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Why Can’t I Get Pregnant? The Emotional Impact of Unexplained Infertility

If you have just received the news that you and your partner are suffering from unexplained infertility, the shock may be so great that you might feel as if you have just been punched. Or you could be numb – trying to take it all in. You’ve been trying for so long and going to see a specialist was the light at the end of the tunnel.  They would find out what was wrong and fix it for you. At last you’d both allowed yourselves a glimmer of hope that you were getting nearer to your dream of starting a family.

Many people have heard of couples with a problem with “her” or a problem with “him”. Her eggs aren’t right, his sperm aren’t right…and so it goes on. But you don’t often hear people say “They don’t know what is wrong”.

For a specialist to admit to you that they don’t know what is stopping your from having a baby is absolutely devastating. If they don’t know – what on earth are you supposed to do now? Couples have reported feeling as if they’re on a sinking ship and the last lifeboat has just left without them.

There have been so many medical advances – how can they not know? It defies belief.

Anxiety levels go up

Because no one can give you a reason, you become more anxious than you were before. There are moments when you wish you’d been told that you just couldn’t have a child because then you could grieve and move forward with your lives. This frustrating, disappointing, crushing blow leaves you in a no man’s land where you just don’t know what to do next. You don’t even have any power in the situation and so you may start to feel helpless.

It’s little wonder that anxiety and depression are the most common emotions experienced by people who have Fertility Center Corona CAjust been given the diagnosis of unexplained infertility. Those two emotions bring a great risk of developing depression – which is all you need right now.

Your anxiety increases because no one can identify the cause. Even if the result of those interminable, painful, intrusive tests had been that you or your partner could not have a biological child, at least then you could grieve and move on.

You may crave support, warmth and understanding from your family and friends but they may appear to not know what to say to help. Why should they? You don’t know what to do either. Instead of a safe haven of understanding you may feel awkward and stressed around them as if you have to apologise for upsetting them.

Now comes the part that may help to get your back on your feet again. A study found that three years afer unsuccessful attempts at IVF, couples with unexplained infertility were suffering from unresolved grief. They had just pushed it down and hoped it would go away.

Not surprisingly, the study recommended that couples should get counseling to help with their feelings. There are counselors who specialize in helping infertile couples and you can bet that they have come across how you are feeling and will be able to pull that last lifeboat back and sit you safely in it.

Can Stress Lead to Infertility?

One of the worst things that you can say to a person dealing with infertility is “Just relax and it will happen.” [1] There is some truth in this as research is finding that stress may impact negatively on the production of both sperm and eggs [2] The truth is that stress impacts on all of your body so that is not surprising news. The truth is that stress is caused by infertility. And you can’t begin to imagine how much stress. fertility doctorThis is so difficult for your friend so try not to use clichéd phrases that can be very hurtful. Trying to tell someone to relax when they are probably the most stressed out that they have ever been is not only tactless – it’s going to cause more stress. Not helpful.

It’s a medical fact that if a couple conceive after months of ‘relaxing’ they are not truly infertile. In order for a couple to be classed as infertile, they have to have been trying for a baby for a year – with no success. Many infertility Physicians won’t even see a couple until they have had that year of trying. And that has to be pretty stressful.

Infertile women are particularly at risk from well meaning but ultimately thoughtless and unhelpful people telling them to ‘Have a romantic meal and a bottle of wine’ or ‘Take a relaxing holiday somewhere.’ It is highly likely that the woman already feels she must be doing something wrong which is a huge burden to carry and it’s not even true. It is much more likely that she has an undiagnosed (or diagnosed) physical issue that is stopping her from conceiving a baby.

These comments are particularly upsetting if they come from someone that the infertile couple don’t know very well. For all you know, they may have endured surgery, hormone treatments, inseminations and the indignity and embarrassment of being prodded an probed by numerous Doctors.

Infertility is not a state of mind. It is a medical condition which is diagnosed and treated as much as possible. You need to bear in mind that even with treatment, some couples may never realise their dream of building a family. Relaxing, holidays and a positive attitude do not cure medically diagnosed infertility so please, please don’t suggest it.

