Thursday, May 6, 2010

A Positive Attitude during Infertility Treatment

Infertility treatment is a precarious process intercepted with dramatic emotional swings knowing that there is nothing that can be done to guarantee that treatments will work. Since infertility is defined as a condition that sets in after trying to conceive for 12 months or more, those confronting it may already be drained emotionally. A sense of sadness coupled with shock sets in when recurrent pregnancy checks turn in negative. The anguish of putting up with continual cycle failures creates great aggravation. It is important however to ensure that infertility does not take over your life. Ensure that your self-esteem and outlook towards life remains positive while dealing with the emotional ups and downs of infertility treatment.

How do people manage to stay positive while facing fertility challenges? The answer lies in positive thought processes. You will feel miserable if you view your life as worthless without a child. But a positive frame of mind makes you feel that your life will be nicer once a baby enters your family sphere even if you have to undergo difficulties to conceive. It all boils down to the half-empty versus the half-full view of life.

Positive thinking decreases stress levels and the risk of depression, which in turn increases odds of becoming pregnant. Often, getting pregnant with IVF is just a matter of time. Just because you did not conceive in the first cycle does not mean you won’t conceive in the second cycle.

Feelings of anxiety and depression are common emotions experienced during infertility treatment. Letting go of negative feelings by talking to a close relative, friends or a support group will help in generating positive thoughts and feelings. Using positive affirmations and visualizations also help. Block out negative thoughts by repeating positive statements like “I can have a baby”, “I am doing everything I can to have a baby" or “I am a healthy, fertile woman.” Visualization involves picturing a happy outcome like the baby growing within you or how you will look with a big tummy. Finally, act on what you have control on, for instance your weight, giving up on cigarettes and alcohol. Don’t dwell too long on what is beyond your control.

Support groups foster positive feelings and inspire hope in those suffering from infertility or have endured pregnancy loss. On joining infertility support groups, members get support on issues such as adoption options, becoming foster parents and obtain up to date knowledge about the latest treatment options all of which propel them back into a positive frame of mind. Create a support network of those closest to you—and don’t be afraid to lean on them during this trying time.

Maintaining a positive frame of mind during infertility treatment is easier said than done. It requires tremendous courage and conviction not to give in to despair. However, if fertility treatment is the route you need to take to realize your dream of having a baby, go ahead with an open mind and a willingness to give it a try.

East Bay Fertility Center located in Dublin, California is well equipped with the latest technology and offers the most comprehensive consultation available in the field of Reproductive Endocrinology. The Center is headed by Dr. Ellen U. Snowden a Board Certified Reproductive Endocrinologist and offers a complete mind-body experience for couples with fertility issues. A former infertility patient herself, Dr. Snowden brings to her patients a rare and valuable firsthand empathy for the personal pain and emotional stress of dealing with infertility.

The Gestational Surrogacy option in Infertility Treatment

Gestational surrogacy is the most popular type of commercial surrogacy in the United States. It is an option if the female partner has viable eggs, but does not have a normal uterus or can’t carry a baby for other medical reasons. Gestational surrogacy is done via In Vitro Fertilization (IVF), where a surrogate carries embryos that have been created from the eggs of the baby's intended mother and sperm of the intended father. In cases where the intended parents are unable to produce the necessary sperm or eggs, a donor may be used.

Under the gestational surrogacy option, the female partner will not have any genetic contribution to the pregnancy and neither will she get to carry or deliver the baby. On the other hand, the gestational surrogate mother is in no way biologically related to the baby or surrogate babies she carries. She is merely the carrier of someone else's biological child. In fact surrogacy is a sacrifice for the surrogate mother because when the child is born, the carrier will turn the baby over to the intended parents, signing away her parental rights.

In gestational surrogacy, surrogate mothers are required to go through an extensive medical protocol in preparation of an embryo transfer, as well as to sustain the surrogate pregnancy. This could involve hormonal medication taken orally, vaginally, or through injections.

