Testosterone Testing during Infertility Treatment

Testosterone levels are an important factor in fertility. When infertility is suspected, testosterone testing may be recommended for both partners. It involves a blood test and in the male, the test primarily looks for a lower than normal level of testosterone since sufficient testosterone is absolutely critical for normal sperm production. A testosterone test may be used to see whether a problem with the testicles or pituitary gland is preventing a man from being able to father a child. If the testosterone level is abnormal that could also be the reason for erectile dysfunction. Low testosterone may be caused by an underlying hormonal problem such as a pituitary problem, a disease affecting the testes, or physical damage to the testes. Damage may be caused by physical injury, chronic alcohol abuse or a history of mumps.

Testosterone Testing in Women
Testosterone was once considered an exclusively male hormone; but research over the past decade has shown that this hormone also plays a crucial role in women's physical and psychological health. Endocrine abnormalities like increased testosterone levels are factors that affect female fertility.

A blood test to determine testosterone levels is recommended if a woman has irregular periods or none at all. Most of the testosterone in the blood is bound to a protein called sex hormone binding globulin (SHBG). Obesity or hyperthyroidism could lead to increased SHBG levels and therefore, "Free" testosterone may be checked when such conditions are present.

Testosterone and Infertility
Testosterone has an indirect impact on female fertility and female testosterone levels can be an indication for certain conditions that can cause female infertility. High testosterone caused by low estrogen or by ovarian cancer in females may be the root cause for many infertility related issues. Polycystic ovarian syndrome (PCOS) is another possible cause. Another symptom is anovulation (not producing mature egg cells), which leads to infertility. High testosterone does not cause infertility, but testosterone levels can rise in women because of tumors that develop in the ovaries or PCOS.

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. 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.

Endometrial Biopsy during Infertility Investigation

In the course of infertility assessment, an endometrial biopsy is one diagnostic tool used to investigate hormonal imbalances that can lead to irregular cycles, frequent miscarriages, or even irregular uterine bleeding. It is indicated when diseases of the endometrium are suspected to be the cause of the infertility and also to find out how ready the endometrium is to accept the implantation of an embryo. The test analyzes whether the lining of a woman’s uterus can support a pregnancy. During an endometrial biopsy a soft, straw-like device (pipelle) or any other pliable instrument is used to suction a small sample of lining from the uterus. The endometrial lining is then analyzed in a lab for abnormal cells.

Problems with the endometrium are called “luteal phase defect", which is a hormonal disorder. An endometrial biopsy checks to see if the endometrium can support implantation and growth of a fertilized egg. The entire procedure takes less than 10 minutes and is far less invasive than a hysteroscopic procedure. The biopsy is usually done about three days before the start of the period. Prior to the biopsy, if a pregnancy is suspected, a pregnancy test must be done to rule out this possibility.

Endometrial biopsy and Infertility
In women with infertility issues, it is very important to know what causes this infertility. The outcome of an endometrial biopsy may determine whether there exists a progesterone deficiency, an estrogen deficiency, or a luteinizing hormone (LH) deficiency. Depending on the hormonal imbalance, a hormone supplement or a prescription drug may be recommended. The test can also be used to check for infection and if this is discovered, a D&C may be needed and/or treatment with antibiotics.

Thus an endometrial biopsy is sometimes necessary to determine the cause of infertility and in some cases the infertility can be reversed. This is a useful tool to detect hormone imbalance that may be the cause of infertility and the doctor will usually prescribe progesterone to relieve it. Thus by performing the simple endometrial biopsy for infertility, a couple may have well taken the first step towards having a child.

East Bay fertility clinic specializes in the comprehensive evaluation and treatment of infertility. Their experienced medical staff is headed by Dr. Ellen U. Snowden, Medical Director and physician. Dr Snowden is Board Certified in Obstetric, Gynecology, and Reproductive Endocrinology with advanced Fellowship training in the treatment of infertility, recurrent miscarriages and hormonal disorders in women. 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. Call 925.828.9235 for a free initial consultation.

Dealing with High-FSH levels and Pregnancy

Follicle Stimulating Hormone (FSH) stimulates the female ovaries to produce a mature egg for fertilization. By measuring a woman's FSH levels, doctors get an indication of the quantity of the woman’s eggs remaining as well as her chances of having a successful pregnancy. Eggs are not replaceable as a woman is born with all of the eggs she will ever have. As she ages, the quality and quantity of the eggs decreases.

Declining ovarian function is indicated by an elevation of FSH levels. Increased levels are seen in primary or premature ovarian failure, sometimes referred to as early menopause. FSH levels are usually checked around cycle day three. The tests may show a rise or fall in FSH levels over a couple of months. A rise is an indication of a problem with a woman’s ovarian egg supply, leading to difficulties in treating infertility. This however does not mean that a woman with high FSH levels cannot get pregnant. Checking FSH levels assists in deciding upon treatment options. Along with FSH level, Estradiol levels are also tested since they are indicators of ovarian reserve.

By measuring the amount of FSH, doctors can suggest specific treatments (such as in-vitro fertilization or intrauterine insemination) that could maximize the chances of becoming pregnant. Assisted hatching in IVF is also an option for women with elevated basal FSH levels who may also have a thickened wall around the egg called the zona.

Can FSH Levels be lowered?

FSH can be artificially suppressed by taking birth control pills or synthetic estrogen. However there are mixed reports whether these options are really beneficial. Research is currently underway to find a way of using stem cells to either create egg cells or to fabricate eggs using donated egg material and the woman’s DNA.

High FSH Levels – What they could mean

High FSH levels correlate with poor pregnancy rates. A normal FSH level is usually under 10, whereas an abnormal level is anything above 25. Measurements between 10 and 25 are generally considered to be borderline cases. FSH levels vary a bit across laboratories depending on which assay system is used. It’s best to retest the FSH in the new RE’s lab so that there is no confusion.

High FSH levels warrant an immediate treatment regimen since even a short delay in treatment could mean the difference between conceiving and not conceiving. This condition is also a case for considering using an egg donor.

For women, in their 20s or early 30s, high FSH may be due to immune abnormalities or an undetected infection. Sometimes the level returns to normalcy on its own. However the high FSH levels that occur in women age 38 and older are unlikely to be reversible.

East Bay fertility Center Dublin California, specializes in the comprehensive evaluation and treatment of infertility providing a complete mind-body experience for fertility couples. East Bay’s experienced medical staff is headed by Dr. Ellen U. Snowden, Medical Director and physician. Dr Snowden is Board Certified in Obstetric, Gynecology, and Reproductive Endocrinology with advanced Fellowship training in the treatment of infertility, recurrent miscarriages and hormonal disorders in women. East Bay Fertility Center conducts FSH tests in the course of infertility tests to check the ovarian egg supply and recommends the best possible course of treatment.

Call 925.828.9235 for a free initial consultation.

Assisted Hatching – Conception Option for Older Women

Assisted hatching is a good option for couples experiencing poor IVF outcomes or who have been diagnosed with a poor fertility prognosis. The procedure offers them a better chance for conception. It is a technique where an embryo is fertilized outside the womb via IVF and the zona pellucida or outer coating of an embryo is partially opened so as to assist the embryo to escape or hatch from the zona and improve implantation and pregnancy rates.

