A Positive Attitude during Infertility Treatment

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

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

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

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

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

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

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

The Gestational Surrogacy option in Infertility Treatment

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

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

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

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

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

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

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

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

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

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

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

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


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

Hypothyroidism – Can it impact fertility?

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

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

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

How hypothyroidism influences fertility

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

Symptoms and treatment

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

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

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

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

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

Perimenopause - How it Impacts Fertility

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

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

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

Fertility options for women in the perimenopause stage

FSH

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

Clomiphene

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

IVF

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

Egg Donation

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

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

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

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

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

Sperm Allergy as a Cause of Infertility

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

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

Diagnosis and treatment

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

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

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

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

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

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

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

Endometrial polyps - an Impediment to a Successful Pregnancy

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

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

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

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

Symptoms and Treatment

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

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

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

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

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

How Eating Disorders Affect Fertility

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

Types of eating disorders

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

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

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

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

Adverse effects on pregnancy

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

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

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

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

Egg Freezing – an Alternative to Beat the Biological Clock

Egg freezing is a breakthrough technology for scores of women faced with the dilemma of career and family. It provides them an option to delay http://www.ebfertility.com/index.htmlwhile pursuing professional and personal goals. The 'biological clock' generally slows down by the late 30’s and early 40’s. The female egg quality declines with age. The option of freezing eggs extends fertility and offers women an alternative to store their eggs during their reproductive prime for use when they wish to start or expand their families after the age of 35. At this point the eggs are thawed, fertilized and transferred to the uterus as embryos. Unlike the ovary and eggs, the uterus does not age and can carry a pregnancy well in to the 40s and 50s.

The Process

The process of egg freezing (also referred to as Oocyte cryopreservation) is made up of the same steps that are involved in a typical IVF cycle: ovulation stimulation, ultrasound monitoring, and egg retrieval. The woman self administers hormone injections along with birth control pills to turn off natural hormones. Following this, hormone injections are given to stimulate the ovaries and ripen multiple eggs. The eggs are then retrieved and frozen. When the woman is ready for embryo transfer, the eggs are thawed, injected with a single sperm to achieve fertilization, and transferred to the uterus as embryos.

Other Issues

Until recently, freezing and thawing eggs without damage was a scientific challenge. The key requirement for a successful egg freezing program is a top of the line storage facility since the eggs have to be stored and maintained for a long period of time - anywhere from months to years after they are frozen. They have to be stored under proper conditions backed with controlled access, continuous monitoring and full-proof backup systems.

The ideal time to freeze eggs is when a woman is in her 20s or early 30s. After the age of 37 this procedure is usually not recommended since both the quality and number of eggs decline rapidly around then. Just how long female eggs can safely be stored before they can no longer be used for treatment is still a matter of debate.

Originally designed for women undergoing cancer treatment, egg freezing as a form of fertility preservation is a rather involved process but thanks to technological advances, is becoming more successful and popular world-wide. Egg freezing is still classified as an experimental technique by the American Society for Reproductive Medicine (ASRM) and the process should be opted for after careful consideration.

The modern trend of waiting longer to have children has led to challenges in having a healthy pregnancy later on in life. Egg freezing helps women enjoy reproductive freedom while they pursue other priorities.

Expertise in the procedure

Since egg freezing is still a fledging technology with changes and innovations taking place rapidly, it should only be offered by experts in the field, who have the requisite experience and capability of conducting this delicate procedure. East Bay Fertility Center, offers the latest infertility treatment options strictly adhering to the guidelines of the American Society of Reproductive Medicine (ASRM) in all their procedures.

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. Call 925.828.9235 for a free initial consultation.

The Luteal Phase Defect issue in Conception

When the body is unable to produce sufficient amounts of progesterone during the luteal phase of the menstrual cycle it is called a luteal phase defect (LPD). In other words, the endometrium does not respond appropriately to the progesterone stimulation due to which the endometrial lining is not sufficiently prepared for implantation.

The luteal phase refers to the second half of the menstrual cycle - the two-week period which begins after ovulation under the influence of estrogen and progesterone produced by the corpus luteum. If the luteal phase is shorter than 10 days or longer than 14 days, a luteal phase defect may be suspected. Luteal phase defect can impact fertility since a pregnancy cannot be sustained because the uterine lining begins to break down, bringing on menstrual bleeding and causes early miscarriage.

