Reproductive Endocrinology is a subspecialty of obstetrics and gynecology (OB/GYN) focused on evaluation and treatment of hormonal disturbances, anatomic disorders, and other conditions that can affect fertility (the ability to conceive) or the ability to carry a pregnancy to term. Physicians who practice in this area of OB/GYN are called reproductive endocrinologists. Reproductive endocrinologists first complete training in the specialty of OB/GYN before completing advanced training in reproductive endocrinology.
Reproductive endocrinologists manage many problems that involve the reproductive organs or that impact conception and child bearing, including:
- Female and male infertility
- Repeated pregnancy loss
- Menstrual irregularities
- Uterine fibroids
- Polycystic ovary syndrome
- Early menopause
- Early or delayed puberty
- Congenital defects of the reproductive organs
- Hormonal dysfunctions that affect reproduction
Most reproductive endocrinologists focus their practice on issues of fertility. As such, their goal is to optimize and maintain fertility potential (in both men and women) and to identify and treat causes of infertility.
An OB/GYN or a primary care physician may refer a woman or couples to a reproductive endocrinologist after attempts to conceive have been unsuccessful. Generally, further evaluation by a reproductive endocrinologist is warranted if a couple has not been successful in conceiving after 12 months of unprotected intercourse if the woman is younger than 35, or after 6 months of unprotected intercourse if the woman is older than 35.
An evaluation for infertility begins with a thorough physical examination and detailed personal and family medical history for each partner. This is followed by a close review of results from blood tests, a semen analysis, and imaging tests to look for an anatomic cause of infertility (e.g., a problem in the uterus, ovaries, or fallopian tubes).
Once a diagnosis is established, an individualized treatment plan is provided, with the ultimate goal of successful conception. Treatments may include monitoring hormone levels, administering medications to stimulate ovulation or regulate hormones, or surgically correcting a problem that is interfering with conception (e.g., a blocked fallopian tube).
If conception cannot be achieved with these measures, reproductive endocrinologists are skilled in techniques of assisted reproduction, such as:
- Intrauterine insemination -- inserting sperm directly into the uterus to facilitate fertilization
- In-vitro fertilization (IVF) -- combining an egg with semen outside the body in a laboratory for fertilization, and then transferring the fertilized egg (embryo) into the uterus
- Intracytoplasmic sperm injection (ICSI) -- similar to IVF, except an individual sperm is injected directly into an egg in a laboratory, and then the embryo is transferred into the uterus
- Egg or embryo cryopreservation -- freezing an egg or embryo for future pregnancy attempts
- Sperm cryopreservation -- freezing sperm cells to preserve them for future pregnancy attempts
- Ovarian tissue cryopreservation -- a procedure to preserve a part of the ovary for future attempts for pregnancy (typically for women whose fertility is threatened by cancer)
Once a woman becomes pregnant, medical care often is transferred to an OB/GYN, who will continue to monitor the pregnancy until the child is born.
Reproductive endocrinologists are trained in minimally invasive and open surgical techniques to help treat a range of abnormalities of the reproductive organs. For example, they can perform surgery to remove growths (e.g., uterine fibroids, uterine polyps, ovarian cysts) or scar tissue, treat endometriosis, correct congenital abnormalities, open blocked fallopian tubes, and tie off varicose veins in the testicles.
Reproductive Endocrinology and Chester County Hospital
Chester County Hospital offers expert care through a multidisciplinary team of compassionate and caring reproductive specialists, including geneticists, reproductive endocrinologists, perinatologists, diagnostic experts, and highly trained nursing and technical staffs. Our team will assist you throughout your personal experience from diagnosis through your individualized treatment plan.
For more information about reproductive endocrinologists on the Medical Staff at Chester County Hospital, call our Physician Referral Service at 800-789-PENN (7366) or visit the Find a Doctor section of our website.