A gestational surrogate should have had at least one successful pregnancy and child birth, is between the ages of 21 and 35 (preferably less than 40), is a non-smoker, lives in a stable household, has reliable transportation and is not receiving state financial assistance.

The different stages of a gestational surrogacy process can be explained thus:
1. The surrogate chosen is thoroughly screened for infectious diseases.

2. She undergoes at least one session with a Psychologist/Counselor.

3. The most important step in surrogacy is that all potential issues need to be carefully clarified, put in writing, signed, and understood by all parties prior to initiation of the process. This should be done with the help of an experienced lawyer or agency.

4. The patient is stimulated with medications for egg development.

5. The surrogate is placed on medications that suppress her own menstrual cycle and stimulate development of a receptive uterine lining.

6. When the patient's follicles are mature, an egg retrieval procedure is performed to remove the eggs from her ovaries. The eggs are then fertilized in the laboratory with her partner's sperm.

7. The embryos developed are then transferred to the surrogate's uterus where they will hopefully implant and develop to result in a live birth.

8. The baby goes home from the hospital with the genetic parents.
Gestational surrogacy is sometimes the only way in which a couple can have a biological child. The increased legal benefits of gestational surrogacy and lack of a genetic bond are strong selling points for the intended parents and surrogates who choose this route.


At East Bay Fertility Center, Dublin, California, Dr. Ellen U. Snowden, Medical Director and physician and her highly qualified team help infertile couples realize the dream of having a family through the latest technology and most comprehensive consultation in the field of Reproductive Endocrinology. EBFC’s gestational surrogacy program is based on personalized care and support, every step of the way. EBFC only works with surrogates who come from a reputable agency or who are very closely connected (friend or relative) to the patients.

Hypothyroidism – Can it impact fertility?

Sometimes infertility is caused by a condition of the thyroid known as hypothyroidism. Both men and women need to have enough thyroid hormone for a successful pregnancy. Thyroid secretion is essential not only for egg fertilization and development, but also for sperm production. Hypothyroidism along with infertility in a male causes low sperm count or the reduction of the sperm's lifespan. If a woman does not treat a thyroid problem, she is more likely to have a higher chance of miscarriage.

This tiny gland at the base of the neck can cause serious health complications if it is over or under active. Hypothyroidism can cause decreased sex drive, menstrual irregularities, failure to ovulate, miscarriage, premature childbirth and preeclampsia. For women, treating hypothyroidism is an important part of any effort to correct infertility. In fact many younger women with hypothyroidism become aware of this condition for the first time during a fertility evaluation.

Women who have been trying unsuccessfully to get pregnant for more than a year, have irregular menstrual cycles, or have had more than two miscarriages should talk to their doctors about screening for possible thyroid issues. A family history of thyroid disease is another reason to test.

How hypothyroidism influences fertility

Thyroid dysfunction can shorten the length of the luteal phase that leads to heightened risk of miscarriage early on in pregnancy. Decreased thyroid hormone causes low levels of progesterone. This inhibits thickening of the uterine wall, preventing the embryo from attaching. Some women with hypothyroidism also have polycystic ovaries or cysts on the ovaries which hamper ovulation and can cause fertility problems.

Symptoms and treatment

Fatigue and weight gain, irritability, quick heart beat, depression, irregular menstrual cycles, sensitivity to cold, and dry skin are all symptoms of hypothyroidism.

Treatment with oral thyroid hormone supplements will often correct the hypothyroidism and results in a return to normal ovulation and regular menstrual cycles.

For a woman having difficulty becoming pregnant and facing irregular menstruation, a simple blood test to check thyroid gland function is an important part of infertility evaluation during the very first check. An underactive thyroid gland can be easily treated with thyroid hormone replacement therapy.

