Infertility

Infertility affects many individuals and couples, and it can be emotionally stressful when pregnancy does not occur as expected. Infertility is generally defined as the inability to conceive after 12 months of regular, unprotected intercourse—or after 6 months for individuals over age 35.

At The Medical Group of New Jersey, our Ob/Gyn team provides compassionate support, thorough evaluation, and evidence-based management to help you understand the cause and explore the best path toward achieving pregnancy.

Symptom Onset & Initial Evaluation

People often seek infertility evaluation after noticing irregular cycles, difficulty predicting ovulation, or months of trying without success. Others may have a known condition, such as endometriosis, polycystic ovary syndrome (PCOS), or a history of pelvic infection, which raises concern from the start.

During your initial visit, your OB/GYN will learn about your medical history, menstrual patterns, and reproductive goals. This helps guide a tailored, gentle, and comprehensive evaluation.

Your Initial Evaluation May Include:

• Detailed menstrual and ovulation history
• Review of previous pregnancies, miscarriages, or ectopic pregnancies
• Assessment of timing and frequency of intercourse
• Medical conditions such as thyroid disorders or metabolic concerns
• Past surgeries, pelvic infections, or sexually transmitted infections
• Family history of early menopause or genetic conditions

A physical exam may be performed to assess pelvic health and identify signs of hormonal imbalance or structural concerns.

Diagnosis & Risk Assessment

Infertility can arise from ovulatory issues, tubal blockage, uterine abnormalities, sperm concerns, or unexplained factors. Evaluation focuses on identifying where the difficulty lies so the right treatment path can be chosen. Diagnostic testing may include:

Ovulation & Hormonal Evaluation

• Thyroid function tests
• Hormone panel (FSH, LH, estradiol, prolactin, AMH)
• Progesterone testing to confirm ovulation
• Hemoglobin A1c for metabolic assessment

Pelvic Imaging

• Transvaginal ultrasound to assess ovarian function, follicle count, and uterine structure
• Screening for fibroids, endometrial polyps, or ovarian cysts

Fallopian Tube & Uterine Evaluation

• Hysterosalpingogram (HSG) to determine whether tubes are open
• Saline infusion sonogram (SIS) to evaluate the uterine cavity

Partner Evaluation

Male factor infertility contributes to about 40% of cases. Semen analysis evaluates:

• Sperm count
• Motility (movement)
• Morphology (shape)

Screening for Associated Conditions

• Endometriosis
• Polycystic ovary syndrome (PCOS)
• Pelvic inflammatory disease (PID)
• Premature ovarian insufficiency

Your OB/GYN will review each result with you in a clear and supportive way, explaining what they mean and how they guide treatment.

Treatment & Management

Treatment depends on the underlying cause—and your reproductive goals. Options range from simple cycle tracking to fertility medications or specialized reproductive technologies.

Lifestyle & Supportive Approaches

Your care plan may begin with:

• Guidance on timing intercourse with ovulation
• Nutrition and exercise recommendations
• Weight optimization, when beneficial
• Stress reduction and mental health support
• Screening for vitamin deficiencies

Medications to Support Ovulation

If irregular ovulation is the primary concern, medications may help stimulate predictable cycles. These medications help more eggs reach maturity and improve timing for conception:

• Letrozole (first-line ovulation induction)
• Clomiphene citrate
• Metformin, especially for insulin-resistant PCOS

Procedures & Advanced Options

If structural or tubal issues are identified, the following procedures may be performed:

• Hysteroscopy to remove polyps or fibroids
• Laparoscopy for endometriosis treatment
• Tubal surgery in select cases

Assisted Reproductive Technologies (ART)

For persistent infertility or more complex cases, your OB/GYN may coordinate your care with a reproductive endocrinologist. ART includes:

• Intrauterine insemination (IUI)
• In vitro fertilization (IVF)
• Intracytoplasmic sperm injection (ICSI)
• Egg or sperm donation
• Fertility preservation in those undergoing medical treatment

Your clinician will walk you through each option with sensitivity and clarity.

Monitoring & Follow-Up

Infertility care often involves multiple steps, and consistent follow-up is key. Your OB/GYN will:

• Monitor cycle patterns and ovulation response
• Review medication side effects
• Reassess lab work or imaging as needed
• Coordinate referrals to reproductive endocrinology when appropriate
• Offer emotional support, mental health resources, and guidance throughout the process

Our team is dedicated to ensuring you feel informed, supported, and empowered at each stage.

Many individuals and couples facing infertility ultimately achieve pregnancy, either naturally, with medication, through procedures, or with IVF. Even when the cause is unexplained, the chances of success remain strong with the right care and strategy.

Regardless of the path, the OB/GYN team at The Medical Group of New Jersey is dedicated to helping you move forward with confidence and hope.