Sometimes IVF may not lead to positive results because of genetic abnormalities of embryos and abnormalities of the zona pellucida which may impair embryonic hatching.

Assisted hatching helps in overcoming these conditions.
Assisted hatching is recommended in case of advanced maternal age, for those who have had a number of unsuccessful embryo transfers and where embryos have increased zona thickness.

How Assisted Hatching is Performed
Assisted hatching is a very delicate procedure and can be performed only by a skilled micromanipulator or an embryologist. The embryo is held with a specialized holding pipette and a very delicate, hollow needle is used to expel an acidic solution against the outer shell or zona pellucida of the embryo. A small hole is made in the shell by the acidic solution and the embryo is then washed and put back in the incubator. Shortly afterwards, the embryo transfer procedure is initiated. This procedure may be accomplished chemically, mechanically, or with a laser.

Risks Associated with Assisted Hatching
Those opting for assisted hatching should be made aware of some of the risks associated with this procedure:
• A small risk exists of damage to the embryo during the micromanipulation process or at the time of transfer
• Risk of identical twins and in rare cases Siamese twins
• A greater chance of fetal complications
• It does add extra laboratory manipulation and therefore added costs

East Bay Fertility Center offers several IVF techniques, including assisted hatching in select appropriate cases. The Center assesses the possible benefits of assisted hatching before finalizing the process as part of a treatment plan. The patient is made aware of the risks and benefits of the procedure and consent must be given for an embryologist to use assisted hatching. 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.
For couples who have attempted assisted reproductive procedures many times and for women, whose time is running out because of their age, assisted hatching offers hope of realizing their dreams of becoming parents.

Pre-Implantation Genetic Diagnosis (PGD) in Fertility Treatments

For couples undergoing in vitro fertilization (IVF), pre-implantation genetic diagnosis (PGD) is a procedure undertaken to screen the embryos for a host of genetic diseases and disorders to ensure the delivery of a healthy baby. PGD helps physicians to identify some genetic defects within the embryo, prior to implantation, before the pregnancy is established. The couple can then decide whether or not they want to continue with the pregnancy. The procedure was first conducted in 1988 and since then this technology is increasingly being used in fertility clinics in the United States.

PGD is normally recommended for couples where one or both of the parents are a known carrier of a genetic disease such as hemophilia. The procedure involves the removal of one or two cells from an embryo which are then screened for genetic abnormalities. PGD identifies the embryos with chromosome abnormalities, thereby avoiding their transfer during an in vitro fertilization procedure. The analysis helps to detect certain inherited or chromosomal diseases such as Down syndrome, Thalassemia, cystic fibrosis, hemophilia A, Tay-Sachs disease, and Turner syndrome among others, prior to implantation.

Most fertility clinics offer PGD in select cases such as:
• Women over the age of 35 who have had miscarriages or failed attempts at becoming pregnant through IVF
• Women who have repeated pregnancy loss due to genetic disorders or who already have one child with a genetic problem
• Any couple who have been unable to become pregnant through multiple IVF cycles
• Couples who wish to identify a tissue match for a sick sibling who can be cured with transplanted cells

For couples who are at risk of passing on serious inheritable genetic diseases to their offspring, a diagnosis before embarking on a pregnancy is preferable to medically invasive, emotionally demanding prenatal diagnostic techniques. However couples with genetic disorders should receive adequate counseling about the risks of misdiagnosis and the possibility of no diagnosis before going in for PGD.

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.

At the center, PGD is offered as an option to couples who are at high risk of passing on a genetic disease to their children. The Center’s IVF experience and access to advanced genetic testing and counseling holds the promise of increasing the probability of a successful pregnancy outcome from an in vitro fertilization procedure and reducing the incidence of genetic disease. The use of this advanced genetic testing procedure allows only normal embryos to be transferred back into the uterus, providing a much better chance of achieving a full-term pregnancy with chromosomally healthy embryos.

The Embryo Toxic Factor in Recurrent Miscarriages

One of the complex medical reasons for recurrent miscarriages may be traced to a condition known as embryo toxic factor (ETF). ETF is a cytokine secreted by the immune system’s white blood cells in response to pregnancy tissue. If excess amounts of cytokine are produced by white blood cells during pregnancy, the immune system may consider the embryo as a foreign body and try and eliminate it, thus leading to miscarriage. Embryo toxic factors have also been reported in women experiencing unexplained infertility and infertility associated with endometriosis.

Diagnosing Embryo Toxic Factor
Testing for embryo toxic factor is a complex laboratory experiment and is opted for only if other tests for miscarriage do not lead to any conclusive results. ETF testing is still considered an experimental testing.

A blood sample is first taken and the lymphocytes are cultured for several days. They are then combined with cultured mouse embryos and left to sit for a few days. Subsequently, a fertility specialist studies the embryo development in relation to how it has been affected by these lymphocytes. If the embryos have stopped developing or have died, it shows the presence of ETF. If the embryos are developing normally, the conclusion is that no ETF is secreted.

The Treatment Regimen

Women suffering from ETF usually have to engage in a multiple treatment regimen to avoid future pregnancy complications. Since the cause of ETF is an over-active immune response, the treatment for ETF revolves around immune system repression. This includes

Intravenous immunoglobin (IVIg) infusions which suppresses the production of cytokines
Vaginal applications of progesterone in suppositories or gel caps, taken until the sixteenth week of pregnancy

In case the woman is undergoing IVF treatment, progesterone oil injections may be given

Recurrent miscarriage is a condition that could be a sign of a more serious problem and a fertility specialist should be immediately consulted. 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. East Bay Fertility Center specializes in providing infertility treatments such as in-vitro fertilization, insemination, Intracytoplasmic sperm injection, egg donation and gestational surrogacy. 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.

Coping with Side Effects of Fertility Treatment Medication

Fertility drugs are used extensively to stimulate the reproductive system; but they occasionally come with physical discomfort. Although there is a concern about an increased risk of breast and ovarian cancer with the use of fertility drugs, studies have not shown a link between the two.

The most common fertility drugs include Clomiphene popularly known by the brand name Clomid, Human Menopausal Gonadotrophin, and Bromocriptine.

Clomiphene, taken as a pill daily, stimulates the pituitary gland to produce follicle stimulating hormones and luteinizing hormone, which is the hormone that triggers ovulation. The most common side effects of Clomiphene affecting 10 to 14 percent of patients are mild ovarian enlargement and hot flashes.

Clomiphene can also cause mood swings, dry cervical mucus, and stomach pain. A side effect that requires immediate attention is headaches or visual disturbances, especially “floaters” that cloud vision. Clomiphene can also lead to superovulation, which increases the chance of multiple pregnancies.

Human Menopausal Gonadotropin (hMG) is often used as an alternative if Clomiphene does not work effectively. Possible side effects from hMG include head aches and swelling or bruising at the injection site. In rare cases, women develop hyperstimulated ovaries, in which the ovaries become much enlarged. This is a serious condition signaled by sudden onset of severe pelvic pain, nausea, vomiting, or weight gain. If symptoms are severe, close monitoring, including daily weight measurements and ultrasounds may be necessary.

