Whether you’re struggling with infertility or experiencing symptoms of a reproductive disorder, a reproductive endocrinologist could be the specialist you need.
What do reproductive endocrinologists do?
Unlike primary care physicians (PCPs) or OB/GYNs who provide general women’s health care, reproductive endocrinologists (REs) specialize in diagnosing and treating complex hormonal and reproductive issues, including:
Infertility
When couples have trouble getting pregnant, REs are the experts who figure out why. (That’s why they’re often referred to as “fertility specialists” or “fertility doctors.”) They run tests, check hormone levels, and perform diagnostic procedures to pinpoint the issue — whether it’s due to ovulatory dysfunction, tubal disease, genetic factors, endometriosis, male factor infertility, or other concerns.
Once they know what’s going on, they’ll create a personalized plan to treat the underlying cause. This could involve prescribing ovulation induction medications, performing surgery to fix any blockages, or recommending assisted reproductive technologies (ART) like in vitro fertilization (IVF).
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Hormonal Conditions
Reproductive endocrinologists also treat other reproductive and hormonal conditions, like polycystic ovary syndrome (PCOS), uterine fibroids, endometriosis, and recurrent miscarriages.
They can also help with menstrual irregularities (irregular, painful, or missing periods), abnormal bleeding, and menopausal issues.
Fertility Preservation
REs also offer options for future family planning, like egg or embryo freezing.
People who may benefit from fertility preservation include:
- Women with ovarian, uterine, breast, or cervical cancer.
- People undergoing other treatments that may impact fertility.
- People with a family history of early menopause.
- Those carrying the BRCA gene, which increases the risk of certain cancers.
- Those undergoing hormone therapy or gender-affirming surgery.
- People who wish to delay childbearing for personal or career reasons.
REs are like the go-to doctors for anything related to the reproductive system.
Key Services Offered by Reproductive Endocrinologists
Every RE clinic looks a little different, but a few services are standard across the board, including fertility treatment, hormone testing, and reproductive counseling.
Fertility Treatment and Patient Care
REs can provide a range of fertility treatments, including intrauterine insemination (IUI), in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), frozen embryo transfer, and donor egg/sperm services.
Their clinics often have on-site labs and advanced technology like ultrasound and IVF labs.
Intrauterine insemination (IUI) and in vitro fertilization (IVF)
Some fertility specialists offer multiple ART options, but the two most common are IUI and IVF. IUI involves placing sperm directly into the uterus, while IVF takes things a step further by fertilizing eggs in a lab and then transferring the resulting embryos back into the uterus.
Ovarian stimulation and fertility preservation techniques
REs may recommend ovarian stimulation using medications like Clomid or gonadotropins.
Ovarian stimulation is recommended for women who ovulate but are unable to conceive naturally. Ovarian stimulation can help to ovulate more than one egg to increase the chances of pregnancy.
For those facing cancer treatments, gender-affirming procedures, or other situations that might affect their fertility down the road, REs provide options for preserving their ability to have children in the future. This might include freezing eggs or embryos, giving them peace of mind, and possibly starting a family later on.
Tests Conducted by Reproductive Endocrinologists
REs will run a comprehensive set of tests to figure out what’s happening and create a personalized treatment plan.
Typical tests include:
- Blood tests: These check hormone levels, like estrogen, progesterone, testosterone, FSH (follicle-stimulating hormone), and LH (luteinizing hormone), as well as thyroid function, immunity, and genetics.
- Transvaginal ultrasound: This uses sound waves to create images of the ovaries and uterus to look for fibroids, polyps, cysts, or blockages. In men, ultrasound can be used to evaluate testicular health and identify any structural issues.
- Hysterosalpingography: This x-ray checks for blockages in the fallopian tubes and uterus.
- Semen analysis: If male infertility is a possibility, this checks the sperm count, movement, and shape.
Besides doing tests, the fertility doctor will also talk to the patient about their medical history, perform a physical exam, and ask about any problems they’re having. They might also ask about things like medicines, smoking, drinking, or weight, which can affect getting pregnant. The more they know, the better they can help.
Understanding the Diagnosis Process
Determining why someone is having fertility issues is a complex and often multi-step process. The first step is to gather as much information as possible via tests, one-on-one discussions, and a thorough medical history.
This is what we call a “fertility workup.” The REs use it to see what’s going on inside the body. By checking hormone levels, looking at the reproductive organs, and seeing how well each functions, they can begin to map out a likely cause or combination of causes.
Sometimes, there’s a clear reason why someone isn’t getting pregnant; other times, it’s not so simple. They might recommend medication, procedures, or changing lifestyle habits based on what they find.
The goal is to create a plan that gives the best chance of having a baby. It’s a team effort between the doctor and the patient to find what works best for them.
Gynecologist vs. Endocrinologist: Knowing the Difference
A gynecologist or OB/GYN focuses on the overall health of a woman’s reproductive system (including pregnancy and childbirth), while an endocrinologist specializes in treating issues related to the endocrine system — the hormones and glands that control these functions.
Here’s a breakdown of the key differences between these two types of doctors:
General Gynecology
Education:
- Bachelor’s degree
- 4 years of medical school
- 4-year OB/GYN residency program
- Optional 1-3-year fellowship program
- Board certification from the American Board of Obstetrics and Gynecology (ABOG)
- Maintenance exam every 6-10 years
Services:
- Routine pelvic exams and Pap smears
- Screening and treatment for sexually transmitted infections (STIs)
- Contraception counseling and management
- Management of menstrual irregularities
- Treatment of common gynecological conditions like fibroids or ovarian cysts
- Preconception counseling
- Prenatal, natal, and postpartum care
- Deliveries
Reproductive Endocrinology
Education:
- Bachelor’s degree
- 4 years of medical school
- 4 years of OB/GYN residency
- 3-year fellowship in Reproductive Endocrinology and Infertility (REI)
- Board certification the American Board of Obstetrics and Gynecology (ABOG)
Services:
- Diagnosis and treatment of infertility
- Genetic testing
- Management of polycystic ovary syndrome (PCOS)
- Treatment of endometriosis
- Fertility preservation (egg freezing, embryo freezing)
- Assisted reproductive technologies (IVF, IUI)
- Management of menopause and hormonal imbalances
How Obstetrics and Gynecology (OB/GYN) Integrates with Fertility Care
OB/GYNs are an important part of a woman’s healthcare team, even when it comes to fertility. They’re often the first stop for women who are thinking about getting pregnant or who are having trouble conceiving.
An OB/GYN can help patients prepare for pregnancy by offering preconception counseling, performing basic fertility evaluations, and managing any underlying medical conditions that could impact fertility.
When things get a bit more complicated, however, they may refer patients to a RE for advanced fertility treatments. This is especially true for patients who show signs of a potential hormonal imbalance, suspected endometriosis, recurrent pregnancy loss, or if basic treatments aren’t successful.
REs have additional training and access to advanced diagnostic tools and treatment options, so they’re best equipped to handle complex infertility cases.
When to See a Reproductive Endocrinologist Over a Gynecologist
While an OB/GYN can perform routine check-ups and see patients with common gynecological issues, there are certain situations where it’s better to see a RE:
- Difficulty conceiving: Those who’ve been trying to get pregnant for 12 months (or six months if over 35) without success should see an RE.
- Known reproductive conditions: People with conditions like PCOS, endometriosis, or recurrent miscarriages should see an RE.
- Male factor infertility: If there are concerns with the male partner’s sperm, an RE can work with a urologist to address the issue.
- Fertility preservation: People getting medical treatments like chemotherapy or radiation or undergoing gender-affirming procedures have the option to consult an RE about preserving their fertility.
- Advanced fertility treatments: Patients who need IVF or other ART procedures should see an RE.
- Hormonal imbalances: An RE can diagnose and treat any hormonal imbalances affecting fertility, including issues with the reproductive system or endocrine system.
PCOS and Reproductive Endocrinology
PCOS is one of the most common causes of anovulatory (no ovulation) infertility. This hormonal condition can affect the menstrual cycle and cause acne, hair growth, weight gain, and other symptoms.
REs are trained to diagnose and manage PCOS using a combination of medical history, physical exam, blood tests, and imaging. Effective treatments may include lifestyle changes, medications to regulate menstrual cycles and ovulation, or assisted reproductive technologies like IVF.
Studies show that with the right treatment plan, women with PCOS can have a successful pregnancy. One 2019 review found that 75-80% of women with PCOS ovulate following clomiphene citrate treatment with a conception rate of 22% per cycle.
Advancements and Success in Fertility Treatment
PCOS isn’t the only condition that can be managed and successfully treated with the help of a RE. Thanks to ongoing research and technological advancements, the success rates for infertility treatment have been steadily improving over the past few decades.
Although IVF success rates depend on the patient’s age and underlying cause of infertility, most women under 35 (using their own eggs) have about a 40-50% chance of having a baby from a single IVF cycle. Other ART procedures, like IUI and egg freezing, also have promising success rates.
As more clinical trials are conducted and new techniques are developed, these numbers will likely continue to improve.
Takeaway
Reproductive endocrinologists are trained to handle complex infertility cases, including hormonal imbalances, menstrual irregularities, ovulation dysfunction, and advanced ART procedures like IVF.
They don’t replace OB/GYN care — they work together to provide a comprehensive, personalized treatment plan for patients who need specialized fertility care.
Tips for Finding the Right Fertility Specialist
- Ask your OB/GYN, friends, family, or online support groups for recommendations.
- Double-check to make sure the specialist is board-certified in reproductive endocrinology and infertility.
- If you have a specific condition, like endometriosis, look for an RE who’s an expert in that area.
- Look at the clinic’s success rates for treatment procedures like IVF and IUI.
- Consider the staff’s bedside manner and whether you feel comfortable with them.
A Word from RMA
The fertility doctors at RMA Network are committed to providing patient-centered fertility care, no matter the cause or complexity of your infertility. We’re dedicated to helping our clients get through this difficult process by giving them the best possible chance of conceiving.
If you’re considering fertility treatment or have questions about whether or not a fertility specialist is right for you, give us a call or fill out our contact form.
