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The urge to reproduce is a dominant characteristic of living organisms, from the tiniest virus to the largest of whales. For humans that biological imperative is often reinforced by emotional, cultural or religious factors, which can make infertility an unusually difficult condition for patients to cope with. Doctors called reproductive endocrinologists work with patients who are experiencing fertility issues, helping them overcome their medical issues.
According to the American Society for Reproductive Medicine, infertility affects about 12 percent of the U.S. population. Many medical and genetic factors can make conception difficult for couples, or make carrying a child to term difficult. In approximately 85 to 90 percent of those cases, doctors can restore fertility through traditional therapies like medications and surgery, depending on the cause of infertility. A smaller number can't conceive without in vitro fertilization or similar techniques. In most cases, the doctor performing these procedures is a reproductive endocrinologist.
Examination and Diagnosis
When couples are unable to conceive or experience recurrent miscarriages, their regular physician will usually refer them to a reproductive endocrinologist for diagnosis and treatment. Most infertility results from a small number of common causes, such as irregular ovulation, sexually transmitted diseases, unusually high or low body weight or genetic factors. The reproductive endocrinologist interviews patients, reviews their medical histories, performs physical examinations, and orders medical imaging or other laboratory tests as necessary. Armed with this information, the doctor can usually determine the cause of the infertility and an appropriate course of therapy to correct it.
A patient's treatment will vary, depending on the root cause of the fertility problem. Ovulation can be stimulated and regulated by pharmaceuticals, and other medications can be prescribed to treat STDs or autoimmune disorders. Patients with very high or low body weight can restore fertility by gaining or losing weight, and both men and women can improve their fertility by adopting a healthier lifestyle, avoiding alcohol, tobacco and drugs. Physical bars to fertility, such as uterine polyps, can be addressed through surgery. Reproductive endocrinologists also counsel patients on in-vitro fertilization, surrogacy and other strategies, and perform those procedures if necessary.
Conventional endocrinology is a branch of internal medicine, but reproductive endocrinologists train first as obstetrician/gynecologists. After graduating from medical school they spend a year in a general internship, then three more in an ob/gyn residency. After completing the gynecological residency, doctors must spend three more years in a reproductive endocrinology fellowship to qualify in that specialty. Income for reproductive endocrinologists falls into the midrange for physicians. A 2012 salary survey conducted by the American Medical Group Association reported their median salary as $336,352 per year. The baby boomers' children and grandchildren, a large demographic group known as the "millennials" or "echo boomers," are currently entering their childbearing years. This should ensure strong demand for reproductive endocrinologists for many years to come.
Fred Decker is a trained chef and certified food-safety trainer. Decker wrote for the Saint John, New Brunswick Telegraph-Journal, and has been published in Canada's Hospitality and Foodservice magazine. He's held positions selling computers, insurance and mutual funds, and was educated at Memorial University of Newfoundland and the Northern Alberta Institute of Technology.