The Mommyish Definitive Guide To Infertility: The Basics, As Explained By Your Best Friend

mad woman with pregnancy testInfertility can be emotionally charged topic filled with medical jargon and unfamiliar terms. Maybe you’re having difficulty trying to conceive. Maybe you’re looking for more information to support a friend or family member who is dealing with infertility or maybe you’re just curious. Either way, I’ve been there, so here’s a simple guide to help you understand how infertility is diagnosed, along with some of the dirty details I wish I had known beforehand.

 What is infertilty?

Just the facts:

Barring exception circumstances, if you are trying to get pregnant but haven’t, most OB/GYNs won’t meet with you about getting pregnant until you are considered infertile. For a woman under age 35, infertility is generally defined as the inability to become pregnant after 12 months of trying. For woman over 35, trying for six months without becoming pregnant is the typical standard before you can meet with a doctor. Just because you are classified as infertile doesn’t mean you can’t or won’t have a baby. The majority of couples with infertility issues are able to get pregnant with the help of medications or procedures.

The real deal:

I happened to fall into the “exceptional circumstances” category, as when I went off birth control, I never got my period. At first, I thought my husband had super sperm and I had gotten knocked up Jill Duggar style, but when multiple pee sticks said I wasn’t pregnant, my OB wanted to see me right away.

Even though it can be so frustrating to try with no results, the general rule of trying on your own seems to pan out. On average, it can take a year for a couple to get pregnant. I have girlfriends that popped up pregnant the first month they tried, and others who had their appointments with the OB to discuss infertility already scheduled when they found out they were expecting. So if you’re only a few months in, don’t be discouraged, it doesn’t mean something is wrong, sometimes it really does just take time.

How are infertility issues diagnosed?

Just the facts:

Your doctor may perform a physical exam. This exam could include the use of an intervaginal ultrasound. It is likely that the doctor will want blood tests for both partners and possibly a sperm sample from your partner.

The real deal:

In any movie or TV show that features a pregnant lady, there’s always the scene where they are in the doctor’s office, and they put the goo on her belly and they show the baby as a little gummi bear-looking blog on screen, even if she just found out she’s pregnant. Let me tell you, that scene is a dirty, dirty LIE.

When my doctor said they wanted to do an ultrasound to try and troubleshoot my fertility issues, my biggest concern was whether or not he would think my stomach was too hairy. When he pulled out what looked like a giant sex toy and covered it in a lubricated extra large condom I realized I had much bigger things to worry about (pun intended). And, they use that Wand of Doom for a while even after you get pregnant, because the baby needs to be pretty big before it will show up using the belly ultrasound. Consider yourself warned.

Also, tip for the fellas- if you have to provide a sperm sample, consider bringing along your own porn. From my understanding, the pickings provided can be pretty slim, plus, do you really want to touch that? No, no you don’t.

What happens next?

Just the facts:

Depending on the results of the tests, your OB/GYN may refer you to a reproductive endocrinologist, also known as an RE, for further treatment. RE’s are doctors who have highly specialized training and knowledge about fertility. The RE will discuss your test results with you, may order further testing, and will discuss your options.

The real deal:

You wait for the test results and try to stay calm. You will also turn to Dr. Google, which will serve no purpose other than to scare you. I spent the time waiting for my test results by eating tons of brownies, avoiding pregnant friends and spending a small fortune by taking pregnancy tests almost every day, because I was in denial that something could be wrong. In other words, I was a joy to be around.

A word about your first RE appointment. Because their training is so specialized, most RE’s are very busy and are often located in major cities. If you live in a more rural area, expect some travel time to get to an RE near you. And no matter where you live, there could be a substantial wait time before the RE has an opening. I tell this to prepare you, because when I found out it was a two month wait to see the RE I burst into tears on the receptionist, and it was very, very awkward.

What are the treatment options?

Just the facts:

Depending on the results of the test, treatment options range from non invasive, like medication, to highly invasive, like in vitro fertilization, or IVF.

The real deal:

What happens next depends on a lot of things- what your condition is, what your insurance will cover, how much you can afford or want to spend, and how comfortable you are with using science to help you get pregnant. Two very common diagnoses for women with fertility issues are polycystic ovary syndrome, or PCOS and irregular ovulation. While it sucks to have any fertility issues, the good news is both of these conditions are typically treated with medication. If the medication is unsuccessful, after a few months, your doctor may discuss trying a medical procedure to get pregnant.

How much will all this cost?

Just the facts:

Coverage for fertility treatments vary. Contact your insurance provider for more details.

The real deal:

Unfortunately, there is no way to know for sure. Insurance companies vary greatly in coverage. The spotty coverage for fertility treatments is part of the reason why most doctors will require patients to try for a pregnancy without medical intervention for a year before seeking treatment, and why most couples start out taking medication before moving on to medical procedures, because many insurance companies will only provide coverage for invasive procedures after any lesser treatment has been tried and failed. Even if your insurance company will cover some of your fertility treatments, they may not cover all of it. The silver lining is that most doctor’s offices will take credit cards, and depending on how expensive your treatments are, you can rack up a lot of rewards points towards your future babymoon.

Coming next week: Fertility Medications And Intrauterine Insemination, As Explained By Your Best Friend

(Image: Shutterstock.com)

 

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