Ladies, beware: this post is for all the guys out there. Feel free to share it with all the men in your life, because I’m betting you want to keep them around as long as possible. Most of them, anyway.

Guys, here’s the deal. It’s National Men’s Health Week, which gives me a great excuse to talk directly to you. I know you don’t like going to the doctor. I’m a doctor and I don’t like going to the doctor. But sometimes you have to bite the bullet and do things you don’t want to do – taking your partner to some fancy event rather than kicking back to watch football, cleaning the gutters rather than kicking back to watch football, going to the opera rather than watching paint dry, etc. This is one of those times.

You need to be as healthy as possible for obvious reasons – suddenly dropping dead puts a serious cramp in your weekend plans. Seriously, and especially if you and your partner are trying to have a baby, you’re going to need to be around for the next 20 years or so to help out: labor coaching, nighttime feedings and shouldering at least some of the estimated $250,000+ it’ll cost to get that baby through high school are just a few of the activities on your new dad to-do list.

So go get a checkup, especially if you and your partner are struggling with infertility. As much as our egos may hate to admit it, at least 30 percent of the time, the medical issue causing the problem is ours – and that fertility statistic holds true across all ethnicities. The good news is, in most cases, there are treatments that can help male infertility. We’ll even turn on the baseball game while you’re at the clinic - your partner will be so happy you’re there getting the medical care you need that she (or he – we’re equal opportunity) won’t think twice about the ESPN Sportscenter theme playing in the background.

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Dr. Ryan Riggs with the Reproductive Resource Center is going through his basics of infertility - an "Infertility 101" class. Key points:

• If you're over 35 (Dr. Simckes actually lowers that to 30) and haven't conceived in six months of trying, go see a doctor.
• Many people have multiple problems - everything from tubal issues to endometriosis to male infertility.
• 1 in 6 couples have trouble conceiving.
• Even if everything is perfect, 25-year-old women and men will only have about a 20 percent chance of getting pregnant in any given month.
• There's a range of treatment options you can consider - everything from 9-12 percent for oral medications to up to 60 percent success rates for IVF.
• In Vitro Fertilization (IVF) is Dr. Riggs' first-line treatment for long-standing infertility or severe male factor infertility.
• Fun fact of the day - five percent of babies born in Europe are the result of IVF.
• He recommends only doing three to four cycles of oral medications, injectibles or IUI before moving to IVF.
• The best treatment for you is the most conservative treatment likely to result in birth.

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(Note: We welcome Fertility Partnership Executive Director Andria Simckes as a guest blogger.)

As Fertility Partnership grows its practice and continues to reach out to people of all ethnicities, we find ourselves battling some deeply held fears and beliefs about infertility in the African-American community. This is personally frustrating to me, because one of my key goals with helping my husband start Fertility Partnership was to lower the infertility rate among people of color. While overall, approximately one in seven couples experience infertility, the rate is 1.5 times higher in the African-American community, and that’s not acceptable to me.

Unfortunately, historical experience makes it hard for African-Americans to ask for help, or to even trust help that’s offered, for such a personal issue. According to psychologist Dr. Marva M. Robinson, utilization statistics clearly show that African-Americans often only seek medical help in the event of an emergency. This is probably due to a long-held distrust of the medical establishment after historical abuses such as the Tuskegee research project and the experience of Henrietta Lacks.

Additionally, we as a community don’t want to talk about infertility because we don’t want to “admit” that we as women are “broken” or that our men are “less of a man.” I understand the sentiment, but if we want to find real answers to the health problems that we face, we have to move past this. This secrecy is causing an immense amount of pain – both physical and emotional – and holding us back from finding real answers.

I’m focused on working to find solutions to these problems and helping African-Americans throw off the shame of infertility to get the help our community needs, but I need your input to help make real progress. I’d love to hear your thoughts and ideas about this issue, either in the comments section of this blog post or by emailing me directly at adsimckes@fertilitypartnership.com. Let’s work together to reduce the soaring infertility rate in the African-American community.

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(Note: We welcome Fertility Partnership Executive Director Andria Simckes in writing her first guest post for Dr. Simckes' blog.)

Misperceptions are sometimes hurtful, occasionally dangerous, and often get in the way of getting what we really want in our lives. The misperceptions about African-Americans and infertility are a perfect case in point.