Women who are pregnant or who desire to start a family need to start thyroid hormone therapy if they have a borderline thyroid function. This is to maintain a thyroid hormone level within high normal range during pregnancy. Uncontrolled hypothyroidism in pregnant women is likely to have long-term effects on the children they bear.The mother is the only source of thyroid hormones for the baby until the baby’s thyroid gland becomes fully functional after around 12 weeks of pregnancy. Hence a woman is at an increased risk of miscarriage, and the baby is at increased risk of developmental problems if she lacks sufficient thyroid hormones.

The good news is that most women with thyroid disease are able to have an uneventful pregnancy and healthy baby. East Bay Fertility Center California, offers a wide range of infertility treatments along with expert medical counseling to couples facing difficulty in conceiving. Under the guidance of Dr. Ellen U. Snowden, Medical Director and Reproductive Endocrinologist, medical staff at East Bay provides dedicated treatment for infertility and reproductive endocrine issues. Testing for thyroid dysfunction is a part of the basic infertility evaluation at the Center. With the right type of treatment and intervention, the Center assists couples who have been having problems conceiving to overcome those difficulties in the shortest possible time in order to realize their dreams of having a healthy baby. Call 925.828.9235 for a free initial consultation.

Saturday, April 17, 2010

Perimenopause - How it Impacts Fertility

Perimenopause is a natural part of aging and includes the years leading up to menopause that could range from two to eight years, plus the first year after a woman’s final period. It’s a transition period that precedes menopause. During this phase, a woman typically experiences the first signs that she is nearing the end of her reproductive years. Perimenopause can begin as early as age 35 or as late as age 60, however it usually begins when women are in their 40s and 50s.


During perimenopause, a woman’s sex hormones (estrogen and progesterone) begin to decline, due to which her cycles may become irregular often with wide and unpredictable fluctuations in level leading to diminished fertility levels.

Ovulation also becomes irregular with the ovaries releasing fewer eggs. Diminished ovarian reserve can occur in younger women due to perimenopause. Hence it becomes difficult to become pregnant.

Fertility options for women in the perimenopause stage

FSH

Some women experiencing perimenopause can use follicle stimulating hormone, or FSH to induce ovulation. Those with a good ovarian reserve can use FSH to stimulate ovulation and increase their chances of conception. FSH is often used in combination with IUI.


Clomiphene

Clomiphene citrate is a fertility drug that is often used during IUI procedures to help induce ovulation.


IVF

IVF is a successful fertility treatment option for women facing perimenopause where a fertilized egg is directly placed into the woman’s uterus. Particularly for women under the age of 40, IVF shows high success rates.


Egg Donation

The most effective treatment option for women going through perimenopause is egg donation which involves fertilizing an egg from another woman with the partner’s sperm. The egg is then implanted into the uterus allowing a woman to experience the whole cycle of pregnancy and childbirth.

Fertility-enhancing techniques are discouraged for women older than age 43 years, and are not recommended for women aged 51 years and above.


The most rapid decline in female fertility begins at about age 30–31 which is, on average, 20 years before menopause. This is not a well known fact and hence many women have planned their lives and careers based on the mistaken belief that their fertility will remain normal well into their forties. Age-related uterine changes also contribute to reduced fertility.


In today’s fast-paced, highly competitive lifestyle, it is no surprise that younger and younger women are facing symptoms of hormonal imbalance and perimenopause. So if you want to get pregnant you should see a doctor as soon as possible to preserve fertility in this stage.


East Bay Fertility Center, Dublin, California has an experienced team of doctors headed by Board Certified Reproductive Endocrinologist Dr Ellen Snowden. At the Center, couples get access to the latest technology and comprehensive consultation with fertility specialists. East Bay specializes in providing infertility treatments such as in-vitro fertilization, insemination, Intracytoplasmic sperm injection, egg donation and gestational surrogacy. Call 925.828.9235 for a free initial consultation.

