CALL US AT: (877) 838.BABY


Archive for the ‘Uterine fibroids’ Category

6 Potential Causes of Miscarriage and Recurrent Pregnancy Loss (RPL)

By Satu Kuokkanen, MD, PhD

May 2nd, 2016 at 11:31 am

image courtesy of David Castillo Dominici/ freedigitlaphotos.net

Experiencing a pregnancy loss is always devastating for individuals hoping to establish or expand their family. Patients describe a range of grieving emotions related to the loss of a person they never had a chance to meet, love and share the future.  This grieving process may last anywhere from few weeks up to several years.  Not surprisingly, I have heard from many patients that one of the most difficult coping times was around the expected due date of the pregnancy that they miscarried.

 

It may be somewhat comforting for patients to know that they are not alone. In fact, miscarriage is the most common pregnancy complication and it affects 1 in every 6-8 confirmed pregnancies, that’s 12-15%. The risk of miscarriage increases with maternal age. While women younger than 30 years old have a 10-12% risk of pregnancy loss, the risk is four fold higher for women in their 40’s. Identifying a potential cause may help with the emotional impact of the pregnancy loss whether it is isolated or recurrent loss.

 

Recurrent pregnancy loss (RPL) is diagnosed after a woman has had two or more consecutive miscarriages and RPL affects 1 in 20 couples who are attempting to conceive. While isolated miscarriages are commonly due to chromosomal and genetic abnormalities, other factors are responsible for RPL. These factors vary depending on the gestational age of the pregnancy loss. Evaluation of potential RPL causes is important in determining whether therapy is available to the patient.

 

6 Potential causes of RPL:

 

  1. Congenital and acquired structural uterine factors. A uterine septum, a partial or complete division of the uterine cavity, is the most common congenital structural uterine abnormality.  Uterine septum and bicornuate uterus (“heart shaped womb”) have been linked to RPL. Acquired structural uterine pathologies that distort the normal uterine cavity include endometrial polyps that are skin tag-like growths of the uterine lining, fibroids that are affecting the uterine cavity, and intrauterine scarring that can develop after surgical procedures, such as dilatation and curettage (also known as D&C).  Radiology studies of the uterus with saline ultrasound (‘water sonogram”) or magnetic resonance imaging (MRI) are standard methods to evaluate the womb.

 

  1. Chronic endometritis is inflammation of the uterine lining. This condition is diagnosed by sampling of the uterine lining with an endometrial biopsy or D&C.

 

  1. Structural chromosome abnormalities of the parents is a rare but known cause of RPL. A simple blood test of both parents to assess numeric and structural chromosomal component (karyotype) is done.

 

  1. Abnormalities of blood clotting.  The well-known condition in this category is anti-phospholipid antibody syndrome (APAS) which women can acquire during their reproductive years. Anti-phospholipid antibody levels can be measured in blood for diagnostic purposes.

 

  1. Endocrine-related abnormalities include elevation in alterations in thyroid hormone secretion and diabetes with uncontrolled blood sugar levels.  Also, women with polycystic ovary syndrome (PCOS) appear to have heightened risk of pregnancy losses.

 

  1. Environmental and lifestyle factors have also been linked to an increased risk of miscarriages. Such factors may include maternal obesity, cigarette smoking, and exposure to environmental toxins. How these factors may impact pregnancy or pregnancy loss differs and is still being studied at the current time.

 

It is important to remember that, although painful, an isolated miscarriage may often be followed by a healthy and successful pregnancy. And that, RPL, while devastating, can be caused by a factor that may be treated with proper, specialized medical care. In either case, your dream of parenthood may still be within reach.

* * * ** * ** ** *** ** *** * ** ** ****

Have you suffered one or miscarriages, been treated for an underlying cause, and gone on to have a successful pregnancy?

