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Archive for the ‘blocked tubes’ tag

Infertility Care: Starting with the Basics

By Steven Brenner MD

October 18th, 2014 at 10:52 am

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“Thinking the worst” is a very common reaction for individuals experiencing adversity.

This is especially true for people experiencing infertility. Concerns regarding the question of establishing the family someone has dreamed of since they were young is daunting and can leave a person with significant anxiety and doubt regarding her/his future.

In this context it is important to go back to basics regarding fertility and understand that many people suffering from this disorder will be successfully treated with relatively simple techniques and therapies. For the more severe abnormalities, it is comforting to know current available therapies can address these issues with great success.

Establishing a pregnancy without infertility treatment requires a healthy egg, functioning sperm and an anatomic path that allows sperm to ascend the genital tract and an egg to travel into a fallopian tube where fertilization takes place. The anatomic path needs to allow the fertilized egg to travel into the uterine cavity. A receptive uterine lining is then required for the pregnancy to implant and grow. To make things more challenging, sperm and egg have a very small window of time to find each for fertilization to take place.

Many couples have experienced infertility as a result of improperly timed intercourse.  This often results from the couple not being aware of the timing of ovulation and the short duration of egg viability. The “fix” for something like this is very simple, requiring merely an understanding of the basic physiology.  Sexual dysfunction can plague a relationship, but it is often not until fertility is compromised that couples seek treatment. The simple fix for fertility may involve nothing more than inseminations timed to natural ovulation. Much more in depth therapies may be required to overcome the other, additional concerns associated with sexual dysfunction.

Ovulatory dysfunction, while a very complex issue, is often very easily addressed with simple treatments. Weight loss or gain may be all that is needed to establish regular ovulatory cycles. Correction of hormonal abnormalities leading to problems with ovulation can often be treated with medications that do not require the intense monitoring of injectable fertility medications associated with in vitro fertilization procedures.  Sluggish thyroid activity and elevations in a hormone named prolactin are such issues that readily respond to oral medications.

A receptive uterine lining to allow for implantation of an embryo that formed in the fallopian tube is needed to allow a pregnancy to be established in the uterus. Although a scarred endometrium or one that is distorted from fibroids may require surgical repair, other disorders of the lining can be treated with local hormonal supplementation. The endometrium, the uterine lining, may not develop appropriately after ovulation secondary to hormonal abnormalities. This may reflect an abnormality in egg production and the hormones associated with ovulation.

Therapies directed at improving ovulation or directly supporting the lining of the uterus with vaginal application of the hormone progesterone may be all that is needed to correct this problem.

Anatomic problems such as scarring of the fallopian tubes may require surgical correction. However, blocked tubes may be opened by minimally invasive procedures at the time of a hysterosalpingogram (HSG). In such procedures, a tube blocked where it inserts into the uterus is opened with a catheter in a setting that does not require general anesthesia.

Many patients will be successfully treated with simple techniques and procedures that are not associated with the expense and invasiveness of the therapies that most people think they will require.

For each infertile person a plan of evaluation and therapy needs to be developed, beginning with the basics. It does not necessarily lead to those treatments that are more detailed and invasive.

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Did you put off an infertility evaluation out of fear of needing expensive, invasive fertility treatments?

 

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Micro-IVF May Be Your Answer—and You Could Win a Free Cycle!!!

By David Kreiner MD, and Tracey Minella

August 21st, 2012 at 9:22 pm

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What better time than now to have Dr. Kreiner explain what Micro-IVF is all about!

Why? Because there are 5 days left to enter to win a FREE MICRO-IVF CYCLE FROM LIIVF! After you read all about the many benefits of Micro-IVF, I’m sure you’ll be excited enough to want to enter to win our annual contest.

Here’s the link for the contest: http://bit.ly/LHbmQR

Dr. Kreiner of Long Island IVF explains the process and who can benefit from it:

You’ve already crossed the bridge from “We’re going to get pregnant!” to “We need help…” But this other side looks filled with more obstacles, including expensive and risky fertility medications.

How far do you have to go just to have a baby?

Micro-IVF (sometimes called mini-IVF) may be your answer.

The primary point of MicroIVF: fewer fertility drugs, less cost.

Plus you get additional benefits: decreased chances of ovarian hyperstimulation syndrome and of multiple pregnancies.

Additionally, Long Island IVF patients who choose MicroIVF can increase their savings if they also use our Single Embryo Transfer Program — embryo freezing, storage, and future frozen embryo transfers are free.

Why go Micro?

I learned long ago that pregnancies of twins, triplets, and more can bring heartache to what should be a joyous journey for fertility patients. So the LIIVF team has dedicated our practice to the achievement of safe, healthy pregnancies.

IUI or IVF?

Intrauterine insemination (IUI) is often considered the first order of business for many infertility patients.

Sometimes called “artificial insemination,” the usual protocol — oral and injectable fertility medications to induce superovulation (of more than one egg in a cycle), followed by insemination via exam room procedure — is believed to be simpler and, therefore, less costly than IVF.

That’s just not true any longer.

The facts now are that success rates can be far better for IVF than for IUI, depending on the individual’s or couple’s cause of infertility. Many women undergo several IUI’s before achieving conception.

Some infertility causes — pelvic adhesions/scarring, blocked fallopian tubes, endometriosis, and severe male factor issues — will not respond to IUI but are treatable with IVF.

Even patients who would otherwise try IUI to get pregnant will find that choosing Micro-IVF can result in cost savings and greater safety:

Micro-IVF fee (current as of August 2012): $3900

ICSI (if required): $2000

Anesthesia (as requested): $550

IUI with hormone injections: $3500 to $4500

Is Micro-IVF right for you? Each patient’s case is considered carefully and individually.

The following are conditions that might respond best to Micro-IVF:

Young healthy women with PCOS or who otherwise produce many follicles

Women with pelvic adhesions or scarring, blocked fallopian tubes, or endometriosis

Couples with severe male factor infertility

Micro-IVF really is a case of a little treatment going a long way! With it, you can access the world’s most successful assisted reproductive technology at far less cost.

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So, are you excited or interested in learning if you are a good candidate? Why not enter our contest before it ends this Sunday?

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