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.