Causes and Symptoms

LPD could be attributed to more than one reason. Poor follicle production, premature demise of the corpus luteum, and failure of the uterine lining to respond to normal levels of progesterone are the three main reasons. Majority of women with LPD will have a normal menstrual cycle because of their regular periods. A few women may experience frequent but light periods.

For most women, the main cause of a luteal phase defect is low progesterone levels. A progesterone test is conducted seven days after ovulation to determine the exact deficiency. There are several ways of correcting this defect.

Diagnoses and correction of the defect

LPD can be diagnosed through the measurement of basal body temperature using a daily basis fertility chart. The basal body temperature of women with LPD does not stay elevated for the normal 12 days of the luteal phase of the cycle. Also, their next cycle will begin sooner than the normal 12 to 14 day time span.

Endometrial biopsy is another line of testing which involves the removal of a sample of the endometrium which is then studied under a microscope. This test checks to see if the endometrium can support implantation and growth of a fertilized egg. This is a test that must be done about three days before the start of the period.

On testing the progesterone levels if a hormone problem is identified, the doctor may suggest a fertility drug to see if the progesterone levels increase.
Luteal phase defects are easily treated with supplements and/or with prescription drugs. The most common prescription drugs for luteal phase defect patients are Clomid or progesterone suppositories. These are taken after ovulation has occurred until the 10th to 12th week of pregnancy - should one occur.

A luteal phase below 10 days cannot sustain a pregnancy since sufficient progesterone is not being produced. If a woman were to get pregnant with a luteal phase defect, she would most likely miscarry. However with the right treatment, fertility problems can be quickly handled. Depending on what is causing LPD, the appropriate hormonal drugs will be prescribed.

East Bay Fertility Center, Dublin, 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. The center conducts endometrial biopsy which is a test for luteal phase defect and is one among the various female fertility tests offered. Call 925.828.9235 for a free initial consultation.

Sperm Banks - How they help in Fertility Treatment

A sperm bank collects, filters and stores sperm from donors for third party reproduction, mainly, artificial insemination. The need for donor sperm arises in cases where the woman's partner is infertile or the woman chooses to conceive without the participation of a partner. Donor sperm can be used in IVF or intrauterine insemination (IUI). A sperm bank is the facility from where the sperm of an anonymous donor can be purchased, that is then used by the fertility clinic for reproductive treatment processes.

Through a process known as cryopreservation, sperm samples can be frozen for future use. This process is generally used by patients who need to undergo cancer and other treatments that may destroy their future fertility.

Sperm donation through a sperm bank helps in the following circumstances
• When the male partner is sterile and unable to provide sperm sample for IVF or ICSI

• If the partner is experiencing low sperm count, poor motility or abnormal sperm morphology

• A couple may use a sperm donor to avoid passing on a genetic disease or disorder that is carried by the male sperm

• Single women and lesbian couples can take advantage of donor sperm to help them achieve the dream of having children

If a sperm donor is used in an IVF procedure, fertility medications are given to prepare the eggs for harvesting. Once retrieved, the eggs will be combined with the donor sperm and any resulting embryos will then be transferred back to the uterus. For women undergoing IUI, the donor sperm will be deposited directly into the uterus around the time of ovulation. With this method, it is possible to do two inseminations in one cycle, thereby increasing chances of pregnancy.

Donor sperm screening procedure
All sperm donors undergo rigorous personal medical testing to ensure the health of their sperm. At the time of donation, they are screened for different infectious and genetic diseases like hepatitis B, HIV, syphilis, gonorrhea etc. Sperm is then frozen and quarantined for six months. After the quarantine period, the sperm is then evaluated again for many of the infectious diseases it was originally tested for.

Legalities involved in sperm donation
While using sperm of an anonymous donor in a sperm bank, it is important that the couple or individual are given comprehensive orientation and even counseling to understand the psychological long-term effect of the process and to deal with the many legal questions and issues this procedure may throw up in the future. The choice of sperm donor is usually made based on factors such as his ethnic and/or racial background, physical characteristics, religion, education level and so on. The sperm donor does not have access to the woman's identity at any time. In some states of the USA, a child conceived through donor sperm may have the right to request identifying information once they reach their 18th birthday. However, the fact that sperm banks have had no claims for paternal rights arising from donors in more than 50 years of sperm donation in this country is a very reassuring thought.

East Bay Fertility Center, Dublin California offers the latest infertility treatment options including Donor Sperm Intrauterine Inseminations, strictly adhering to the guidelines of the American Society of Reproductive Medicine (ASRM) regarding the use of donor sperm.

