Having a Baby on Your Own (Part 2): Building Your Fertility Team

By Mikki Morrissett

Part 2: Choosing a Fertility Specialist:
Q: Should I use my ob/gyn or a fertility doctor?
Unlike married couples, who go to fertility specialists after a long period of unprotected sex, the single woman is generally trying to conceive without having tried to get pregnant before.
Many women into their early 40s are able to conceive without medical intervention. But after the age of 35, our fertility does tend to drop dramatically. So it becomes a gamble: Spend money upfront for a specialist and fertility tests, or try it for a few cycles and see what happens at the lower cost?
Fellow Choice Moms will differ significantly in their advice to women just beginning this journey. Many who felt they waited too long to conceive the first time — or those who had fertility challenges to confront — urge women to visit a specialist right away, especially if they eventually want more than one child. Others who conceived easily are optimistic that trial-and-error can be worthwhile.
Obstetricians/gynecologists (ob/gyns) are sometimes more likely to be covered by health care plans, making them the preferred first choice by women who have no obvious fertility challenges. Their overall costs may be lower, too. Often they are someone we’ve been seeing for Pap smears and annual exams, and that existing relationship can make the process less overwhelming.
One doctor pointed out, however, that in his city, the ob/gyns in outlying areas seem almost more well-rounded in addressing fertility issues. He believed that the city ob/gyns who tended to be connected to HMO programs were often not as effective in helping women pinpoint issues early enough.
Reproductive endocrinologists (REs) in the U.S. must complete a fellowship, tend to have more experience with inseminations, and have the equipment to provide more fertility-related follow-up. Many are available seven days per week for inseminations, which is important.
As Dr. Arthur Wisot (Los Angeles) says: “What you don’t want is an ob/gyn who gives you a six-month prescription for Clomid and says ‘go out and get pregnant.’ Initially, your physician should take a full medical history, do a physical exam and hopefully an ultrasound to see the anatomy of your pelvis. He or she should then offer you some basic finding regarding what your fertility options are and should then sit down and talk with you about those options.”
Q: Once you’ve decided between ob/gyn and RE, how do you pick one?
There generally are two categories of doctors: 1) those with good “bedside manner” who can walk a patient through the process, and 2) those who might not be warm and fuzzy but know some of the best ways to get people pregnant. You’ll find doctors who can do both. But many times a woman needs to choose which is most important to her at that stage of her life.
Fertility specialists who perform in vitro fertilization (IVF) — a costly laboratory procedure that many single women do not need unless intrauterine insemination (IUI) is not a viable option — are reported on SART.org. This is where you should check a clinic’s success rates (although some clinics turn away certain patients to keep their success rate high).
Before you make any appointment, call the front desk and ask if the doctor is supportive of single women having babies. ChoiceMoms.org is currently compiling a list of clinics that do and do not work with singles and lesbians. Women from Florida to Texas have reported challenges.
Also look for a clinic that performs IUIs seven days a week. The egg generally lives for only one day after ovulation. That narrow window for insemination doesn’t stop for weekends and holidays, even if your doctor does.

Read Part 1 of Having a Baby on Your Own

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Raising a Fatherless Boy: What Single Moms Need to Know

Eight Ways to Prepare for Baby and Me