Bromocriptine is taken orally or as a vaginal pill. Side effects from Bromocriptine include headache, nausea, dizziness and low blood pressure. Patients who take the drug vaginally often report fewer side effects. In general, injectible fertility medications tend to have fewer side effects than oral fertility drugs.

One side effect that is common with fertility drugs is the risk of multiple births. The multiple pregnancy rate is 7-8% of Clomid patients and 30-35% of Gonadotropin (injectable) patients. The majority of these multiple pregnancies are twins.

Offsetting the Side Effects
Before taking any medication, discuss the side effects with your health care provider at length. Most side-effects are usually short-lived and are no cause for concern. Some simple measures that can be taken to minimize the discomfort of fertility drugs are listed below:
• Take the pills after intake of food to prevent abdominal upsets
• To minimize the discomfort of injections, topical anesthetic may be applied prior to the injection. Ice should not be used as it may affect the absorption of the medication due to decreased blood flow.
• Other common symptoms such as insomnia, mild ovarian swelling, breast tenderness and weight gain are normal symptoms where nothing much can be done
• Irritability, mood swings and all the extra pounds that a woman gains are also normal but a temporary phenomenon that go away in due course
• Get plenty of fluids, since even mild dehydration can lead to headaches
• Linking up with support groups helps to share common concerns and advice from those in similar situations.

Also keep in mind that each patient's drug protocol is unique, so no two women will have the same side effects with fertility medication.

Thousands of women undergo fertility treatment every year with no major complaints. When the end result is a safe pregnancy and healthy baby, most women forget the pain and discomfort that they experienced in the course of medication.

East Bay Fertility Center is well equipped with the latest infertility treatment options and offers comprehensive consultation 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. Dr. Snowden brings to her patients a rare and valuable firsthand empathy for the personal pain and emotional stress of dealing with infertility.

To learn more about East Bay’s infertility treatment options and counseling sessions, call 925.828.9235

Careful Embryo Transfer for a Successful IVF Outcome

For a successful IVF outcome, the procedure of embryo transfer should be done with great care to ensure that the embryos are delivered gently inside the uterine cavity without any trauma. The process usually takes between 10 and 20 minutes. A carelessly performed embryo transfer can ruin the chances of conception.

Once the embryos are transferred, there’s nothing a patient can do to influence the outcome of her cycle. A few hours of bed rest after the transfer is required. It is important that physical activities be limited for the remainder of the day and the following day or two.

Conception depends upon the genetic quality of the eggs. Nature will only allow genetically perfect embryos to survive.

Ensuring a Safe Embryo Transfer
All along there was the misconception that the method of embryo transfer really did not affect outcome. However studies have proved that the key to IVF success is meticulous embryo transfer.

A dummy embryo transfer or a precycle trial transfer is sometimes recommended to ensure that a proper evaluation of the uterine cavity and utero–cervical angulation is done.

Some doctors perform the transfer under ultrasound guidance, to ensure proper placement of the embryos in the uterine cavity. Ultrasound guidance has many potential advantages. The full bladder required to perform transabdominal ultrasound guidance is helpful in straightening the cervical uterine access and substantially improves pregnancy rates.

Hindrance to a Successful Embryo Transfer
Uterine contractions, blood or mucus on the catheter tip, bacterial contamination of the catheter and expulsion of embryos are some of the main reasons for problematic and unsuccessful embryo transfers.

The surgeon who performs the embryo transfer has to ensure that any cervical mucus within the cervical canal is removed so that it does not stick to the catheter and inadvertently remove the embryo during catheter withdrawal. Cervical mucus can also be a source of bacterial contamination that could adversely affect the results.
The ultimate goal of a successful embryo transfer is to deliver the embryos with the least trauma to the uterine fundus in a location where implantation is maximized. It is here that the skill of the surgeon performing the embryo transfer influences the outcome of the procedure.

East Bay Fertility Center 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 physician, medical staff at East Bay provides dedicated treatment for infertility and reproductive endocrine issues. East Bay Fertility Center specializes in providing infertility treatments such as in-vitro fertilization, insemination, Intracytoplasmic sperm injection, egg donation and gestational surrogacy.

At East Bay embryo transfer is a completely painless process usually done three days after the egg retrieval. It is very much like a routine pelvic exam and involves the passage of a very small plastic catheter through the cervix. A tiny drop (20-30 microliters) of culture media with the microscopic embryos suspended within is deposited in the upper reaches of the uterus.

With the right type of treatment and intervention, East Bay Fertility 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.

Infertility Treatment & Ectopic Pregnancy

Ectopic pregnancy is a well-known but relatively rare complication of assisted conception treatments. In a majority of ectopic pregnancies the embryo implants itself outside the uterus in the fallopian tubes. There occurs a space restriction as the embryo grows and eventually the tube ruptures. This is life threatening and necessitates removal of a portion of the fallopian tube or the entire tube itself. Thus the ability to get pregnant reduces significantly.

Ectopic pregnancy may also occur in the cervix, ovary, or abdominal cavity. There's no way of transplanting an ectopic (literally, "out of place") pregnancy into the uterus, so ending the pregnancy is the only option.

What are the Causes that Lead to an Ectopic Pregnancy?
Pelvic Inflammatory Disease (PID), which leads to scarring of the tubes, is the most common cause of ectopic pregnancy. Other factors that may lead to an ectopic pregnancy include:
• Tumors or cysts in the tubes
• Endometriosis
• Fibroids in the uterus
• Previous tubal surgery
• A previous ectopic pregnancy increases risk of a second ectopic pregnancy
• Women who have had assisted conception through IVF or IUI have an increased risk of ectopic pregnancy
• Taking medication to stimulate ovulation increases the risk of ectopic pregnancy

IVF & IUI as Potential Causes for Ectopic Pregnancy

The chances of an ectopic pregnancy seem to be higher in women undergoing in vitro fertilization (IVF). They are at risk particularly if they already have problems affecting their tubes.

During IVF, ectopic pregnancy may occur if the embryos when transferred to the womb are placed too high in the womb cavity. The embryos then have a greater chance of "wandering" and implanting themselves in places where they are not supposed to be, such as the fallopian tubes. It is also possible that embryos may make their way into the fallopian tubes if they are injected into the womb with too much force.
During IUI treatment also when inserting sperm directly into the womb cavity the risk of an ectopic pregnancy developing in the fallopian tubes or elsewhere exists if the sperm is injected with too much force or is placed too high in the womb cavity.

Thus between 2 and 5 % of IVF treatments result in ectopic pregnancy. Those who become pregnant in the course of undergoing IVF or IUI treatment should be aware of and look-out for symptoms of ectopic pregnancy. Medical help should be immediately availed on experiencing any symptoms of ectopic pregnancy.

Treatment

Ectopic pregnancy can occur both with natural conception and with infertility treatment. Most ectopic pregnancies that happen in the course of IVF treatment are diagnosed early since such women are closely monitored. If it is diagnosed in the early stages it may be possible to use a drug to eliminate the ectopic pregnancy However, surgery may be the only treatment option if an ectopic pregnancy has gone past 6 weeks or if there is internal bleeding. Surgical options include laparoscopy or laparotomy. Removal of the tube (salpingectomy) remains a necessity in emergency cases.

