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.