Posts filed under 'Reproductive Endocrinologist'
When to Consult a Reproductive Endocrinologist
When the basic treatment for fertility related problems as recommended by an obstetrician/ gynecologist (OB/GYN) do not seem to work, it may be time to start seeing a Fertility Specialist, also called a Reproductive Endocrinologist (RE) who may recommend advanced treatments and medications. The OB/GYN treating infertility usually recognizes the limits of their capabilities and makes appropriate referrals to more specialized care whenever necessary.
Who is a Reproductive Endocrinologist?
Reproductive Endocrinologists complete the same education and medical requirements as OB/GYNs. In addition, they also finish a two- to three-year fellowship in reproductive endocrinology, pass specialized examinations (board certified) and complete a two-year practice in reproductive endocrinology. Thus they are the physicians with the broadest range of qualification, training, specialization and experience in treating reproductive disorders. In fact Board Certification in reproductive endocrinology infertility is the only sure identifier of a trained fertility specialist.
Reproductive Endocrinology combines reproductive medicine and endocrinology, which focuses on organs of the endocrine system and the hormones they produce. These specialists also deal with issues related to menstrual disorders, puberty-related problems and sexual dysfunction as well as the treatment of transsexuals and intersexed individuals undergoing hormone treatment.
A Positive Step towards Infertility Treatment
The decision to consult a RE is a proactive, tangible step towards addressing fertility issues. Board certification is important when choosing a reproductive endocrinologist. At the first visit the RE will ask about the patient’s medical history, any diagnostic procedures that have been done so far, and procreative efforts to date. The RE then specifies the tests which are necessary to be performed.
Who Should Consult a Reproductive Endocrinologist?
In general, women aged thirty-five or older if experiencing fertility issues should seek specialty care from a reproductive endocrinologist as their fertility can decline rapidly. Staying with their OB/GYN for far too long expecting positive results is the error most couples make, thus wasting valuable time. Younger women can also experience premature menopause, termed “declining ovarian reserve”. Such a condition, as also disorders like polycystic ovarian syndrome (PCOS), male factor infertility, fallopian tube disease and severe endometriosis all warrant immediate consultation with a reproductive endocrinologist.
Often patients hesitate to consult a fertility specialist due to cost concerns. But since appropriate diagnostic tests and treatment are ordered early in the evaluation during a consult with a specilist, it leads to effective treatment options and ultimately to overall savings in cost. Patients under the care of a reproductive endocrinologist are more likely to conceive, and in a much shorter period of time.
East Bay fertility clinic (http://www.ebfertility.com/) specializes in the comprehensive evaluation and treatment of infertility. Their experienced medical staff is headed by Dr. Ellen U. Snowden, Medical Director and physician. Dr Snowden is Board Certified in Obstetric, Gynecology, and Reproductive Endocrinology with advanced Fellowship training in the treatment of infertility, recurrent miscarriages and hormonal disorders in women. A former infertility patient herself, Dr. Snowden brings to her patients a rare and valuable firsthand empathy for the personal pain and emotional stress of dealing with infertility. Call 925.828.9235 for a free initial consultation.
Add comment September 1, 2009
Female Infertility Due to Fallopian Tube Damage
A common cause of female infertility is due to blockage and scarring of the fallopian tube. This condition prevents the egg from travelling to the fallopian tube and onward to be implanted in the uterus. Blockage of the tube increases the chance of ectopic pregnancy, where the fertilized egg settles in the fallopian tube rather than the uterus.
Fallopian tube block can be caused by untreated pelvic inflammatory disease (PID), endometriosis and sexually transmitted diseases. Sometimes it can be caused by scar tissue that forms after pelvic surgery. Other potential causes of blocked fallopian tubes include a previous history of uterine infection caused by an abortion or miscarriage, a history of abdominal surgery or a ruptured appendix.