Successful pregnancy after an ectopic pregnancy is possible. Even if one tube was injured or removed, an egg may be fertilized in the other fallopian tube before entering the uterus. If both tubes were injured or removed, IVF is a viable option. In this procedure, mature eggs are fertilized in the lab and then implanted into the uterus.

At East Bay Fertility Center, ectopic pregnancy is diagnosed very early allowing a choice between two forms of treatment: laparoscopic surgery to remove the ectopic or an injection of methotrexate to dissolve it. Under the guidance of Reproductive Endocrinologist and Medical Director Dr. Ellen U. Snowden, medical staff at East Bay provides dedicated treatment for infertility and reproductive endocrine issues. The Center 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 and for more details about infertility treatments.

Female infertility Due to Fallopian Tube Damage

A common cause of female infertility is due to blockage and scarring of the fallopian tube. This condition prevents the egg from traveling to the fallopian tube and onward to be implanted in the uterus. Blockage of the tube increases the chance of ectopic pregnancy, where the fertilized egg settles in the fallopian tube rather than the uterus.
Fallopian tube block can be caused by untreated pelvic inflammatory disease (PID), endometriosis and sexually transmitted diseases. Sometimes it can be caused by scar tissue that forms after pelvic surgery. Other potential causes of blocked fallopian tubes include a previous history of uterine infection caused by an abortion or miscarriage, a history of abdominal surgery or a ruptured appendix.

The common tests to diagnose infertility due to fallopian tube damage include
• A hysterosalpingogram (HSG) which is a medical procedure where radio opaque dye is injected through the cervix into the uterus and fallopian tubes. A special X-ray machine then scans the pelvic region to diagnose fibroid tumors, scar tissue, an unusually shaped uterus or blockages in the fallopian tubes.
• Laparoscopic surgery is sometimes performed in order to diagnose tubal factor infertility. This involves making a small incision in the abdomen. A tiny camera is then inserted into this incision, allowing the surgeon to view the fallopian tubes.
Treating Tubal Factor Infertility
Tubal factor infertility can be treated through IVF or fallopian tube surgery.
Invitro Fertilization (IVF)
IVF is recommended for women suffering from tubal factor infertility. IVF involves fertilizing an egg outside the fallopian tubes and then implanting the embryo inside the uterus. Chances of pregnancy through this process are quite high.
Fallopian Tube Surgery
Surgery to remove scar tissue, adhesions and fallopian tube blockage is another option although subsequent pregnancy rates do vary.
A reproductive endocrinologist (fertility specialist) is best suited to take the decision about which of these therapies are to be opted based on several factors, the most significant factor being the degree of tubal damage, the age of the female, and whether other infertility factors (male or female) are present.
For women with significant damage to the ends (fimbria) of their tubes, one IVF attempt offers a better chance of a viable pregnancy than surgery ever will and at a lower overall cost.
East Bay fertility Center Dublin California, specializes in the comprehensive evaluation and treatment of infertility providing a complete mind-body experience for fertility couples. East Bay’s experienced medical staff is headed by Dr. Ellen U. Snowden, Medical Director and physician. Dr Snowden is Board Certified in Obstetric, Gynecology, and Reproductive Endocrinology with advanced Fellowship training in the treatment of infertility, recurrent miscarriages and hormonal disorders in women. East Bay Fertility Center performs tests to check the extent of fallopian tube blockage or damage and recommends tubal surgery if necessary. Call 925.828.9235 for a free initial consultation.

Azoospermia – A Cause of Male Infertility

Azoospermia is the complete lack of sperm in the ejaculate and is one of the most severe forms of male factor infertility. Since azoospermia does not have any symptoms, it often comes as a surprise to a couple planning parenthood. This condition does not rule out the possibility of fathering a child. New techniques are now being perfected to help men with azoospermia become a parent to biological children.

Azoospermia is of two types:
• Obstructive Azoospermia that occurs when a blockage in the duct system prevents sperm from mixing with the semen.
• Non-Obstructive Azoospermia occurs when there is a problem with the actual production of sperm within the body and is generally attributed to hormonal imbalances.
Causes of Azoospermia
Failed sperm production is often the result of hormonal abnormalities, undescended testicles or vascular trauma to the testes or to the blood vessels within the testes.
Sperm transport problems are often caused by infection including STDS, by congenital absence of Vans Deferens which are tiny tubes that carry sperm to the urethra for ejaculation or due to a previous vasectomy procedure that prevents the sperm from mixing with the ejaculate.
Diagnosis

The initial semen analysis reveals if there is a problem with sperm production or there is a blockage preventing sperm from reaching the ejaculate. A medical evaluation of a male suspected to be suffering from azoospermia includes:
• A thorough physical examination
• Semen analysis
• Blood tests that include a testosterone and FSH level
• A complete review of medical problems, past surgeries, medications and family history

A testis biopsy under local anesthesia may be performed if the above procedures fail to throw light on the sperm production problem.

Treating Azoospermia
There are ways to treat azoospermia and possibly restore fertility in men suffering from the condition. Treatment options include:
• removing blockages in the duct system
• using medications to restore hormonal balances
New methods of surgical sperm removal are now available, wherein small quantities of sperm can be removed from the testes or around blockages. These include:
• PESA (Percutaneous Sperm Aspiration), in which sperm is taken directly from the epididymis.
• MESA (Microsurgical Epididymal Sperm Aspiration), in which sperm is retrieved in higher numbers from the epididymis.
• TESE (Testicular Sperm Extraction), in which a small tissue sample is taken from the testicles in order to retrieve viable sperm.
Thus even if there are no sperm in the ejaculate, sperm can often be harvested and used to achieve fertilization. Assisted Reproductive Techniques (ART) like IVF and ICSI manipulate sperm in a controlled manner and greatly facilitate infertility treatment.

It is important not to give up hope when confronted with azoospermia. A consultation with an infertility specialist for treatment options is the immediate step to be taken. East Bay Fertility Center located in Dublin, California is well equipped with the latest technology and offers comprehensive infertility consultation. 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 including male infertiity.

Call 925.828.9235 for a free initial consultation.

When to Consult a Reproductive Endocrinologist

When the basic treatment for fertility related problems as recommended by an obstetrician/ gynecologist (OB/GYN) do not seem to work, it may be time to start seeing a Fertility Specialist, also called a Reproductive Endocrinologist (RE) who may recommend advanced treatments and medications. The OB/GYN treating infertility usually recognizes the limits of their capabilities and makes appropriate referrals to more specialized care whenever necessary.

Who is a Reproductive Endocrinologist?

Reproductive Endocrinologists complete the same education and medical requirements as OB/GYNs. In addition, they also finish a two- to three-year fellowship in reproductive endocrinology, pass specialized examinations (board certified) and complete a two-year practice in reproductive endocrinology. Thus they are the physicians with the broadest range of qualification, training, specialization and experience in treating reproductive disorders. In fact Board Certification in reproductive endocrinology infertility is the only sure identifier of a trained fertility specialist.

