Overview of a reproductive endocrinologist (RE)
A reproductive endocrinologist (RE), commonly known as a reproductive physician, specializes in diagnosing and treating conditions that interfere with pregnancy and help with the reproduction system.
A reproductive endocrinologist sometimes referred to as an RE. REs have a comprehensive understanding of the anatomy and function of the female reproductive and endocrine (hormonal) systems, as well as knowledge of the male systems.
Reproductive endocrinologists diagnose the causes of infertility along with many other problems such as polycystic ovary syndrome, endometriosis, anaesthesia, and male infertility.
Many ERs did specialized training in surgical procedures to prevent pregnancy or correct the physical difficulties of miscarriage. This can include surgeries such as myomectomy or tubal ligation reversal.
When most people think of trying to conceive, they usually think of gynaecologists first.
While some OB/GYNs help with fertility in basic ways, such as prescribing Clomid, most of the OB/GYNs job is assisting with the delivery, along with routine pregnancy tests, including breast and pelvic exams for common problems of the woman.
Meanwhile, ERs receive specialized training and extensive professional experience specifically focused on helping those with infertility. To become a reproductive endocrinologist, you must first complete training to become an obstetrician (4 years of medical school + 4 years of residency in obstetrics) and also complete an additional three years of training known as the Fellowship in Reproductive Endocrinology and Infertility This scholarship includes intensive training in male and female reproductive anatomy, endocrine systems, and all medications and procedures to treat infertility.
In addition to this training, ERs generally assign patient care to OB/ GYNs after the first few months of early prenatal care, when pregnancy is reliably established. That means in addition to those three extra years of specialized training, they will focus their entire career on this short gestation period of 3 to 4 months and the critical first months of pregnancy.
Reasons to see a reproductive endocrinologist
You should consider seeing a reproductive endocrinologist if you’re having trouble getting pregnant. As a general guideline, if you’re under 35 and want to conceive a child, you should spend a year trying before you see a reproductive endocrinologist. If you’re over 35, you should try for at least 6 months.
However, you may want to book an appointment with a reproductive endocrinologist if you have any of the following issues:
- Irregular, absent, or painful menstrual periods
- One or more miscarriages
- Treatment(s) that may affect your fertility
- Endometriosis symptoms or diagnosis
- Polycystic ovary syndrome (PCOS) symptoms or diagnosis
What tests does the reproductive endocrinologist do?
A reproductive endocrinologist and infertility physician may order or perform a variety of diagnostic and screening tests, including:
- Fluid tests before and after sexual intercourse, including cervical mucus tests and postcoital tests.
- Hormonal tests including luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, progesterone, prolactin, thyroid hormones, total testosterone, free testosterone, and androstenedione
- Imaging tests including pelvic ultrasound, abdominal ultrasound, testicular ultrasound, and transvaginal ultrasound.
- Complete blood count (CBC), blood chemistry, urinalysis, genetic testing, and lab tests for sexually transmitted diseases such as HIV and hepatitis.
- Hysterosalpingogram (special x-ray to examine the uterus and fallopian tubes), hysteroscopy (examination with an endoscope through the uterus), laparoscopy (examination with an endoscope through the abdomen), testicular biopsy, and endometrial biopsy.
What conditions and diseases and how are they treated?
The reproductive endocrinologist and infertility doctor treat conditions and diseases including:
- Female infertility conditions including uterine fibroids, endometriosis, polycystic ovary syndrome, age-related infertility, and fallopian tube problems. Fertility care for men and women with cancer.
- Hormonal disorders, including prolactin disorders and abnormal hair growth.
- Male infertility conditions including varicocele, low sperm count, low testosterone, erectile dysfunction, ejaculatory dysfunction, and post-vasectomy infertility
- Menopause and hormonal reinstallation, including hormonal reinstallation for both natural menopause and menopause induced by various medical treatments.
- Structural problems such as non-erosion of the structure, irregular eruption of the structure, abnormally severe erosion of the structure, and painful eruption of the structure. Ovarian defects, including ovarian cysts.
- Recurrent miscarriage, including recurrent pregnancy after a previous successful pregnancy.
- Secondary infertility, including complications such as pregnancy or miscarriage after a previous successful delivery.
- Congenital abnormalities (abnormal development of the reproductive organs at birth), delayed puberty, sexual dysfunction in young children, and sexual dysfunction, such as traumatic intercourse.
Procedures and treatment options
Reproductive endocrinologists and infertility doctors prescribe or perform various procedures and treatments to maintain reproductive health conditions. Reproductive endocrinologists and infertility doctors are trained in medical and surgical treatments. General procedures and treatments:
- Artificial insemination, gamete intraplopion transfer (GIFT), in vitro fertilization (IVF), cryopreservation (embryo and sperm coagulation), frozen embryo transfer, and intracytoplasmic sperm injection (ICSI)
- Counselling for individuals and couples experiencing infertility and undergoing fertility treatments.
- Donor programs, including shared oocytes, egg donation, sperm donation, and embryo donation programs.
- Fertility drugs, including oral and injectable drugs, to induce ovulation.
- Fertility care, including in vitro oocyte maturation, oocyte vitrification (coagulation), ovarian coagulation, cryopreservation (embryonic or sperm coagulation), and coagulation of testicular tissue.
- Surgical procedures such as tubal sterilization reversal, fibroid removal, varicocele repair, vasectomy reversal, transurethral ejaculatory duct resection (TURED), and sperm retrieval.
- Surgery programs, including traditional egg surgeons and non-genetic pregnancy surrogates.