What is the Role of Fertility Specialist in treating infertility?

Are you someone who has been trying to conceive for over a year without success? Have you visited the right doctor to help you conceive? If not then this blog is for you. Here we will be talking about fertility specialists and how they with their team take care of infertility and help couples and individuals conceive successfully. 

Who is a fertility specialist?

Fertility specialists are often gynaecologists or urologists who have received additional training to deal with reproductive organ disorders. Your doctor may recommend you to a fertility expert for a variety of reasons, including:

• Difficulties conceiving for more than six months if you are 35 or older, or more than a year if you are younger
• Having experienced two or more miscarriages
• Beginning to try to conceive with known infertility risk factors or symptoms, such as irregular cycles, genetic disorders, or prior sexually transmitted diseases (even if cured)
• The desire for permanent birth control methods such as tubal ligation or vasectomy
• People with cancer who need advice on how to retain fertility prior to treatment or who are ready to conceive after treatment

Types of fertility specialists and their roles

Fertility specialists include a wide range of medical professionals. The most beneficial choice for you will be determined by your medical history and needs.

• Reproductive Endocrinologists: A reproductive endocrinologist is a gynaecologist who has additional training in infertility and fertility treatment; they handle both male and female fertility disorders. Most people associate fertility specialists with reproductive endocrinologists (or REs). 
• Andrologists: Andrologists are urologists who have completed additional training in male fertility. Andrologists can evaluate and treat male fertility difficulties alone or in collaboration with a reproductive endocrinologist. They may investigate further to determine the source of low or nonexistent sperm counts and, if possible, cure the condition so that the couple can conceive without IVF.
• Reproductive Surgeons: A reproductive surgeon is yet another type of fertility specialist. While reproductive endocrinologists also perform surgery, reproductive surgeons have additional surgical expertise and may treat patients for reasons other than infertility.  Reproductive surgeons, for example, can remove fibroids or treat endometriosis surgically.
• Reproductive Immunologists: Reproductive immunologists combine their expertise in immunology and reproductive medicine. In cases of recurrent miscarriage, unexplained infertility, or unexplained recurrent IVF failure, a reproductive immunologist may be consulted.

What is the difference between an OB-GYN and infertility specialist?

1. Specialisation
   • OB-GYN: Obstetricians deliver infants and care for pregnant women and a gynaecologist is an expert in the female reproductive system who does not treat pregnant patients or assist in childbirth. They specialise in women’s healthcare. 
   • Fertility Specialist: An OB-GYN with knowledge of infertility and reproductive endocrinology is a fertility specialist. They cover areas such as fertility preservation, treatments for infertility, hereditary illnesses that could influence future offspring, and uterine issues.
2. Focus
   • OB-GYN: They assist expectant mothers during their pregnancies, and the immediate postpartum period. They also diagnose, treat, and prevent medical disorders that impact women.
   • Fertility Specialist: Their primary purpose is to support couples and occasionally individuals who want to start families but are unable to do so naturally, due to medical reasons.
3. Diagnosis
   • OB-GYN: The diagnosis done by an OB-GYN will include speculum examinations, sonography (ultrasound), colposcopy, cervical biopsy and endocervical curettage, loop electrosurgical excision procedures, vulvar biopsy, endometrial biopsy, hysteroscopy, and hysterosalpingography (HSG).
   • Fertility Specialist: Following a review of your medical background, fertility specialists will describe the fertility tests you (and your partner, if applicable) will need to undergo. These will comprise physical exams, blood tests, semen analysis, ovulation testing, hysterosalpingography, ovarian reserve testing, other hormone testing and imaging tests.
4. Treatment and services offered
   • OB-GYN: In addition to pelvic examinations, Pap tests, cancer screenings, and diagnosis and treatment for vaginal infections, gynaecologists also provide reproductive and sexual health services. They identify and handle conditions affecting the reproductive system that includes endometriosis, infertility, ovarian cysts, and pelvic pain.
   • Fertility Specialist: Treatments and services offered by them include ovulation cycle tracking, ovulation induction, artificial insemination (IUI), In vitro fertilisation (IVF), Intracytoplasmic sperm injection (ICSI) treatment, time-lapse imaging, Preimplantation genetic diagnosis (PGD), fertility surgery, fertility preservation, assisted reproductive treatments such as egg, sperm or embryo donation and fertility treatment for same sex couples.
5. Fertility Care
   • OB-GYN: Regular check-ups and guidance on your reproductive health can be obtained from your OB-GYN. Your OB-GYN is a great resource for basic reproductive treatment and can offer guidance on preconception wellness and the right time to have intercourse, in order to get pregnant. 
   • Fertility Specialist: Fertility specialists provide advanced reproductive treatments for people suffering from infertility. They are the gateway to conceiving a baby for couples or individuals who had given up hope of ever holding their child in their arms. Along with medical treatments, they also provide mental support to their patients to help them stay hopeful and strong throughout the process.

