Unfortunately, miscarriage is the most common type of pregnancyloss, according to the American College of Obstetriciansand Gynecologists (ACOG). Studies reveal that anywhere from 10-25% of all clinically recognized pregnancieswill end in miscarriage, and most miscarriages occur during the first 13 weeksof pregnancy. Pregnancy can be such an exciting time, but with the great number of recognized miscarriages that occur, it is beneficial to be informed on miscarriage in the unfortunate event that you find yourself or someone you know faced with one. The main goal of treatment during or after a miscarriage isto prevent hemorrhagingand/or infection. The earlier you are in the pregnancy, the more likely that your body will expel all the fetal tissue by itself and will not require further medical procedures. If the body does not expel all the tissue, the most common procedure performed to stop bleeding and prevent infection is a D&C. What is a D&C Procedure? D&C, also known asdilation and curettage, is a surgical procedure often performed after a first trimester miscarriage. Dilation means to open up the cervix; curettage means to remove the contents of the uterus. Curettage may be performed by scraping the uterine wall with acurette instrument or by a suction curettage (also called vacuum aspiration), using avacuum-type instrument. Is a D&C necessary after a miscarriage? About 50%of women who miscarry do not undergo a D&C procedure. Women can safely miscarry on their own, with few problems in pregnancies that end before 10 weeks. After 10weeks, the miscarriage is more likely to be incomplete, requiring aD&C procedure to be performed. Choosing whether to miscarry naturally (called expectant management) or to have a D&C procedure is often a personal choice, best decided after talking with your health care provider. Some women feel comfort in going through a miscarriage in their own home, trusting their own body to do what it needs to. Some see this as a vital part of the healing process, eliminatingthe question of “what if?” about the health of the pregnancy. There are also many women who miscarrywho have ahistory of gynecological problemsand don’t want to risk the possibility of anymore complications occurring from having a D&C procedure done. For most first trimester miscarriages, expectant management should be a viable option. For some women, the emotional toll of waiting to miscarry naturally is just too unpredictable and too much to handle in an already challenging time. Healing for them may only start once the D&C procedure is done. A D&C may be recommended for women who miscarrylater than 10-12 weeks, have had any type of complications, or have any medical conditions in which emergency care could be needed. How is a D&C procedure done? A D&C procedure may be done asan outpatient or inpatient procedure in a hospital or other type of surgical center. A sedative is usually given first to help you relax. Most often, general anesthesia is used, but IV anesthesia or paracervical anesthesiamay also be used. You should be prepared to have someone drive you home after the procedure if general or IV anesthesia is used. 1) You may receive antibiotics intravenously or orally to help prevent infection. 2) The cervix is examined to evaluate if it isopen or not. If the cervix isclosed, dilators (narrow instrumentsin varying sizes) will be inserted to open the cervix to allow the surgical instruments to pass through. A speculum will be placed to keep the cervix open. 3) The vacuum aspiration (also called suction curettage) procedure usesa plastic cannula(aflexible tube) attached to a suction device to remove the contents of the uterus. The cannula is approximately the diameter in millimeters as the number of weeks gestation the pregnancyis. For example, a 7mm cannula would be used for a pregnancy that is 7 weeks gestation. The use of acurette (sharp edged loop)to scrape the lining of the uterus may also be used, but is often not necessary. 4) The tissue removed during the procedure may be sent off to the pathology lab for testing. 5) Once the health care provider has seen that the uterushas firmed up and that the bleeding hasstopped or is minimal, the speculum will be removed and you will be sent to recovery. What are the possible risks and complications of a D&C procedure? Risksassociated with anesthesia such asadverse reaction to medication and breathing problems Hemorrhage or heavybleeding Infection in the uterus or other pelvic organs Perforation or puncture to the uterus Laceration or weakeningof the cervix Scarring of the uterus or cervix, which may require further treatment Incomplete procedure which requiresanother procedure to be performed

Miscarriage

What is Miscarriage?

Miscarriage or spontaneous abortion is the term used to denote the loss of a fetus within the womb before the 20th week of pregnancy is completed.

