Specialty Area: Reproductive Endocrinology and Infertility

Description of Specialty: A specialist in Obstetrics and Gynecology who is capable of managing complex problems relating to hormonal issues in women and to the promotion of pregnancy.

1. Diagnosis: Male Factor Infertility

Questions that should be asked:

1. Is there a medical therapy which will improve my (husband's) semen parameters?
2. Is it possible to use my (husband's) sperm for: artificial insemination?
3. In Vitro Fertilization (IVF)?
4. Does insurance usually pay for this treatment?

2. Diagnosis: Therapeutic Donor Insemination

Questions that should be asked:

1. Who are the donors that are recruited?
2. How are they screened to avoid transmission of: infectious disease?
3. genetic abnormalities?
4. How are the donor characteristics matched to my needs?
5. What controls assure I am receiving the correct samples?
6. What technique is used to place the sample: vaginal cap?
7. intra-cervical placement?
8. Intra-uterine placement (IUI)?
9. intra-tubal placement (SIFT)?
10. What is the pregnancy rate per cycle or per 6 cycles in your unit?

3. Diagnosis: Anovulation

Questions that should be asked:

1. Have you checked my thyroid hormone levels?
2. prolactin level? androgen levels?
3. If all I need is regular menstrual periods, why do I need birth control pills?

4. Diagnosis: Ovulation Induction Drugs

Questions that should be asked:

1. What is the likelihood for multiple pregnancy?
2. What is the risk for ovarian tumors/cancer?
3. What is the risk for abnormalities in the baby?

5. Diagnosis: Tubal Blockage

Questions that should be asked:

1. Compare the effectiveness of surgery in my case to In Vitro Fertilization (IVF).
2. Should my tubes be removed to improve the effectiveness of In Vitro Fertilization (IVF)?
3. How often do you do tubal reconstructive surgery?
4. What techniques do you use to assure the tubes will heal open?
5. When and how do you test that the tubes have healed open?
6. How many patients in your practice have a baby and how many have an ectopic pregnancy?

6. Diagnosis: Unexplained Infertility

Questions that should be asked:

1. What empiric therapies do you recommend?
2. How many women have a living baby following these therapies in your unit?
3. Why are you recommending this therapy in my case?

7. Diagnosis: In Vitro Fertilization (IVF)/Gamete Intrafallopian Transfer (GIFT)

Questions that should be asked:

1. What are the indications for these technologies in your unit?
2. Why are you recommending IVF/GIFT in my case?
3. How many patients: are cancelled before egg recovery?
4. have no eggs captured?
5. have no fertilization? have no embryo development?
6. What is the number of embryos (eggs) that you recommend for transfer in my age group?
7. How many patients have a multiple gestation?
8. How many patients have a living baby?
9. How often do your patients experience Ovarian Hyperstimulation Syndrome?
10. What surgical complications have your patients experienced?

8. Diagnosis: Intra-Cytoplasmic Sperm Injection (ICSI)

Questions that should be asked:

1. What are the indications to use this technology in your unit?
2. Why are you recommending this technology in my case?
3. How often do eggs fertilize?
4. How often do patients have a living baby?

9. Diagnosis: Assisted Hatching

Questions that should be asked:

1. What are the indications to use this technology in your unit?
2. Why are you recommending this technology in my case?
3. How often are embryos damaged and become unfit for transfer?
4. How often do patients have a living baby?

Ronald C. Strickler, M.D. Chief, OB-GYN Henry Ford Hospital Detroit, MI