ORLANDO, Fla. – In recognition of National Infertility Awareness Week, Bridgett talked to a local OB-GYN about the wide variety of experiences and issues tied to infertility. According to the World Health Organization, one in six people are affected worldwide by infertility issues.
Although issues and questions surrounding fertility are common, Dr. Scott Bovelsky says many people don’t talk about it. That’s why he says he reassures his patients dealing with questions about why they’re not getting pregnant or why they’ve miscarried.
“Infertility has a lot of emotional component to it. Women and couples that are trying to get pregnant and then they can’t and they see all their friends with kids. I think it becomes, hopefully not an embarrassment, but it’s certainly a stressful part of their life,” he said. “Miscarriages are very common. I see five to 10 a week, but nobody talks about them. You are correct, they can be quite emotional. I tell people, try to reassure them, it can happen very frequently. It’s nothing they did, it’s just part of human nature,” Bovelsky said.
“Several types of patients that come in. Ones that have been trying for six months to a year and can’t get pregnant at all. And those are the majority. Then you have the women that have recurrent miscarriages. In the women who have been trying for six months to a year, first thing we want to do is look for any reasons they might not be getting pregnant. We check some lab work, I talk to them, if they’re having a normal menstrual cycle, they’re likely releasing an egg. If their cycles are not normal, they may have something called PCOS, polycystic ovarian syndrome, and that’s something we can actually treat. So we go down this pathway of trying to identify any reason you may not be able to get pregnant. Semen analysis is another very important thing and once we come up with a reason why you may not be able to get pregnant, then we can treat it,” he said.
Bovelsky says a woman’s OB-GYN can help with many of the most common issues before going to an infertility specialist is deemed necessary.
“A majority of women, can get a lot of their infertility workup at a general gynecology office like myself. There are certain things, if women are not ovulating, it’s actually not that hard for me to get somebody to ovulate. Certainly if you do the workup and something like their tubes are blocked or everything is completely normal and you just have unexplained infertility that’s when they need to go to the infertility/IVF specialist. I tell patients, even if I start making you ovulate, this could be a six-month process. So it’s an emotional toll that can last a long time, so you have to prepare patients for that so they know what’s coming.”
Fibroid tumors are common and can also pose a problem and risk surrounding pregnancy.
“The key with fibroids and pregnancy is their location. If the fibroid is impinging or pushing in on the cavity, the endometrial cavity where the baby grows, then that’s going to be an issue and has to be surgically removed. If they’re fibroids in the muscle, but are not distorting the cavity, you really don’t have to take those out,” he said.
Even with miscarriage being common, the doctor says many women miscarry and don’t even know it.
“Sometimes you’ll hear the term chemical pregnancy: a positive pregnancy test, but we never saw anything on ultrasound and those happen quite frequently. In fact it happens a lot more than women realize because they’ll be late on their cycle a couple days, they’re like, ‘Oh, I’m late a couple days,’ then all of sudden, they have a cycle. They could have been pregnant and just never knew it,” Bovelsky explained.
When it comes to advanced maternal age, Bovelsky says certain challenges and risks are higher, but more women are waiting to become mothers.
“The older a woman gets, it doesn’t matter what age you compare it, whether it’s 40 to 35 or 35 to 30, the eggs are just not as good as they were when you were 20. So a 40-year-old’s eggs have a much higher chance of having a chromosome problem and having a miscarriage. I have plenty of women in their 40′s that get pregnant, so I tell people don’t be discouraged, but you have to go into it knowing it’s more difficult to get pregnant and you do have a higher chance of having a miscarriage. When you start getting into the 40s, 45s, late 40s, that’s when you really start the discussion about donor eggs,” he said.
“I do see a lot of women waiting longer and I think that’s fine. They have this term: advanced maternal age, over the age of 35 is really a misnomer. It’s not until you hit 38, 39, 40, your ability to get pregnant really drops. I think it’s fine for women to you know try for that. I will never tell a woman you can’t get pregnant. Ever. That’s just not my role, my role is to help them with the best chance they can have.”
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