Reproductive Endocrinology combines reproductive medicine and endocrinology, which focuses on organs of the endocrine system and the hormones they produce. These specialists also deal with issues related to menstrual disorders, puberty-related problems and sexual dysfunction as well as the treatment of transsexuals and intersexed individuals undergoing hormone treatment.

A Positive Step towards Infertility Treatment

The decision to consult a RE is a proactive, tangible step towards addressing fertility issues. Board certification is important when choosing a reproductive endocrinologist. At the first visit the RE will ask about the patient’s medical history, any diagnostic procedures that have been done so far, and procreative efforts to date. The RE then specifies the tests which are necessary to be performed.

Who Should Consult a Reproductive Endocrinologist?

In general, women aged thirty-five or older if experiencing fertility issues should seek specialty care from a reproductive endocrinologist as their fertility can decline rapidly. Staying with their OB/GYN for far too long expecting positive results is the error most couples make, thus wasting valuable time. Younger women can also experience premature menopause, termed “declining ovarian reserve”. Such a condition, as also disorders like polycystic ovarian syndrome (PCOS), male factor infertility, fallopian tube disease and severe endometriosis all warrant immediate consultation with a reproductive endocrinologist.

Often patients hesitate to consult a fertility specialist due to cost concerns. But since appropriate diagnostic tests and treatment are ordered early in the evaluation during a consult with a specilist, it leads to effective treatment options and ultimately to overall savings in cost. Patients under the care of a reproductive endocrinologist are more likely to conceive, and in a much shorter period of time.

East Bay fertility clinic (http://www.ebfertility.com/) specializes in the comprehensive evaluation and treatment of infertility. Their experienced medical staff is headed by Dr. Ellen U. Snowden, Medical Director and physician. Dr Snowden is Board Certified in Obstetric, Gynecology, and Reproductive Endocrinology with advanced Fellowship training in the treatment of infertility, recurrent miscarriages and hormonal disorders in women. 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. Call 925.828.9235 for a free initial consultation.

Coping with Premature Ovarian Failure

Premature Ovarian Failure (POF) is the loss of ovarian function in women under the age of 40. In such a condition, the woman does not ovulate (release an egg) each month. This can be due to a dysfunction in the ovaries. If a woman suffers from POF, it becomes very difficult for her to conceive.

It is difficult to pinpoint an exact cause for this condition. There are however, some causes that may likely be identified as the cause for POF. These include:

• Genetic factors
• Exposure to chemotherapy and radiation
• Autoimmune disorder
• Hysterectomy with both ovaries removed
• Thyroid dysfunction
• Viral infection
• Inadequate gondaotropin secretion or action

Some of the symptoms of POF are:

• Irregular periods
• Hot flashes and night sweats
• Decrease in sexual drive
• Irritability
• Painful sex
• Thinning and drying of vagina

Treatment Options for Women with POF

Options for women who have POF and desire to have children include using donor eggs, going in for fertility treatments or adoption. Sometimes Hormone Replacement Therapy (HRT) has aided in helping women achieve pregnancy. For women with POF and their families, emotional support is as important as medical treatment for dealing with the condition. With the correct fertility treatment there is hope of getting pregnant. Between 5 percent and 10 percent of women with POF do become pregnant, even without fertility treatment.

POF and Fertility

Egg donation offers significant hope for those desiring pregnancy and is generally the only fertility option available. POF does not affect a woman’s uterus, which means she may be able to carry a child. Egg donation makes it possible to combine donor eggs and sperm in a laboratory, and then place the resulting embryos into the uterus of a woman who has POF. IVF is also used to help in conception. New research on POF may offer more alternative treatment options over the next few years.

If you think you have POF, talk to your gynecologist or reproductive endocrinologist about the possible treatment options. East Bay fertility Center Dublin California, (www.ebfertility.com) specializes in the comprehensive evaluation and treatment of infertility providing a complete mind-body experience for fertility couples. East Bay’s experienced medical staff is headed by Dr. Ellen U. Snowden, Medical Director and physician. Dr Snowden is Board Certified in Obstetric, Gynecology, and Reproductive Endocrinology with advanced Fellowship training in the treatment of infertility, recurrent miscarriages and hormonal disorders in women.

Treatment options are pursued based on all known parameters and the preferences of the couple. Call 925.828.9235 for a free initial consultation.

How Pesticides Can Impact Fertility Levels

Environmental threats to male reproduction was first discovered around 30 years ago when sperm formation was shown to be severely impaired among agricultural workers and pesticide manufacturers. It is a well documented fact that exposure to environmental toxins such as pesticides, insecticides and herbicides can decrease sperm production and quality. Among men seeking infertility treatment, those who were exposed to pesticides were most likely to have a very low sperm output. What’s more, sperm concentration, output and morphology were all significantly worse in men more frequently exposed to pesticides.

Those living and working on a farm land, mixing and applying pesticides – including insect killers, weed killers as well as fungal killers and fungicides are potentially in danger of experiencing a low sperm count.

The Pesticide-Fertility Connection

It is important to note that many of the studies conducted on pesticides only examined people who live in an agricultural area or regularly work with pesticides. Therefore, an average person is not likely to have such a high-exposure to these chemicals. However the danger lies in the fact that even a low-level of exposure to pesticides has been found to cause health problems.

As infertility rates continue to rise in many countries, more and more studies are directed at possible environmental factors such as the effect of various chemicals, toxins and pesticides as a potential cause of infertility. Most tests have revealed alarming results. Pesticides have an adverse effect of causing health and reproductive problems in people who are continuously exposed to these strong chemicals. Here is a sampling of various findings:

• Chlorpyrifos has been found to cause autoimmune responses whereby the body attacks the sperm or egg
• DDT and chlordane are of particular concern as they have both been found to reduce sperm counts
• Many pesticides have proven links with reduced sperm counts, including ethylene dibromide (pesticide), kepone (pesticide) and DBCP (agricultural nematocide)
• Exposure to pesticides also leads to decreased levels of testosterone in men.

Pesticides in the home include indoor insect repellants and pesticides used in the garden. The combined exposure of using both types can be significant.

It’s not just men, but women also whose fertility may be disrupted by pesticide exposures. Women who live near crops on which pesticides have been sprayed may have anywhere from a 40 to 120% increased risk of miscarriage.

Tips for Safeguarding Fertility from Pesticide Exposure

• If your work involves handling chemicals consider if you can reduce the number of hours you are exposed to them. If this is not possible always wear gloves and a mask for protection.
• If you intend to put pesticide on your lawn and you are planning a baby see if there is someone else who can do the job for you
• Consider using organic fertilizers since they don’t carry a chemical risk.

Fertility Treatment Options

There has been growing concern about the effect pesticides may have on the delicate human reproductive system, and particularly on the quality of sperm. If you discover you are pregnant and you live near an agricultural area where pesticides are being used, it is advised you remove yourself to avoid exposure to these chemicals.

East Bay fertility Center, Dublin, California, (www.ebfertility.com) specializes in the comprehensive evaluation and treatment of infertility, providing a complete mind-body experience for fertility couples. Treatment options are pursued based on all known parameters and the preferences of the couple.

