Wednesday, September 2, 2009

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.

Tuesday, September 1, 2009

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.