On this week’s 51%, Albany OB GYN Dr. Katherine Cartwright offers her guidance for those struggling with infertility, and we speak with Albany Medical Center’s Dr. Erica Nicasio about her work monitoring high-risk pregnancies.

Guests: Dr. Katherine Cartwright, Albany Obstetrics & Gynecology; Dr. Erica Nicasio, Albany Medical Center; Natalie Rudd, learning and engagement manager at the National Women's Hall of Fame

51% is a national production of WAMC Northeast Public Radio. It’s produced by Jesse King. Our executive producer is Dr. Alan Chartock, and our theme is “Lolita” by the Albany-based artist Girl Blue.

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You’re listening to 51%, a WAMC production dedicated to women’s issues and experiences. Thanks for tuning in, I’m Jesse King. 

We’ve got another roundup of health-related conversations for you today. Last week, we took an in-depth look at endometriosis, a disease that, in addition to causing a lot of pain, can also contribute to issues like infertility. But as our first guest today will tell us, there’s actually a lot of reasons why someone may have trouble getting pregnant. It’s an issue that can feel very personal and heartbreaking, so to dispel some myths right up front: infertility doesn’t necessarily mean there’s anything wrong with your body, and it’s actually more common than you might think. According to the Centers for Disease Control and Prevention, roughly one in five American, heterosexual women up to age 49 (with no prior births) will have trouble conceiving after their first year of trying. So if you think you might fall in that group, hopefully today’s episode has some basic information to get you thinking and put you at ease. 

Dr. Katherine Cartwright is an OB GYN with Albany Obstetrics & Gynecology. She got her medical degree from Nova Southeastern University and completed her residency at SUNY’s University at Buffalo. Dr. Cartwright says she provides comprehensive women’s health care for patients at various stages in their lives, but as part of that, she provides an awful lot of guidance to women (and couples) struggling to conceive. 

The way that we medically define infertility is 12 months of inability to conceive, despite regular intercourse and regular cycles. Within 12 months, somewhere between 80-90 percent of couples will be able to achieve a pregnancy on their own. So once they've reached a year, that's when we have a medical diagnosis of infertility. It's a little bit different in patients with different risk factors. So patients who are a little bit older, patients over 35, we use more of a six-month cut off. That has a little bit less to do with a difference in them suddenly being infertile after six months, and more to do with known declining fertility with age and wanting to get those people into medical care and into a workup [sooner].

When we have a patient that's concerned about infertility, there's a wide range of things that we really need to talk to them about. Their medical history is one of the most important things, and then talking to their partner and having a patient come in and be evaluated with their partner – or at least have good information about their partner – is really important. This is really a two-person issue, if there is a concern about ability to conceive, and about a third of infertility issues actually are male-factor issues. So I think it often is looked at as a solely female problem if someone's not conceiving, and it's something that we have to talk about very early on and make sure that we are looking at all angles.

The basic workup is looking at the very basic building blocks of “How do we make a baby here?” And are all of those parts here? So, is this person making eggs? And are they releasing an egg every month? That's obviously something that's necessary. Is there sperm, and is the sperm normal? Is it present? And then the third thing that we really need to look at i