnormalities are found, most infertile couples have a good prognosis.
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