Many pregnancies are lost spontaneously before a woman recognizes that she is pregnant, and the clinical signs of miscarriage are mistaken for a heavy or late menses.

The term miscarriage is often subdivided for clinical purposes into:

Threatened abortion: A pregnancy complicated by bleeding before 20 weeks’ gestation.
Inevitable abortion: The products of conception have not been expelled but a miscarriage will happen.
Incomplete abortion: Some, but not all, of the products of conception have been passed; retained products may be part of the fetus, placenta or membranes.

Missed abortion: A pregnancy in which there is a fetal demise (usually for a number of weeks) but the products of conception are not expelled.
Complete abortion: All products of conception have been passed without the need for surgical or medical intervention.
What are the Causes and risk factors of Miscarriage?
Following are the most important known causes of spontaneous abortion.
Genetic and uterine abnormalities
Endocrine and immune system dysfunctions
Infectious agents
Environmental pollutants
Psychogenetic factors and
Endometriosis
Some of the risk factors that have been associated with increased incidences of spontaneous pregnancy loss include
Advanced maternal age
Maternal alcohol abuse
Maternal cigarette smoking
Medications
Multiple previous elective abortions
Previous spontaneous abortion and
Chronic exposure to toxins.
Certain maternal disorders such as poorly controlled diabetes, celiac disease and autoimmune diseases also play a role. 1,2
What are the Signs and Symptoms of Miscarriage?
The hallmark of spontaneous abortion in a pregnant woman is vaginal bleeding, which may vary from scanty spotting to frank bleeding. It may be associated with mild to severe pain in the abdomen.
The pattern of bleeding is slight in case of a threatened miscarriage while greater amounts may signify an inevitable miscarriage.
Partial or complete expulsion of the products of conception may occur within a few hours of the onset of symptoms, or expulsion may be delayed for several days.
How is Miscarriage Diagnosed?
The doctor diagnoses the condition based on the following:
Signs and symptoms observed,
Vaginal examination,
Certain laboratory investigations and
Imaging stud Vaginal examination helps the doctor to assess the severity of the condition and determine the status of the other organs of reproduction.
Blood tests are advised to know the levels of different hormones and also as a routine investigation to rule out other abnormalities.
Ultrasound examination is used to confirm the diagnosis.
What is the Treatment for Miscarriage?
The management depends on the type of abortion and ranges from expectant management to prompt surgical evacuation. Severe cases may require hospitalization and surgical evacuation of the contents of the uterus. In case of threatened abortion, if symptoms are mild, one may be advised bed rest and the avoidance of sexual intercourse along with increased fluid intake. This may be successful in preventing pregnancy loss when the gestation is greater than 12 weeks. Painkillers and sedatives may be advised to reduce the anxiety. However, it is considered as a high-risk pregnancy, which can progress to abortion at any stage.
If the bleeding does not stop with the above steps, evacuation of the products of conception may be carried out by the administration of certain drugs or by surgical measures.
These procedures are also carried out in case of inevitable and incomplete abortions. Other types are managed appropriately based on the signs of miscarriage. 1,2

What are the Complications of Miscarriage?

Complications to the mother are quite rare. However, in certain cases one may suffer from infection due to retained products of conception, which may need surgical intervention.
How can Miscarriage be Prevented
Proper care of the underlying disorders can prevent complications of these disorders resulting in miscarriage. Always speak to the doctor before planning for a pregnancy and discuss the precautions that need to be taken along with periodic visits to the antenatal clinics.

cost of all type of infertility treatment

think fertility treatments are only for fantastically wealthy celebs like Sarah Jessica Parker and Nicole Kidman? Think again. While some types of babymaking assistance can cost up to $100,000, there are others that can cost as little as $5 per month. So how much will they cost you? Well, we can’t tell you that exactly. “The actual costs vary depending on where you live,” says Natalie Burger, MD, a fertility specialist at Texas Fertility Center. “And insurance coverage for fertility treatment varies widely by insurance plan.”

