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Houston Fertility Journal

    Can a Gynecologist Test for Infertility?

    September 12, 2018 / by Center of Reproductive Medicine   

    Center of Reproductive Medicine


    Can a gynecologist test for infertility? The answer might be more complex than you expect. That’s because infertility is a symptom, not a single diagnosis. So while your gynecologist might be perfectly qualified to test for, and even treat, certain types of infertility, your gynecologist doesn’t have the skills necessary to treat other forms of infertility. And because a person can have several different factors playing a role in infertility, even if they do have a type of infertility a gynecologist can treat, their doctor can easily miss other forms of infertility.

    Your gynecologist is a great ally in your quest for good health. They can offer an education in the art and science of baby-making, and provide you some preliminary tips that may increase your odds of success. But a gynecologist is not an infertility specialist. So asking a gynecologist to diagnose and treat your infertility may be a waste of your time and money, since experts offer faster and more effective treatment.

    Infertility is agonizing enough on its own. The last thing you need to add to your stress load is a bunch of infertility treatments that fail. Here’s what you need to know about a gynecologist vs. an infertility specialist, and how to make the decision.

    What Do Gynecologists Do?

    Gynecologists are experts in treating women’s health issues, especially reproductive and breast health issues. So it might seem natural to turn to a gynecologist for help with fertility issues. Here’s the problem: gynecologists are generalists, not specialists. If your gynecologist diagnosed you with cancer, they would refer you to an oncologist. The same is true of other complex conditions. Think of a gynecologist as a general practitioner for women’s health. Their job is to counsel you on health issues, diagnose and treat simple issues, and refer to specialists for complex health issues.

    Infertility is inherently complex. It involves multiple systems of the body, and may involve both the man and woman. So while your gynecologist can offer some preliminary information on fertility, they’re not an expert in the treatment of this difficult condition.

    Gynecologist vs. Infertility Specialist: Know the Difference


    A gynecologist has a general understanding of fertility issues. They can detect obvious problems, and even make some preliminary treatment recommendations. But they are not equipped to diagnose the many things that can go wrong with fertility. That takes a specialist.

    So what’s different about a specialist? Plenty. Some differences between infertility specialists and gynecologists include:

    • Training. Gynecologists focus generally on women’s health. Infertility specialists are focused specifically on fertility issues, so they have a much more specific and detailed understanding of the myriad factors that can play a role in infertility.
    • The ability to treat both men and women. When you see an infertility specialist, you’re seeking comprehensive treatment. That means issues in both the man and the woman can be identified and treated.
    • Knowledge of alternative medication uses. Some drugs can be used “off label” to treat infertility conditions. Infertility specialists are much more skilled at this off label use. They know how to make recommendations that are low risk, but that are also highly effective.
    • Specialized skill. Much of infertility medicine requires extensive practice. For example, while it’s easy to look up the dosing of fertility drugs, it requires both knowledge and experience to know the right dose for a specific person—or to know what the safest high dose is or how low the dose can be without losing effectiveness. Infertility specialists have much more flexibility in this regard. This means they’re better equipped to choose effective medications, and to adapt those prescriptions to your specific needs and goals.
    • The intuition that comes with experience. Infertility medicine is a science. It’s also an art that can’t be taught. It must be learned with time and experience. Infertility specialists have spent years working with people just like you. Their intuition is sharper because of that experience, and this may mean better results.
    • Involvement in the field. As specialists, infertility doctors not only practice medicine. They may also be involved in research and teaching. This offers them unique insights into infertility, especially for complex or challenging cases.
    • Knowledge of recent research. Infertility medicine is a relatively new field. Two generations ago, no one had even heard of in vitro fertilization (IVF). Today, it’s one of the most successful options for couples pursuing infertility treatment. Infertility medicine changes rapidly. So to have the best chances of a successful and healthy pregnancy, you need someone who’s up to date on recent research. Your gynecologist may only know what they learned in medical school, two or more decades ago. At best, they might have read a few journal articles on the topic. Your infertility specialist, by contrast, may have written the journal articles your gynecologist read.
    • Awareness of alternative treatments. Many couples seek treatment for infertility with specific fears about specific treatments. They worry about hormones, want to avoid IVF, or have religious objections to using donor sperm or eggs. Infertility specialists are skilled at working with people from a variety of backgrounds. They can often offer an alternative based on your values and treatment goals. Gynecologists tend to lean heavily on just one or two treatment options.
    • Comprehensive testing. If you seek treatment for infertility with a gynecologist, the first line of treatment is often Clomid, a hormone that can induce ovulation. This can work great—if, and only if, you aren’t ovulating, your partner has no fertility issues, and you’re a good candidate for Clomid. Otherwise, it may do nothing at all—or even make you sick. An infertility specialist offers comprehensive testing. After all, to aggressively and effectively treat infertility, you need a diagnosis.
    • Knowledge of lifestyle factors. The sad truth is that no single vitamin, supplement, or nutritional regimen will get you pregnant, especially if you have a serious medical condition. But there’s a lot you can do to improve your fertility, especially once you know your diagnosis. A fertility specialist can make customized recommendations based on the latest research.
    • Connection to community resources. Infertility is more than just a medical problem. It can fundamentally affect your sense of self, trigger marriage problems, and be the source of ongoing family drama. Infertility specialists know this. They’ve seen hundreds, or even thousands, of people just like you. They understand the challenges you face, and can help you talk about them. They can also connect you to community resources—including support groups and therapists—that can make the journey easier.
    • Coverage for treatment. Many insurance plans won’t cover infertility treatment. But many cases of infertility are caused by diagnosable medical conditions that affect far more than just fertility. An infertility specialist knows how to diagnose and treat these conditions—and how to bill insurance in a way that ensures you get the benefits you are entitled to. With a gynecologist, your treatment may be billed as infertility treatment, lowering the chances of payment by your insurer.