How to book your consultation with a fertility specialist? 

Step 1- Call on the number provided in the website of your fertility clinic of choice

Step 2- Share in details, the trouble you are facing in your pregnancy journey to the consultant taking your call.

Step 3- Note down the date and time provided to you by the consultant to visit the fertility specialist.

Step 4- Go visit the fertility specialist for a thorough diagnosis and treatment

Role of embryologist

Who is an embryologist?

Embryologists are highly trained medical experts who develop healthy embryos for use in in vitro fertilisation (IVF) transfers or freezing for later use. They are in charge of managing genetic materials (sperm and eggs) as they develop into embryos. They also ensure that the embryology laboratory is an appropriate environment for embryo growth and storage.

What are the functions of an embryologist?

An embryologist is not a doctor, yet he or she is skilled in the following procedures: 

1. Egg Recovery: When ovarian follicles have matured, they are extracted using a needle. A doctor extracts the follicular fluid, which contains the eggs for the ovaries. The embryologist next separates the eggs from the fluid and prepares them for the next step of treatment.
2. Development of Embryos: The embryologist then combines sperm and egg to form an embryo. In the event of specialised methods such as ICSI, the embryologist inserts a single sperm into the egg using micromanipulation. This is done in extreme cases of male infertility.
3. Transfer of Embryos: In about 5 days, the embryo reaches the many cell stage. 1-2 embryos may be transplanted to the woman’s uterus at this time. The embryologist chooses the embryo and places it in a catheter for the doctor to implant it in the uterus.
4. Freezing of Embryos: To preserve healthy embryos, embryologists employ a technique called cryopreservation. This procedure prevents ice crystals from damaging the embryo and halts biological activity in the embryo until it is thawed at a later time. 

Embryologists also do embryo biopsies and genetic tests like PGD and PGS.

Fertility treatments available

Fertility specialists will suggest one of these three methods of conception based on your condition

• Natural pregnancy
• IUI
• IVF

1. Natural Pregnancy: Your fertility expert will suggest you to naturally conceive by performing intercourse 11-18 days after your periods. It is the time of ovulation when a woman’s fertile window is wide open. You may be given some ovulation inducing medicines or some medications for your hormones to better your chances at getting pregnant. 
2. IUI: Intrauterine insemination (IUI) is a simple treatment that places sperm directly within your uterus during ovulation, allowing healthy sperm to reach closer to your egg. It is a fertility treatment that improves the chances of sperm fertilizing an egg. 
3. IVF: In vitro fertilization (IVF) is the process of extracting eggs from ovaries and manually mixing them with sperm in a laboratory for fertilization. The fertilized egg (now called an embryo) is implanted inside a uterus several days after fertilization. When this embryo inserts itself into the uterine wall, pregnancy takes place. IVF can be of three types 
   • Intracytoplasmic sperm injection (ICSI): For men with infertility, ICSI is a suggested treatment option. In this treatment, the sperm is directly inserted into the egg. A surgical sperm extraction may be required for some men. It is possible to receive treatment using either one’s own sperm or a donor’s.
   • Oocyte Donation (OD): The female partner can bear and give birth to a child using her husband’s genetic material thanks to oocyte donation. The donor’s age, who should ideally be under 35, is the key factor that affects the success of oocyte donation.
   • Embryo donation (ED): Donating embryos is a type of third-party donation. The embryos are produced during the donation process utilising a donor egg and sperm. An embryo is produced with IVF techniques using donor sperm and donor eggs.

Importance of counselling while availing fertility treatments

What is fertility counselling?

Infertility counselling is a type of psychotherapy that is meant to help people or couples who are experiencing fertility issues. If you are having difficulty conceiving a child, considering utilizing a sperm or egg donor, or exploring adoption or surrogacy, you might consult with an infertility counsellor.

What is the role of a counsellor

1. IVF Treatment Counseling provides a non-judgmental platform for patients to be more clear about their options and discover what works best for them.
2. It makes it easier for them to decide whether or not to continue with the treatment.
3. It provides them with an advanced approach to their confusions and queries, providing therapeutic support to handle the issue maturely.
4. Acceptance, loss, mourning, future planning, and interpersonal issues are addressed, and ethics are included into rational thinking.

How to choose a good fertility clinic

• The clinic should be known for providing fertility care beyond treatment
• The clinic should have the highest success rates
• The clinic should have expert and experienced IVF doctors
• The clinic must be using the most cutting-edge fertility technologies 
• Their treatment should be available at affordable prices
• The clinic should provide post-treatment support, counselling, and follow-up care