Your age, medical history and fertility test results will help your doctor determine which fertility treatments may work best for you. These are some common ones, with prices for how much they usually cost in Burger’s area, Austin, Texas:


Oral Medications

Some of the most common fertility medications are oral medications, like Clomid or Femara. These medications are used to induce ovulation in women. And the great news about these is that they’re relatively inexpensive: about $5 to $20 per month. They’re commonly combined with intrauterine insemination (IUI). A typical cycle with oral medication, IUI and ultrasound monitoring can cost about $500 to $700 per month without insurance.

Injectable Hormones

There are some more potent hormones, called gonadotropins (“aka the injectables,” says Burger), which are a little more expensive -- used with IUI, you could expect to pay about $2,500 to $3,500 per month. But they’re more powerful at boosting fertility. “These medications can be helpful to further increase the number of eggs that ovulate in a cycle,” says Burger.

Or your doctor might suggest a “hybrid” cycle --where an oral medication like Femara is combined with a low dose of the injectable hormones. That usually costs about $1,500 to $2,000 per month.

In Vitro Fertilization

In vitro fertilization (IVF) “is the most successful treatment option,” says Burger. If you go the IVF route, you’ll probably need medications, ultrasounds, blood work, anesthesia and embryology procedures, which could add up to a total of $13,000 to $14,000. “This figure can vary, depending on how much medication the patient needs or if special IVF procedures need to be done,” says Burger.

Frozen Embryo Transfer



Considering a frozen embryo transfer? This is where you can store an embryo taken during IVF to potentially use later. The ultrasound, blood work, embryology procedures and uterine transfer involved could total about $2,500.

Egg and Sperm Donation



If you to use donor sperm to get pregnant, you’ll probably pay about $500 for one vial of donated sperm. If you get IUI with it, it will cost about $330, and if you get IVF, it will cost the normal IVF rate (see above). Donor eggs are much more expensive: about $24,000 to $25,000 per cycle.

Gestational Carrier

Commonly as a surrogate, a gestational carrier is a woman who can carry your pregnancy for you. If you go through an agency to find your gestational carrier, you could pay $80,000 to $100,000. If you have a sister or friend who’ll be your carrier, you’ll probably pay much less.

Egg Preservation

A typical egg preservation cycle is about $10,000 --but know that it can vary depending on the amount of medication needed to stimulate the ovaries.

How to Make Them More Affordable

Overwhelmed by those numbers? There are ways you may be able to pay less. “First, look closely at your insurance coverage to figure out which treatments are both medically appropriate for you and financially feasible,” suggests Burger. “If your insurance is coming up for renewal, consider speaking with your company’s HR department to see if there are plan choices that can better cover fertility treatment and evaluation.”

Currently, 15 states have laws that say insurance carriers must offer plans that include fertility treatment coverage, but unfortunately, your employer isn’t obligated to offer them. For more information for your particular state, check this out.

You might also want to contact your fertility treatment center and ask if it’s doing any studies you can participate in. Often, you can get reduced costs for taking part. “Many times clinics also have information on financing for patients who need it in order to proceed with treatment,” says Burger.

the cost of infertility treament in usa

The Costs of Infertility Treatment

While medical staff expertise and clinic success rates, reputation and location will most likely be the criteria you use to choose an infertility clinic, cost may also be a . Since most assisted reproductive technologies (ART) are not covered by insurance, the patient has to pay “out-of-pocket,” often leading to increased stress as well as long-term financial burdens.


Trying to find the costs associated with infertility treatment can be frustrating. RESOLVE sought cost information from more than 30 clinics across the country. Most clinic websites do not list pricing; in fact, the financial information on most clinic websites deals primarily with insurance issues, not treatment cost or payment terms. Some clinics have relationships with financing organizations such as Advanced Reproductive Care (ARC) or IntegraMed, (see “Infertility Financing Programs"), and include links to those services on their websites, but offer little information about the actual cost of treatment.

