FAQs

• You are 35 years of age or older
• You have been trying to get pregnant for at least one year
• You have been receiving infertility medical treatment from your gynecologist or primary care provider for approximately three months and have not gotten pregnant
• You have a history of irregular menstrual cycles, sexually transmitted disease, pelvic infection, hormone problems, excessive weight gain, endometriosis, fibroids, chronic pelvic pain, DES exposure, excessive facial or body hair, adult acne, or your male partner has been diagnosed with infertility issues
• You have had two or more miscarriages
• You are about to start injectable infertility medications
• The doctor you are seeing does not offer holiday or weekend office hours for ultrasounds, blood work and inseminations
• The doctor you are seeing is only using abdominal ultrasound and not transvaginal ultrasound scans
• The doctor you are seeing does not check your ovaries and hormone levels while on clomiphene (clomid) to monitor the size of your ovaries, your response to the medication and to determine when or if ovulation occurs
• You have been on clomiphene (clomid) for several months and have not gotten pregnant, and there is no change in your future treatment plan
• You have been on clomiphene (clomid) for several months and your dosage is simply being increased without any monitoring to determine how your body is responding to the increased doses
• Intrauterine insemination is not an option at your present doctor’s office
• You are considering a laparotomy or laparoscopy, but would like a second opinion
• You have pain, prolonged bleeding and/or bowel or bladder symptoms around the time of your period, and your doctor doesn’t suggest having a hysterosalpingogram (HSG), a hysteroscopy or a laparoscopy to determine the cause of the symptoms
• A fibroid, polyp, uterine anomoly or tubal blockage has been noted on a hysterosalpingogram (HSG). (It is recommended you view the film yourself with the doctor showing you the exact problem noted.)
• You or your male partner have been diagnosed with a significant infertility issue (consistently abnormal semen analyses, severe endometriosis, blocked fallopian tubes, etc.), and in vitro fertilization is not offered as a treatment option by your doctor.

A reproductive endocrinologist is a subspecialist physician who has received residency training in Obstetrics and Gynecology and advanced training, a fellowship, in the treatment of infertility, recurrent miscarriages and hormonal disorders in women. A typical Ob/Gyn resident receives between 5 and 12 weeks of training in Reproductive Endocrinology and Infertility, while a fellow has that initial training and then dedicates an additional 2-3 years to the field after completing residency.

Reproductive Endocrine fellows are trained in advanced procedures necessary for difficult infertility surgeries, with a focus on minimally invasive laser surgery that allows the woman to return to her regular schedule quickly and can save precious months of fertility that would have been spent recovering, procedures to reverse tubal ligation, injectable fertility drugs and assisted reproductive technologies such as in vitro fertilization (IVF). Although most Reproductive Endocrinology and Infertility fellowships emphasize infertility, training also focuses on hormonal problems associated with menopause, abnormal menstrual cycles, polycystic ovary syndrome, endometriosis, pelvic pain and recurrent pregnancy loss.

During their training, reproductive endocrinologists gain a comprehensive exposure to diagnostic tests, learn to manage ovulation induction, receive training in surgical techniques relevant to reproductive endocrinology and infertility, and are trained to provide the assisted reproductive technologies (ART), including in vitro fertilization. Most importantly, they are trained to manage potential side effects and complications that may result from these treatments and procedures.

To obtain Board Certification, Reproductive Endocrinologists must publish a thesis and pass separate written and oral examinations. Prior to taking the Reproductive Endocrinology and Infertility examinations, they must successfully pass the written and oral examinations to earn Board Certification in Obstetrics and Gynecology. Most Reproductive Endocrinologists are equipped and capable of caring for the problems of over 95% of the patients seen.

For the patient who has an unusual problem requiring special care, the Reproductive Endocrinologist is likely to know where to find unique treatment and expertise and can facilitate seamless coordination of care. Not every practicing Reproductive Endocrinologist is board-certified, so the prospective patient is advised to check the doctor’s credentials.

