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Many couples wonder when it is appropriate to consult a fertility specialist. The American Society for Reproductive Medicine defines infertility as the inability to become pregnant after one year of regular intercourse. Because female fertility is directly affected by age, the definition is often shortened to six months in women aged over 35.
Many women first consult their OB/GYN with fertility issues, which may be appropriate for younger women. The OB/GYN may prescribe first level medications, such as Clomid , to establish regular ovulation. Women aged 35 and over should not delay consulting a trained fertility specialist as fertility can decline very rapidly in this age group.
Unfortunately, virtually any physician can promote his/her self as a fertility specialist regardless of training, so it is definitely “buyer beware”. The Yellow Pages often feature large ads for fertility specialists that are actually OB/GYNs who offer therapies such as stimulated (use of fertility drugs) intrauterine insemination (IUI). Unfortunately, many patients exhaust all of their treatment funds on repeat IUIs that have very little chance of success. Most fertility specialists will move to other therapies, such as IVF, if three cycles of IUI fail. This treatment decision depends on many "couple specific" factors.
Fertility specialist training is similar to any other physician specialty such as cardiology, oncology, or orthopedics. Consulting an OB/GYN for advanced fertility diagnosis and treatment is like contacting a general practitioner to treat cancer or a heart attack. Obviously, you want the most qualified, and best trained, physician which will increase the chances of a successful outcome.
After achieving their medical degree, fertility specialists must complete a residency in obstetrics and gynecology. Most fertility specialists focus on infertility and do not deliver babies.
Once the OB residency is completed, and OB Board Certification achieved, the fertility specialist must complete an advanced two year (or more) Fellowship program in Reproductive Endocrinology and Infertility at an approved educational institution. The Fellowship includes advanced training in the diagnosis and treatment of infertility, how to prescribe fertility drugs and manage in vitro fertilization cycles, advanced training in delicate microsurgical techniques, and many other areas. The Fellow also completes original research while in training.
Advanced training in the management of FSH stimulated cycles for IUI and IVF is critical. Many of the stories of multiple births, sextuplets and above, are a result of stimulated cycles managed by non fertility specialists. Specialists closely monitor stimulation cycles to reduce the risk of high order multiple births. Also, fertility drugs must be carefully monitored to avoid potential serious side effects.
After completion of the Fellowship training requirements, the candidate must pass written and oral examinations to achieve board certification in reproductive endocrinology and infertility. This testing assures that only the most qualified fertility specialists are designated as “board certified”.
Dov B. Goldstein M.D., Reproductive Endocrinologist, Infertility Specialist, has over 26 years of experience in the diagnosis and treatment of infertility and there have been over 950 babies born as a result of his helping infertile couples conceive. He is highly trained in the management of IVF and donor egg cycles and is an expert in laser microsurgical treatment techniques. He also opened one of the first New York fertility clinics.
In addition to his fertility treatment expertise, Dr. Goldstein is focused on offering his services in a highly compassionate, comfortable, and individualized setting. He personally examines each patient at every office visit and feels that each patient deserve this level of individualized care. Dr. Goldstein is committed to offering the services most likely to result in pregnancy while considering other factors such as cost and emotional strain. |