The American Society of Reproductive Medicine (ASRM) lists the average price of an in vitro fertilization (IVF) cycle in the U.S. to be $12,400. (ASRM does not qualify if this includes medications.) We sought to find the price of intrauterine insemination (IUI), one IVF cycle using fresh embryos, and the additional charges for intracytoplasmic sperm injection (ICSI) and preimplantation genetic diagnosis (PGD) (where offered) from a cross section of clinics throughout the U.S. We called and e-mailed clinics that did not list prices on their websites, and discovered that some clinics generally do not give cost information over the phone (but they did for this story). When clinics do list the prices on their website, the information is clear and easy to understand, without many exclusions or disclaimers. RESOLVE encourages all clinics to post updated pricing on their websites.


Average cost of an IUI cycle: $865; Median Cost: $350 Average Cost of an IVF cycle using fresh embryos (not including medications): $8,158; Median Cost: $7,500 Average additional cost of ICSI procedure:$1,544; Median Cost: $1,500 Average additional cost of PGD procedure: $3,550; Median Cost: $3,200 (Note: Medications for IVF are $3,000 $5,000 per fresh cycle on average.)
Several interesting trends in clinic pricing have surfaced:

In areas with few infertility clinics, prices, on average, are higher High cost of living does not equate to high treatment costs IUI prices ranged from $275 to $2,457—a huge differential. Some prices quoted include medications, blood work and sonograms; others do not—hence the huge price differential. ICSI prices across the country are within $500 of each other—$1,000 to $1,500.

Conclusion Patients seeking ART such as IVF should choose their physician carefully and weigh a number of factors. If cost is a factor in your decision making, ask the clinic for a detailed list of procedures and corresponding costs, and follow up with these questions:
Are medications, tests, lab work and consultations included in the cost of treatment? Does the clinic provide financial counseling and psychological counseling? If so, are there fees for these services? Since most patients do not have insurance coverage for infertility treatment, knowing the costs up front makes good financial sense.m

Getting pregnant in your 30s and 40s At PFC, we use a number of means to evaluate fertility health. In the case of female infertility, one of the first things we look at is a patient’s age -- in particular, the age of her ovarian reserve or, put simply, her egg supply. An increasing number of women are choosing to have their first child in their mid-30s or later. The challenge for this age group is that with the body’s natural aging process, a woman’s eggs age as well; and this phenomenon is a significant cause of infertility and miscarriage. Getting pregnant after age 40 is a challenge for women that may have no other impediment to conception.
The decline in fertility potential or ‘ovarian reserve’ means that not only do the ovaries have fewer eggs to offer, but the eggs they have are of poorer quality, and thus have a harder time producing eggs that are capable of fertilizing and resulting in a healthy pregnancy. (For many years, researchers wondered whether the uterus was also affected by the aging process, but today it is clear that decline in fertility is mostly due to the results of the aging egg.)
The inability to produce healthy, viable eggs often results in lower pregnancy rates as well as higher rates of miscarriage in women over the age of 35. For women over 40, getting pregnant is only half the journey. As miscarriage rates over 40 are 50% and rise quickly with each advancing year.
Hormone testing to assess egg quality

Three simple blood tests can check hormone levels and reveal more information about egg quality. These tests may also help diagnose infertility in a younger woman, who ordinarily would not be experiencing diminished ovarian reserve or poor quality:

1. Basal FSH. FSH (follicle stimulating hormone) is the main hormone involved in producing mature eggs in the ovaries. If this test reveals excessive levels of FSH in the body, it is a signal that the brain is trying to boost poorly performing ovaries into action. (In other words, the ovaries may need extra help to make eggs.)
2. Estradiol. Estradiol is the most important form of estrogen found in the body, and is responsible for maintaining healthy eggs in a woman’s ovaries, as well as for facilitating a healthy pregnancy. If this test shows high levels of Estradiol, it indicates a problem with egg numbers and/or quality.