* * ****** **** * * * * * ** *** * * * * *

Long Island IVF-WINNER: Best in Vitro Fertility Practice 2015 AND 2016

It is with humble yet excited hearts that we announce that Long Island IVF was voted the Best In Vitro Fertility Practice in the Best Of Long Island 2015 and 2016 contest…two years in a row!

The doctors, nurses, embryologists, and the rest of the Long Island IVF staff are so proud of this honor and so thankful to every one of you who took the time to vote. From the moms juggling LIIVF babies… to the dads coaching LIIVF teens…to the parents sending LIIVF adults off to college or down the aisles… to the LIIVF patients still on their journeys to parenthood who are confident in the care they’re receiving…we thank you all.

We love what we’ve gotten to do every day more than 28 years…build families. If you are having trouble conceiving, please call us. Many of our nurses and staff were also our patients, so we really do understand what you’re going through. And we’d like to help. 631-752-0606.

 

no comments

Fibroids and Fertility

By David Kreiner MD

February 24th, 2015 at 6:59 am

 

photo courtesy of dream designs/freedigitalphotos.net


Fertility is dependent upon so many things!

We must have healthy gametes (eggs and sperm) capable of fertilizing and implanting in a uterus with a normal endometrial lining unimpeded by any uterine or endometrial pathology. The sperm need be in sufficient number and capable of swimming up through a cervix which is not inflamed and provides a mucous medium that promotes sperm motility. The eggs need to ovulate and be picked up by normal healthy fimbriated ends (finger like projections) of the fallopian tubes. The tubes need to be covered with normal micro hairs called cilia that help transport the egg one third of the way down the tube where one of the sperm will fertilize it.

The united egg and sperm (the “conceptus”) then needs to undergo cell division, growth and development as it traverses the tube and makes its way to the uterine cavity by the embryo’s fifth day of life at which point it is a blastocyst. The blastocyst hatches out of its shell (“zona pellucidum”) and implants into the endometrial lining requiring adequate blood flow.

And you wonder why getting pregnant is so hard?

All too often patients, in some groups as many as 30% of women, are told that they have fibroids that may be contributing to their infertility. Fibroids or leiomyomata are non malignant smooth muscle tumors of the uterus. They can vary in number, size and location in the uterus including; the outside facing the pelvic cavity (subserosal), the inside facing the uterine cavity (submucosal) and in between inside the uterine wall (intramural). Fortunately, most fibroids have minimal or no effect on fertility and may be ignored.

The subserosal myoma will rarely cause fertility issues. If it were distorting the tubo- ovarian anatomy so that eggs could not get picked up by the fimbria then it can cause infertility. Otherwise, the subserosal fibroid does not cause problems conceiving.

Occasionally, an intramural myoma may obstruct adequate blood flow to the endometrial lining. The likelihood of this being significant increases with the number and size of the fibroids. The more space occupied by the fibroids, the greater the likelihood of intruding on blood vessels traveling to the endometrium. Diminished blood flow to the uterine lining can prevent implantation or increase the risk of miscarriage. Surgery may be recommended when it is feared that the number and size of fibroids is great enough to have such an impact.
However, it is the submucosal myoma, inside the uterine cavity, that can irritate the endometrium and have the greatest effect on the implanting embryo.

To determine if your fertility is being hindered by these growths you may have a hydrosonogram. A hydrosonogram is a procedure where your doctor or a radiologist injects water through your cervix while performing a transvaginal ultrasound of your uterus. On the ultrasound, the water shows up as black against a white endometrial border. A defect in the smooth edges of the uterine cavity caused by an endometrial polyp or fibroid may be easily seen.

Submucosal as well as intramural myomata can also cause abnormal vaginal bleeding and occasionally cramping. Intramural myomata will usually cause heavy but regular menses that can create fairly severe anemias. Submucosal myomata can cause bleeding throughout the cycle.

