Gynecologist-reproductologist

For many couples, the issue of having a baby sooner or later becomes relevant. According to general statistics for the states of the former CIS, among couples who decide to have a child, 30% of families get pregnant in the first three months, 60% – within 7-10 months, and the rest – within a year. In the medical field, the average normal period during which a woman in a healthy married couple becomes pregnant is exactly a year. If, in the absence of protection, a man and a woman fail to have a child, this is a reason to contact a reproductive specialist.

Who is a reproductive specialist, gynecologist-reproductologist, endocrinologist-reproductologist

Reproductology is a subsection of gynecology, a medical science responsible for the health of the female reproductive system. A related area is obstetrics – the science of pregnancy and childbirth.

A doctor who has received a higher specialized education, completed training and practice in residency in the relevant specialization, and successfully passed the final exam in the specialty “obstetrics and gynecology”, receives a doctor’s certificate with the right to conduct pregnancy and childbirth, as well as treat women’s reproductive health problems. However, the entire field of gynecology and obstetrics is very voluminous, so physicians generally choose a narrower industry for themselves and specialize in it. That is why there are such specialists as a gynecologist-endocrinologist, a gynecologist-reproductologist, an obstetrician-reproductologist. In general, all reproductive medicine combines the theory and practice of such branches of medicine as gynecology, endocrinology, andrology. A reproductive gynecologist is a doctor who deals with cases of the impossibility of conceiving a child caused by health disorders in a woman, while male sexual health disorders are the area of ​​​​competence of an andrologist, who can also specialize in reproductive medicine. A reproductive endocrinologist can deal with infertility problems caused precisely by disorders of the endocrine system.

Quite often, in medical institutions, the reception is carried out simply by a reproductive specialist who helps to cope with infertility for both men and women.

What does a fertility doctor do?

Unlike most other doctors, both a man and a woman go through the initial appointment with this specialist, since the problem with conception can be caused by any factors specific to one of the couple, or it can be the reason for the incompatibility of the physiological parameters of a man and a woman. In the second case, only a joint examination will help determine what exactly the problem is.

Each patient who first comes to see a reproductologist is interviewed by the doctor in order to obtain information about exactly what symptoms and for how long they have been bothering him. The doctor asks patients questions about their lifestyle, whether they have bad habits and which ones, what diseases they have suffered, whether there are chronic ailments, because all these factors affect human fertility.

Having received information directly from the patient, if necessary, the reproductologist examines the patients, and also prescribes additional studies, for example, tests, ultrasound examinations. In addition, the doctor decides whether it is necessary to visit other specialists – an endocrinologist, andrologist, urologist, geneticist, immunologist, if he has reason to believe that problems with conception are within their area of ​​​​competence.

After all the data on the physiological state of the patient has been collected, the reproductive specialist determines the reasons why the woman does not get pregnant, establishes a diagnosis, determines the methods and directions of treatment or overcoming the problem.

Infertility is a concept that characterizes the state of a couple when a man and a woman, in the absence of contraception, cannot conceive a child. A reproductologist can treat or overcome such a condition. In the first case, factors and indicators that interfere with conception are treated, after which they disappear or return to normal, and fertility in men and women is restored. If it is impossible to restore it, the doctor offers his patients to use assisted reproductive technologies that allow, without curing infertility, to conceive a child.

Another area of ​​activity of this specialist is the prevention of infertility – in this area, he can take part in examinations and determine the treatment regimen for adolescents with diseases that may cause fertility disorders in the future.

An obstetrician-reproductologist specializes in the management of pregnancy in women who conceived artificially. He can also take part in the birth process.

Organs treated by a reproductive specialist-gynecologist

The competence of this doctor includes the organ system of a woman, which is responsible for the reproduction of offspring, namely:

• uterus and fallopian tubes;
• vagina;
• Cervix;
• ovaries.

If a thorough examination of a male partner is necessary, the doctor sends him, for example, to a urologist or andrologist, who study the state of his reproductive system:

• penis;
• testicles;
• spermatic cord and seminal vesicles.

Diseases and pathologies that are the specialization of a doctor

A reproductive doctor is the very specialist who should help a man and a woman achieve the desired result – the conception of a child.

There are many reasons why conception becomes more difficult or impossible without minimal medical intervention. Basically, these are pathologies and diseases, as well as the consequences of illnesses or injuries. Among them:

• anovulatory cycle, other menstrual disorders;
• adhesive processes in the fallopian tubes;
• oncogenic factors of the human papillomavirus; pathological processes in the uterus (infectious, inflammatory, oncogenic and others);
• sexually transmitted diseases that cause infertility;
• consequences of abortions, curettage;
• congenital anomalies in the development of the genital organs that affect the possibility of conception;
• genital and extragenital endometriosis;
• deformation of the fallopian tubes;
• cytomegaly, polycystic ovary syndrome, bacterial vaginosis.