3. Anti-mullerian hormone (AMH). AMH is a blood test that directly measures ovarian reserve. It is produced directly by early stage ovarian follicles. High levels (over 1.0) are favorable, while low levels (less than 1.0) indicate decreased ovarian reserve. AMH may be the best measure of the menopausal transition and ovarian age. It may also be useful in predicting ovarian hyperstimulation syndrome, the effects of chemotherapy, and in determining the treatment of PCOS.
AMH seems a superior predictor of ovarian response compared to other markers, including age, and day 3 FSH and estradiol. It offers similar predictive value compared to AFC. AMH can be drawn at any time in the menstrual cycle, and is not affected by hormonal therapy, including oral contraceptives.
Ultrasound evaluation to assess egg quantity
Antral Follicle Count. One of the first tests that is typically performed at an initial patient visit at PFC is a trans-vaginal ultrasound. This ultrasound allows the physician to evaluate the uterus and uterine cavity, and ovaries. Especially if done just prior to ovulation, the ultrasound can be very informative in making sure there are no fibroids or endometrial polyps affecting the uterine lining. Very importantly, the physician can assess the number of small follicles in the ovaries. Ideally, about 10-20 total follicles should be visualized between the two ovaries. If the follicle count is much lower, this may be an indication of declining ovarian reserve.

treatment and understanding of infertility

Treatment of infertility depends aff Treatment of infertility depends on the cause, how long you've been infertile, your age and your partner’s age, and many personal preferences. Some causes of infertility can't be corrected. However, a woman can still become pregnant with assisted reproductive technology or other procedures to restore fertility.

Treatment for men Approaches that involve the male include treatment for:

General sexual problems. Addressing impotence or premature ejaculation can improve fertility. Treatment for these problems often is with medication or behavioral approaches.

Lack of sperm. If a lack of sperm is suspected as the cause of a man's infertility, surgery or hormones to correct the problem or use of assisted reproductive technology is sometimes possible. In some cases, sperm can be taken directly from the testicles or recovered from the bladder and injected into an egg in the laboratory setting.

Treatment for women Fertility drugs are the main treatment for women who are infertile due to ovulation disorders. These medications regulate or induce ovulation. In general, they work like natural hormones — such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH) — to trigger ovulation. Commonly used fertility drugs include:

Clomiphene citrate (Clomid, Serophene). This drug is taken orally and stimulates ovulation in women who have polycystic ovary syndrome (PCOS) or other ovulatory disorders. It causes the pituitary gland to release more FSH and LH, which stimulate the growth of an ovarian follicle containing an egg.

Human menopausal gonadotropin (Repronex, Menopur). This injected medication is for women who don't ovulate on their own due to the failure of the pituitary gland to stimulate ovulation. Unlike clomiphene, which stimulates the pituitary gland, human menopausal gonadotropin (hMG) and other gonadotropins directly stimulate the ovaries. This drug contains both FSH and LH.

Follicle-stimulating hormone (Bravelle). FSH works by stimulating maturation of egg follicles the ovaries.

Human chorionic gonadotropin (Ovidrel, Pregnyl). Used in combination with clomiphene, hMG and FSH, human chorionic gonadotropin (HCG) stimulates the follicle to release its egg (ovulate).
Gonadotropin-releasing hormone analogs. This treatment is for women with irregular ovulatory cycles or who ovulate prematurely —before the lead follicle is mature enough — during hMG treatment. Gonadotropin-releasing hormone (Gn-RH) analogs suppress pituitary gland activity, which alters hormone production so that a doctor can induce follicle growth with FSH.


Aromatase inhibitors. This class of medications, which includes letrozole (Femara) and anastrozole (Arimidex), is approved for treatment of advanced breast cancer. Doctors sometimes prescribe them for women who don't ovulate on their own and who haven't responded to treatment with clomiphene citrate. These drugs are not approved by the Food and Drug Administration for inducing ovulation, and their effect on early pregnancy isn't yet known.


Metformin (Glucophage). This oral drug is taken to boost ovulation. It's used when insulin resistance is a known or suspected cause of infertility. Insulin resistance may play a role in the development of PCOS.

Bromocriptine (Parlodel). This medication is for women whose ovulation cycles are irregular due to elevated levels of prolactin, the hormone that stimulates milk production in new mothers. Bromocriptine inhibits prolactin production.

Surgery Depending on the cause, surgery may be a treatment option for infertility. Blockages or other problems in the fallopian tubes can often be surgically repaired. Laparoscopic techniques allow delicate operations on the fallopian tubes.