Though these submucosal fibroids are almost always benign they need to be removed to allow implantation. A submucosal myoma may be removed by hysteroscopy through cutting, chopping or vaporizing the tissue. A hysteroscopy is performed vaginally, while a patient is asleep under anesthesia. A scope is placed through the cervix into the uterus in order to look inside the uterine cavity. This procedure can be performed as an outpatient in an ambulatory or office based surgery unit. The risk of bleeding, infection or injury to the uterus or pelvic organs is small.

Resection of the submucosal myoma can be difficult especially when the fibroid is large and can sometimes take longer than is safe to be performed in a single procedure. It is not uncommon that when the fibroid is large, it will take multiple procedures in order to remove the fibroid in its entirety. It will be necessary to repeat the hydrosonogram after the fibroid resection to make sure the cavity is satisfactory for implantation.

The good news is, when no other causes of infertility are found, removal of a submucosal fibroid is often successful in allowing conception to occur naturally or at least with assisted reproduction.

 

* * * * * ** * * ** * *

Anyone have a fibroid story to share?

 

Photo credit: http://www.freedigitalphotos.net/images/female-reproductive-system-photo-p284491

 

 

 

2 comments

Fibroids and Fertility

By David Kreiner MD

December 13th, 2013 at 9:13 am

 

 

 

Fertility is dependent upon so many things!

We must have healthy gametes (eggs and sperm) capable of fertilizing and implanting in a uterus with a normal endometrial lining unimpeded by any uterine or endometrial pathology. The sperm need be in sufficient number and capable of swimming up through a cervix which is not inflamed and provides a mucous medium that promotes sperm motility. The eggs need to ovulate and be picked up by normal healthy fimbriated ends (finger like projections) of the fallopian tubes. The tubes need to be covered with normal micro hairs called cilia that help transport the egg one third of the way down the tube where one of the sperm will fertilize it.

The united egg and sperm (the “conceptus”) then needs to undergo cell division, growth and development as it traverses the tube and makes its way to the uterine cavity by the embryo’s fifth day of life at which point it is a blastocyst. The blastocyst hatches out of its shell (“zona pellucidum”) and implants into the endometrial lining requiring adequate blood flow.

And you wonder why getting pregnant is so hard?

All too often patients, in some groups as many as 30% of women, are told that they have fibroids that may be contributing to their infertility. Fibroids or leiomyomata are non malignant smooth muscle tumors of the uterus. They can vary in number, size and location in the uterus including; the outside facing the pelvic cavity (subserosal), the inside facing the uterine cavity (submucosal) and in between inside the uterine wall (intramural). Fortunately, most fibroids have minimal or no effect on fertility and may be ignored.

The subserosal myoma will rarely cause fertility issues. If it were distorting the tubo- ovarian anatomy so that eggs could not get picked up by the fimbria then it can cause infertility. Otherwise, the subserosal fibroid does not cause problems conceiving.

Occasionally, an intramural myoma may obstruct adequate blood flow to the endometrial lining. The likelihood of this being significant increases with the number and size of the fibroids. The more space occupied by the fibroids, the greater the likelihood of intruding on blood vessels traveling to the endometrium. Diminished blood flow to the uterine lining can prevent implantation or increase the risk of miscarriage. Surgery may be recommended when it is feared that the number and size of fibroids is great enough to have such an impact.
However, it is the submucosal myoma, inside the uterine cavity, that can irritate the endometrium and have the greatest effect on the implanting embryo.

To determine if your fertility is being hindered by these growths you may have a hydrosonogram. A hydrosonogram is a procedure where your doctor or a radiologist injects water through your cervix while performing a transvaginal ultrasound of your uterus. On the ultrasound, the water shows up as black against a white endometrial border. A defect in the smooth edges of the uterine cavity caused by an endometrial polyp or fibroid may be easily seen.

Submucosal as well as intramural myomata can also cause abnormal vaginal bleeding and occasionally cramping. Intramural myomata will usually cause heavy but regular menses that can create fairly severe anemias. Submucosal myomata can cause bleeding throughout the cycle.