If the cause of fertility disorders is hidden, for example, in the peculiarities of the functioning of the endocrine system, the gynecologist-reproductologist sends the patient to an endocrinologist if he himself cannot examine and treat them.

In what cases and for what symptoms should you consult a doctor

First of all, the reason for visiting a doctor is the inability to conceive a child. This is true if a woman does not become pregnant within a year without using contraception for no obvious reason, provided that she has no problems with the onset of ovulation, the cycle is constant, and sexual life is conducted regularly with the same partner.

In addition, it is imperative to get a consultation with a doctor if previous pregnancies ended in miscarriage or fetal fading. Symptoms for which you need to visit a reproductologist are:

• irregular menstrual cycle or its absence;
• hormonal disorders;
• abnormal development of the uterus;
• primary infertility syndrome;
• symptoms of sexually transmitted diseases (characteristic rashes, itching, inflammation).

You should also consult a doctor if your partner has premature ejaculation or abnormalities in the spermogram (low concentration or low sperm motility).

A gynecologist-reproductologist usually accepts in hospitals, antenatal clinics, specialized medical institutions and clinics.

Methods of examination and treatment used by a gynecologist-reproductologist

It is more expedient to come to the doctor’s appointment together, together with a partner. If you have current advisory opinions from related specialists (endocrinologist, immunologist, urologist), as well as test results, you must take them with you.

You need to be prepared for the fact that the doctor will ask questions of an intimate nature, as well as those related to lifestyle and bad habits – the maximum truthfulness in answering them is one of the guarantees of successful treatment.

In order to most accurately determine the cause of infertility, the doctor, in addition to the initial examination and questioning, prescribes special measures for the patient to examine the state of health:

1. Ultrasound examination of the reproductive organs: during the examination, the doctor, using a special apparatus, examines the pathological condition of the pelvic and abdominal organs, the thyroid gland and adrenal glands, and can also assess the patency of the fallopian tubes.
2. Blood tests for pituitary, adrenal and thyroid hormones: a hormonal examination allows you to detect a malfunction in the endocrine glands and ovaries, helps to assess the supply of eggs.
3. Examination of the adrenal cortex.
4. Hysteroscopy or laparoscopy: invasive methods allow you to study the condition of the fallopian tubes and the inner layer of the uterine epithelium. In the first case, the probe is inserted into the uterine cavity after it has been treated with an expanding fluid. In the second, an incision is made in the abdominal cavity while the patient is under general anesthesia, after which the internal organs are examined with a laparoscope (a special tube with a camera).
5. Immunogram.
6. Analysis of blood coagulability and indicators of follicular reserve.
7. Biopsy of the endometrium.
8. Analysis of the presence of antisperm antibodies (ASAT).
9. Hysterosalpenography (a method by which it is possible to assess abnormalities in the formation of the uterus and the patency of the fallopian tubes).

Partners also need to undergo a genetic examination: for this, a CFTR blood test is performed, as well as karyotyping.

Men need to take some blood tests like immunograms and ACAT, as well as an analysis called “spermogram”.

Treatment and overcoming of infertility can be carried out by various methods – through the appointment of anti-inflammatory or hormonal therapy, surgical intervention, artificial methods of conception.

For example, hormonal medication can stimulate ovulation. Intrauterine insemination is a medical technology in which pre-obtained male sperm is injected into a woman’s cervical canal or uterus for fertilization. Sperm injection into the cytoplasm of the cell is another auxiliary way to overcome infertility, when the sperm is immobilized and injected directly into the egg. The IVF method or in vitro fertilization is a method in which a pre-selected egg and sperm cell meet and merge outside the body of the expectant mother (in a test tube), after which they are surgically introduced into the uterus of a woman – the patient herself, or a surrogate mother.

Reproductologist’s recommendations for conceiving a healthy baby

Of course, situations in life are different, but early pregnancy planning is one of the guarantees that the conception and bearing of a child will be successful and easier. As part of the planning, it is imperative to undergo a general medical examination, as well as visit narrow specialists, for example, a mammologist for women, a urologist for men.

Doctors recommend that at least a year and a half before planning a pregnancy, say goodbye to some bad habits like smoking, drinking alcohol, and malnutrition.

Before and during attempts at conception, it is useful for a man and a woman to use vitamin complexes and mineral preparations that the attending physician will prescribe.

Baths, saunas, and hot baths have a negative impact on sperm quality and sperm motility. But food rich in vitamins E, C and D, selenium and zinc improves its quality.

An important criterion for easy conception and gestation is normal body weight. Obesity, fullness, lack of weight in a woman can become serious obstacles to pregnancy.

A gynecologist-reproductologist is a doctor who helps couples cope with the causes of infertility. This specialist deals with the treatment or overcoming of infertility, depending on what exactly caused the fertility disorder. Technologies such as IVF or VI (intrauterine insemination) have become a real breakthrough in this area, which helps to feel the joy of motherhood and fatherhood, even in cases where there are objective obstacles to this.