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.