If you genuinely want to help (and we’re sure you do) it’s an interesting exercise to visit a forum for infertile people and it won’t take you long to find threads of comments about insensitive things that have been said to them. Try FertileThoughts.com, TheBump.com, ivillage.com

We do understand how difficult it is when you are only trying to help, so here are some things not to say, courtesy of The National Infertility Association RESOLVE Some of them will make you wince but these are all the sort of comments that infertile couples face. We have added our thoughts in brackets to some of them. Their number one offender is…you guessed it…

  • “Just relax…”Fertility Center Corona CA
  • “Just enjoy being able to sleep late…travel…etc.,”
  • “There are worse things that could happen” (Oh, that’s all right then. Seriously?)
  • ‘Maybe God doesn’t intend for you to be a mother.’ (Oooh, that’s an awful one!)
  • “Why aren’t you trying IVF?”
  • “Why don’t you just adopt?”
  • “You’re young – you have plenty of time to get pregnant.”
  • “I’ll donate the sperm” (ouch…can we say crude?)

References

1 http://www.resolve.org/support/for-family–friends/infertility-etiquette.html

2 https://www.health.ny.gov/publications/1128/

Sperm and Embryo Freezing & Storage

Freezing Sperm & Storage

Scientists and researchers have started freeing sperm for decades. Sperm samples are frozen and stored until needed. The frozen process is tolerated well. There are many reasons why sperm are stored frozen. Some are stored frozen for convenience (for example, the male partner will be travelling on the day his female partner is due for insemination). For some men, surgeries can be performed to harvest sperm and the sperm is frozen and stored in several batches to prevent the need of going through the surgery again in the future. For some men, their sperm numbers are low and their sperm is hence stored cumulatively to allow the couple to go through in vitro fertilization (artificial insemination). Sperm freezing may also be recommended for those who are anxious about producing sperm sample on the day of insemination.

Once sperm is thawed, it is normal for some of the sperm to die. Since most sperm samples have millions of live sperm, there is no consequence to losing a fraction of them due to thawing. Individuals who opt for sperm freezing includes: cancer patients, pre-vasectomy patients, military personnel, police officers, firefighters, high impact athletes, transgender clients and advancing paternal age.

Human embryo freezing and storing

The first human embryo was successfully frozen in 1984. Embryo freezing is routine after in vitro fertilization and approximately 60% end up with embryos in storage. Freezing of excess good quality embryo allows for the transfer of less embryos and avoiding higher-order pregnancies such as twins or triplets which may compromise the mother’s health. This also provides patients with a back-up if the first embryo does not result in pregnancy. Embryos can be frozen at any stage of the development. They tolerate freeing extremely well. Pregnancy rates with frozen embryos are comparable to fresh embryos that are transferred without ever being frozen.

What is embryo storage

PREIMPLANTATION GENETIC TESTING                  Embryo storage is preservation of the embryo in the cold for future use. To collect eggs, women are given fertility drugs to stimulate the ovaries to produce more eggs.  Patients who use embryo storage are patients who are undergoing in vitro fertilization (IVF) or intra cytoplasmic injection (ICSI). These are methods of fertility treatment procedures to help couples who are diagnosed with infertility. Other patients who opt for embryo storage include women who are concerned with their future fertility, cancer patients, military personnel, police officers, firefighters, high impact athletes, transgender clients and more. It is more cost effective to go through egg collection only once and have the unused embryos stored instead of collecting eggs before every treatment.

How are embryos thawed?

The embryos that are taken out of the freezer are warmed to room temperature in 3 seconds. The rapid thaw method minimizes the damage to the embryos. After the thawing process is performed at room temperature, the embryo is warmed up to body temperature (37 Celsius) and can be ready for transfer 40 minutes after leaving the freezer.

Reference:

Early Pregnancy Obesity Linked to Fetal and Infant Death

In a 2005 Los Angeles study, researchers found that one out of five adults is obese. Currently, the Centers for Disease Control and Prevention (CDC) reports that 70% (two-thirds) of Americans are overweight and 37% (roughly one-third) are considered obese. What’s more shocking is that 6% have extreme obesity.