Though these submucosal fibroids are almost always benign they need to be removed to allow implantation. A submucosal myoma may be removed by hysteroscopy through cutting, chopping or vaporizing the tissue. A hysteroscopy is performed vaginally, while a patient is asleep under anesthesia. A scope is placed through the cervix into the uterus in order to look inside the uterine cavity. This procedure can be performed as an outpatient in an ambulatory or office based surgery unit. The risk of bleeding, infection or injury to the uterus or pelvic organs is small.

Resection of the submucosal myoma can be difficult especially when the fibroid is large and can sometimes take longer than is safe to be performed in a single procedure. It is not uncommon that when the fibroid is large, it will take multiple procedures in order to remove the fibroid in its entirety. It will be necessary to repeat the hydrosonogram after the fibroid resection to make sure the cavity is satisfactory for implantation.

The good news is, when no other causes of infertility are found, removal of a submucosal fibroid is often successful in allowing conception to occur naturally or at least with assisted reproduction.

* * * * * ** * * ** * *

Anyone have a fibroid story to share?

Photo credit: public domain: http://en.wikipedia.org/wiki/File:Fibroids.jpg

 

no comments

Fertile Food Summer Series – Dark Chocolate…and Oysters

By Tracey Minella

August 2nd, 2013 at 11:44 pm

image courtesy of idea go/freedigitalphotos.net

 

 

 

Welcome back to Long Island IVF’s “Fertile Food Friday Summer Series”*! This is our fifth week of focusing on foods that can potentially boost male or female fertility. If you missed them, be sure to check out our earlier featured foods…including avocados, blueberries, red meat, and tomatoes…covered the past few Fridays.

This week we’re focusing on Zinc. Many people know Oysters are loaded with zinc…but many people gag at the thought of slurping down raw oysters (including me!) So, we can get our zinc from other foods, including  Dark Chocolate!

So how can zinc help your fertility?

Zinc is a mineral and also a known aphrodisiac. And what infertile couple …faced with libido-wilting intrusions like temperature charts and fertility shots…couldn’t use a little help now and then getting in the mood? Zinc is critical for both female and male fertility.

According to Natural Fertility Info, not only can an insufficient zinc level contribute to early miscarriage, but it can deplete follicular fluid levels and thereby impede the egg’s ability travel to and implant into the uterus. Zinc has a crucial role in the production of mature eggs capable of being fertilized and in the hormonal regulation of a woman’s menstrual cycle. Like a woman’s eggs, a man’s sperm relies on a sufficient supply of zinc in order to produce a strong tail and mature to a stage capable of journeying to and fertilizing an egg. Even if fertilization does occur, low levels of zinc in men can be responsible for chromosomal defects that contribute to early miscarriage. *

If you have known or suspected male factor infertility, have fibroids, have had a miscarriage, or have hormonal regulatory issues, eating a diet rich in zinc-rich foods may help. Or ask your physician about zinc supplementation. Zinc and copper levels are related and your doctor can help you regulate both. Never take any supplements without your doctor’s approval since unsupervised supplementation can be harmful.

photo credit: primallyinspired.com

This week, I am sharing a simple recipe for Homemade Dark Chocolate that is healthy and versatile! You can dip or cover Vitamin C-rich fruits in it, pour it over calcium-rich ice cream, or even layer it in candy molds with some peanut butter (another high-zinc food) for some decadent, fun peanut butter cups. The recipe is from Kelly over at PrimallyInspired. Get the recipe here: http://bit.ly/17Zh6AR

Oy! I almost forgot the Oysters. If you’d like to know how to prepare them on the grill with a quick little mango salsa, check out this great Food Network You Tube video of expert chef Bobby Flay. It’s under a minute long. http://youtu.be/UpWQOT2qMO0

If you make either recipe, come back and tell me how it was!

