Infertility Specialist

Steven A. Brody, MD, PhD -  - Fertility Specialist

Infertility & Lifespan Medical Institute

Steven A. Brody, MD, PhD

Fertility Specialist & Reproductive Endocrinologist located in San Diego, CA

Women and couples who have trouble conceiving naturally may find the help they need with Dr. Steven Brody at the Infertility & Lifespan Medical Institute in San Diego, California. Dr. Brody offers a wide range of fertility treatments including artificial insemination. If you’ve been trying to become pregnant for more than a year, call or schedule an appointment online to talk to Dr. Brody in more detail about your concerns and fertility options.

Infertility Q & A

What is Infertility?

Infertility is the unable to get pregnant despite persistent trying. The medical definition of infertility is a failure to achieve pregnancy within a 12-month period following unprotected regular sexual intercourse. When we refer to the failure to achieve pregnancy were talking about a clinical pregnancy. A clinical pregnancy is not just positive pregnancy hormone. It requires the confirmation by ultrasound of an embryo, with or without a heartbeat, or the demonstration of a gestational sac, which is the fluid-filled encasement for the growing embryo.

It's important to note that infertility is not only associated with a problem in the woman; men can be the cause of a couple's infertility as well. In fact, in many cases, both the man and women have fertility issues. In my experience, about one-third of infertility cases are attributed to female infertility, whereas men's problems add up to another third of infertility cases. The remaining third are caused by a combination of male and female infertility or cannot be identified.

How Common Is Infertility?

Infertility affects 10 to 18% of all couples trying to conceive. In general, it can be said that about one out of every six couples will have trouble with achieving pregnancy, avoiding miscarriage, and experiencing the birth of a healthy baby. The fact that so many couples can experience this kind of problem underscores how important it is for both society and the family.

This represents over 6 million women. Let's not leave out the men; they have about an 8 to 11% chance of reduced fertility.

It is important to understand that after 1 year of having unprotected sex, 12 to 15% of otherwise “normal” fertile couples will still be unable to conceive. This observation underscores the fact that the classic definition of infertility is inadequate. How can the definition be one year of failure to conceive, when 15% of so-called normal fertile couples will still not be pregnant after this one year? At Infertility and Lifespan Medical Institute our goal is to elucidate all of the problems which may be unrecognized and yet contribute to the failure to conceive. Using state of the art methodologies we can get to the underlying issues that affect fertility and successfully treat them.

How Long Should a Woman Try to Conceive Before She Should See a Doctor?

If you and your partner are trying to conceive, every month without a positive sign can feel dreadful. However, you do not have to go running to your doctor just yet. Here is some information on when you should go see a fertility doctor:

If you are under the age of 35 and healthy, you can wait even for up to a year. It normally takes a couple up to 12 months to get pregnant. In my practice, I recommend that if a woman is over 35, she should not wait more than six months to proceed when the fertility evaluation.

You never have to wait for this evaluation to begin. However, often proceeding so quickly would not be necessary. The reason I don't recommend waiting for more than six months is that the infertility evaluation itself can take one month or sometimes two, and the basic treatments we apply can range from 1 to 4 months. Hence, time can be lost if you wait more than six months or so start the process.

If you are over 40, I recommend coming in for a fertility evaluation right away. After 40, the quality and quantity of a woman’s eggs drop. Therefore, not only the chances of conceiving are few, but the risk for miscarriage is greater.

What Causes Infertility?

A lot of people want to conceive a child at some point in their life. Understanding what defines fertility is vital to help a person know when they should be seeking help.

Failure to Ovulate Regularly

When a woman has regular menstrual periods, which is after every 21 to 35 days, she regularly ovulates. The ovulation of the egg happens 2 weeks before the next period starts. If a woman has her period cycles in more than 35 days, it shows that she is not ovulating. For a woman to be pregnant, she needs to ovulate.

Decreasing Egg Quality with Advancing Age

For many reasons unclear, the number of eggs a woman produces tends to reduce rapidly as she ages. Therefore, the couple should take a fertility evaluation if they have been trying to conceive for 6 months or more when the woman's age is 35 or older.

Endometriosis

Endometriosis is a painful disorder where tissue similar to the tissue that lines the insides of the uterus begins growing outside the uterus. Endometriosis involves your ovaries, fallopian tubes, and the tissue that lines the pelvis. The endometrial tissue may rarely spread beyond the pelvic organs.

With endometriosis, the endometrial-like tissue acts as it should, such as thickens, breaks down, and bleed with each menstrual cycle. But because this tissue has no other way to exit your body, it becomes trapped. The surrounding tissue becomes irritated, which develops scar tissue and adhesions, which are abnormal bands of fibrous tissue that cause the pelvic tissues and the organs to stick to each other.

Male Semen Abnormalities

Suppose a male partner has a history of infertility or an abnormality in his semen analysis. In that case, it is best to go for a fertility evaluation within 6 months of trying to conceive.

Blocked Tube and Pelvic Scar Tissues

STDs such as chlamydia or gonorrhea can cause inflammation and permanent scarring in the fallopian tubes. Open tubes are necessary for natural conception because the sperm has to travel through the tube to reach and fertilize the egg.

What is the Role of IVF?

Today, the word in vitro fertilization (IVF) has become very common. However, not so long ago, it was a procedure that produced “test tube babies.” Unlike the traditional process of artificial insemination where the sperm is placed in the uterus, and the conception occurs, IVF is a process where the eggs and the sperm are combined outside the body in a laboratory.  

As soon as the embryo or the embryos are formed, they are then placed in the uterus. IVF is a procedure that is complex and expensive. Only 5% of couples suffering from infertility opt for this procedure. However, since this procedure had been introduced in the US in 1981, IVF and other techniques have helped bring more than 200,000 babies to life.

IVF is never the first treatment given to treat infertility except for severe cases like a complete tubal blockage or extreme sperm dysfunction. Instead, IVF is used for cases where other methods like drugs, surgery, and artificial insemination have not worked.

Treatments for infertility include: hormonal methods to enhance ovulation, procedures to unblock fallopian tubes or eliminate scar tissue, laser treatments of endometriosis, and the use of techniques to enhance sperm function.

Why Choose Infertility and Lifespan Medical Institute?

At Infertility and Lifespan Medical Institute we can offer you personalized advanced treatments to overcome virtually any fertility problem. As the Medical Director of the Institute, I shall personally leave “no stone unturned” to elucidate the problem, provide compassionate care and help you succeed in building your family.

Our Institute is a national leader in IVF and reproductive medicine

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