East Bay’s experienced medical staff is headed by Dr. Ellen U. Snowden, Medical Director and physician. Dr Snowden is Board Certified in Obstetric, Gynecology, and Reproductive Endocrinology with advanced Fellowship training in the treatment of infertility, recurrent miscarriages and hormonal disorders in women. Call 925.828.9235 for a free initial consultation.

Secondary Infertility – Causes and Remedies

Secondary infertility is a term used to describe a condition where a woman who was able to conceive naturally in the past has difficulty conceiving another child. This is a fairly common problem that can be attributed to a number of factors such as low sperm count, endometriosis, damaged fallopian tubes, ovulation problems, fibroids or change in partner.

In some cases, medical tests indicate that the cause of secondary infertility is a combination of factors shared by both partners.

Age as a Cause of Secondary Infertility

The most common cause of secondary infertility may be age. There is a marked decrease in fertility by 35 years of age. By age 45 the chances of natural conception are extremely low. Thus the possibility of becoming pregnant decreases with rising age. Moreover, a woman's eggs suffer chromosomal damage as they age; the older the eggs, the less likely they are to become fertilized or go to term. Some women also go through menopause at an early age; this may also be a cause of secondary infertility.

Some experts in the field of human reproduction have suggested that male fertility is also affected by age and that male fertility starts declining after the age of 35.

Stress and Secondary Infertility

Stress may also be a factor affecting fertility. Studies show that if a man already has a low sperm count, stress worsens this condition. While stress itself does not cause infertility, the process of "trying" to become pregnant can be stressful, especially on your relationship. The stress levels are often the result of infertility, not the cause of it.

Diet and Lifestyle

Being either underweight or overweight can affect fertility. Smoking and excessive consumption of alcohol has also been found to affect fertility.

Chronic Illness

Chronic illness can also lead to secondary infertility. High blood pressure, diabetes and asthma can affect fertility. Sometimes chemotherapy or radiation treatments for cancer can reduce a person’s fertility.

Remedies for Secondary Infertility

There are a number of steps that can be taken when confronted with secondary infertility to improve chances of conception. The first obvious step is for both the partners to get a complete medical check up done.

Things may change after the birth of the first child. For instance one of the partners could now have a low sperm count; hormones could be out of sync etc. Taking control of the situation and opting for the right line of treatment will help in surmounting the condition.

If faced with fibroids, endometriosis, vaginal infections and pelvic adhesions – all potential causes of secondary infertility - get treatment for these issues which can sometimes successfully cure infertility.

Fertility treatments may be the next line of treatment for curing secondary infertility. A referral to a reproductive endocrinologist for appropriate treatment may be necessary. Initially the fertility specialist will prescribe medications to help conceive another child. If this proves ineffective, more advanced treatments may be necessary.

On a Positive Note

The good news is that secondary infertility is more likely to be treatable than primary infertility. Consult with a specialist, and faithfully follow the prescribed treatment plan, and you can be sure that you'll have another baby soon.

East Bay Fertility Center, Dublin, California (www.ebfertility.com) has an experienced team of doctors headed by Board Certified Reproductive Endocrinologist Dr Ellen Snowden and offers the most comprehensive line of treatment and intervention for secondary infertility. East Bay Fertility Center makes sure that couples who have been facing problems conceiving a second time will successfully overcome the problem in the shortest possible time and realize their dreams of having a healthy baby. Call 925.828.9235 for a free initial consultation.

Infertility Support Groups

For couples dealing with infertility, it is extremely important to connect with other people who understand exactly what they are going through. Family and friends at best can only offer solace. Infertility support groups provide the link to interact with others who are dealing with similar challenges and medical conditions. The emotional and physical strains that the infertility treatment process brings about and the anguish of putting up with continual cycle failures are extremely overwhelming for couples.

Professional counseling groups and online infertility forums prove to be of great support and help in coping with infertility. Sometimes just knowing other people are in related situations helps. Infertility support groups can be either a local group that meets at regular intervals or an online forum offering a channel to express concerns and get information from others in a similar situation.

How Can Infertility Support Groups Help?
• Support groups foster positive feelings and inspire hope in those suffering from infertility or have endured pregnancy loss
• They provide members with resources and information about different fertility treatment options
• These support groups help foster long-lasting friendships with like minded people who can offer emotional support and comfort
• They guide you on how to cope with infertility and provide a safe environment to talk
• Members are able to discuss their experiences more openly and freely with other individuals.

There are numerous online fertility support groups providing support and encouragement to those struggling to cope with infertility related issues. Many online support groups also conduct workshops and classes and occasionally have group meetings.

Infertility support groups are ideal for both primary and secondary infertility cases as well as those who have the hope that some day they will experience parenthood. Members get support on issues such as adoption options, becoming foster parents and getting up to date knowledge about the latest treatment options all of which propel them back into a positive frame of mind.

You are not alone!

There are hundreds of different infertility support groups to guide couples through their infertility journey. Many are run by trained social workers while others are run by people who have themselves been diagnosed with infertility. Local health care practitioners and infertility specialists are useful resources to locate a good support group. It also helps to check online and to check the hospital bulletin boards and the local press.

It is crucial that infertility issues are addressed on time or they may leave couples feeling utterly worthless and cast a shadow over their self-esteem and confidence. Infertility support groups are an important part of the healing process for individuals and couples coming to terms with their condition. Most support groups are run by people with a genuine desire to help ease through this difficult time and get on with life, offering hope that some day, pregnancy will become reality.

East Bay Fertility Center (www.ebfertility.com) located in Dublin, California is well equipped with the latest infertility treatment options and offers comprehensive consultation 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.

To learn more about East Bay’s infertility treatment options and counseling sessions, please log on to http://ebfertility.com/Infertility_Counseling.html

Unexplained Infertility

Unexplained infertility is a fairly common medical condition which indicates a failure to determine a credible underlying cause of infertility despite a thorough evaluation of both the male and female partner. Knowing that you’re infertile is tough enough, but not knowing the underlying cause for the problem can be extremely painful to reconcile with.

The diagnosis of unexplained infertility is a difficult process involving a series of exclusion and elimination based on a large number of infertility tests making it an extremely frustrating experience.

Doctors are now of the opinion that unexplained infertility is probably caused by a small problem in each partner, affecting the chances of getting pregnant. These problems are so subtle that they don’t show up on current tests. This means that a clinical problem exists but the probable cause for this problem remains elusive.

Possible Factors Leading to Unexplained Infertility

Abnormal fallopian tubes
Abnormal eggs
Prematurely Aging Ovaries Syndrome
Weak sperm
Immune System Problems
Emotional Distress

Possible Treatment Options for Unexplained Infertility

Intrauterine Insemination (IUI) – Under this assisted reproductive technology, the fertilization process is initiated by collecting sperm from the male partner and releasing it into the female partner’s uterus.

In-vitro Fertilization (IVF) – This process is followed for women who have faulty fallopian tubes or ovaries. The process involves placing the egg and the sperm in a dish and once fertilized, the embryo is placed into the woman’s uterus.