    Male Factor Infertility: Why We Still Blame Women for Fertility Issues

    Pick up any old text—the Bible, the Quran, a book of ancient myths—and you’ll soon see a recurring theme: women are blamed for infertility. Our ancestors thought infertility was the woman's fault—a punishment for bad choices, or merely the result of bad luck. In either scenario, the man had nothing whatsoever to do with the issue. That’s because we had little understanding of how human bodies work.

    We now know that it takes two to make a baby, and that if either body isn’t functioning optimally, infertility is the result. In 20% of infertile couples, the man is the one with the issue. In an additional 30-40% of cases, both the man and woman have a fertility issue. That means that 50-60% of infertility cases involve a problem with the male.

    Therein lies the problem. Gynecologists specialize in treating women’s health issues. They don’t typically treat mean, and they’re certainly not experts in male fertility. Yet the pervasive myth that infertility is usually the woman’s “fault” causes many couples to seek treatment from a gynecologist. The end result is an incomplete treatment strategy that can needlessly delay pregnancy.

    Worse still, if a gynecologist finds nothing wrong with the woman, this can create a false sense of security. The couple will continue trying, thinking nothing is wrong, when the problem may be with the man.

    Some couples opt for the woman to see a gynecologist while the man sees a urologist. This, too, is fraught with issues. That’s because neither doctor is experts in both male and female infertility. So even if the two doctors communicate—unlikely, unless they’re in the same office—they may not put together a comprehensive treatment strategy that’s supported by scientific research.

    What Can a Gynecologist Do to Help?


    The fact that only an infertility specialist can treat infertility doesn’t mean your gynecologist is useless. In fact, your gynecologist is a valuable part of your treatment team. A gynecologist can:

    • Educate you about the basics of fertility and baby-making when you first begin trying to have a baby. Don’t shy away from asking advice. You may be surprised by what you don’t know.
    • Let you know if you have any risk factors for infertility.
    • Support your quest for continued good health as you pursue treatment for infertility.
    • Offer a referral to an infertility specialist.
    • Offer preliminary testing. For instance, a gynecologist can tell you if you are ovulating.
    • Refer the man to a urologist who can do a semen analysis.

    So lean on your gynecologist, but don’t count on them to treat any serious underlying fertility issues.

    When to Talk to a Gynecologist About Fertility Issues

    The time to talk to a gynecologist about your fertility is before you have an obvious fertility issue. When you begin trying to have a baby, try asking your gynecologist some of the following questions:

    • Do I have any risk factors for infertility?
    • Should I consider charting my cycles to better time intercourse? How do I do that?
    • Can you recommend any fertility strategies that are especially helpful?
    • What fertility books do you recommend?
    • Are there any lifestyle changes I can make that might improve my fertility?

    Consider also taking your partner to a gynecologist appointment. It gets you in the habit of working together with a doctor—something you’ll spend a lot of time doing if you pursue infertility treatment, and something that’s an absolute must when you get pregnant. Pregnancy requires a team effort, so get in the team spirit with your gynecologist now.

    When to See an Infertility Specialist


    Let’s face it: infertility is painful. The drive to procreate is one of the most powerful human drives, so the inability to have a baby strikes at the very core of who we are as human beings. No wonder so many marriages buckle under the stress of infertility.

    No one wants to admit that they’re infertile. That’s why some couples try for years before seeking help, and why others never seek help at all. In some cases, couples mistakenly believe that IVF is the only option, or that infertility treatment doesn’t work. None of this is true. Infertility treatment works. Especially when you seek treatment from a skillful infertility specialist.

    Sadly, fertility is attached to a ticking clock. Both men and women see declines in fertility as they age, though the decline in women is more precipitous. This means that if you have a fertility issue and don’t seek treatment, each month you spend trying is a month of wasted time. Please seek treatment now.

    For most couples, it’s time to seek treatment after a year of trying with no pregnancy. If either you or your partner have a known fertility issue, seek treatment right away—even before you begin trying. If you have a chronic illness, the woman is over the age of 35, or the woman has a history of irregular periods, seek help after six months of trying with no results.

    The Center of Reproductive Medicine with 5 locations in and around Houston, is here to support you on your journey from infertility to parenthood. Parenthood is possible. You don’t have to walk this path alone. Let us show you the way forward.

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    Topics: Health, Fertility Specialist, Signs of Infertility

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