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Visiting the Reproductive Endocrinologist

What to Expect the First Time You See the R.E.

By Lisa Hurt Kozarovich

Laparoscopy – In this procedure, a narrow fiber optic telescope is inserted through the woman's abdomen to evaluate the ovaries and look for signs of endometriosis.

By the time Michelle Alfon and her husband, Glenn, had their first appointment with a specialist, they had already undergone many of those initial tests – including a semen analysis, ultrasound, HSG, post-coital evaluation and six months worth of basal body temperature records.

That left only blood work to be performed during their first visit. After reviewing the blood work and prior fertility tests – none of which gave any explanation for the couple's infertility – their specialist prescribed the oral fertility pill Clomid and four sessions of artificial insemination (at $300 each). Following the failed attempts at artificial insemination, the Alfons' doctor is now recommending a laparoscopy.

According to Dr. Richard-Davis, about 30 to 40 percent of the time, infertility is caused by ovulation problems. About 40 percent of the time, it's due to sperm factors. In 10 to 15 percent of cases, infertility is caused by tubal abnormalities, and 10 percent of the time there is no explanation at all.

Depending on the diagnosis, either surgery to correct a problem or oral fertility drugs are the first attempts to help the couple achieve pregnancy. If that doesn't work, more powerful, injectable fertility drugs are sometimes tried, followed by artificial insemination and finally in vitro fertilization.

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