Controlled ovarian hyperstimulation - Intrauterine insemination in conjunction with controlled ovarian hyperstimulation is often used as first-line treatment for couples with unexplained infertility. The treatment involves using drugs to make the woman's ovaries produce eggs and inserting her partner's sperm directly into her womb.

For those grappling with a diagnosis of unexplained infertility, the good news is that medical science has made great inroads in cutting down the incidence of this condition. On-going research is tipped to further reduce the incidence of unexplained fertility in the coming years. Moreover studies reveal that very often such couples conceive naturally over a three year period.

East Bay fertility Center, Dublin, California, (www.ebfertility.com) specializes in the comprehensive evaluation and treatment of infertility, providing a complete mind-body experience for fertility couples. At East Bay, our reproductive endocrinologists conduct a detailed review of the entire infertility evaluation when couples approach us with a prior diagnosis of unexplained fertility. This can sometimes reveal an error made in either testing or interpretation in which case we recommend further investigation into questionable fertility factors. Treatment options are pursued based on all known parameters and the preferences of the couple.

East Bay’s experienced medical staff is headed by Dr. Ellen U. Snowden, Medical Director and physician. Dr Snowden is Board Certified in Obstetric, Gynecology, and Reproductive Endocrinology with advanced Fellowship training in the treatment of infertility, recurrent miscarriages and hormonal disorders in women. Call us at 925.828.9235 for a free initial consultation.

Intracytoplasmic Sperm Injection for Infertility Treatment

Intracytoplasmic sperm injection, or ICSI, is used to treat couples who have fertilization issues if the male partner has very low sperm count, low sperm motility or poor-quality sperm. ICSI is used to enhance the fertilization phase of in-vitro fertilization (IVF), giving couples a better chance of achieving conception. ICSI may also be used to treat a condition called azoospermia, which is the complete absence of sperm in the man's ejaculate. In such a scenario, Epididymal Sperm Aspiration and Testicular Sperm Extraction (TESE) may be used to obtain sperm from the male's reproductive tract. These sperm are then used in conjunction with IVF and ICSI.

The ICSI Process

The first step in ICSI involves selecting a normal-appearing sperm for injection into a mature egg. The woman is given fertility drugs to stimulate her ovaries to develop several mature eggs for fertilization. Once the eggs are ready, the sperm is inserted into the egg using a micropipet. The eggs and the sperm are fertilized in the laboratory. If fertilization occurs after ICSI, the embryo may then be transferred into the uterus on either Day 2, 3 or 5 of embryo development. The number of embryos to be transferred will vary depending on age, quality and prior experience with IVF. Extra embryos, if there are any, may be frozen in case this cycle isn't successful or can be used for a future pregnancy. Around two weeks later, the woman can take a pregnancy test.

The Genetic Issue in ICSI

Doctors advise men who have little or no sperm in their semen to conduct genetic testing before the ICSI procedure. Intracytoplasmic sperm injection carries with it a small probability of bringing about genetic risks. Although the likelihood of congenital malformations in children conceived with ICSI is marginally low, it is nevertheless important to share this information with couples opting for ICSI. Some genetic disorders can be identified with specialized testing before an embryo is transferred. Therefore, couples are advised to consider genetic counseling to learn their potential for having a child with birth defects.

With increasing number of clinics opting for ICSI, the clinical pregnancy rates for ICSI is much higher than those achieved using conventional IVF methods. This technique has opened the doors of parenthood to many couples who were confronted with male infertility issues. ICSI has revolutionized treatment for severe male factor infertility since the procedure requires only one healthy sperm to potentially achieve fertilization.

East Bay Fertility Center (www.ebfertility.com), 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 physician, medical staff at East Bay provides dedicated treatment for infertility and reproductive endocrine issues. East Bay Fertility Center specializes in providing infertility treatments such as in-vitro fertilization, insemination, Intracytoplasmic sperm injection, egg donation and gestational surrogacy.

With the right type of treatment and intervention, East Bay Fertility 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 us at 925.828.9235 for a free initial consultation or visit our website at www.ebfertility.com for more details about infertility treatments and more.

Polycystic Ovary Syndrome Affecting Infertility

Polycystic Ovary Syndrome, also called PCOS, is an endocrine or hormonal disorder and is the most common cause of infertility in women. PCOS may affect a woman's menstrual cycle, hormones, insulin production, heart blood vessels. and finally appearance. If the quantity of male hormones is more than that of female hormones in a woman’s body then she is likely to suffer from PCOS. This growth of PCOS adversely affects the ovulation rate of a woman and can cause irregular ovulation.

PCOS restricts the growth of ovarian follicles and as a result these follicles are not able to release eggs. The follicles are left with less time to reach maturity and they continue to grow as small size cysts (fluid-filled sacs) in the ovaries. However women with cysts need not necessarily have PCOS.

Symptoms of Polycystic Ovarian Syndrome (PCOS)

The main symptoms of PCOS that doctors look for while diagnosing the causes of infertility include:

• Irregular and/or no ovulation which means no eggs to be impregnated
• Irregular and/or no menstruation
• Increased growth of hair on the face, chest, stomach, back, thumbs, or toes
• High levels of male hormones, also called androgens
• Severe acne, oily skin, or dandruff
• Considerable pelvic pain
• Weight gain or obesity, especially extra weight around the waist
• High cholesterol level and high blood pressure
• Type 2 diabetes
• Male-pattern baldness or thinning of hair
• Skin discolorations around the genitals, chest and arm pits
• Growth of skin tags, or tiny flaps of skin in the armpits or neck area
• Sleep apnea i.e. excessive snoring and occasional stoppage of breathing while sleeping
• Insulin resistance

All of these symptoms need not be present for the diagnosis of PCO. The tests to confirm the suspected diagnosis include:

1. A reverse FSH/LH ratio performed on Day 3 of the menstrual cycle
2. Characteristic appearance of the ovaries on a pelvic ultrasound
3. Characteristic appearance of the ovaries when visualized surgically by laparoscopy or laparotomy

Treatment for Polycystic Ovarian Syndrome (PCOS)

As per the U.S. Department of Health & Human Services, treatment procedures for PCOS differ from one patient to another based on symptoms and whether the woman wants to conceive or needs contraception. A detailed look at the symptoms and family history is essential to start appropriate treatment. Controlling the symptoms of PCOS is the best cure to reduce the risks associated with it.

To control the side effects of PCOS a healthy diet and regular exercise are crucial. The remedies for Polycystic Ovarian Syndrome (PCOS) include:

• Contraceptive pills: Not exactly a cure for PCOS, these pills regulates menstrual periods, reduce male hormone levels and acne growth. But once the pills are discontinued, the menstrual cycle tends to again become abnormal.
• Diabetes Medications: Medicines for type 2 diabetes such as Metformin, also called Glucophage, regulates glucose, decreases testosterone production, slows down abnormal hair growth and normalize ovulation after a few months of use.
• Fertility treatments: The lack of ovulation is the main fertility problem for women with PCOS. However, before starting with fertility treatment it is essential that sperm count and the partner’s tubes are checked to make sure they are open.
• Ovarian Drilling Surgery: This surgery, considered the last treatment option, is used to induce ovulation. This helps in reducing male hormone levels and aids ovulation. However, the surgery carries a risk of developing scar tissue on the ovary.
• Maintaining a healthy body weight: Healthy weight lowers glucose levels, restores regular periods and uses insulin more effectively. It has been proved that losing even a small amount of weight can help balance hormones and restore fertility.

