Infertility patients often start treatment with their obstetrician or gynecologist but move on to treatment by doctors with a specific interest in infertility. These doctors are usually, but not always, doctors with a background in OB/GYN (obstetrics and gynecology) and are board certified. OB/GYN doctors with a special interest in infertility apply for a two- or three-year fellowship in infertility at a teaching hospital.
Training
Doctors who have advanced training in infertility are called reproductive endocrinologists (REs). Most, but not all, doctors who work with assisted reproductive technology (ART) with in vitro fertilization (IVF) patients are reproductive endocrinologists. Their additional training gives them deeper knowledge of the causes and treatment of infertility. While gynecologists can prescribe medications and perform testing, they don't have the facilities or training to do advanced fertility treatments such as in vitro fertilization.
The Society for Reproductive Endocrinology and Infertility publishes a online pamphlet that outlines the different roles of obstetricians/gynecologists and REs, and explains how to determine when to see an RE.
Where Fertility Doctors Practice
REs and other fertility specialists practice in hospitals and private practices. Many work in group clinics, so that they don't have to be on call 24/7 for patients and emergencies. Many infertility clinics are open seven days a week and do procedures every day, including holidays. Some do procedures in the hospital; others use their own private facilities for testing and treatments such as in vitro fertilization.
Some fertility specialists do their own ultrasounds, but most large practices have sonographers that do them. Infertility doctors don't usually work in their laboratories analyzing sperm or working with embryos. Andrologists work in the sperm lab and embryologists, who may be doctors but could also be technicians, work with embryos.
Treatments Done by Infertility Specialists
Infertility doctors handle almost every aspect of infertility, including analyzing blood tests, performing diagnostic procedures such as semen analysis and hysterosalpingograms and prescribing medication to induce ovulation. They also
educate patients on different treatments, perform intrauterine insemination (IUIs)
and perform egg retrievals and embryo transfers.
Finding a Fertility Specialist
The Society for Reproductive Endocrinology and Infertility has a list of practitioners on its website. While websites such as these give the basic information on a doctor's background, they can't assess personality, office "feel" or staff competence. A personal recommendation from another doctor can be helpful but should be taken with a grain of salt since doctors often recommend other doctors because they work together at the same hospital. Visiting different doctors and checking them out personally, even if it involves seeing two or three before making a decision, is money well spent.
The CDC website also maintains a list of accredited clinics and their success rates, but keep in mind that different doctors may treat different types of fertility patients, and a clinic that takes only young patients may have much better statistics than one that specializes in women over 40 or "hard cases."