The common tests to diagnose infertility due to fallopian tube damage include
- A hysterosalpingogram (HSG) which is a medical procedure where radio opaque dye is injected through the cervix into the uterus and fallopian tubes. A special X-ray machine then scans the pelvic region to diagnose fibroid tumors, scar tissue, an unusually shaped uterus or blockages in the fallopian tubes.
- Laparoscopic surgery is sometimes performed in order to diagnose tubal factor infertility. This involves making a small incision in the abdomen. A tiny camera is then inserted into this incision, allowing the surgeon to view the fallopian tubes.
Treating Tubal Factor Infertility
Tubal factor infertility can be treated through IVF or fallopian tube surgery.
Invitro Fertilization (IVF)
IVF is recommended for women suffering from tubal factor infertility. IVF involves fertilizing an egg outside the fallopian tubes and then implanting the embryo inside the uterus. Chances of pregnancy through this process are quite high.
Fallopian Tube Surgery
Surgery to remove scar tissue, adhesions and fallopian tube blockage is another option although subsequent pregnancy rates do vary.
A reproductive endocrinologist (fertility specialist) is best suited to take the decision about which of these therapies are to be opted based on several factors, the most significant factor being the degree of tubal damage, the age of the female, and whether other infertility factors (male or female) are present.
For women with significant damage to the ends (fimbria) of their tubes, one IVF attempt offers a better chance of a viable pregnancy than surgery ever will and at a lower overall cost.
East Bay fertility Center Dublin California, (www.ebfertility.com) specializes in the comprehensive evaluation and treatment of infertility providing a complete mind-body experience for fertility couples. East Bay’s experienced medical staff is headed by Dr. Ellen U. Snowden, Medical Director and physician. Dr Snowden is Board Certified in Obstetric, Gynecology, and Reproductive Endocrinology with advanced Fellowship training in the treatment of infertility, recurrent miscarriages and hormonal disorders in women. East Bay Fertility Center performs tests to check the extent of fallopian tube blockage or damage and recommends tubal surgery if necessary. Call 925.828.9235 for a free initial consultation.
3 comments September 1, 2009
Azoospermia – A Cause of Male Infertility
Azoospermia is the complete lack of sperm in the ejaculate and is one of the most severe forms of male factor infertility. Since azoospermia does not have any symptoms, it often comes as a surprise to a couple planning parenthood. This condition does not rule out the possibility of fathering a child. New techniques are now being perfected to help men with azoospermia become a parent to biological children.
Azoospermia is of two types:
- Obstructive Azoospermia that occurs when a blockage in the duct system prevents sperm from mixing with the semen.
- Non-Obstructive Azoospermia occurs when there is a problem with the actual production of sperm within the body and is generally attributed to hormonal imbalances.
Causes of Azoospermia
Failed sperm production is often the result of hormonal abnormalities, undescended testicles or vascular trauma to the testes or to the blood vessels within the testes.
Sperm transport problems are often caused by infection including STDS, by congenital absence of Vans Deferens which are tiny tubes that carry sperm to the urethra for ejaculation or due to a previous vasectomy procedure that prevents the sperm from mixing with the ejaculate.
Diagnosis
The initial semen analysis reveals if there is a problem with sperm production or there is a blockage preventing sperm from reaching the ejaculate. A medical evaluation of a male suspected to be suffering from azoospermia includes:
- A thorough physical examination
- Semen analysis
- Blood tests that include a testosterone and FSH level
- A complete review of medical problems, past surgeries, medications and family history
A testis biopsy under local anesthesia may be performed if the above procedures fail to throw light on the sperm production problem.
Treating Azoospermia
There are ways to treat azoospermia and possibly restore fertility in men suffering from the condition. Treatment options include:
- removing blockages in the duct system
- using medications to restore hormonal balances
New methods of surgical sperm removal are now available, wherein small quantities of sperm can be removed from the testes or around blockages. These include:
- PESA (Percutaneous Sperm Aspiration), in which sperm is taken directly from the epididymis.
- MESA (Microsurgical Epididymal Sperm Aspiration), in which sperm is retrieved in higher numbers from the epididymis.