If the normal course of treatment for PCOS does not yield positive conception results, it is essential to seek out the care of a Reproductive Endocrinologist. East Bay Fertility Center (www.ebfertility.com), 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 physician, medical staff at East Bay provides dedicated treatment for infertility and reproductive endocrine issues. East Bay Fertility Center specializes in providing infertility treatments such as in-vitro fertilization, insemination, Intracytoplasmic sperm injection, egg donation and gestational surrogacy.

With the right type of treatment and intervention, East Bay Fertility 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 us at 925.828.9235 for a free initial consultation or visit our website at www.ebfertility.com for more details about infertility treatments and more.

Smoking Vs Infertility

Infertility arises because of many reasons such as problems in the ovaries and uterus and fluctuations in hormone levels which reduce the chances of conceiving. In addition there are external factors that could contribute to infertility. Smoking is one of them.

The link between Smoking and Infertility

Latest studies show that a considerable amount of infertility cases are the after effect of smoking. Smoking can cause severe side effects both in men and women. Women smokers have higher risk of affecting their reproductive ability and further increasing the chances of cancer in their offspring because of alterations in the genes and chromosomes.

Women who have tried to get pregnant with In Vitro Fertilization (IVF) and those who have been smokers in the past produce fewer eggs with IVF than non smokers. In addition, smokers also experience reduced capacity of fertilization of the eggs and increased chances of miscarriages with IVF. The reason might be nicotine, found in cigarettes, which have adverse effects on the follicles that are necessary for the induction of IVF.

Smoking during Pregnancy

The pregnancy rates of women smokers are greatly affected by nicotine. Moreover, smoking negatively influences not just the mother, but the baby as well. Even before delivery, smoking can harm a fetus exposed to nicotine while in the womb causing low birth weight, poor lung function and several other problems. The nicotine in cigarettes obstructs the flow of oxygen needed for healthy growth to the baby's blood. Needless to say the chances of a healthy pregnancy can be improved by keeping the body smoke free.

Effects of Smoking on Female and Male Fertility

Some of the negative consequences of smoking on the female reproduction ability include:

• Damage to the fallopian tubes that produce healthy eggs


• Lower rates of fertilization of the eggs with IVF


• Chances of reaching menopause early by 1 to 4 years


• Increased risk of unprompted abortion and ectopic pregnancy


• Alterations in ovum


• Likelihood of occurrence of cancer in the babies of smoking parents

Significant consequences of smoking contributing to male infertility include:

• Decreased sperm count in men


• lterations in the sperm morphology, sperm strength and quantity of ejaculated semen


• Infertility caused by changes in the series of DNA in sperm cells

Infertility itself can be cured with the help of treatments and medications and IVF success rates are higher in women that have quit smoking. Fertility improves considerably in women who have quit smoking. Couples planning on starting a family and particularly those experiencing problems while conceiving should make a maximum effort towards cessation of smoking..

East Bay Fertility Center, Dublin, California (www.ebfertility.com) offers personalized medical counseling and treatments for infertile couples. The clinic’s experienced medical staff is headed by Dr. Ellen U. Snowden, Medical Director and physician who is Board Certified in Obstetrics, Gynecology, and Reproductive Endocrinology. East Bay Fertility Center provides comprehensive infertility services and motivates infertile patients throughout their course of infertility treatment. East Bay specializes in providing infertility treatments such as in-vitro fertilization, insemination, Intracytoplasmic sperm injection, egg donation and gestational surrogacy.

Visit our website http://ebfertility.com/ to know more about different treatment options that we provide.

Is Laparoscopy Beneficial for Endometriosis?

Laparoscopy is a surgical procedure and an advanced tool that is used in different areas of medical science; infertility treatment being one of them. Endometriosis, one of the most common causes of infertility, and a painful disorder in a women’s reproductive system, is usually treated using laparoscopy.

What is Endometriosis?

The abnormal growth of endometrial cells outside the uterus that attaches to other organs in the pelvic cavity such as the fallopian tubes and ovaries is known as Endometriosis. The endometriosis implants will bleed during the menstrual period. As the tissues become enlarged, inflammation may cause pain. One of the possible reasons for endometriosis may be excess estrogen levels in a women’s body. There is an increased incidence among family members suggesting a genetic component to the disease. Endometriosis may affect fertility in many ways. Some of these include:

1. The over-production of prostaglandins which are hormones that plays an important role in the fertilization of the egg and implantation of the embryo.
2. Ovulation disturbances due to involvement of the ovaries
3. Pelvic scarring restricting the tubes and ovaries
4. Painful intercourse resulting in decreased frequency
5. Immunological abnormalities leading to an increased risk of miscarriage

Laparoscopy as a Treatment Option for Endometriosis

In women with moderate to severe endometriosis, laparoscopic surgery is an effective treatment for endometriosis-related infertility, as it leads to better pregnancy rates. It is unclear whether mild disease is similarly impacted by laparoscopic surgery. Laparoscopy is conducted to confirm the diagnosis and remove adhesions caused by endometriosis.

Laparoscopy, considered as one of the least invasive surgical treatment option that is available today, is usually done under general anesthesia. The procedure includes insertion of an instrument that has a tiny camera attached to it with a light, known as laparoscope, through a small abdominal incision. More than one incision may be required for inserting other surgical instruments for better access.

The Need of Laparoscopy

While treating Endometriosis, Laparoscopy is usually carried out for checking and treating the following:

• Examining the pelvic organs causing pelvic pain.
• Removal of endometriosis implants and scar tissues.
• Removal of endometriosis cyst on an ovary (endometrioma).
• Endometriosis pain after a hormone therapy.

Disadvantages of Laparoscopy used for Endometriosis

Though laparoscopy is a great tool, it does have certain drawbacks when it comes to diagnosing Endometriosis. A laparoscopic surgery is not always helpful to patients of endometriosis on a long term basis. There might be some accidental damage to the surrounding organs while the doctor maneuvers the instruments inside the body. There are also chances of the incision getting infected at times.

A Positive Note

The heartening news is that having endometriosis does not automatically mean that you will never have children. Rather, it means that you may face problems in the journey towards parenthood.
At East Bay Fertility Center, California, (www.ebfertility.com) an experienced team of doctors headed by Dr Ellen Snowden specialize in examining and treating potential causes of both male and female infertility including Endometriosis diagnosis and treatment. The process of treatment starts with free initial consultation with East Bay’s infertility specialist followed by a thorough diagnostic evaluation. The next step would be to identify the problem and start with the treatment.

With the right course of treatment and medical intervention, East Bay Fertility Center is committed to assisting couples facing problems conceiving. The goal is to help them overcome their infertility problem in the shortest possible time and realize their dreams of having a healthy baby.

For more information on fertility treatment options log on to http://ebfertility.com/