If you have endometriosis, your doctor may treat you with ovulation therapy, in which medication is used to stimulate or regulate ovulation, or in vitro fertilization, in which the egg and sperm are joined in the laboratory and transferred to the uterus.


Assisted reproductive technology (ART) Each year thousands of babies are born in the United States as a result of ART. An ART health team includes physicians, psychologists, embryologists, laboratory technicians, nurses and allied health professionals who work together to help infertile couples achieve pregnancy.


The most common forms of ART include:
In vitro fertilization (IVF). IVF involves retrieving mature eggs from a woman, fertilizing them with a man's sperm in a dish in a laboratory, and implanting the embryos in the uterus three to five days after fertilization.

Electric or vibratory stimulation to achieve ejaculation. Electric or vibratory stimulation brings about ejaculation to obtain semen. This procedure can be used in men with a spinal cord injury who can't otherwise achieve ejaculation.

Surgical sperm aspiration. This technique involves removing sperm from part of the male reproductive tract, such as the epididymis, vas deferens or testicle. This allows retrieval of sperm if the ejaculatory duct is blocked.

Intracytoplasmic sperm injection (ICSI). This procedure consists of a microscopic technique (micromanipulation) in which a single sperm is injected directly into an egg to achieve fertilization in conjunction with the standard IVF procedure.


Assisted hatching. This technique attempts to assist the implantation of the embryo into the lining of the uterus by opening the outer covering of the embryo (hatching).

ART works best when the woman has a healthy uterus, responds well to fertility drugs, and ovulates naturally or uses donor eggs. The man should have healthy sperm, or donor sperm should be available. The success rate of ART is lower after age 35.

Complications of treatment Certain complications exist with the treatment of infertility. These include:
Multiple pregnancy. The most common complication of ART is a multiple fetus pregnancy. Generally, the greater the number of fetuses, the higher the risk of premature labor. Babies born prematurely are at increased risk of health and developmental problems.
The number of quality embryos kept and matured to fetuses and birth ultimately is a decision made by the couple. If too many are conceived, the removal of one or more fetuses (multifetal pregnancy reduction) is possible to improve survival odds for the other fetuses.
Ovarian hyperstimulation syndrome (OHSS). If overstimulated, a woman's ovaries may enlarge and cause pain and bloating. Mild to moderate symptoms often resolve without treatment, but severe cases — marked by abdominal swelling and shortness of breath —require emergency treatment. Younger women and those who have polycystic ovary syndrome have a higher risk of developing OHSS than do other women.
Bleeding or infection. As with any invasive procedure, there is a risk of bleeding or infection with assisted reproductive technology.
Low birth weight. The greatest risk factor for low birth weight is a multiple fetus pregnancy. In single live births, there may be a greater chance of low birth weight associated with ART.

Birth defects. There is some concern about the possible relationship between ART and birth defects. More research is necessary to confirm this possible connection. Weigh this factor if you're considering whether to take advantage of this treatment. ART is the most successful fertility-enhancing therapy to date