- TESE (Testicular Sperm Extraction), in which a small tissue sample is taken from the testicles in order to retrieve viable sperm.
Thus even if there are no sperm in the ejaculate, sperm can often be harvested and used to achieve fertilization. Assisted Reproductive Techniques (ART) like IVF and ICSI manipulate sperm in a controlled manner and greatly facilitate infertility treatment.
It is important not to give up hope when confronted with azoospermia. A consultation with an infertility specialist for treatment options is the immediate step to be taken. East Bay Fertility Center located in Dublin, California (www.ebfertility.com) is well equipped with the latest technology and offers comprehensive infertility consultation. The Center is headed by Dr. Ellen U. Snowden a Board Certified Reproductive Endocrinologist and offers a complete mind-body experience for couples with fertility issues including male infertiity.
Call 925.828.9235 for a free initial consultation.
Add comment September 1, 2009
Secondary Infertility – Causes and Remedies
Secondary infertility is a term used to describe a condition where a woman who was able to conceive naturally in the past has difficulty conceiving another child. This is a fairly common problem that can be attributed to a number of factors such as low sperm count, endometriosis, damaged fallopian tubes, ovulation problems, fibroids or change in partner.
In some cases, medical tests indicate that the cause of secondary infertility is a combination of factors shared by both partners.
Age as a Cause of Secondary Infertility
The most common cause of secondary infertility may be age. There is a marked decrease in fertility by 35 years of age. By age 45 the chances of natural conception are extremely low. Thus the possibility of becoming pregnant decreases with rising age. Moreover, a woman’s eggs suffer chromosomal damage as they age; the older the eggs, the less likely they are to become fertilized or go to term. Some women also go through menopause at an early age; this may also be a cause of secondary infertility.
Some experts in the field of human reproduction have suggested that male fertility is also affected by age and that male fertility starts declining after the age of 35.
Stress and Secondary Infertility
Stress may also be a factor affecting fertility. Studies show that if a man already has a low sperm count, stress worsens this condition. While stress itself does not cause infertility, the process of “trying” to become pregnant can be stressful, especially on your relationship. The stress levels are often the result of infertility, not the cause of it.
Diet and Lifestyle
Being either underweight or overweight can affect fertility. Smoking and excessive consumption of alcohol has also been found to affect fertility.
Chronic Illness
Chronic illness can also lead to secondary infertility. High blood pressure, diabetes and asthma can affect fertility. Sometimes chemotherapy or radiation treatments for cancer can reduce a person’s fertility.
Remedies for Secondary Infertility
There are a number of steps that can be taken when confronted with secondary infertility to improve chances of conception. The first obvious step is for both the partners to get a complete medical check up done.
Things may change after the birth of the first child. For instance one of the partners could now have a low sperm count; hormones could be out of sync etc. Taking control of the situation and opting for the right line of treatment will help in surmounting the condition.
If faced with fibroids, endometriosis, vaginal infections and pelvic adhesions – all potential causes of secondary infertility – get treatment for these issues which can sometimes successfully cure infertility.
Fertility treatments may be the next line of treatment for curing secondary infertility. A referral to a reproductive endocrinologist for appropriate treatment may be necessary. Initially the fertility specialist will prescribe medications to help conceive another child. If this proves ineffective, more advanced treatments may be necessary.
On a Positive Note
The good news is that secondary infertility is more likely to be treatable than primary infertility. Consult with a specialist, and faithfully follow the prescribed treatment plan, and you can be sure that you’ll have another baby soon.
East Bay Fertility Center, Dublin, California (www.ebfertility.com) has an experienced team of doctors headed by Board Certified Reproductive Endocrinologist Dr Ellen Snowden and offers the most comprehensive line of treatment and intervention for secondary infertility. East Bay Fertility Center makes sure that couples who have been facing problems conceiving a second time will successfully overcome the problem in the shortest possible time and realize their dreams of having a healthy baby. Call 925.828.9235 for a free initial consultation.
