Dr. Phillip Romanski, MD, MSc

Menopause is a natural process all women will eventually go through as they reach middle age. During menopause, the ovaries stop releasing eggs, menstrual periods become less frequent and eventually cease, and hormones such as estrogen and progesterone decrease. While menopause marks the end of fertility, there is still a chance to become pregnant during menopause - either naturally or through fertility treatments.

ERA, which stands for endometrial receptivity analysis (previously known as endometrial receptivity array), is a diagnostic tool intended to determine how “receptive” the maternal uterine lining (endometrium) is towards implantation of a transferred embryo.^i,ii ERA evaluates the expression of genes involved in endometrial receptivity during the window of implantation (WOI). These results are then used to determine whether a patient should have a frozen embryo transfer with standard timing, or if timing needs to be adjusted to account for a displaced WOI, a process known as personalized embryo transfer (pET).

For clients going through in vitro fertilization (IVF) or any type of fertility treatment, the associated clinic will build a comprehensive plan to examine all risk factors, health conditions, and reproductive issues that may interfere with the ability to conceive. Much of what is assessed will be associated with the physiological form and function of the reproductive system. The uterine lining is one component of the reproductive system that will be assessed.  

The endometrial lining changes in thickness and appearance in response to the changing hormone levels throughout the menstrual cycle and therefore is used as part of the assessment for how a patient is responding to treatment; as such, it is an important aspect to examine as one part of the reproductive system as a whole.  

Because hypothyroidism can play a role in infertility, a woman going through in vitro fertilization (IVF) should be aware of the symptoms of hypothyroidism and possible treatments.

Infertility is recognized as a disease by the World Health Organization (WHO), as well as many other professional societies, including the American Medical Association (AMA), the American Society for Reproductive Medicine (ASRM), and the European Society of Human Reproduction and Embryology (ESHRE).^i,ii,iii,iv Estimates of infertility frequency vary worldwide, and even differ depending on the way data is collected. Prevalence is the term used to describe how common a disease/condition is in a particular population. According to the US National Survey of Family Growth, approximately 19.4 percent of married heterosexual women aged 15-49 years have experienced infertility.^v Estimates in the UK population for a similar population were 12.5 percent.^vi Some studies indicate that the prevalence of male infertility is approximately 10-15 percent, but these estimates may not be accurate due to the lack of good quality evidence.^vii

Sperm donation is a process in which a fertile male donates semen (ejaculatory fluid containing sperm) that can be used by an individual or couple wanting to have a baby. An understanding of how sperm donation works, what its success rates are, and why people might opt to use sperm donation are helpful in determining what that type of fertility journey might look like.

Egg donation is a process in which a fertile woman donates her eggs (oocytes) to another individual or couple who want to conceive a baby. There are a number of steps involved in not only the decision to use donor eggs, but then to move forward once that decision has been made. For anyone considering using donor eggs, it is important to understand the details around how egg donation works, how to find an egg donor, and what success looks like in this type of fertility journey.

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Pelvic inflammatory disease (PID) refers to an infection of the female reproductive organs. PID can occur without symptoms but may also cause mild to severe pelvic pain. In rare cases, it can lead to chronic complications.ⁱ PID is also a risk factor for female infertility. Understanding what causes PID and how it is treated can help women avoid the long-term complications related to this disease.

Endometriosis is a medical condition that affects millions of women worldwide, who can develop endometriosis at an early age. Not only can endometriosis lead to severe pain (including pelvic inflammatory disease) and painful menstrual periods, but it can also negatively affect fertility. Many reproductive-age women who have previously not been formally diagnosed with endometriosis may not realize that they have it until they experience struggles as they attempt to conceive children. In order to recognize and subsequently treat endometriosis, it is critical to first understand the various types of endometriosis symptoms, surgical therapies, and fertility treatments available. In some cases, the most effective treatments are minor surgical procedures. What is most notable is the fact that due to medical advances, there are treatments currently available to effectively manage and treat endometriosis pain.

Thyroid disorders include hyperthyroidism and hypothyroidism, both of which have to do with thyroid function. Hyperthyroidism, also called overactive thyroid, is when the body produces too much thyroid hormone. Typically, there are changes in weight as well as an increased heartbeat with this thyroid disease, though some people also experience problems with fertility and issues during pregnancy. Treatment options for hyperthyroidism include medication or thyroid surgery.