National Infertility Awareness with Virginia Fertility & IVF

For National Infertility Awareness Week, we reached out to local fertility center Virginia Fertility & IVF. We spoke with Laura Smith, MD, about how she became involved with VA Fertility, some of the fears and misconceptions around fertility treatment, and general advice for those who are considering fertility treatment. Virginia Fertility & IVF offers all levels of female and male infertility evaluation and treatment and reproductive health services. They are the only comprehensive fertility center with their own on-site IVF laboratory, and the practice is open 7 days a week to optimize care.

1. What led you to specialize in reproductive endocrinology? 

I was drawn to Reproductive Endocrinology for several reasons, the most important of which is that I think that helping couples and individuals create and build a family is one of the most special gifts that can be given.  Sometimes the path to family building is long, or winding, or doesn’t take the exact route that we think it will, but the journey is so important both for the patient and for her care team, and I wanted to spend my professional life helping people navigate this journey.

2. ACOG defines infertility as one year of trying without birth control, however, your website shares there are circumstances when you do not need to wait 6 months to a year before seeing a specialist. Can you elaborate on this recommendation?

It is normal for it to take more than one month to conceive because there are so many steps that have to work perfectly to achieve pregnancy.  While it can be a very long wait, technically, the definition of infertility is regular intercourse without conception for one year for women who are younger than 35 years old and 6 months for women who are older than 35 years old.  The reason that the timeline is shortened over the age of 35 years is that as we get older, unfortunately, our egg supply naturally decreases, and time becomes more and more important.  For this reason, we recommend trying to conceive naturally initially, but if a patient is not having success, then the first step is having fertility testing through either your regular Ob/Gyn provider like the physicians at Jefferson Ob/Gyn or seeking a consultation with a Reproductive Endocrinologist.  The reason that our website shares that you do not need to wait 6 months before seeing a specialist, however, is that there are situations where it is likely that pregnancy probably will not occur in the standard timeline, such as when a woman has polycystic ovary syndrome and very irregular periods, endometriosis which can affect the fallopian tubes, or if there is a known sperm problem.  Even if you do not think that you have one of these problems, we are happy to do fertility testing to evaluate egg supply, the uterus and fallopian tubes, and sperm quality to optimize your time trying to conceive even before you have been trying for 6 months or more. 

3. What are some of the misconceptions you hear about fertility treatments that you would like to help clear up?

I think that the biggest misconception is that you are the only one struggling to conceive, and everyone else had pregnancy happen so easily.  In reality, about 15% of patients are diagnosed with infertility, which turns out to be a huge number of people (many of whom may be your friends or colleagues, and you do not even realize what they are also going through). Infertility can be very isolating and lead to personal shame and self-blame.  Seeking our testing and treatment is empowering both in terms of understanding what may or may not be the problem and also likely to shorten the time to pregnancy.  Furthermore, we have resources at Virginia Fertility & IVF, such as the group counseling sessions that the practice sponsors with Mother Tree Wellness, which allow you to connect with other patients on this journey.  Most insurance policies have infertility testing coverage, which should at least help you start to understand the cause of the prolonged timeline.

4. What are words of support you can provide to someone who is struggling with fertility?

To anyone who is struggling with infertility or recurrent miscarriage, please know that there are resources to whom you can turn, either through Jefferson Ob/Gyn or through an infertility clinic, to work as a team with you to achieve the shared goal of building a family.