 

With early pregnancy obesity, the woman is at risk for fetal and infant death and maternal pregestational diabetes. This 2011 study was the first to examine the continuous relationship between body mass index (BMI) and fetal/infant deaths. The investigators have linked data on single birth pregnancies from 3 regional registers in the United States.

 

Miscarriage or spontaneous fetal death is any loss of pregnancy at 20 weeks gestation or more. Infant death is any loss of a child from birth up to one year. Underweight is considered a BMI of 25 to 29.9 kg/m2, obese as a BMI of 30 kg/m2 or more, and recommended BMI as 18.5 to 24.9 kg/m2. The crude and adjusted odds ratios of spontaneous fetal death and infant death among obese, overweight, and underweight women were determined using the logistic regression model. The study found that risks for fetal and infant death were greatly increased for obese women.

 

In reference to the categories, no significant excess risks were seen for those underweight or overweight. For the obese women, no specific cause of death was found to explain the increased odds of fetal or infant death, except for slight higher rates for preeclampsia among stillbirths. Experts are unsure why obesity is associated with fetal and infant death, but not exactly sure why. It is noted that there is a risk for increased blood pressure and diabetes during pregnancy, but how obesity is related to miscarriage is not yet known.

 

Most women will deliver a healthy baby, regardless of weight. However, women who are struggling with fertility should consider weight loss before conception. Current research shows that this gives the baby the best possible start in life. Women should attempt to lose weight during the pregnancy, but should also ensure that they eat a balanced, healthy diet and avoid excess high-fat, high-calorie foods.

 

fertility doctorA team of researchers based in the US and Sweden decided to test the theory that maternal weight was related to infant mortality. They analyzed over 1.8 million birth records from 1992 to 2010. The causes of death among these infants included birth asphyxia, congenital anomalies, infections, and sudden infant death syndrome (SIDS). The results were adjusted for maternal height, age, smoking, country of birth, education, and year of delivery.

 

A total of 5,428 infant deaths were noted during the study, which was 2.9 per 1,000 infants born. Of these deaths, two-thirds occurred during the neonatal period (first 28 days of life). As noted in the study, the infant mortality rates went up with increasing maternal BMI in early pregnancy, with 6 deaths per 1,000 women with obesity. When compared to infants of normal weight mothers and those only mildly obese, whereas mothers with obesity grade 2 or 3 had more than doubled risks of infant mortality.

 

In the study, the association between infant mortality and maternal weight was confined to the first 37 weeks gestation in the neonatal period (within 28 days of birth). Infant mortality is associated with obesity grade 2-3 in preterm births. Also, 81% of infant deaths in term infants were due to birth asphyxia, congenital anomalies, SIDS, infections, and other neonatal morbidities.

Do Antidepressants Lead to Miscarriages or Autism?

According to current research, certain antidepressants known as selective serotonin reuptake inhibitors (SSRIs) should only be prescribed for serious mental health conditions. Depression is more than simply feeling down in the dumps. It is a serious mental health issue, which involves the brain. These feelings often interfere with daily routines and can be mild to severe. canstockphoto45542488According to the World Health Organization, major depression affects 15.7 million adults in the United States, which is approximately 6.5%.

In the past 20 years, use of antidepressants has increased by 400%, and they are the most commonly used medications for people ages 18-44 years, which is the childbearing years for women. In addition, women in their late 30s and early 40s are more likely to experience infertility.

SSRI’s and Increased Risk for Miscarriage

Elevated risk for miscarriage, early delivery, infant health complications, and autism are associated with SSRIs, according to a study from Beth Israel Deaconess Medical Center. Infertility and depression are two complex conditions that often go hand in hand. Lead research Alice Domar and colleagues conducted a large review of studies involving women with depression who took SSRIs while pregnant.

Three main findings stood out in the review of studies. First, there was concerning, clear evidence that SSRI during pregnancy was associated with risk of miscarriage. Women taking these drugs have worse pregnancy outcomes. Second, there was no proof of benefit or evidence that these medications lead to better outcomes for babies and moms. Finally, the researchers concluded that patients, obstetrics physicians, and the general public should be fully aware of these research findings.

