Fertility Facts & Options from OU Health Reproductive REI Specialists

Fertility and infertility issues can be confusing, frustrating and hard to deal with and understand. If you have been trying to conceive for more than a year (or less in certain circumstances) an evaluation with a fertility specialist may help determine the causes of the difficulty and offer possible treatment options to help you conceive.

OU Health Reproductive Endocrinology and Infertility (REI) specialists are double board-certified physicians. These highly trained and qualified specialists diagnose and treat infertility as well as a range of reproductive disorders that affect both men and women.

“Infertility affects as many as 1 in 6 couples, which is extremely common. Oklahoma is no exemption to this statistic,” said Reproductive Endocrinology and Infertility (REI) specialist Dr. M. Blake Evans, D.O., assistant professor in the Section of Reproductive Endocrinology & Infertility in the Department of Obstetrics and Gynecology at The University of Oklahoma College of Medicine.
 

An evaluation of a woman for infertility is appropriate for women who have not become pregnant after having 12 months of regular, unprotected intercourse. An earlier evaluation is appropriate after 6 months for women who are older than age 35, or who have irregular menstrual cycles, known or suspected uterine or fallopian tube problems or for men with known or suspected male infertility problems. In someone who is 40 or older, an immediate evaluation is often indicated.

A basic workup usually involves a thorough history, a transvaginal ultrasound and hysterosalpingogram (fallopian tube evaluation) for women and a semen analysis for men.

What are the Main Causes/Reasons for Fertility Issues?

A woman’s age is the most important prognostic factor when considering pregnancy success. For a healthy woman in her 20s or early 30s, the chance of conceiving each month is 25-30%. By the time a woman is 40 years old, the chances are only 5-10%. Other common causes include ovulation disorders like polycystic ovary syndrome (PCOS), blocked fallopian tubes from a prior pelvic infection or endometriosis, uterine anomalies, problems with sperm parameters and unexplained infertility.

“It’s important for couples/patients to know they aren’t struggling alone,” said Dr. Evans. “Infertility is a common problem for many, and the team at OU Health is here to help you on your journey to achieving the dream of starting a family.”

What Treatments are Available?
 

OU Health Physicians – Reproductive Medicine offers several services for patients including, but not limited to:

• Fertility testing with ultrasound, semen analysis, hysterosalpingogram and a saline sonogram
• In vitro fertilization (IVF)
• Ovulation induction
• Intrauterine insemination (IUI)
• Donor sperm, egg or embryo services
• Pregnancy through a gestational carrier
• Egg cryopreservation, sperm cryopreservation and embryo cryopreservation
• Reproductive surgeries including laparoscopy, hysteroscopy, abdominal myomectomy and more
• Gestational carrier assistance – Using a gestational carrier is a process in which a woman carries and delivers a child for a couple or individual

“There is only so much ‘Googling’ and talking to friends and family with a history of infertility that can help when it comes to this,” said Dr. Evans. “Friends and family want what is best for you, but everyone has their own infertility journey. It is likely that their situation differs from yours. Ultimately, establishing care with our clinic, having a consultation with one of our providers, and undergoing a thorough evaluation is the best way to determine what treatment is recommended.”

A patient’s general OB/GYN can also run basic infertility testing (and in certain circumstances, do basic treatments) before referral to the REI clinic.

Common Misconceptions About Infertility

Like many other complicated medical concerns, misconceptions about fertility and treatments exist.

“One of the most common misconceptions that I encounter is that if you are struggling with infertility, then you should just take clomid or letrozole and have timed intercourse,” said Dr. Evans. “These are oral medications that increase follicle (has an egg inside) production in the ovary. Interestingly, previous studies show that in patients with unexplained infertility with normal menstrual cycles, normal sperm, and at least one open fallopian tube who are taking these medications along with timed intercourse, the success rates for pregnancy are no different than timed intercourse by itself.”

However, when these medications are combined with intrauterine insemination, pregnancy rates can improve by three to four-fold in patients with unexplained infertility.

“It is not uncommon for patients to have undergone several cycles of oral medications plus timed intercourse prior to seeing us, and they have spent several months unfortunately wasting their time doing a treatment that is not the correct one for them,” Dr. Evans said. “If struggling with infertility or concerned about infertility, I would encourage you to get a consult with an REI and discuss what tests and treatments are the best for you.”

Dr. Evans knows firsthand how challenging starting a family can be. He and his wife underwent infertility treatments, and because of it are proud parents.

“Our patients are often emotionally exhausted from trying to conceive before they even get into our clinic,” he said. “Add to that the emotional, physical and financial burden of undergoing potentially multiple treatment cycles to get to a single baby. But hearing that heartbeat with the patient for the first time is truly an unforgettable moment. Knowing that our clinic helped them cross that finish line is an honor that I never take for granted.”

Embarking on a journey to start and build a family involves difficult decision-making processes. When choosing a doctor or clinic, patients must choose the highest caliber of care available and ensure their doctor has undergone the correct subspecialty training to become double board certified in OB/GYN as well as REI.

“The experts at OU Health Physicians – Reproductive Medicine are here to help and guide every step of the way,” Dr. Evans said. “It is truly a joy to help families achieve their dream of starting a family. Never hesitate to reach out to us with any questions or concerns. You aren’t alone on this journey, and we are dedicated to your care.”

Learn more about Fertility Services and Reproductive Medicine at OU Health or speak with one of our experts about PCOS and fertility at (405) 271-1616.