February 21, 2007

Prairie du Sac, Wis.—“Where do babies come from?” is a question most adults think they can answer, but for couples struggling to get pregnant, it’s important to go looking for answers, says Todd Schad, MD, a board certified obstetrician and gynecologist at Prairie Clinic, who delivers babies at Sauk Prairie Memorial Hospital.

“One of the biggest myths about conception is that it’s easy to get pregnant, so once a couple decides to start a family, they’re usually pretty impatient to get pregnant. When months pass without a positive pregnancy test, they start to worry,” says Schad. “But,” he stresses, “infertility isn’t diagnosed until a couple has been actively trying to get pregnant for at least a year.”

Since many women will seek treatment before a year, doctors can step in with counseling and education to increase chances of conception. But once a year has passed, couples should start a process to diagnose a cause for their infertility and pursue treatment.

Because fertility problems can occur in both men and women, couples begin evaluation together. “The good news is that most of the testing can be done here in the office or hospital,” says Schad. For women, the first step is to verify that ovulation is occurring. “There are many reasons why a woman is not producing eggs each month,” he explains. These include stress, anorexia, age and other diseases that can interfere with getting pregnant. If a cause is found, treatment for that alone can improve chances of conception.

For men, a simple test determines if enough viable sperm are available. There are many causes of low count or low-quality sperm production such as drinking, smoking and some diseases. Sometimes, a referral to a urologist is necessary.

After trying to conceive a child for years, B.J. and Melanie Hellenbrand of Lodi, Wis., turned to Schad for help. The Hellenbrands, both healthy and in their mid-20s, stopped birth control in 2002, a year after getting married. “We weren’t sure what to do when we didn’t get pregnant,” says Melanie. “We started really trying in January of 2003.” Still, they couldn’t conceive a child, despite tracking Melanie’s menstrual cycle and daily temperature. For six months she took her temperature and charted the results in hopes of determining when she might be ovulating. Typically a sharp rise in temperature indicates ovulation is occurring. Still, with frustration and anxiety mounting, the couple remained unable to conceive. “It tears you up inside,” says Melanie, who was also mourning the recent death of her brother. “I assumed I wasn’t getting pregnant because of the stress related to my brother’s death.” That’s when a friend, who also had trouble conceiving a child, suggested the Hellenbrands see Schad. “

This is a high anxiety time for a couple, and we understand that this is more than a medical issue. The diagnosis and treatment require sensitivity and reassurance that there are many options to begin a family,” says Schad. “We approach fertility treatments in a step-wise fashion because they can be expensive and insurance coverage varies. Couples need to know the investment they will make financially and emotionally.”

During the couple’s visit with Schad, he determined that Melanie wasn’t ovulating, and as a result, wasn’t getting pregnant. In addition to performing an exam and some tests, Schad carefully reviewed Melanie’s ovulation chart of six months. “I thought everything was fine with my ovulation because my temperature was rising, but Dr. Schad said it wasn’t rising enough,” says Melanie. “He was almost sure of the problem right away. He put me on a drug to stimulate ovulation. I was on it for a few months and still didn’t get pregnant so he performed an intrauterine insemination.”

B.J. and Melanie Hellenbrand with their son, Tyler.

Intrauterine insemination is a form of artificial insemination that is often successful for couples who are experiencing unpredictable ovulation or low sperm count. The process is performed in the doctor’s office and doesn’t require a hospital stay. First, the woman uses a fertility drug and hormone injection to stimulate ovulation. An ultrasoudconfirms that an egg is ready for fertilization. A semen sample is collected and processed to gather only the most viable sperm.

Using a catheter, the sperm is placed into the uterus where it should meet and fertilize an egg. The process is completed two consecutive days to assure fertilization occurs. In two weeks, a pregnancy test reveals if the process was successful.

On the first try, the Hellenbrands conceived. Their baby boy, Tyler, was born in May of 2006. Nearly a year later, Melanie urges couples struggling to conceive to contact Schad. “It doesn’t hurt to be sure everything is okay,” she says. “We both feel he is a phenomenal doctor. There was no waiting; he took us seriously right from the start and took charge of our fertility.” Looking back, Melanie admits she wishes she’d seen Schad sooner.“

Fertility varies from couple to couple, individual to individual,” adds Schad. “When couples have all the facts about conception, they realize that it’s rather difficult to get pregnant. It’s never too late for a biology lesson and accurate information helps couples determine their best strategy to conceive a baby.”

Schad also notes that babies conceived using intrauterine insemination are just as likely to experience a normal pregnancy as other babies. He adds that infertility isn’t necessarily a chronic condition and successive children may be traditionally conceived. “Dr. Schad told us that it’s pretty common to get pregnant the second time without help,” says Melanie. “The body often corrects itself after pregnancy.”

In addition to Prairie Clinic, Dr. Schad also sees patients at Lodi Medical Clinic and River Valley Medical Clinic. To schedule an appointment with him to pursue infertility concerns or for other obstetrical and gynecological issues, contact Prairie Clinic at 608/643-3351.