Miscarriage Risk Statistics

Overall, risks for miscarriage are:

  • A 75% increased risk associated with Paxil, a commonly prescribed SSRI.
  • A 68% increased risk women using any antidepressant compared to women who do not use antidepressants.
  • A 61% increased risk for use of any SSRI antidepressant.
  • A 19% increased risk for women with a history of depression.

SSRIs and Autism

In a new study from the University of Montreal, researchers found that women taking antidepressants in the last trimester had an 87% increased risk for delivering a child who will be later diagnosed with autism. Additionally, taking SSRIs increased the canstockphoto45750520risk of the diagnosis. Around 1 in 68 children are diagnosed with autism, according to the CDC, and this rate has continued to increase over the last three decades. Additionally, in the U.S., around 4.5% of women take an antidepressant during pregnancy.

In another study at John Hopkins University, researchers Berard and associates found that boys with autism were 3 times more likely to have been exposed to SSRIs during the pregnancy than girls. In a 2014 meta-analysis of studies, these researchers also found an increased risk for autism when children were exposed to SSRI antidepressants in utero.

Women should consult with their doctors before immediately stopping antidepressants, according to experts. Dr. King of the Seattle Children’s Autism Center emphasizes that many studies show a genetic overlap in women who have depression and children with autism. It appears that people who have a family history of depression also have an increased risk for delivering a child who will be diagnosed with autism.

King also believes these studies do not provide a definitive answer as to how or why antidepressants increase the risk for child autism. The increased risk of autism translates into one additional child born with the disorder for every 200 mothers who continue their SSRI medications during pregnancy.

Your Fertility Diet & Conceiving

                  Infertility is defined as the inability to conceive after a year of regular intercourse (at least twice a week). In the United States, 10.9% of women aged 15-44 have impaired fertility. There are many states that offer minimal or no insurance coverage for fertility treatments, this can be an expensive ordeal. Many turn to claims that supplements, complementary medicine and other measures to aid them. There have also been discussions on how diet and nutrition can aid fertility.canstockphoto45557864

                  It was found that patients who are overweight (Body Mass Index (BMI) > 35kg/m2) or underweight (BMI<19kg/m2) took a longer time to conceive compared to women who are in the normal weight range (19-35kg/m2). It is then recommended that women who are overweight or obese to lose weight and women who are underweight to gain weight to reach the normal weight range so fertility can be improved. Women with higher BMI who undergo in vitro fertilization (IVF) also have less successful pregnancy rates when compared to those in the normal range. Although obesity does not affect men and the conception rates for their partners, it was found that the rates of having a live birth (a baby that is alive at delivery) is lower compared to couples with male partners of normal BMI.

                  The optimal diet for fertility is still mostly unknown but dietary modifications have been shown to improve infertility that is caused by ovulation problems. The consumption of chicken or turkey was associated with a higher rate of infertility due to ovulatory issues while the consumption of processed meats and fish was not associated with a greater rate of infertility. The intake of foods rich in vegetable protein showed a decreased risk of ovulatory disorder but it was not significant enough to be recommended to all patients.

                  Although there is limited evidence, current data showed that a high fertility diet consists of:

  1. Avoid trans-fat: this is a type of fat that clogs arteries and threatens fertility.
  2. Greater intake of monounsaturated fat: it helps improve the body’s sensitivity to insulin and reduce inflammation, both are good for fertility. Take more vegetable oil, nuts, seeds and cold water fish such as salmon and sardines.canstockphoto45942965
  3. Turn to vegerable protein: replacing meat with plant based protein such as soybeans, tofu, beans, peas or nuts can help improve fertility.
  4. Increased consumption of high-fiber, low glycemic carbohydrates: choose slow digesting carbohydrates that are rich in fiber such as whole grains, and vegetables. This improves fertility by controlling blood sugar and insulin levels.
  5. Intake of high-fat dairy products: whole milk instead of skim milk was found to improve fertility. Choose a small dish of ice cream of full fat yoghurt every day.
  6. High non-heme iron intake which are mostly plant based: this can be obtained from whole-grain cereals, spinach, beans, pumpkin, tomatoes and beets.
  7. Taking extra folic acid: helps with nutrition for a healthy pregnancy.
  8. Hydration: water is the best for hydration. Coffee and tea can be consumed in moderation. Sugared sodas should be avoided.