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

Coping with Molar Pregnancy

Molar pregnancies are a rare complication, classified as a type of gestational trophoblastic disease (GTD) caused by chromosomal abnormalities during conception in the fertilized egg, which leads to overgrowth of pregnancy tissue.

Molar pregnancies are of two types – complete and partial. Complete molar pregnancies occur when the sperm fertilizes an empty egg due to which no baby is formed. The woman assumes she is pregnant because the placenta grows and produces the pregnancy hormone, called HCG. An ultrasound will reveal that there is no baby, only placenta.

Though a partial molar pregnancy is likely to develop into a fetus, the abnormal placenta cannot sustain a pregnancy. The embryo does not develop at all or develops incompletely. A cluster of grape-like cysts grows in the uterus.

Women, who have had a previous molar pregnancy and those over 40, are at increased risks of encountering a molar pregnancy. Sometimes it can even occur after ectopic pregnancies or a normal pregnancy. Women from Southeast Asia, Mexico and the Philippines have higher rates of molar pregnancy than white US women. White women in the US are at higher risk than black women.

Why molar pregnancy can be a cause for concern
In about 20% of women who have had complete molar pregnancies there is the likelihood of two serious problems arising: an invasive mole or choriocarcinoma. Invasive moles are more common. Choriocarcinoma is a type of cancer that can develop at the placenta site and spread to the body. Though this cancer is a serious condition, it is almost always treatable with chemotherapy. Only 2 to 4% cases of partial molar pregnancies will develop either condition.

Symptoms and diagnosis of molar pregnancy
Bleeding, severe nausea and vomiting are some of the indications of a possible molar pregnancy. A blood test to measure levels of HCG confirms the diagnosis. However partial molar pregnancies can sometimes be more difficult to diagnose. In the event of a miscarriage of a suspected molar pregnancy, a pathologist may confirm the condition on examining the miscarried tissue.

Most of the time a molar pregnancy ends spontaneously when a grape like tissue is discharged. It is also possible to diagnose a molar pregnancy with the help of ultrasound which will reveal an abnormal placenta that appears like a bunch of grapes. When a molar pregnancy is detected by ultrasound, doctors usually recommend a D & C or medication in order to reduce risk of further complications. A small percentage of cases require additional treatment in the form of chemotherapy.

Treatment and follow-up

It is crucial for women who have had a molar pregnancy to be in constant touch with her doctor to monitor the situation since there is a likelihood of molar pregnancies recurring. A minimum of six months of regular follow-ups is recommended and doctors recommend waiting for a year before trying for another pregnancy to make sure that the uterus is free of molar tissue.

A molar pregnancy can be a trying, upsetting experience. Grief about losing a baby, combined with fear of cancer and other health complications is very unsettling. It is here that counseling can effectively tackle feelings of grief and loss.

The cure rate of molar pregnancy is usually very good with vast majority of couples going on to have healthy babies. Chemotherapy also usually does not impact fertility.

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 physician, medical staff at East Bay provides dedicated treatment for infertility and reproductive endocrine issues. 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

The Role of Progesterone for a Successful Pregnancy

Progesterone a hormone produced by the ovaries helps prepare the uterus for pregnancy. It is first produced by the corpus luteum in the ovaries and later is maintained by the placenta. Healthy progesterone levels can help to maintain healthy estrogen levels, which are also crucial for achieving and maintaining pregnancy. Referred to as the pregnancy hormone, progesterone production is necessary for the safe maintenance of pregnancy. Progesterone supports pregnancy throughout the first trimester. In some women, a lack of progesterone may cause a spontaneous abortion

During pregnancy, progesterone is required for the following reasons:
• To keep the endometrium in a thickened condition for egg implantation

• To prevent the onset of uterine contractions

• To stimulate the growth of breast tissue and prevent lactation until after the birth

• To create a mucous plug that prevents bacteria from entering the uterus

After the egg is implanted in the endometrium, the growing embryo receives nourishment from progesterone produced by the ovaries. Around 8 weeks after implantation, the placenta takes over the production of progesterone and estrogen from the ovaries, producing substantial levels of progesterone to maintain a healthy pregnancy.

The failure of the corpus luteum to adequately support the pregnancy with progesterone can sometimes result in an early pregnancy loss. Progesterone levels may be monitored in such cases. In order to maintain a high progesterone level, injections, oral supplements and vaginal suppositories may be prescribed.

