Since opening our doors in 1976, our goal at Austin Women’s Health Center has been to build a practice that offers Central Texan’s compassionate and comprehensive women’s health care at every stage of life. At different times in their lives, our patients need care to prevent a pregnancy, terminate an existing pregnancy, or start and maintain a healthy pregnancy.
Luckily, we have all your needs covered here at the clinic. We recently added the wonderful and capable Dr. Jessica Rubino to our practice who provides comprehensive sexual and reproductive health care and believes every patient across the gender spectrum deserves that comprehensive care. A lot has changed in the fields of fertility treatments and testing in the 40 years we’ve been in practice. But we’re proud to say we’ve kept up with the times and our staff is here to help you navigate your options.
In this article, we explore the most commonly used resources available at our office. If you’re trying to get pregnant and facing some difficulties, our staff is here to offer guidance, information, and support!
When You’re Ready
We recommend talking to your practitioner as soon as you start thinking about starting a pregnancy to discuss what you can do to ensure the best chances of getting pregnant and having a healthy pregnancy. Our providers can discuss the best way to stop your birth control method (like getting off the pill or IUD removal), order preconception lab work, and review your cycle timing so you have the best chance of getting pregnant. Make an appointment with our staff for a preconception consultation and preconception services like genetic testing, lab work, and IUD removal.
Trying To Get Pregnant
There are numerous factors that contribute to getting pregnant, and success can often take time. We understand that trying and waiting is hard, especially when you’re ready and excited to become a parent. The general recommendation is to try for 12 months if you’re younger than 35, and six months if you’re 35 or older. If after a year you still aren’t pregnant, you may need to see our physician for further testing. Our doctors can order and interpret fertility tests to better understand hormone levels, ovulation cycle, and sperm count. We also offer treatments like ovarian stimulation and monitoring, as well as intrauterine insemination.
What Causes Infertility?
Our bodies are complex and dynamic systems that sometimes require patience when trying to become pregnant. The Mayo Clinic says an estimated 10-18% of couples have difficulty getting pregnant or having a successful delivery.
In order to conceive, you need to be ovulating, have open fallopian tubes and a healthy uterus, have regular intercourse, and your partner needs sperm. A lot can happen to interrupt any of those factors. Here are the most common causes of infertility.
There are a number of common disorders that can interrupt ovulation, meaning you ovulate infrequently or not at all. These include Polycystic Ovary Syndrome (PCOS), hypothalamic dysfunction, premature ovarian failure, or too much prolactin. Read more about what these disorders are here.
Fallopian Tube and Uterus Damage
Damaged fallopian tubes can either be blocking the sperm from getting to the egg or block the fertilized egg from entering the uterus. Damaged fallopian tubes can be caused by a pelvic inflammatory disease. Or an infection of the uterus and fallopian tubes due to chlamydia, gonorrhea, or other sexually transmitted infections. It can also be caused by damage from previous surgery or pelvic tuberculosis.
A condition called Endometriosis is another known cause of infertility. It occurs when tissue normally in the uterus implants and grows in other locations. This extra tissue growth — and the surgical removal of it — can cause scarring, which may block fallopian tubes and keep an egg and sperm from uniting.
Uterine and Cervical Defects
Uterine and cervical defects can also impact your chances of getting pregnant, such as uterine abnormalities present from birth like an abnormally shaped uterus. Mayo Clinic says cervical stenosis, a narrowing of the cervix, can be caused by an inherited malformation or damage to the cervix. Also, sometimes the cervix can’t produce the best type of mucus to allow the sperm to travel through the cervix into the uterus. Treatments for these conditions are covered in the following section.
Causes of Male Infertility
If you’re having difficulty getting pregnant with a male partner or donor, we suggest both partners seek a consult to explore their fertility. Some of the common causes of infertility in males include:
- Abnormal sperm production or function. This is often referred to casually as “low sperm count” and can be caused by undescended testicles, genetic defects, diseases such as diabetes, or infections such as chlamydia, gonorrhea, mumps or HIV. Enlarged veins in the testes (varicocele) can also affect the quality of sperm.
- Inability to deliver the sperm. Several issues can block the sperm from being delivered to the egg, including premature ejaculation; certain genetic diseases, such as cystic fibrosis; structural problems, such as a blockage in the testicle; or damage or injury to the reproductive organs.
- Environmental factors. Overexposure to certain environmental factors can impact the production and quality of one’s sperm, such as pesticides and other chemicals. Cancer treatments like radiation and chemotherapy can also cause damage. Cigarette smoking, alcohol, marijuana or taking certain medications, such as select antibiotics, antihypertensives, anabolic steroids or others can also affect fertility. Frequent exposure to heat, such as in saunas or hot tubs, can raise the core body temperature and may affect sperm production. Testing and treatments for these causes are also covered in the below section.
Types of Fertility Treatments/IUI
Reproductive Endo is a field of gynecology specializing in diagnosing and treating fertility challenges. Reproductive Endocrinologists use tests like Semen Analysis and Ovarian Reserve Testing to understand the underlying causes of infertility. They also perform procedures like Hysteroscopy, Laparoscopy, and Intrauterine Insemination to help treat fertility challenges. Semen Analysis examines the quantity and condition of sperm present in a sample. The test is used to diagnose and understand the underlying cause of infertility. Semen analysis can also be used to aid other fertility treatments, like ovarian stimulation and intrauterine insemination.
Hysteroscopy is a procedure where the uterus is viewed by inserting a small device (hysteroscope) through the vagina and cervix. It is commonly used in the treatment of a gynecological disorder and is especially helpful in both the diagnosis and treatment of many infertility challenges.
Laparoscopy is a surgical procedure used to view the uterus by inserting a small instrument through the abdominal wall. Like hysteroscopy, laparoscopy is utilized to both pinpoint the cause of infertility and as part of treatment protocols.
Ovarian Stimulation and Monitoring is a fertility treatment that uses medications to boost the process of egg maturation and release. The medications are usually taken either orally or as an injection. A doctor then monitors hormone levels through the fertility cycle to determine the best course of action for treatment. Ovarian stimulation itself is often an effective infertility treatment, but can also be used with IUI to increase the chances of fertilization.
Intrauterine Insemination (IUI) is a procedure used to increase the chance of egg fertilization by inserting semen directly into the uterus. First, the semen is analyzed and prepared to increase the chance of success. Next, the sperm is inserted deep into the uterus. IUI can be done alone or in conjunction with ovarian stimulation.
The test and procedures we discussed above are just a few of the tools available for treating and overcoming infertility. If you would like to learn more, RESOLVE is a great place to start.
If you have fertility questions, schedule an appointment to speak with one of our practitioners. We offer fertility treatments at Brookside Woman’s Medical Center our sister practice in Suite B which offers full spectrum gynecological care!
We’re always happy to offer our recommendations based on your specific medical history and time frame. If you have been putting your fertility questions aside, do not hesitate to schedule some time to contact us about your concerns.