And if you can’t eat oysters or chocolate, here’s a great “top 10” list of other foods rich in zinc. http://bit.ly/1bV26cT

image courtesy of Tina Phillips/freedigitlaphotos.net

 

*Disclaimer:Any recipe we offer is only meant for those who aren’t sensitive or allergic to the ingredients. Recipes are shared simply for fun only and nothing contained herein constitutes medical advice or a guarantee that eating any particular food will have any effect on your fertility. And remember NEVER to take any vitamin, mineral, dietary or other supplements unless advised to do so by your physician.

 

* * * * * * * * * * * * * **

Have a recipe high in zinc? If so, please share it here. And if you try these, let us know what you thought.

 * http://bit.ly/13JK57u

 

Chocolate splash photo credit: Idea go/ http://www.freedigitalphotos.net/images/agree-terms.php?id=10012400

Oyster photo credit: Tina Phillips/  http://www.freedigitalphotos.net/images/agree-terms.php?id=10019608

Homemade Chocolate photo credit: Kelly/ http://www.primallyinspired.com/easy-healthy-homemade-dark-chocolate/

 

 

no comments

Fertile Food Friday- Blueberries

By Tracey Minella

July 5th, 2013 at 8:50 pm

 

image courtesy of Mr GC/freedigitalphotos.net

Welcome back to Long Island IVF’s “Fertile Food Fridays”*! This is our second week of focusing on foods that can potentially boost male and female fertility. If you missed it, be sure to check out last Friday’s Avocado post with a mean guacamole demonstration and a testicle tree. With the Fourth of July holiday celebrations continuing over the next few days, we’ve got the perfect food for you to add to your barbeque (or take to a potluck) this week.

So without further ado, the second first fertile food will be Blueberries.

Blueberries  are one of the best sources of antioxidants you can find. Only have raspberries, strawberries or blackberries on hand? No problem. Most berries are high in antioxidants, so feel free to eat them all or substitute your favorites in the accompanying recipe. The antioxidants in berries protect against cell damage and cell aging, so help keep those reproductive cells at their peak by loading up on these healthy fruits.  

Blueberries have anthocyanins which give them their namesake color. [“Cyan” means blue in Greek] and are a great source of Vitamin C. Studies show that compounds and vitamins in blueberries may help with some of the symptoms of endometriosis and uterine fibroids by easing some of the pain and heavy bleeding… and blueberries may even positively affect the uterine lining which may help with implantation**.

Ready for an easy blueberry recipe?

A popular use for fresh blueberries is in Fresh Berry Kebobs and Fruit Dip, served with a creamy fruit dip. This dip is one of my own creations and is also great whenever you’re serving a platter of fresh fruit instead of the fruit kebobs. All you need for the kebobs are wooden skewers, blueberries (and strawberries or other fruits that work well on sticks) to thread onto the skewers and the following easy dip ingredients, which you combine in a bowl and refrigerate until ready to use:

1- 15 oz. can of frozen Bacardi® pina colada mixer (there is no alcohol in it), thawed,

1- 8 oz. container of Cool Whip®, thawed and

1- 8 oz. can of crushed pineapple, drained.

Another great blueberry recipe that is really patriotic and easy is this gorgeous 4th of July Strawberry (and Blueberry) Shortcake Kabobs from Foods 101 with Deronda . Check out the quick video here: http://www.youtube.com/watch?v=YpqVNEFzF-s  You will be a hit at any summer gathering with this one!

* * * * * * * * *

Did you make either of these eye catching patriotic treats? Have another blueberry recipe to share?


*Disclaimer:Any recipe we offer is only meant for those who aren’t sensitive or allergic to the ingredients. Recipes are shared simply for fun only and nothing contained herein constitutes medical advice or a guarantee that eating any particular food will have any affect on your fertility.

 * http://www.livestrong.com/article/543691-blueberries-the-uterus/

photo credit: Grant Cohrane http://www.freedigitalphotos.net/images/agree-terms.php?id=10047219

no comments


The Fertility Daily Blog by Long Island IVF
© Copyright 2010-2012