Progesterone in Fertility Treatment

Women who seek fertility treatment will most likely need to take a progesterone test. This test is also recommended for women with a history of miscarriages, stillbirth, unexplained infertility, and/or abnormal uterine bleeding.

Women facing infertility issues producing low levels of progesterone require progesterone supplementation to bring them into the safe levels. The type of fertility treatment used will determine the type of supplemental progesterone used. Progesterone is prescribed with in vitro fertilization (IVF) treatments and other assisted reproductive technology (ART) treatments. To prepare the lining of the uterus for implantation of the fertilized egg, most women undergoing IVF will be given progesterone after the retrieval of her eggs. In an IVF cycle the progesterone needs to be replaced in the form of injections and/or vaginal suppositories. A complete progesterone supplementation may be necessary in most frozen embryo transfer protocols. Progesterone levels in the blood are monitored by blood draws and supplemental doses adjusted accordingly.

Progesterone is a vital component for a successful pregnancy and low levels of this hormone have been found in many women who have suffered recurrent miscarriages or who are unable to get pregnant. It is important that these women meet a fertility expert and discuss the possibility of progesterone hormone therapy to increase their chances of sustaining a healthy pregnancy.

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. 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.

How Therapeutic Donor Insemination Works

Therapeutic donor insemination (TDI) helps couples facing significant sperm abnormality to conceive through IUI procedures. In this process, screened sperm from an anonymous donor is used instead of the male partner’s sperm thus making it a treatment of choice for those suffering from severe, untreatable male factor infertility or for males carrying a hereditary disease that may be dangerous to pass on to offspring. However, success rates of TDI decrease with increasing female age.

Who can benefit from TDI?

This procedure is recommended for couples who are experiencing male fertility problems such as:
• Azoospermia (absence of sperm)
• Poor sperm count and motility
• Erectile dysfunction
• Failed ICSI
• Residual effects from chemotherapy or radiation therapy
• Single women who wish to become pregnant
The TDI Process

In Therapeutic Donor Insemination, donor sperm that are thoroughly screened and frozen are inserted through a small catheter (tube) into the uterus at the time of ovulation. After the insemination is complete, the woman has to remain lying down for ten minutes or so. In two weeks a pregnancy test is conducted. Once pregnancy occurs, it is no different than one that occurs naturally with the same rate of complications as natural pregnancies.

Sometimes, couples undergoing IVF treatment fertilize the eggs with the help of donor sperm. Most couples try to find a donor who has a similar cultural background and religion.

Donor sperm specimens are frozen and quarantined for six months to ensure that the donor still tests negative for infectious diseases such as HIV and hepatitis after initial testing. This is necessary to make the specimen as safe as medically possible. The female is required to have a pelvic exam and is tested for sexually transmitted diseases and other diseases before undergoing TDI.

Infertility counseling is important for couples or women who consider TDI as a conception option in order to understand fully the immediate and long term psychological, emotional and social implication of using donor sperm.
East Bay Fertility Center offers TDI as an infertility treatment option, adhering to the guidelines of the American Society of Reproductive Medicine (ASRM) regarding the use of donor sperm. Before proceeding with TDI, a complete examination and basic lab tests are performed. Thorough screening of donor sperm is carried out as well.

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.

Uterine Malformation as a Hindrance to Conception

A small percentage of women face difficulties in conceiving due to a malformation in the uterus. A congenital uterine malformation is a deviation in the shape of the uterus that may occur during a woman's prenatal development. Some uterine malformations are present from birth, while others develop during the woman’s adult life.

Specific uterine malformations include septate uterus, bicornuate uterus, unicornuate uterus, arcuate uterus, didelphic uterus, or T-shaped uterus. The septate uterus seems to be the most frequent anomaly accounting for 30 to 50% of all cases, followed by the bicornuate uterus and unicornuate uterus.

A bicornuate uterus is a condition where the uterus, instead of being pear-shaped, is formed like a heart. This gives the embryo less space to grow than in a normally shaped uterus. Surgery may be performed to create a larger uterine cavity and to correct this condition. However unicornuate uterus and didelphic uterus cannot be surgically corrected.

Diagnosis of a Uterine Malfunction
The physician uses imaging techniques to analyze the character of the malformation in the uterus and they are generally revealed at the time of the first sonographic examination in early pregnancy. When the diagnosis is made at the beginning of pregnancy, preventive treatment such as taking rest, and periodic sonographic monitoring of the fetal growth are recommended.