Sperm Allergy as a Cause of Infertility

Sperm allergy or semen allergy known as human seminal plasma hypersensitivity can significantly affect a couple's chances of conception. It manifests as a condition where a man develops allergy to his own sperm (which happens sometimes after a vasectomy, testicular torsion, trauma or infection) or a woman can become allergic to her partner’s seminal fluid causing her mild yet unpleasant sperm allergy symptoms like soreness, burning, hives, itching etc. This may force the couple to use a condom which though one of the most effective ways to prevent the allergic reaction also ends up preventing pregnancy. Semen allergy is usually caused due to a reaction or allergy to certain proteins that are found in the partner’s semen.

A woman who is allergic to sperm may produce antibodies which fight the sperm cells (interpreted as a foreign presence in the body that needs to be eliminated) whenever they enter her body. These antibodies may completely disable the sperm cells and prevent them from reaching or fertilizing the woman's egg thus acting as an obstacle to conception.


Diagnosis and treatment

Often semen allergies are misdiagnosed as common yeast infection or herpes infection. Hence it’s important that a proper assessment and diagnosis is conducted. Once accurately diagnosed, couples can be treated successfully and fertility restored. The treatment regimen would include one of the following:


• Protein Desensitization is a process where allergy shots are given to the woman to desensitize her reaction to the proteins found in her partner’s semen. The injections are given once every 10-15 minutes for several hours. The desensitization treatment is concluded to have been successful if no reaction takes place during subsequent vaginal contact.

• Semen Desensitization is a cheaper but laborious fertility treatment option where a series of injections of diluted seminal fluid, at higher and higher concentrations are inserted into the vagina to desensitize it

• If desensitizing treatments prove to be unsuccessful, it is indicative of a very serious sperm allergy. The woman may then have to consider more radical treatment options of assisted reproduction methods such as intrauterine insemination (IUI) or in-vitro fertilization (IVF). These methods allow a woman to get pregnant without coming into contact with the proteins in her partner's sperm. Artificial Insemination with sperm that has gone through a protein removal process where they are washed free of semen protein is another treatment option.

It is important for women (and men) to consult with an OBGYN if they suspect that they have symptoms of sperm allergy. A proper line of treatment which might include assisted reproductive technologies (ART) will bring things back to normal, increasing chances of getting pregnant.


East Bay Fertility Center, California, specializes in providing infertility treatments such as in-vitro fertilization, insemination, Intracytoplasmic sperm injection, egg donation and gestational surrogacy. Under the guidance of Dr. Ellen U. Snowden, Medical Director and Reproductive Endocrinologist, medical staff at East Bay provides dedicated treatment for infertility and reproductive endocrine issues.


Call 925.828.9235 for a free initial consultation and for more details about infertility treatments and more.

Endometrial polyps - an Impediment to a Successful Pregnancy

Uterine problems can sometimes affect fertility. Uterine polyps or endometrial polyps are localized overgrowth of tissues in the endometrium lining of the uterus that protrude into the uterine cavity. They may occur alone or in clusters. The precise causes leading to their development are not clearly defined. They are believed to form spontaneously due to hormonal factors or as a result of too much estrogen.

Polyp overgrowth in the uterine cavity may interfere with implantation and fertility by preventing the egg from implanting into the endometrial wall after it is fertilized. Also if the polyps are located near the area where the fallopian tube is connected with the uterus it will disable the sperm from entering the uterus.


Polyps can be identified by HSG or vaginal ultrasound. The incidence of these polyps rises with increasing age, is at its peak in the fifth decade, and gradually declines after menopause.


The smaller categories of polyps which are a few millimeters do not impact reproductive capabilities. However large polyps can interfere with reproduction by impacting implantation and fertility. There is also an increased possibility of miscarriages.


Symptoms and Treatment

Most women with endometrial polyps face no symptoms. Some others face irregular menstrual bleeding or excessive bleeding. Thus, abnormal bleeding episodes are the most common presenting factor related to the presence of endometrial polyps.

