Once you have made the decision to seek medical advice for potential problems in the area of your fertility, you must find a practitioner who will meet your needs. There are many options — sorting through the list of practitioners can be a very hard task.

The OB/GYN or Midwife

The first person you are likely to talk to or seek treatment from will be your midwife or obstetrician/gynecologist. These practitioners usually handle this first line of testing and treatment. However, it is wise to ask them questions about what testing and treatments they feel comfortable with and at what point they would recommend you seeing a specialist.

Midwives are usually well versed in reading basal body temperature charts to help you determine any irregularities seen in your cycles. They may also order blood work to check for various problems. Many midwives also offer preconception counseling. However, midwives, in general, do not provide testing and treatment for fertility issues. They will usually refer you to the doctors whom they are affiliated with or to a specialist in infertility.

Your obstetrician/gynecologist has training in many subspecialties of obstetrics and gynecology, which may include reproductive endocrinology. This type of practitioner is also trained in screening processes, and normal and abnormal hormones — the basics of fertility, testing, and surgery. All obstetrician/gynecologists are able to test and treat patients for problems related to infertility.

The Reproductive Endocrinologist

The person with the most training in fertility-related subjects is the reproductive endocrinologist, a physician who is board certified in reproductive endocrinology and has completed a general obstetrics and gynecology residency as well as an additional two- to three-year program in reproductive endocrinology and infertility, called a fellowship.

During the period of this fellowship your reproductive endocrinologist will have specialized in the treatment of endocrine (hormonal) problems and infertility testing and treatment. He or she has also learned procedures such as in vitro fertilization, fertility-related surgeries and procedures, inseminations, ultrasounds to aid in fertility treatment, and more.

The choice between being treated by your regular obstetrician/ gynecologist or seeking the subspecialty care of a reproductive endocrinologist can be a very difficult decision. You may have already built a great relationship with your doctor. Leaving this relationship and someone who knows you personally can be difficult. Have a heart-to-heart conversation with your current doctor. Ask her about her feelings about seeking a specialist.