However, unicornuate uterus is difficult to locate as also discrete forms of septate and bicornuate uterus. 3D ultrasonography seems the ideal method of imaging for uterine malformations. An evaluation of the uterine malformations should be accompanied by a renal investigation as there can be a direct association between the malformation and the kidneys.

Uterine Malfunction and Infertility
Patients with uterine malformations have higher rates of reproductive loss, preterm delivery, breech presentation and complications that increase obstetric intervention. The risk of breech or transverse presentation is higher, since normal rotation of the fetus in the uterine cavity is impeded.

It is seen that pregnancy outcome is poorer in the bicornuate and arcuate uterus groups. The incidence of miscarriages seems to be highest in the case of septate uterus. Early abortions can also be traced to uterine malformations.
However, uterine malformations are not the only factor responsible for infertility; this condition can increase the risk of endometriosis. Uterine problems are but one of the causes of infertility which can be revealed in the course of basic infertility tests.

Treatment of Uterine Malformation
Surgical intervention differs from case to case and depends on the extent of the specific problem. For a septate uterus, surgery is performed to remove the septum (wall). The procedure is performed either through hysteroscopy or laparoscopy. Once this corrective surgery is done, chances of conceiving are good.

At East Bay Fertility Center, California, couples dealing with infertility get access to the latest technology and comprehensive consultation with a reproductive endocrinologist and fertility specialists. East Bay specializes in providing infertility treatments such as in-vitro fertilization, insemination, Intracytoplasmic sperm injection, egg donation and gestational surrogacy. Call 925.828.9235 for a free initial consultation.

Infertility as a Result of Adhesions

Sometimes, infertility can be traced to pelvic scarring and adhesions. Infertility is caused when abdominal adhesions prevent the fertilized egg from reaching the uterus. Adhesions around the fallopian tubes can also make it difficult for sperm to reach the ovum. Tubal ectopic pregnancy is very often traced to adhesions in or around the fallopian tubes. Surgical intervention is needed to remove the adhesions which may be causing infertility.

What are Adhesions?
Adhesions or injuries are a type of scar tissue that may form between organs and tissues after a surgical procedure. Adhesions that form after surgery in the pelvic area and after surgeries to remove fibroids are among the leading causes of post-operative infertility. The main cause of intrauterine adhesions is trauma to the uterine cavity following a D&C procedure, prolonged use of an intrauterine device (IUD), endometritis and removal of fibroids in the uterus.

These injuries are typically caused by cauterization, suturing, and abrading tissues and organs during surgery. This internal trauma may lead to infertility and other issues. Once formed, adhesions need to be surgically removed. This means that adhesions that form in one surgery may require future surgery to cut through them to correct infertility or other complications.

Diagnosing Adhesions

Intrauterine adhesions may be diagnosed using an x-ray procedure called hysterosalpingography (HSG). Hysteroscopy is also another method of diagnosis where a hysteroscope (a thin telescope-like instrument) is inserted through the cervix to allow direct visualization of the uterine cavity. Both HSG and hysteroscopy can be performed without general anesthesia.

How are Adhesions removed?

Generally, trauma caused by intrauterine adhesions is removed with hysteroscopic guidance using instruments such as a laser, electrocautery device, or scissors. They are inserted through small incisions. Pelvic adhesions may sometimes be treated by laparoscopy. A laparoscopy is conducted under general anesthesia where the laparoscope is inserted into the pelvic cavity through a tiny incision made just below the woman's navel. After the adhesions are removed, surgeons recommend placing a device such as a plastic catheter temporarily inside the uterus to prevent the adhesions from forming again. Hormonal treatment with progestins estrogens and non-steroidal anti-inflammatory medications are prescribed post surgery to lessen the chance of adhesion reformation.

Conception Chances

After treatment it is seen that patients with mild to moderate adhesions have full-term pregnancy rates of around 70 to 80 percent. Patients with severe adhesions may only have full-term pregnancy rates in the 20 to 40 percent range after treatment. In-vitro fertilization (IVF) is ideally suited for women with blocked fallopian tubes or pelvic adhesions.

East Bay Fertility Center specializes in the comprehensive evaluation and treatment of infertility providing a complete mind-body experience for fertility couples. The Center performs extensive tests to find out the cause of infertility that also includes investigating suspected adhesions in the uterine cavity. Call 925.828.9235 for a free initial consultation.