Some polyps disappear on their own. When removal becomes necessary, endometrial polyps are cured thorough curettage, specifically hysteroscopic-guided curettage. This technique, which involves removing the endometrial lining of the uterus, is especially successful in women who fall in the post-menopausal age group. Larger polyps are removed under general anesthesia to control possible bleeding. If numerous polyps are found, a hysterectomy may be recommended.


Women who get their uterine polyps removed are usually able to get pregnant thereafter with reduced risk of a miscarriage. If a woman undergoing IVF treatment is detected with uterine polyps, embryo transfer is recommended only after polyp removal.

At East Bay Fertility Center, California, couples dealing with infertility get access to the latest technology and comprehensive consultation with a reproductive endocrinologist and fertility specialists. At the Center, a hysteroscopy would be recommended if a patient's history or sonogram findings indicate the presence of a polyp or scar tissue inside the uterus. This is a minor procedure involving the passing of a small telescope through the cervix so the doctor can directly visualize the uterine cavity and remove the abnormal tissue.

East Bay specializes in providing infertility treatments such as in-vitro fertilization, insemination, Intracytoplasmic sperm injection, egg donation and gestational surrogacy. Call 925.828.9235 for a free initial consultation.

Friday, March 19, 2010

How Eating Disorders Affect Fertility

Very often fertility problems can be traced to eating disorders and it is estimated that as many as one out of every five infertility cases are the result of unhealthy eating habits. Long periods of depleted nutrition and rapid weight loss interfere with hormonal balance which has an effect on the menstrual cycle and egg release and thus adversely affects fertility. Other infertility related problems that may arise among women with eating disorders include low libido, poor uterine environment, reduced egg quality (due to polycystic ovary syndrome) and ovarian failure.


Types of eating disorders

Anorexia nervosa is the most common eating disorder. It is a condition of food deprival in an effort to become thin. Characteristics of this self imposed starvation include a mortal fear of fatness leading to food avoidance, excessive exercise and a completely unhealthy eating regimen.

Bulimia nervosa on the other hand involves binge eating and then purging the food, either by vomiting or through the use of laxatives.

The other extreme condition is compulsive overeating where the person will binge on food but will not purge afterwards. This is often accompanied by feelings of guilt and shame since it involves the issue of overweight. Such women carry the risk of miscarriage due to the pressure on the body.

Since these are mental illnesses as well, anorexics, bulimics and compulsive overeaters are more likely to suffer from anxiety, stress and depression which in turn adversely affect their chance of conceiving.


Adverse effects on pregnancy

Even if a woman with an eating disorder does become pregnant, it is detrimental to the health of both mother and child. Continued avoidance of food leads to delayed fetal growth, gestational diabetes, jaundice, preeclampsia, premature labor, low birth weight and birth defects such as mental retardation and blindness. In the event that a baby is carried to term, such women tend to have problems with breast feeding and may also suffer from postpartum depression.

Women who are excessively underweight or overweight are susceptible to amenorrhea which is the cessation of menstruation. On a positive note, most women start menstruating again when they begin to gain weight and consequently achieve conception. Women identified with eating disorders should be counseled and treated for the eating disorder before further hormonal tests and infertility treatments are pursued. However regaining weight is not enough; eating patterns have to be normalized with a good distribution of eating healthy food at regular intervals.

Those struggling with an eating disorder are encouraged to consult with a gynecologist before trying to conceive. They will then be directed to a counselor and nutritionist to discuss a healthy pregnancy diet. It is best to wait until the disorder is under control before trying for a baby. The counseling sessions should ideally be continued post delivery.

East Bay Fertility Center helps couples cope with eating disorders that may be the underlying cause of infertility. As there are emotional issues involved, couples will be given one-on-one counseling to help overcome the situation. The Center offers a complete mind-body experience for couples facing infertility issues. Call 925.828.9235 for a free initial consultation.