Getting Started

Evaluation

The evaluation at Dr. Scott Roseff's Office is your first, critical step in determining the cause(s) of and therefore the appropriate treatment(s) for your infertility.  This step can be completed under the care of a gynecologist (Gyn) or a reproductive endocrinologist (RE).  The Gyn is trained in the basics of infertility and may be a good starting point for women under the age of 35 or in patients without anything in their history that may be contributing to a fertility problem.  For example, if a woman has a history of pelvic inflammatory disease (PID), is over the age of 34, has been trying to conceive for more than 2 years, or has irregular menstrual cycles, these issues may cause reproductive problems that might be better treated by an “advanced” infertility specialist.  Since the RE undergoes several extra years of intensive training in infertility, the RE may thus be better equipped to diagnose and treat more complex fertility problems.

As part of the evaluation, prior medical records (if any) will be reviewed by Dr. Roseff in advance of the first consultation.  At the initial consultation, the patient will undergo a complete history and physical examination.  After this, the doctor will either outline a treatment plan based on his findings at the first visit, or more commonly he will suggest the patient or couple undergo fertility testing.

When to Make an Appointment

Infertility is generally defined as the inability to achieve a successful pregnancy after trying for one year.  This may include not having become pregnant or may include women who became pregnant but have not been able to maintain the pregnancy (miscarried).

If a woman or couple has known factors in their history suggesting they may have fertility problems right from the onset (such as in a man with previous trauma to his testes or a woman who underwent prior pelvic surgery), it may be best to be seen immediately and not wait so as to avoid suffering through potential frustration.  Also, as previously mentioned, if a woman is over 34 and has failed to conceive after six months of trying, she should consider being seen sooner rather than later due to the age-related decline in pregnancy success seen in this age group of women.

Many specialists believe that everyone should have at least an initial consultation with a fertility specialist before they trying to conceive so they can undergo “preconception counseling” first.  This can possibly increase the odds of pregnancy success and lower the odds of complications because the doctor can screen for potential problems before the woman conceives.  He/she can also counsel the patient about proper nutrition, exercise, smoking/alcohol cessation, etc. that may optimize success.  Proper folic acid intake before conception lowers the odds of certain types of birth defects, and this can be assured during the preconception counseling visit, too.  Finally, screening can be done to decrease the risk of transmitting certain types of diseases to one’s offspring (such as Sickle Cell Disease, Cystic Fibrosis, and Tay-Sachs).

Back To Top