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Who's Who in the Infertility World?

An Infertility Starting Lineup

By Neilia Sherman

Talking to a family doctor makes a lot of sense; he or she is trained to be a screener who sends patients on to the right specialist. Dr. Jeff Bernholtz, who practices in Richmond Hill, Ont., sees himself as a "gatekeeper."

"I want to make sure that the patient is sent to the right door to help him or her solve their problem," he says. "The role of family practice is to make sure that there are no other easily correctable causes of infertility."

According to Dr. Bernholtz, the family medicine approach involves reviewing the patient's history, doing a physical exam and performing baseline investigations. He looks at how long the patient has been trying to get pregnant, as well as medical history, menstrual abnormalities, history of infections (especially STDs), dietary history and mental health.

Family dynamics can also be very important. In some cases, Dr. Bernholtz says, there is "one family member pushing the other into these investigations – unwillingly. Sometimes it's the spouse and sometimes it's a mother-in-law who wants a grandchild, now! This additional stress may be the cause of the infertility and must be considered in any future therapy."

If there are no medical problems found, Dr. Bernholtz will encourage the couple to keep trying for another three to six months. During this time, the male will give a semen sample for analysis of sperm and infection. He will then instruct the couple about the timing of sexual activity.

If conception still doesn't occur, Dr. Bernholtz willinitiate a referral to an infertility specialist. Depending on his findings, he might also refer to a gynecologist, a urologist, an endocrinologist and/or a psychiatrist.

Want to see more?

• The Infertility Marketplace: What to Ask a Health Care Provider
• Trouble Conceiving? Get the Right Medical Care!
• Preconception Visits: Working with Your Doctor
• Check out our Article Library.
• Talk about it!