Our Reproductive Endocrinology & Infertility Division specializes in aiding patients facing challenges with their reproductive abilities . We are committed to diagnosing conditions and guiding each patient through the available treatment options to help them realize their dreams of starting or expanding their family. We focus on diagnosing and managing endocrine disorders and other chronic conditions that hinder conception or the maintenance of pregnancy. Additionally, we assist patients in preserving their fertility before undergoing cancer treatments. Our expertise extends to supporting individuals without partners, same-sex couples, and transgender individuals in overcoming barriers to parenthood. With its globally recognized reputation, our academic health center is known for cutting-edge therapies and exceptional success rates. Our state-of-the-art facility is staffed by approachable clinicians, many of whom are esteemed experts in fertility treatment. Our clinicians deliver compassionate and personalized care tailored to our patients’ individual needs throughout their journey. Several of our clinicians have held or currently hold leadership positions in prestigious professional organizations, such as the American Society for Reproductive Medicine (ASRM) and the Society for Reproductive Investigation (SRI), underscoring our commitment to excellence in the field of reproductive medicine. Our clinicians have contributed to over 1,000 scientific publications, significantly advancing the field. They have also authored the seminal reference book Speroff's Clinical Gynecologic Endocrinology and Infertility , which guides clinicians in providing comprehensive care to patients with infertility and reproductive disorders. With decades of experience treating patients and helping them achieve pregnancy, our clinicians are also dedicated to advancing research in their specialized areas. Their findings have led to the development of new diagnostic tests, surgical procedures, and innovative technologies, shaping and advancing the field of assisted reproductive technology. As research is integral to our practice, patients can access clinical trials conducted at our facility. Recognizing the emotional complexities associated with infertility, our clinicians offer empathy, support, and a celebration of successes, guiding patients through their challenges. Financial coordinators are available to clarify health insurance eligibility and costs, ensuring transparency and minimizing unexpected fees. The Yale Medicine Reproductive Endocrinology & Infertility Division offers specialized programs including: Endometriosis Program: We diagnose and treat endometriosis , addressing pelvic pain and infertility to improve pregnancy outcomes. Fertility Center: We offer an array of individualized treatment options for both women and men looking to start a family. Our physicians, staff, and scientists share our patients’

Couples experiencing difficulty achieving pregnancy, despite trying for six months to a year (depending on their ages), should seek guidance from a fertility specialist. Male infertility contributes to about half of these cases. Still, numerous treatments are available that may enable men to become parents, even if they have been diagnosed with conditions such as a low sperm count. When a couple consults with a Reproductive Endocrinology & Infertility (REI) specialist, the clinician assesses the health of both partners. A comprehensive health history is obtained, and a semen sample is analyzed. Our Fertility Center employs computer-assisted semen analysis, one of the most advanced methods for evaluating semen quality. This analysis assesses sperm count, morphology (shape and structure), and sperm motility—crucial factors in fertilization. If abnormalities are detected, patients may be referred to a reproductive urologist for further evaluation and treatment. Our Fertility Center is among the few in the country to offer on-site consultations with a reproductive urologist. Poor semen quality is often the primary factor contributing to male infertility. Some patients may have insufficient sperm production or a complete absence of sperm. Others may produce enough sperm, but with abnormalities in morphology or motility. Anatomical abnormalities may also obstruct sperm passage or semen ejaculation. Following a diagnosis, our reproductive specialists collaborate with patients to enhance their chances of achieving parenthood. In cases with a reduced but sufficient number of motile sperm, intrauterine insemination (IUI) may be recommended. Here, ejaculated sperm is washed and directly injected into the uterus by a clinician. IUI is often combined with ovarian stimulation medications to increase the chance of achieving a pregnancy. If sperm quantity is insufficient for an IUI procedure, or if IUI proves unsuccessful, in vitro fertilization (IVF) may be employed to improve pregnancy success rates. A patient’s sperm is combined with their partner's egg in the IVF laboratory. Intracytoplasmic sperm injection (ICSI) is often utilized, in which a single sperm is injected directly into the egg to facilitate fertilization. Subsequently, one of the resulting embryos is transferred into the partner's uterus. For patients with complex male fertility issues, medications may be prescribed to enhance sperm production, or procedures may be performed to address physical barriers hindering sperm release. This may include repairing varicoceles , which are dilated blood vessels in the scrotum that impact sperm production. In cases of severely diminished or absent sperm, advanced sperm retrieval techniques may be necessary. Our reproductive urologists perform microsurgical procedures to locate and extract sperm from the testes, a procedure available at only select fertility centers. Extracted sperm is then used in conjunction with IVF, ensuri

The Sexuality, Intimacy, and Menopause Program is one of the only clinics of its kind in the country. By combining both medical and psychological interventions, it is designed to help women who experience sexual dysfunction after cancer. Sexual dysfunction after cancer is common; however, sexual side effects often go untreated after having successfully treated a patient’s cancer. Our doctors look to manage not only the physical issues, but also any psychological concerns that may arise. Founded by Elena Ratner, MD, MBA, associate professor of Obstetrics, Gynecology & Reproductive Sciences and co-chief for the Section of Gynecologic Oncology, and Mary Jane Minkin, MD, clinical professor of Obstetrics, Gynecology & Reproductive Sciences, the clinic began nearly a decade ago. Psychologist Dwain Fehon, PsyD, associate professor of Psychiatry and chief psychologist of Psychiatric Services at Yale New Haven Hospital, is a vital member of the team. He and his staff provide essential emotional care that helps improve our patients’ relationships and personal health. Many women have concerns related to intimacy and menopause because of cancer surgery or treatment. Our specialists consult with patients to address the difficult physical and emotional aspects of cancer care and treatment, and create a personalized care plan for each patient. We have developed a unique focus on menopause management for cancer survivors and “previvors”—healthy women who have their breasts or ovaries removed because of a genetic risk of developing cancer. What types of patients do we see? Women who experience: Changes in sexual function as a result of chemotherapy, radiation, or surgery for cancer Menopause symptoms as a side effect of cancer treatment Early menopause or sexual changes after surgery for cancer risk reduction What we provide: Menopause symptom management Resources for cancer survivors on maintaining sexual health Access to complementary and supportive services Access to individual and couples counseling What to expect from an appointment: Our team will first discuss each patient’s medical and cancer history, as well as what type of treatment they have had. They will be asked about symptoms of menopause and sexual problems, such as hot flashes, night sweats, changes in sexual desire, painful intercourse, vaginal dryness, or changes in mood or sleep patterns. Depending on their symptoms, patients may have a gynecologic exam. The team will then discuss options for symptom management and improving their sexual health. They will also have the opportunity to talk about emotional and relationship issues affecting their life. Women are welcome to bring their partners to the appointment.