Add comment August 31, 2009
Polycystic Ovary Syndrome Affecting Infertility
Polycystic Ovary Syndrome, also called PCOS, is an endocrine or hormonal disorder and is the most common cause of infertility in women. PCOS may affect a woman’s menstrual cycle, hormones, insulin production, heart blood vessels. and finally appearance. If the quantity of male hormones is more than that of female hormones in a woman’s body then she is likely to suffer from PCOS. This growth of PCOS adversely affects the ovulation rate of a woman and can cause irregular ovulation.
PCOS restricts the growth of ovarian follicles and as a result these follicles are not able to release eggs. The follicles are left with less time to reach maturity and they continue to grow as small size cysts (fluid-filled sacs) in the ovaries. However women with cysts need not necessarily have PCOS.
Symptoms of Polycystic Ovarian Syndrome (PCOS)
The main symptoms of PCOS that doctors look for while diagnosing the causes of infertility include:
• Irregular and/or no ovulation which means no eggs to be impregnated
• Irregular and/or no menstruation
• Increased growth of hair on the face, chest, stomach, back, thumbs, or toes
• High levels of male hormones, also called androgens
• Severe acne, oily skin, or dandruff
• Considerable pelvic pain
• Weight gain or obesity, especially extra weight around the waist
• High cholesterol level and high blood pressure
• Type 2 diabetes
• Male-pattern baldness or thinning of hair
• Skin discolorations around the genitals, chest and arm pits
• Growth of skin tags, or tiny flaps of skin in the armpits or neck area
• Sleep apnea i.e. excessive snoring and occasional stoppage of breathing while sleeping
• Insulin resistance
All of these symptoms need not be present for the diagnosis of PCO. The tests to confirm the suspected diagnosis include:
1. A reverse FSH/LH ratio performed on Day 3 of the menstrual cycle
2. Characteristic appearance of the ovaries on a pelvic ultrasound
3. Characteristic appearance of the ovaries when visualized surgically by laparoscopy or laparotomy
Treatment for Polycystic Ovarian Syndrome (PCOS)
As per the U.S. Department of Health & Human Services, treatment procedures for PCOS differ from one patient to another based on symptoms and whether the woman wants to conceive or needs contraception. A detailed look at the symptoms and family history is essential to start appropriate treatment. Controlling the symptoms of PCOS is the best cure to reduce the risks associated with it.
To control the side effects of PCOS a healthy diet and regular exercise are crucial. The remedies for Polycystic Ovarian Syndrome (PCOS) include:
• Contraceptive pills: Not exactly a cure for PCOS, these pills regulates menstrual periods, reduce male hormone levels and acne growth. But once the pills are discontinued, the menstrual cycle tends to again become abnormal.
• Diabetes Medications: Medicines for type 2 diabetes such as Metformin, also called Glucophage, regulates glucose, decreases testosterone production, slows down abnormal hair growth and normalize ovulation after a few months of use.
• Fertility treatments: The lack of ovulation is the main fertility problem for women with PCOS. However, before starting with fertility treatment it is essential that sperm count and the partner’s tubes are checked to make sure they are open.
• Ovarian Drilling Surgery: This surgery, considered the last treatment option, is used to induce ovulation. This helps in reducing male hormone levels and aids ovulation. However, the surgery carries a risk of developing scar tissue on the ovary.
• Maintaining a healthy body weight: Healthy weight lowers glucose levels, restores regular periods and uses insulin more effectively. It has been proved that losing even a small amount of weight can help balance hormones and restore fertility.
If the normal course of treatment for PCOS does not yield positive conception results, it is essential to seek out the care of a Reproductive Endocrinologist. East Bay Fertility Center (www.ebfertility.com), 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. East Bay Fertility Center specializes in providing infertility treatments such as in-vitro fertilization, insemination, Intracytoplasmic sperm injection, egg donation and gestational surrogacy.
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 us at 925.828.9235 for a free initial consultation or visit our website at www.ebfertility.com for more details about infertility treatments and more.
Add comment June 1, 2009
