The general timeline given for going to see a doctor when you are trying for a baby is at least after a year of trying, except in cases where the woman is older than 35 years, and also in instances where the couple already knows they have issues.
With that answer out of the way, the next question is, should I see a regular gynaecologist or a fertility expert? To this question, there are no hard and fast rules. It really depends on the couple and how aggressive they want to be about their treatment. Also, the environment of the couple determines what level of treatment would be immediately available to them.
For instance, a couple who lives in the western world is more than likely to start their TTC journey with a general practice doctor, who would treat before transferring them to a specialist, in this case, a gynaecologist, and if there is a need for even more specialist treatment like an urologist, this would take another referral, not to mention months of waiting.
In fact, even to get a scan done requires you getting on a waiting list, which is so unlike what we have here in Nigeria, where you can simply walk into to a diagnostic centre and get scanned, however many times you like, as long as you can afford it.
Even with the carte blanche approach here, it is still wise to adopt a cautious approach when dealing with hospital runs for fertility issues. Why, you may ask? I have noticed that fertility doctors tend to skip basic treatments and just want to go straight to the current grandfather of all fertility treatments, IVF, when it really shouldn’t be so. Uduak has been there, and shares her experience below.
As a new bride, Uduak was all excited about her change in status, as well as the promise of motherhood that was now within reach for her. She found out less than a month after her wedding that she was pregnant, and was filled with such excitement that surprised even her. She had not realised she had been worried in some ways about her fertility. When she told her husband, he started throwing baby names about, in addition to planning for the christening of the baby.
For them, it was going to really be a case of naming ceremony nine months after wedding. “Perfect!” they said to each other.
Unfortunately, their joy and plans were thrown out the window, when Uduak suffered a miscarriage. It was just unexpected. One moment, she was pregnant, and then the next, she was having an evacuation, because she started bleeding during the night and the baby was no more.
It was far from the dream ending they had in mind, but that was their reality.
The gynaecologist Uduak saw during the unfortunate miscarriage reassured her that miscarriages were quite common, and that she would conceive as soon as her body healed. She was advised to take things easy while she healed.
And she did. She spent a month at home, taking time to heal and work through her emotions.
When she was done healing emotionally, she was ready to start trying for a baby again, and when it didn’t happen as fast as the last time, she was unhappy, but her doctor wanted her to wait. She had age on her side, she was told. Her reproductive system was also top notch, and hardly showed any side effects from the miscarriage…but she just wasn’t getting pregnant.
After eight months of trying after her miscarriage, Uduak went fertility-doctor shopping, and found many options. Her husband was not immediately a fan of her new obsession. He felt the loss of their baby, but he was also enjoying having his wife to himself and didn’t see the reason for the fuss.
Anyways, Uduak found a doctor, and after several investigations, she was diagnosed with PCOS as well as uterine adhesions. The proffered solution was IVF.
This diagnosis scared the daylight out of Uduak, and the IVF part just worsened it for her. In her mind, she was like, “My case is surely not so dreary that I require IVF nau?” By the time, she was done with her doctor search, hospital-jumping and investigations, it was already one year. So, she went back to her old doctor, who had told her to come back after a year, and shared her short experience of the last few months.
In light of the results of the tests she had done earlier, and investigations now done on her husband, the verdict of PCOS was confirmed, but the scar tissue was almost negligible, according to her doctor.
Uduak and her doctor started off with the basics; cycle monitoring, Clomid plus injectables. Before the end of her prescribed three cycles of clomid, Uduak got pregnant. Today, Uduak is a mom of two children. Her second pregnancy happened spontaneously.
However, like I mentioned at the beginning of this article, going through a regular family doctor or a gynae may not work for everyone, especially if any of the underlisted factors apply to you:
Your mom suffered premature menopause: If there is a family history or your mom suffered premature menopause, it is worth going to see fertility doctor directly.
Your health history is complicated: Seeing a fertility doctor is the best option in this instance. The fertility doctor can work with your other specialists to achieve a successful pregnancy, without compromising your health.
You have a known reproductive issue: If you or your husband has been diagnosed with a fertility disorder, then going to a specialist is the best route.
You have suffered multiple miscarriages: It’s time to have a fertility investigation if you’ve had a couple of positive pregnancy tests, but no baby
If you are dealing with any of these issues and you are with a family doctor, let him or her know, and ask to be referred to a specialist, as time is of essence in matters bordering on fertility.
Whichever direction you decide to go; through a family doctor, to a specialist, or straight to a fertility doctor, know that your diagnoses does not have to spell the end of your dream to have a family.
There are many options and treatments available, and will be available as God helps researchers.
Where to start? The ball is in your court.
Join the conversation with any of our TTC and Pregnancy Groups here