References:

  • Chavarro JE, Willett WC, Skerrett PJ. Follow the fertility diet? Harvard Mental Health Letter. Harvard Health Publications. http://www.health.harvard.edu/diseases-and-conditions/follow-fertility-diet. Accessed 2/1/2017.
  • Collins GG, Rossi BV. The impact of lifestyle modifications, diet, and vitamin supplementation on natural fertility. Fertility Research and Practice. 2015;1:11.

 

Can Exercise Help Increase Your Chances of Successful Fertility?

canstockphoto45472561

                  In most cases, when a woman is planning a pregnancy, there is a tendency to make changes in her lifestyle in hopes of conceiving, having a healthy pregnancy and a successful delivery. Lifestyle changes are often made and habits that do not benefit the pregnancy are sacrificed, such as smoking, use of recreational drugs and drinking alcohol. Some go as far as stopping the intake of caffeine. Other lifestyle changes include a better diet; eating more fruits and vegetables and having a balanced meal. These are all beneficial for the general health of the mother-to-be, but what about exercise?

                  Studies have found that moderate and regular exercise is beneficial for fertility and helps increase the pregnancy rate for those who are going through assisted reproductive technology (going through treatment for fertility or conception). Exercise was shown to reduce the risk of infertility due to ovulation (release of eggs) problems. Even for obese patients (which is a risk factor for infertility) who exercise regularly, they had better chances of pregnancy compared to those who are sedentary.

                  There is also evidence that low to moderate exercise increases the rates of implantation (process where the fertilized egg attaches to the uterus/womb to continue growing into a baby) and live birth rates (baby is alive at birth). The recommended exercise in the study is one hour of exercise three times per week.

                  Although exercise has been proven to help with fertility, high intensity exercises were found to reduce fertility (reduced implantation, reduced live birth rates) and increased pregnancy loss. Studies showed that vigorous exercise (exercising daily or to exhaustion) is associated with lower fertility rates. This is the same case with male patients. High intensity exercise was found to reduce male fertility.

                  Exercises that are found to be best for women trying to conceive are:

  1. Brisk walking: five times a week, approximately 30 minutes to 1 hourcanstockphoto45936679
  2. Yoga: 1 hour sessions, 2-3 times a week
  3. Dancing
  4. Zumba, aerobics: 2-3times a week
  5. Bicycle riding leisurely
  6. Light jogging
  7. Swimming

Exercises that should be avoided are:

  1. Core strength training such as core Pilates
  2. Exercising 7 days a week for more than 45 minute
  3. Running for many miles every day
  4. Extreme training exercises
  5. Exercises over an hour long

Evidence has shown that moderate exercise benefits fertility while high intensity and frequency exercises may reduce fertility. This should be recommended to men and women who are looking to increase chances of pregnancy. Guidelines recommend at least 30 minutes of moderate-intensity exercise on most or preferably all days. For individuals who are overweight or obese, achieving and maintaining a modest weight loss may improve fertility.

 

References:

Influenza Vaccine During Pregnancy – Is It Safe?

Influenza (also called “the flu”) is more likely to cause severe illness for healthy, pregnant women compared to those women who are healthy and not pregnant. During pregnancy, a woman’s body has changes in the heart, lungs, and immune system, which makes them more prone to severe illness with the flu.

Getting the flu while pregnant can raise the risks of pregnancy complications as well. This include premature labor, early delivery, and heart infections. Studies show that vaccinating a canstockphoto43956210pregnant women will pass the antibodies on the baby so the child will be protected from the flu for at least 6 months after the birth.

The Centers for Disease Control and Prevention (CDC) recommends that pregnant women receive a flu shot during any trimester of pregnancy to protect themselves and the unborn child. The nasal spray used to immunize against influenza is not recommended, however.

Is it safe for pregnant women and their unborn children to get a flu shot?

