Everything About Fertility Specialists

A fertility specialist is a highly trained medical professional that specialises in helping families conceive. Their proper title is Reproductive Endocrinologist (RE).

REs are trained to diagnose and treat fertility issues, as well as conditions that are related to reproductive organs and the endocrine system (which regulates hormones). 

Contrary to popular belief, fertility specialists aren’t just for women. As pregnancy requires both a man and a woman to happen (biologically speaking), a fertility specialist is knowledgeable in both male and female fertility health.

Both REs and obstetricians/gynaecologistst (OB-GYNs) start off by studying the same branch of medicine; obstetrics and gynaecology. After completing their residency, an OB-GYN is considered fully qualified and may proceed with their practice.

However, in order to qualify as a RE, a doctor would have to undergo additional training after completing their residency. This takes the form of a fellowship in reproductive endocrinology and infertility that typically lasts 3 years. 

Hence, while an OB-GYN can help you during your pregnancy journey, they would likely refer you to an RE should you need a little help getting things started. Once conception has been successfully achieved, your OB-GYN will continue providing prenatal care.

A fertility specialist can help you overcome challenges faced when trying to get pregnant, by identifying the root cause of infertility, and prescribing tests, medication and medical interventions. They may also offer advice on lifestyle changes to support your goal of conceiving.

Based on your needs, your fertility specialist will draw up a fertility treatment plan, which may include the following:    

• Ovulation cycle tracking
• Ovulation induction
• Artificial insemination (AI)
• In-vitro fertilisation (IVF) treatment
• Intracytoplasmic sperm injection (ICSI) treatment
• Preimplantation genetic diagnosis (PGD)
• Fertility surgery
• Fertility preservation
• Assisted reproductive treatments such as surrogacy; egg, sperm or ovary donation 

Now that you understand what a fertility specialist is, and what they can do for you, you might be wondering when you should start seeing one.

Everyone’s situation is different, of course, but here are some guidelines for when you should consider getting a referral to see a fertility specialist. 

Couples under 35 who have been trying to conceive for more than a year should start considering seeing a fertility specialist. This is because on average, most healthy couples who have unprotected sex regularly get pregnant within a year [3]. 

Also, the younger you are, the more likely you are to get pregnant sooner rather than later. So if you’re coming up to a year without results, it’s likely there could be some issues that need looking into.

The quality and number of eggs produced by the body declines with age, which is one of the main reasons why pregnancy becomes more difficult for women who are older [4].

Women who are 35 or older, and have been trying to get pregnant for 6 months or more, may benefit from a consultation with a fertility specialist.

Miscarriages are disheartening, but they are actually quite common among pregnant women. Some estimates indicate that between 10% to 20% of pregnancies end in miscarriage [5]. 

However, women who have experienced recurrent miscarriages - 3 or more miscarriages in a row - may have underlying health conditions that are interfering with the ability to bring a baby to term. 

As such, seeing a fertility specialist is recommended.

Having periods that are irregular, comes with heavy flow, or even completely absent could point to underlying fertility issues. 

Irregular periods could signal a hormonal imbalance or an ovulation disorder, while bleeding between periods or after sex could indicate the presence of uterine polyps, fibroids or  cervical lesions. 

Similarly, periods that last longer than seven days, or if your blood clots are larger than 2cm in diameter, or heavy enough to require a tampon or pad change every hour for several hours could be signs of uterine fibroids or endocrine abnormality. 

And if your period is simply not coming, it is possible that ovulation is not taking place.

Having chronic health conditions may also impact your success rate when trying to get pregnant, so it bears considering seeing a fertility specialist for some added support. 

Some chronic conditions can also point to underlying fertility issues - polycystic ovary syndrome is known to be linked to hypertension [11], for instance. These chronic conditions include diabetes, hypertension, kidney disease, thyroid conditions, and genetic disorders [6]. 

Similarly, sexually transmitted infections (STIs) can also affect the reproductive organs and hinder your chances of conceiving - even the more innocuous ones such as herpes [8]. If you've been exposed to STIs in the past, do have a discussion with a fertility specialist to rule out any negative impact. 

The cost of seeing a fertility specialist often depends on the type of services needed, what tests are required, as well as the duration of treatment. As you’d expect, this can vary widely for different couples or individuals, and doing some price comparisons before committing can be helpful. 

We’ve included some indicative costs for fertility treatments in Singapore and the United Kingdom for your reference.

Of course you can call upon a fertility specialist for some expert help if you require it, but before you do so, you may wish to try some easy solutions that may help you conceive. 

For example, getting rid of unhealthy habits such as smoking and excessive alcohol consumption is often-touted advice for couples trying to get pregnant. The same goes for prioritizing healthy nutrition. Prenatal supplements such as folic acid for women and CoQ10 (coenzyme Q10) for men may help enhance your fertility outcomes, too.

Using a sperm guide (S$68, £43) may also be helpful. Made of 100% medical-grade silicone, we’ve designed our version to be comfortably worn in the body, increasing sperm retention and helping sperm reach the egg after procreative sex. 

Among the several things your fertility specialist will need to understand is your ovulation cycle, so having that information prepared beforehand will be helpful. 

You can use any number of ovulation apps or tracking calendars to get an idea of the duration and character of your cycle, noting down details such as your moods, stress levels and basal body temperature. 

While you’re at it, paying attention to your period such as pain and flow might also be useful. 

For a more in-depth understanding of your cycle, try ordering a Hormone Test (S$299.50, £186), which is professionally administered in the comfort of your own home. You’ll gain a clear and accurate picture of your fertility health which you can then bring to your fertility specialist.

Dealing with fertility issues can seem like a race against time, but simply going with the first fertility specialist you can find may give you a less-than-stellar experience. 

Your fertility journey is a personal and intimate one, so you’ll want to work with a fertility specialist that you can connect with, who listens to your needs and addresses your concerns. 

You certainly don’t want to be treated as just another patient to be dealt with and sent on your way, and neither do you want to keep paying for treatments that don’t work over and over again. Take some time to find the fertility specialist that is right for you. More importantly, don’t be afraid to make a switch if you’re not receiving the care, attention and priority you deserve. 

Hopefully, this article has helped increase your understanding of what fertility specialists do, how they can help with your fertility challenges, and when you should consider seeing one.

Getting the right fertility specialist into the picture may well give you what you need to get over the hump and on your way to a fulfilling, joyous pregnancy.