If you have been trying to get pregnant without success for more than a year, or for more than six months if you are over the age of 35, it may be time to visit a fertility specialist.

Before you see a doctor, however, make sure you have done everything in your power to get pregnant.

• Are you tracking your menstrual cycles and using some method to ensure you are having sex at or around your time of ovulation?
• Does an ovulation predictor kit show that you are ovulating normally?

If this is the case, a fertility specialist should be able to help you pin down the reason you have not been able to conceive and discuss methods that will help you conceive or make a pregnancy possible. Statistics show that 85 percent of all infertility cases are curable.

Testing for Him

The doctor first will take down your medical history. Testing typically begins with the male, because his test involves a simple semen analysis. The analysis will look for sperm count, healthy movement of the sperm, and the shape and maturity of the sperm cells to determine the quality. The semen’s consistency and volume will be analyzed – approximately one teaspoon is considered normal. The pH balance will be tested – it should be slightly alkaline to survive in the environment of the cervix.

If the test results show abnormalities, a doctor specializing in male infertility will repeat the exam two times over the next three months. Many different factors – from a fever or illness to sexually transmitted diseases – can affect sperm count. Additionally, intense physical activity – and especially bicycle riding – can reduce sperm count, as can high temperatures, such as those experienced in a hot tub. Even wearing briefs instead of boxers can create a warm environment in the testes that can lower sperm count.

If the next two exams bring abnormal results, your partner will be referred to a urologist, who will perform the following tests:

• A sperm antibody test

• Hormonal blood tests

• Testicular biopies to determine if he is sterile

• Vasography which checks for any obstructions

• Fructose test

• Bovine cervical mucus test which checks the sperm’s ability to penetrate cervical mucus from cows

• Hamster egg test which determines sperm penetration strength. This test is important, because if his sperm can’t penetrate the egg, in vitro fertilization will not be successful.

Testing for Her

If your partner’s semen analysis results are normal, or if all of the tests performed by the urologist show no problems, testing begins for you. A gynecologist specializing in reproductive endocrinology can take you through this stage of fertility testing.

The doctor will first view both of your charts and review your medical history, paying particular attention to past surgeries such as appendicitis, myomectomies or fibroid surgery, and any STDs on record. He will ask about your menstrual cycle – if you’ve ever had irregular periods, etc., and he will ask about your contraceptive history. He will then conduct interviews with both of you, either together or separately.

He will ask you both questions about previous pregnancies and their outcomes, as well as how long you’ve been trying to get pregnant. He will also ask many lifestyle questions including:

• Frequency of sex

• Do you use any recreational drugs?

• Do you smoke?

• How often do you drink alcohol?

• How healthy is your diet?

• Do you exercise regularly? How often and what activities?

• Have you experienced any stressful events recently, such as a death or new job?

It may be tempting to lie when you answer some of these questions but your honest answers will help your doctor discover the cause of your infertility and make changes that will help you get pregnant.

Your exam includes a complete physical, including an internal, when the doctor will examine your ovaries for signs of problems such as PCOS (polycystic ovarian syndrome), endometriosis, and PID. An ultrasound may be performed to check the condition of the fallopian tubes and ovaries.

Additionally, blood work will be done or scheduled to check reproductive and thyroid hormone levels and to test for STDs.

A visit to a fertility specialist can be a stressful experience, but knowing what to expect and being prepared can help alleviate some of your concerns, as well as make your visit go smoothly.

How can you prepare?

• Bring a list of questions you and your partner want to ask

• Be prepared with your families’ medical histories and your own medical histories

• Be prepared with information about your menstrual cycle, including ovulation dates from charting your cycle for at least three months.

Author: Dawn Allcot

The general population knows very little about Group B Strep (GBS), and many pregnant women have never heard of it, or have only heard of it in passing. Most are shocked when, late in the third trimester their doctor or midwife ask them to be tested, and the test then comes back positive. There are many questions surrounding GBS. What is it? Is it an STD? How does it affect newborns? How is it transmitted to a newborn? How can you prevent infection, and are there alternatives to antibiotics?

What Is It?
GBS is a bacteria found in the lower intestines of 10-35% of all adults. In women it can also be found in the vagina. To test for it, your provider will swab the area between your vagina and anus and send it for a test sometime between the 35th and 37th weeks of your pregnancy. GBS should not be confused with the strep that causes sore throat, Group A Strep. GBS is not contagious, and in most cases it causes no harm to the adult that has it. However, in some cases, it can cause serious infection, known as Group B Strep disease.

Is It An STD?
Since it can be found in the vagina, many people assume that GBS is a STD, which is not true.It is simply a bacterium that is found in many people. It causes no discomfort and can not be transmitted sexually; therefore a carrier of GBS does not need to change their sexual practices.

How Does It Affect Newborns?
Approximately 8,000 babies born each year will contract a serious form of GBS disease. Of these 8,000, as many as 600 will die and another 20% will be left permanently handicapped. If a baby is infected with GBS, will appear either as an infection in the blood (sepsis), or as meningitis. It is also a frequent cause of pneumonia in newborns. It can also leave them with hearing or vision loss, as well as physical or learning disabilities.

How Is It Transmitted To A Newborn?
GBS is transmitted to a newborn during their descent through the birth canal. However, having a c-section is not recommended pas a way to prevent the infection in your baby, as the bacteria can also be found in your uterus and amniotic sac.

Prevention of Infection
If a pregnant woman tests positive for GBS, she can often be given a series of penicillin shots through an IV while in labor, prior to delivery. It is best to get these shots at least 4 hours prior to delivery. In most cases, if the woman has these shots, the baby will not be infected. If time does not permit for the woman to receive these shots, then immediately after birth the nurses will give your baby a shot of penicillin in the leg, to help prevent infection. In this case a mother will normally be asked to stay in the hospital for 48 hours in order for the neonatal team to watch the newborn for signs of infection.

Alternatives to Antibiotics
There have been no studies showing the success of alternative and/or home remedies in the prevention of the passage of GBS to your newborn. However, there are some that doctors and midwives may suggest you try.

Vaginal washing and immunotherapy have been suggested as a way to help clean out your vagina. Some practitioners have suggested supplements for the mother. These supplements include garlic, vitamin C, echinacea, and/or bee propolis. After a series of these supplements a woman can be retested to see if the bacterium has disappeared. This has worked in many, but not all cases of GBS in pregnant women.