The flu shot has been given safely to many pregnant women over the past few decades. Much scientific literature supports the safety of the flu vaccine in pregnant women, as well as the unborn babies. The CDC is continuing to get data regarding this topic.

What side effects do pregnant women experience with the flu shot?

The most common side effects pregnant women experience are the same as other people who receive the flu vaccine. These side effects are mild and include:

  • Fainting
  • Soreness, swelling, and redness at the site
  • Headache
  • Fever
  • Muscle aches
  • Fatigue
  • Nausea

When side effects occur, they typically begin right after the influenza shot is given, and they only last for a couple of days. It is rare for someone to have an allergic reaction to the flu shot, as healthcare professionals screen for risk factors.

Can pregnant women who have egg allergies receive the flu shot?

Most people who have an allergy to eggs should not receive the flu shot. A person with a severe allergy to any vaccine component, such as egg protein, is at risk for a life-threatening anaphylactic reaction. Pregnant women need to tell the healthcare workers about their allergies before getting immunized.canstockphoto42248234

How is the safety of flu vaccines monitored in pregnant women?

The Food and Drug Administration (FDA) conducts ongoing safety monitoring on all vaccines licensed for use in the United States. The CDC and FDA use two systems to monitor the influenza vaccine safety for women during pregnancy. These include:

  • Vaccine Adverse Event Reporting System (VAERS) – This is an early warning system that monitors for problems during vaccination. Anyone can report vaccine side effects, and health concerns that arise after vaccination. These reports also help indicate if further investigations are necessary.
  • Vaccine Safety Datalink (VSD) – This is a collaboration between many health organizations that uses ongoing monitoring approaches and searchers of vaccine data.

Have studies been conducted by the CDC regarding flu vaccine safety during pregnancy?

Many studies were conducted by the CDC and partner organizations. A review of VAERS in 2011 found no link between pregnancy complication or fetal outcomes among women who received a flu shot while pregnant. In addition, a study involving VSD in 2013 found no increased adverse obstetric events for these women, which included pre-eclampsia, chorioamnionitis, and gestational hypertension.

Can a breastfeeding woman get the flu shot?

Breastfeeding women are encouraged to get the flu vaccine, according to the CDC. If the mother gets influenza, it could pass on to her newborn infant, which puts the baby at great risk.

Pacific Reproductive Center offers top fertility treatment at several locations in Southern California including Torrance, Glendale, Corona and Irvine. Treatment success has been shown to be well above the national average. Call us today!

How the Environment can Affect Fertility

                  There are many factors that are believed to affect fertility such as stress, exercise, diet, and weight. What about the environment? It is believed that environmental contaminants may cause infertility by affecting a woman’s menstruation and ovulation (release of eggs). Other factors such as age, stress, poor diet, nutrition, behavior, medication, sports, weight, smoking, alcohol and other problems can contribute to infertility. A man’s sperm can be affected by alcohol, drugs, alcohol, canstockphoto43933925environment, tobacco, medication, radiation or chemotherapy used for cancer treatment.

                  Studies have shown that although the advancement of technology has made lie easier and much more convenient, the chemicals used may have been robbing us slowly of our fertility.  This is especially true for those whose jobs revolve around industrial strength chemicals. There is now increasing evidence that long term low level exposure to chemical substances may produce fertility hazards such as sperm abnormalities, decreased sperm count and repeated miscarriages.

                  The most astounding finding is that these effects begin as early as in the womb, thus explaining the reason why the growing population has increasing fertility problems especially couples in their 20s.

                  The most worrying problem is that some of these chemicals are classified as hormone-disrupters, they mimic, block or upset the usual pattern of hormones in the body. Some of these chemicals can masquerade as natural estrogens leading to a high impact and risk for conception, fetal development, maternal and paternal health. Although there are several chemicals that are yet to be confirmed to affect fertility, these are 4 that are regulated on their base on their infringements to conception.

