If you have tried to conceive a baby for 6 months or more, with properly timed sexual intercourse and using no birth control, you need to consider that there may be a problem.
If you are in a same sex relationship or have irregular periods or know that there's a problem with your fertility, you will need to find a fertility specialist for fertility treatment. In the field of infertility, the specialists are board certified reproductive endocrinologists.
What is Reproductive Endocrinology? Reproductive Endocrinology is a sub-specialty of Obstetrics and Gynecology. This requires 4 years of medical school followed by completion of a 4 year residency in Obstetrics and Gynecology.
After completing a residency program, a physician would apply through a highly competitive system to receive additional training in Reproductive Endocrinology. This is referred to as a fellowship and includes a 3 year intensive training program, which focuses on understanding the complexities of the human female reproductive system.
Reproductive Endocrinologists receive board certification by the American Board of Obstetrics and Gynecology in both Obstetrics and Gynecology and Reproductive Endocrinology and Infertility. These require both written and oral examinations.
If you are trying to conceive and it's not happening, this is the information that you need to move ahead with your dream of creating your family.
Following is a definition about what reproductive endocrinologists do:
A Reproductive Endocrinologist specializes in the following fields of study:
- Polycystic ovarian syndrome (PCOS)
- Endometriosis Hypothalamic pituitary dysfunction
- Congenital adrenal hyperplasia
- Tubal factor infertility
- Male factor infertility
- In vitro fertilization (IVF)
- Fertility preservation
- Congenital uterine anomalies
- Other disorders of the female reproductive tract
Collectively, this field is called Reproductive Endocrinology and Infertility. Most of the patients seen by Reproductive Endocrinologists are experiencing fertility related problems. Get information on infertility testing and treatments.
If you are trying to have a baby, here are some of the most basic of the basics. Maybe you know these things already. Maybe you just need a gentle reminder. If you have any questions about anything listed below, please write to us and ask. Your questions are anonymous and will be responded to by a doctor
• Make sure that you have stopped using all forms of birth control
• Use an over the counter ovulation predictor to make sure that you know when you are ovulating (ovulation is when you release an egg that moves down the fallopian tube and can become fertilized by sperm and become an embryo)
• Have sexual relations when you are ovulating
• Start taking a good quality pre-natal vitamin several months before starting to try to conceive
• Avoid drinking alcohol, smoking of any kind and all recreational drugs.
• Check with your doctor about using any regular prescription or over the counter medications
• If you are under 35, are menstruating regularly (every 22-34 days), don’t have underlying problems that you are aware of (blocked fallopian tubes, problems with the uterus), you can try up to one year to conceive before seeing a fertility specialist (board certified reproductive endocrinologist
• If you are 35 or older, are menstruating regularly (every 22-34 days), don’t have underlying problems that you are aware of (blocked fallopian tubes, problems with the uterus), you can try up to six months to conceive before seeing a fertility specialist (board certified reproductive endocrinologist)
Do not assume that because you have not gotten pregnant quickly or in the time frame listed above that you will not get pregnant or that it will take a very long time or that it will cost thousands of dollars. Many women get pregnant with the help of a doctor, even after trying on their own, simply and easily.
Most important, treat this like any other health problem or concern. If you are not menstruating or ovulating regularly, see a doctor even if you are not trying to conceive. If you are trying to conceive and it’s not happening in the time frames written about above, see a doctor. Find out why.
Often, it’s much simpler than you might imagine it will be.
I was trying to conceive for six and a half years. Maybe it's silly of me to continue to mention the "half" year. For those of you who are trying to conceive, you probably don't think it's so silly.
It was six months of hoping, thinking it possible and then having those hopes go up in smoke with another negative pregnancy test.
Six months is a long time when you're trying to conceive. Maybe not the first six months when you're just hopeful and assuming it will happen this month, or next month. If those six months are in the middle of fertility treatment, then it can be six months of many doctors appointments, blood draws, ultrasounds, rounds of medication, missed work time, missed vacations and other peoples baby showers.
If six months is a long time, then absoloutely, six and a half years is a very long time. So, yes, I still say six and a half years, not just six.
Here's a possible positive spin on the ticking of a woman's biological clock though. You can't be in fertility treatment forever. Whether it's your age, your financial resources, your emotional resources, there is a time when it becomes more and more clear that you need to stop. Sometimes it feels like the clearing of the clouds, sometimes it feels like the clouds turn into thunderstorms.
When leaving treatment is done without a pregnancy or child, it is painful, difficult and often done with resentment and regret. At least at first. Some of us think we can do this forever and we'll stay in it until we have that pregnancy or child. Other's realize full well that their personal psyches will have them finish earlier than that, even if it means no child.
We'll talk about resentment and regret next week. Today is all about not being able to be in fertility treatment forever.
That's the silver lining, I think. That there's a limited time for treatment, no matter how long you are in it. You cannot be in treatment for 30 years. You simply can't. Ok, maybe you can, but in the 22 years, I've been involved with infertility, I have not met someone who has stayed in treatment for that amount of time. Not even nearly that amount of time.
At a certain point, we will exercise options we had not considered before, be that donor egg, donor sperm, gestational surrogacy, adoption, childfree living, or fostering a child.
At a certain point, we will move out of active fertility treatment and onto a different option.
You may not believe that you will do that unless you are pregnant or have a child.
The other incredibly great news? With the pregnancy rates that we have? Chances are, you will leave either pregnant or with your second (third, fourth, etc.) child.
If not, we are still here for you. Helping you move on without regrets, knowing that you have done, that we have done, what we can to help you achieve your dream of having your family.
We know that even with our fabulous pregnancy rates, not everyone gets pregnant or has a child. We're here to help you with that as well, if it means seeing one of our therapists, Dr. Lisa Tuttle or Jane Elisofon MSW,LCSW, if it means attending a support group. If it means just a lot of loving care, here, on the blog.
We're here for you.
If you have been trying to become pregnant and it’s not working, here are five simple things to think about
- Discontinue all forms of birth control. I know this is common sense, I know, but still. This includes condoms and many forms of lubricants that have spermicide. My husband of 26 years will still ask me to check the plug when something’s not working. At least 40% of the time, it’s unplugged. So don’t use any birth control methods.
- Keep track of when you are menstruating. Day one is the first day that you get your period. If you have started menstruating after 2 or 3 in the afternoon, count the next day as day one. I write the number 1 in my date book with a circle around it, makes it simple.
- Make sure that you are having sex at the time you are most likely to become pregnant, during ovulation. Usually that’s around day 12-18, depending on how frequent your menstrual cycle is.
- Have sexual intercourse every other day starting at least two days before you believe you will ovulate (using an ovulation kit will help you be more accurate). Ejaculation should be done inside the woman’s body. Again, I know this makes sense, but still, a reminder.
- Don’t use any methods of vaginal cleansing immediately after intercourse, particularly douching. No spermicide of any kind either.
For those of you who understand all of the above, keep in mind that there are those who do not. Not all of us do understand how things are supposed to work, so while these tips may be obvious beyond belief, they may not be for everyone. Assumptions that we understand our bodies and reproductive cycles are often wrong and the tips above are just a simple reminder.
Another simple reminder, if you are under 35 and have been trying to conceive for a year or over 35 and have been trying for six months, it’s time to consider seeing a board certified reproductive endocrinologist, also known as a fertility specialist.