I bet you didn’t know that January is Cervical Health Awareness Month (honestly, I didn’t either until recently, so I'm getting this information to you just under the wire!). You probably don’t spend too much time wondering about the health of your cervix. Let’s face it, other than your annual checkup and how far you’re dilated when you’re in labor, your cervix doesn’t come up for discussion too often. But, if you want to have children someday or you’re actively trying to conceive now, you need to be aware that cervical problems can affect fertility.

For example, did you know that cervical mucus can be “hostile”? Granted, it’s an over-the-top name, but it’s actually pretty accurate. Cervical mucus is vital in helping sperm travel from the vagina into the uterus, and it can be negatively affected by infection or past trauma such as procedures/surgeries to the cervix. Since some infections and most cervical trauma are completely asymptomatic, you may not even know there’s a problem until you have trouble getting pregnant.

You also can run into problems with recurrent miscarriage because of an incompetent cervix. If your cervix is too weak to support your growing uterus, miscarriage or premature labor and delivery can occur – a heartbreaking and frustrating outcome, especially if you’ve already struggled with infertility.

Additionally, your cervix may be compromised because you are a “DES daughter.” What’s that? From 1941 to 1972, many women were prescribed a drug called diethylstilbestrol (DES) to prevent miscarriage. Unfortunately, what the medical establishment realized was that DES was detrimental to both mother and child, increasing the risk of breast cancer in the mom and causing abnormalities in the reproductive systems of the babies. “DES daughters” – offspring of the women who took DES – face an increased risk of clear cell adenocarcinoma (CCA) of the vagina and cervix (although it’s still very rare), as well as reproductive tract structural differences that may cause infertility and/or difficulties with pregnancy. The youngest of the "DES daughters," however, are now 38, so this will eventually become a non-issue as these women move out of their childbearing years.

What can you do to reduce the odds that a cervical issue will cause infertility? Early detection is key, so make sure you have an annual checkup with your OB/GYN, and don’t let embarrassment hold you back from being open with your doctor about your health. Talk about any concerns you have or issues you suspect with your doctor – make sure you give them all the tools they need to help you protect your fertility and be as healthy as possible. If you need more information, check out the National Cervical Cancer public education campaign or the National Cervical Cancer Coalition. Or, I am always available to answer any questions or concerns you may have – email me at esimckes@fertilitypartnership.com or call me at 800.BabyToday.

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Let's face it, it's time for us to reinvent how we look at infertility. All these years, we have been viewing infertility as a quality of life issue. In fact, it is more like a disease, because human organs are not working as they should. A woman's right to try to get pregnant should be the same as a person's right to not have a broken bone or an infection. Nevertheless, we find ourselves in a situation where only people who can afford it and the few who have insurance can be appropriately treated.

Since infertility care is not generally covered by insurance, the medical community has become reactive as opposed to proactive in our management. Couples often wait a very long time before they seek help, as they fear what lies in store for them if infertility is in fact diagnosed. As a result, many women wait too long and are faced with a serious egg reserve problem. Imagine if a woman or man could find out that there is a problem even before they try to have children. If they found out early on, they could prepare themselves emotionally and financially for the upcoming struggle.

Fertility Partnership has created the Fertility Profile to give women an opportunity to get a snapshot of their reproductive health. If the results indicate that there is a significant depletion in their egg reserve, they can make decisions before it's too late. While the Fertility Profile can give women a good snapshot of their current health, however, it cannot predict that the egg reserve will remain within healthy ranges for a long time. In fact, I have seen women whose fertility indicators have changed dramatically over a very short period of time – as little as six months. But, if there is a problem, a woman has a right to know as soon as possible. As it stands now, a woman generally has to try to get pregnant for a year – six months if over age 35 – before most doctors will initiate a comprehensive workup. At the Fertility Partnership, my objective is to always be proactive and look for problems early on so that big decisions about having a baby can be made in a timely fashion.

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Donna Nichols is one of the most courageous and inspiring women you'll ever meet. Here's her story, courtesy of KTVI-TV, about battling the physical and emotional trauma of nine miscarriages before finally giving birth to two beautiful baby boys. Thanks, Donna, for sharing your story and giving hope to many other women dealing with the sorrow of recurrent miscarriage.

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As Fertility Partnership gathers momentum, we’re continuing to use a variety of methods to spread the word about our clinic’s unique mission and services. I am thrilled that our second cycle has twice the number of patients as our first, but I still cannot help but wonder why OB/GYNs don’t more readily refer patients to fertility doctors. I have a unique perspective on this issue, because I am sure I am one of the few obstetricians who was engaged in IVF while also practicing general obstetrics and gynecology.

The fact of the matter is that many obstetricians don’t want to refer onward. Several reasons come to mind, most of them involving good intentions. First, they know how expensive advanced reproductive technology is and want to solve the problem for their patients much more affordably using simpler, less expensive measures. Some don’t refer because they simply enjoy being a doctor and want to be involved in the “healing process.” From personal experience, I can tell you there’s no greater thrill than calling a patient who’s struggled to have a baby and saying to them, “Guess what? You’re pregnant!”

I am sure there are those doctors who just don’t like admitting they don’t know what to do when a patient can’t get pregnant, so they simply say, “Well, let’s just give it a few more months.” Also, there sometimes is a concern that if they refer their patient out to a fertility doctor, the patient will never come back - their doctor-patient relationship will be undermined by the process, or the specialist will send the successfully pregnant patient to a high risk obstetrician or to another physician who is a better referral source.

In the end, precious months are often wasted. Clomid is given inappropriately, for the wrong reason, and for too long. With the recent study from the University of St. Andrews and Edinburgh University in Scotland that found a woman loses 90 percent of her egg quantity by age 30, we should all be concerned about not wasting valuable time. I built the Fertility Partnership with a goal of developing strong relationships with referring doctors so that many of the obstacles to timely reproductive care can be overcome. We will not price-gouge their patients, we will communicate well with the referring doctor and ensure the patients return to them if the patients choose to, and we will work with the doctors who want to solve the problems in their own practice. It’s just one of the reasons our name is Fertility Partnership.

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