  1. Lead: exposure to lead can have a negative impact on human fertility, it can cause teratospermias (abnormal sperm) and is thought to be a substance that can cause artificial abortion.
  2. Medical treatment and materials: repeated exposure to radiation from medical equipment such as x-rays or chemotherapy canstockphoto44459633(used for treatment of cancer) has been shown to affect the reproductive organs such as contributing to sperm and ovarian problems.
  3. Ethylene Oxide: is a chemical used to sterilize surgical instruments and manufacture pesticides. It has the potential to cause early miscarriages n cause birth defects.
  4. Dibromochloropropane: this is found in pesticides and may cause ovarian problems such as an early menopause or directly affect infertility.

Although humans are exposed to low doses of biologically active chemicals constantly. They are harmless on their own until it interacts with other chemicals to interfere with conception and fertility. Here are steps on how to reduce exposure to chemicals in the environment:

  1. Quit smoking and avoid those who smoke to reduce the effects of second-hand smoke
  2. Contact water authority regarding what is in drinking water. If necessary, filter through the water.
  3. Reduce fish consumption that are high in mercury. Choose contaminant free fish.
  4. If possible buy organic food, reduce use of pesticides and herbicides on lawn.
  5. Look at labels and avoid candy and supplements that contain lead.

 

References:

What is Ovulation Induction? Info from a Los Angeles Fertility Center

                  Ovulation induction is the process to stimulate ovulation (production and release of eggs from a woman) by medication. This is used for women who have difficulty conceiving as their ovaries do not release eggs. Medications can be used to either cause ovulation in a patient who does not ovulate regularly or to cause multiple eggs to be developed and Ovulation Induction Los Angelesreleased. There is approximately 25% of infertile women who have problems with ovulation. By helping these women to ovulate regularly, it increases their chances of pregnancy. These medications are called “fertility drugs” and may also improve the endometrium (lining of the womb or uterus) which is required for pregnancy.

                  Ovulation induction can help women who have irregular periods as they are likely to have ovulatory dysfunction by helping them to have regular ovulation. Some ovulation problems include: polycystic ovarian syndrome (PCOS) – a hormonal condition which causes the eggs to not be released, ovaries that do not respond to hormones that help the maturation and release of the egg (luteinizing hormone (LH) and follicle stimulating hormone (FSH)), thyroid problems, eating disorders, extreme weight gain and weight loss.

                  Before fertility drugs are given to patients, doctors often use a hysterosalpingogram (HSG) to make sure that the fallopian tubes (tubes for the fertilized egg to travel into the womb for implantation) are unblocked. Patients who have a blocked tube may have an ectopic pregnancy (pregnancy that occurs outside of the uterus) and can be dangerous. Many women are suitable candidates for ovulation induction. Women who have ovulation issues and those with unexplained infertility can be treated to increase the number of eggs released. A possible complication that may occur is Ovarian Hyperstimulation Syndrome (OHSS).

Some of the commonly used fertility drugs includes:

  1. Clomiphene Citrate: this medication is commonly used to stimulate the maturation and release of eggs. The standard dose is 50-100 milligrams (mg) every day for 5 consecutive days. Treatment starts usually on the second to fifth day after menstruation begins. Chances of success depends on the age of the patient, health condition and quality of the semen. Theclomiphene chance of twins is 6-10% and chance of triplets is 1% or less.
  2. Aromatase inhibitors: Used to temporarily decrease estrogen levels in the body which leads to the body producing more follicle stimulating hormone (FSH). FSH is used to help in the production and maturation of eggs. Drugs in this class include letrozole and anastrozole. Studies show that pregnancy rates are similar to Clomiphene Citrate.
  3. Other drugs that can be used are insulin sensitizing drugs – Metformin, gonadotropins, human chorionic gonadotropin (hCG), bromocriptine or cabergoline, gonadotropin-releasing hormone (GnRH) and GnRH Analogs.

Long term studies have not found any association of increased birth defects with clomiphene citrate and gonadotropins. There is also no evidence associating an increased ovarian risk with clomiphene citrate, gonadotropins or aromatase inhibitors.

Pacific Reproductive Center offers expertise with helping women reach their fertility goals. This includes ovulation induction and additional treatments that have been shown to work well. PRC has fertility clinics in Los Angeles metro including Torrance, Glendale, Corona and Irvine. Call today!

 

References: