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When Should an Infertility Specialist be Consulted?

Many times couples who are trying to become pregnant wonder if/when they should seek care from an infertility specialist. Sometimes these couples have been trying for months,or years, without medical intervention.

Patients receiving care from an OB/GYN will often be referred to an infertility specialist after failing first line therapies such as Clomid. In the past, some OB/GYNs would administer injectable fertility drugs (FSH) in combination with intrauterine insemination (IUI). This is very rare in today’s environment with the ready availability of qualified fertility specialists who are trained to properly administer these drugs.

Dr. Shaykh is a board certified infertility specialist with extensive advanced training and clinical experience in the diagnosis and treatment of infertility. Please review his biography for an overview of his infertility specialist training. Dr. Shaykh is one of the first board certified infertility specialists to open a fertility clinic in Florida and has practiced there for over twenty years. His program’s success rates greatly exceed the national averages._MG_4661

Board certification as an infertility specialist requires advanced specialized clinical training, research experience, “hands on” management of ART cycles, expertise in managing patients receiving injectable fertility medications, proficiency in delicate microsurgical techniques using the laparoscope, and much more. The infertility specialist must first complete a residency in obstetrics and gynecology and fulfill all of the requirements for board certification.

Even though infertility specialists are trained and qualified to manage pregnancies and deliveries, they rarely offer these services. Rather, they concentrate all of their efforts on staying abreast of the infertility literature, research, advanced training, administering therapies such as IVF and donor egg IVF, and close personal interaction with their patients. This is not unlike the neurosurgeon who must complete all the requirements of a general practitioner before specializing in neurosurgery but does not offer general medical services.

After successful completion of an OB/GYN residency program, the infertility specialist must complete a 2-3 year Fellowship program at an approved medical school. Dr. Shaykh completed his fertility specialist Fellowship at the University of Miami after completion of the OB/GYN residency program at the prestigious Johns Hopkins University Medical Center. In addition to his training as a fertility specialist, Dr. Shaykh completed a fellowship in “High Risk Gynecology” at the SUNY Upstate Medical Center in Syracuse, NY.

Infertility specialist fellowship training involves intense study under the tutelage of respected thought leaders. Fellows must be actively involved in original research, clinical management of all phases of infertility therapy including IVF, donor egg, IUI, etc., interaction with fertility patients, and other aspects of reproductive endocrinology and infertility. The infertility specialist must also demonstrate proficiency in performing delicate microsurgical procedures using the laparoscope. Many times the OB/GYN will refer the most difficult gynecological surgical cases to an infertility specialist.

The American Society of Reproductive Medicine defines infertility as failure to conceive after one year of regular intercourse. The time frame is shortened to 6 months in women who are 35 or older. In today’s society many women are choosing to establish their careers prior to having children and couples are marrying later in life.

Unfortunately, it is a rule of nature that as women age the quality of their eggs diminishes until eventually they cannot fertilize and develop. Many couples who have waited to start their families are finding it difficult to achieve pregnancy and are seeking the care of fertility specialists.

Many OB/GYNS will refer patients to a fertility specialist after 3-6 failed cycles of Clomid. Unfortunately, we also see women who have been on Clomid for a year or longer. This is tragic as the medical literature clearly establishes that Clomid is most likely to be effective in the first 3 cycles and extended therapy is rarely effective. Continual use is expensive; delays more appropriate treatments wasting precious time, and can produce negative side effects.

We now know that male infertility is present in up to half of all infertile couples. An infertility specialist will always order a semen analysis prior to treating the female. Obviously, pregnancy cannot be achieved if there are inadequate or poor quality sperm. Female treatment, in the presence of even mild male infertility, is unlikely to be successful; yet, we still see new patients who have been on Clomid, or other treatments, with no fertility evaluation of their partner.

A fertility specialist should be consulted immediately in many patient types. Women in their thirties with elevated FSH levels should not waste valuable time on inappropriate treatments such as Clomid. Fertility can decline very rapidly in this age group and it is often a question of months before the eggs lose their ability to fertilize and develop.

An infertility specialist such as Dr. Shaykh will rapidly evaluate these women and administer the most appropriate therapy, which is often IVF. Once the eggs have deteriorated, regardless of age, the best option is donor egg IVF which produces comparatively high success rates.

Conditions such as polycystic ovarian syndrome (PCOS) warrant infertility specialist treatment. These cases can be very difficult to manage and the patient’s response to fertility medications can be unpredictable. Also, patients with moderate to severe endometriosis affecting the reproductive organs should seek fertility specialist care. Infertility specialists undergo rigorous training in laparoscopic surgical techniques.

Infertility specialist care does not always involve advanced reproductive technologies. The media often portrays fertility treatment as “high tech” consisting mostly of IVF even though most patients will achieve pregnancy with other treatments such as surgery (for conditions such as endometriosis), medical therapy (such as metformin for PCOS), donor sperm, and many others. This is unfortunate because patients sometimes delay seeing a fertility specialist out of “cost concerns”.

Many studies, conducted by managed care providers, demonstrate that treatment, and ultimate pregnancy success, are less expensive when patients are under the care of a fertility specialist. This is because infertility specialists will not waste time and money on therapies that are not likely to succeed, such as extended Clomid use. Surgical outcomes are also better owing to the advanced training and skill of the specialist.

There is still hope for women who have experienced ovarian failure. They can no longer use their eggs to become pregnant and must rely on an egg donor. Dr. Shaykh has a very successful donor egg program which has helped hundreds of women achieve the child of their dreams. Success rates for donor egg IVF equal the success rates for the donor’s age group. For example, if the eggs of a 21 year old are used in a cycle with a 45 year old recipient, the success rates equal the 21 year old age group and are high.

Dr. Shaykh’s Florida and Virginia fertility clinics offer all infertility treatment and diagnostic services. Throughout the years, his infertility programs have helped thousands of couples achieve pregnancy. He believes in highly personal and compassionate care and is always available to answer his patients’ questions and concerns. A review of his testimonials provides insight into his practice philosophy. Our clinics can accommodate new patients without delay.