Artificial insemination and IUI are the basically the same thing. They are techniques to insert sperm directly into a woman’s cervix and/or uterus. Artificial insemination can describe either intrauterine or intracervical insemination, whereas IUI is strictly for intrauterine insemination. In general, IUI is the most common form of artificial insemination and has been shown to be superior to intracervical insemination.

Herbal supplements are not recommended and may cause unknown effects. The FDA does not regulate herbal supplements; therefore, there is no standard or uniformity to their manufacture. Some herbal supplements mimic hormones. If you are on any herbal supplements, please inform our physicians and nurses.

Yes. Since we opened our doors in 1998, we have never discriminated against anyone based on marital status or sexual orientation. In 1993, shortly after he completed his fellowship, Dr. Mersol-Barg published an article in Postgraduate Obstetrics and Gynecology recommending that physicians should treat single women seeking fertility options.

We have shown our support for the LGBT community by contributing to the opening of Affirmations in Ferndale, along with regularly advertising in Between the Lines and PrideSource publications. Dr. Mersol-Barg was featured in a 2006 article published in Between the Lines. For the last several years, Dr. Mersol-Barg has conducted a seminar at Oakland University William Beaumont School of Medicine to sensitize and inform the next generation of doctors about the healthcare needs of the LGBTQ community. Possible treatment options for single women or same-sex couples are: egg freezing, donor sperm insemination, donor sperm IVF, donor egg IVF with a gestational carrier, or an IVF cycle using frozen donor eggs.

When you meet with the doctors and nurses, they will review your history and develop a personalized treatment plan to fit your needs.

In general, infertility is defined as one year of unprotected intercourse without conception. For women over 35, it is six months of unprotected intercourse without conception. The inability to carry a pregnancy that results in a live birth is also viewed as infertility.

Problems with ovulation account for most cases of infertility in women. Without ovulation, there are no eggs to be fertilized. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods.
Less common causes of fertility problems in women include:

• Blocked fallopian tubes due to pelvic inflammatory disease, endometriosis or surgery for an ectopic pregnancy
• Physical problems with the uterus, such as a septum
• Uterine fibroids.

Infertility is a medical problem. In general terms, about one-third of infertility cases can be attributed to male factors, and about one-third to factors that affect women. For the remaining one-third of infertile couples, infertility is caused by a combination of problems in both partners, or, in about twenty percent of cases, is unexplained.

You can schedule an appointment Monday through Friday from 6:30 am to 2:30 pm and Saturday from 8 am to 10:30 am.

Male infertility refers to the inability to conceive a child, caused by factors not related to the female. Several factors can lead to male infertility, including low sperm production, immobile sperm, malformed sperm, or blockages that prevent sperm delivery to the semen. These conditions can result from illnesses, infections, chronic health problems, injuries and/or environmental factors, such as exposure to certain chemicals.

• Stop smoking cigarettes or marijuana. Smoking tobacco has been linked to low sperm counts and sluggish motility. Long-term use of marijuana can result in low sperm count and abnormally developed sperm.
• Decrease your drinking. Alcohol can reduce the production of normally formed sperm needed for a successful pregnancy.
• Watch your weight. Both overweight and underweight men can have infertility problems. With too much weight, there can be hormonal disturbances, and when a man is too slim, he can have decreased sperm count and functionality.
• Exercise in moderation, and don’t use steroids. Excessive exercise could lower your sperm count indirectly by lowering the amount of testosterone in your body. Steroids can cause testicular shrinkage, resulting in extremely low sperm counts and infertility.
• Avoid toxins. Landscapers, contractors, manufacturing workers, and men who have regular contact with environmental toxins (pesticides, insecticides, lead, radiation, or heavy metals) are all at risk for infertility.

Yes. High temperatures can damage sperm. That is why the scrotum is located outside the body, to act as a kind of “refrigerator” to keep the sperm cool. It is best to avoid hot tubs, saunas, and steam rooms when a man is trying to improve his fertility. Heat-emitting laptops should also be avoided.