On March 17th, in partnership with the FAM Committee, TAG hosted a virtual Lunch & Learn about infertility diagnosis and treatment. Dr. Connie Cheng, an obstetrician and gynecologist practicing at UCLA Health in the Burbank and Pasadena areas, discussed statistics, referrals, and treatment options to assist those facing infertility issues. Below is an overview of topics covered by Dr. Chen.
The rate if infertility increases with age, with the sharpest drop starting around ages 35 to 37. Because of this, early recognition and intervention is important.
Less talked about than female infertility, male infertility is mainly caused by the following issues:
- The ability or inability to make the sperm
- The concentration of the sperm
- The volume of the sperm
- The appropriate mobility of the sperm
The most common causes of female infertility are the following ovulatory disfunctions:
- The ability of the brain to tell the ovaries to ovulate (20%)
- Blocked, scarred, or damaged tubes (14%)
- Endometriosis, which is uterine tissue growing outside the uterus on the pelvic side wall, ovary, etc. (5-6%)
- Unexplained (25-30%)
Infertility Specialist Referrals
If you feel you are dealing with infertility issues, your first step should be to talk to your OB/GYN.
- If you are under the age of 35 and have been trying to get pregnant for twelve months or more, this is likely the time to be referred to an infertility specialist.
- If you are over 35 and having been trying to get pregnant for six months or more, this is likely the time to be referred to an infertility specialist.
- Exceptions for an earlier referral include known irregular periods, Polycystic ovary syndrome (PCOS), a history of cancer, or an injury to the pelvis or abdomen.
Males would be referred to their primary doctor or urologist to have a semen analysis done.
Females would be referred for ultrasounds, lab work, and/or Hysterosalpingography x-rays (HSG) to check for the following:
- Lab work for:
- Thyroid issues
- Elevated prolactin
- Multiple ovulations hormones (on day 3 of the period to check if you have ovulated and are able to ovulate)
- As well as routine lab work for blood type, blood count, immunity to measles, STIs, etc.
- Tests for:
- Are enough eggs being produced?
- Early menopause
- Ultrasounds for:
- Dye injected into the cervix and uterus, followed by an x-ray to see if fallopian tubes are blocked.
- Pelvic ultrasound to check for the amount of follicles.
- Uterine issues affecting the ability to implant or carry the egg:
- Lifestyle changes
- Exercise and lifestyle changes can help reduce pregnancy issues. These include stopping smoking and drug use, in particular marijuana which effects male sperm.
- Uterine treatment
- Removing polyps or fibroids.
- One example is pills to help regulate ovulation
- IUI – Intrauterine Insemination
- Ejaculated semen is washed and injected directly into the uterus. (This method has a 5% chance of success per cycle.)
- ICSI – Intracytoplasmic
- A single sperm is injected into a mature egg (60% success rate)
- IVF – In vitro fertilization
- The egg is fertilized outside the body and reimplanted into the body (45% success rate)
- Alternative medicine
- Some herbs may help with infertility issues, but there is not evidence that this will work.
Mental Health Care
Dealing with infertility can be a stressful journey. This makes it important to consider working with a mental health care specialist to help relieve the stress.
The FAM Committee has compiled comprehensive information about infertility in this Google Folder.
For information about infertility coverage by MPI providers, go to this “MPIPHP Coverage Overview” folder.
*This information is for general reference only. Please consult a specialist for all questions about infertility diagnosis and treatments.