For example, it’s a common perception that black women are incredibly fertile. They couldn’t possibly have problems with infertility, right? Wrong. In fact, according to RESOLVE, the infertility rate among African-Americans is nearly 1.5 times higher than other races. Unfortunately, that’s a statistic that very few people, especially black women, know. As a result, they suffer in silence when they can’t conceive, believing – even more so than other ethnic groups – that they’re all alone in their infertility.

And what about black men? That infertility rate statistic includes them, too, but that’s an even more taboo topic than black female infertility. Black men are supposed to be virile and sexually powerful – they couldn’t possibly have infertility problems, could they? Yes, they can. About one-third of the time when couples are struggling with infertility, the problem lies with the man, no matter the ethnicity. But again, how many black men haven’t even taken a simple, relatively inexpensive test to see if there is a problem, simply because of the misperception?

As African-Americans, we need to take the lead in doing everything we can to shake off these harmful misperceptions about our fertility. We need to demand more medical studies to fully understand why African-Americans suffer from infertility in such inflated numbers – current research is woefully inadequate and doesn’t give doctors enough information on which to base effective treatment protocols. We need to do all we can to spread the word about the sheer prevalence of infertility in our communities, and share the good news that – in many cases – help is out there.

Finally, we need to strip the stigma away from infertility. If you are black and battling infertility, you are not alone. You do not need to hide it. You do not need to just hope it will go away. Doctors like my husband and clinics like Fertility Partnership are out there ready to help with compassion and understanding.  Support is available through websites like The Broken Brown Egg. Let’s crush these misperceptions and turn the lights on a situation that’s been hiding in the dark for far too long.

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When I first meet with a couple struggling with infertility, invariably their first question is “Why?” They want to know the cause – as do I – so that we can prepare a treatment plan and do everything possible to help them have a baby.

Most of the patients I see have distinct, identifiable conditions, syndromes or diseases that cause infertility. I believe it is important to try to find the cause and answer the question of “Why?” After making a diagnosis, we map out a plan of treatment that matches their wishes, emotional state, and financial abilities, always based on a true medical benefit to their goal of a family. I like to start the conversation by saying what may be obvious, but what forms the basis of our search for a solution: “To get pregnant you need eggs, you need sperm, and they need to meet.”

“Egg problems” include conditions like Polycystic Ovarian Syndrome (PCOS) – a disorder of hormones and metabolism that lead to the body not ovulating, or releasing the egg to the tube. PCOS patients have irregular periods and often suffer from conditions including obesity and extra body hair (but not always). Ovarian Failure from natural aging also affects a large portion of our patients. If this is Premature Ovarian Failure, we look for other associated illnesses that may need to be treated before we begin fertility treatments.

Another cause is hypothalamus dysfunction. Since the hypothalamus helps control the pituitary gland, and the pituitary gland controls the ovaries, problems with the hypothalamus can have a devastating effect on a woman’s ability to conceive. There are a number of causes of hypothalamus dysfunction, including everything from genetic disorders to head trauma.

Hyperprolactinemia, or the overproduction of the hormone prolactin, which can block ovulation, is more common than one might think. Other causes of infertility include blocked fallopian tubes, birth defects affecting the reproductive organs, and uterine fibroids. Basically, any defect or injury to the female pelvic organs that can block the transport of sperm from the vagina to the fallopian tube, or prevents good implantation of the embryo when it enters the uterine cavity, can affect fertility.

“Sperm problems” are the cause more than 30 percent of the time. As with female infertility, there are a number of reasons men may suffer from infertility, and hormone disorders can play a big role. Additionally, varicose veins in the scrotum; trauma, often suffered while playing sports; and illnesses like mumps or common sexually transmitted diseases can negatively affect fertility. There are also genetic conditions that prevent the sperm from developing or functioning correctly.

Fortunately, once the problem is identified, we generally can prescribe medications and/or surgery to correct the issue. Although 20-30 percent of all patients who come to us do not have an identifiable cause, we still have established protocols and treatment plans with a proven history of success.

Regardless of whether your reasons for infertility are found or not, our process to help will be the same – we’ll work with you to find the best solutions that have the greatest chance of success for you. We’ll leave no stone unturned in doing everything we can to help you achieve your dream of conceiving a child.

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