male infertility reasons and treatment

MALE INFERTILITY OVERVIEW —

Infertility is defined as a couple's inability to become pregnant after one year of unprotected intercourse. In any given year, about 15 percent of couples in North America and Europe who are trying to conceive are infertile. The fertility of a couple depends upon several factors in both the male and female partner. Among all cases of infertility in developed countries, about 8 percent can be traced to male factors, 37 percent can be traced to female factors, 35 percent can be traced to factors in both the male and female partners, and 5 percent cannot be traced to obvious factors in either partner [1]. When infertility occurs, the male and female partners are evaluated to determine the cause and best treatment options. In the past, men with infertility had few options because there was limited information about uses and even less information about successful treatment. However, new tests have made it possible to determine the causes of male infertility and treatments, and assisted reproductive techniques (ART) offer hope to many couples. 30 to 40 percent of cases are due to problems in the testes (of which about 15 to 25 percent are due to genetic causes) 10 to 20 percent are due to a blockage uin the pathway that sperm use to exit the testes during ejaculation; this can be caused by prior infection (figure 2) 1 to 2 percent of cases are due to conditions of the pituitary gland or hypothalamus 40 to 50 percent of cases have no identifiable cause, even after an evaluation INFERTILITY EVALUATION — A separate article discusses the evaluation of infertility in men. The most important test for infertile men is a semen analysis (sperm evaluation). A normal result tells you that the male partner most likely does not have an infertility problem. (See "Patient information: Evaluation of the infertile couple (Beyond the Basics)".) INFERTILITY TREATMENT — The treatment of male infertility depends upon the underlying cause. Several months to years of treatment are usually necessary to achieve fertility. The treatment often involves both male and female partners. Blockage of the reproductive tract — Men who have a blockage in the ducts conveying the sperm from the testis until ejacuilation (so that sperm cannot get out) can undergo surgery to correct the blockage. If it is not successful, another option is assisted reproductive technologies using sperm retrieved from the testes. (See "Treatment of male infertility", section on 'Retrieval of sperm from the testis'.) Vasectomy (male sterilization) is a different type of blockage. Vasectomies can be reversed in up to 85 percent of cases; over 50 percent of couples can achieve pregnancy following vasectomy reversal. However, the more time that has passed since the vasectomy, the less likely vasectomy reversal is to restore fertility. Treatment of hypothalamic or pituitary deficiency — In a small percentage of cases (1 to 2 percent), male infertility is due to problems in the hypothalamus and pituitary gland (parts of the brain that regulate hormone production). In this case, treatment with human chorionic gonadotropin (hCG), recombinant human follicle stimulating hormone (rhFSH), lso called gonadotropin treatment, is often given. Gonadotropin treatment — Gonadotropin treatment is started with injections of hCG three times per week (or sometimes every other day) for up to six months. Blood tests are used to monitor blood testosterone levels and to adjust the dose if necessary. If sperm cells do not appear in semen after six months of treatment, recombinant human follicle stimulating hormone (rhFSH) is added; this is also given by injection. The success rate for this therapy is high as most men will eventually develop sperm in the ejaculate. In many cases, a total of one to two years of treatment is needed to achieve normal fertility. The cost of these treatments can be significant, especially if health insurance does not cover the costs of infertility treatment.



Varicocele — A varicocele is a dilation of a vein (like a varicose vein) in the scrotum. Many men with varicocele have a low sperm count or abnormal sperm morphology (shape). The reason a varicocele affects the sperm may be related to a higher than normal temperature in the testicles, poor oxygen supply, and poor blood flow in the testes. Varicocele can be treated surgically by cutting the veins connected to the varicocele. However, surgery does not always improve fertility and is not recommended for most men unless there is a large varicocele. A varicocele that has been present for a long time can cause irreversible damage that cannot be surgically treated. An alternative to varicocele repair is assisted reproductive techniques (ART), such as intracytoplasmic sperm injection (ICSI). With ICSI, only a small number of sperm are needed (see 'Intracytoplasmic sperm injection (ICSI)' below). Other — Treatment is not currently available for most types of male infertility. For example, there is no known treatment when the sperm-producing structures of the testes have been severely damaged or are abnormal. This happens in men with certain chromosomal abnormalities such as Klinefelter syndrome and small deletions in the Y (male specific) chromosome (see 'When infertility cannot be treated' below). ASSISTED REPRODUCTIVE TECHNIQUES — If the male partner's semen contains few sperm, no sperm, abnormal sperm, or sperm with poor motility, assisted reproductive techniques can often help. These techniques offer hope to som infertile couples who could not achieve pregnancy without them. However, the techniques are expensive, require a considerable commitment of time and energy, may pose certain health risks, and may have disappointingly low success rates. Couples should discuss the pros, cons, and success rates of these techniques with an infertility specialist. In vitro fertilization (IVF) —




VF is a commonly used technique for a variety of infertility problems, including female tubal blockages and unexplained infertility. IVF is usually recommended for men with infertility. (See 'Intracytoplasmic sperm injection (ICSI)' below.) IVF success rates depend upon a number of variables, including the age and health of the woman, health of the male sperm and female egg, and to some extent, the experience of the infertility center. Approximately 28 percent of IVF cycles result in pregnancy, and 82 percent of those pregnancies result in the birth of one or more children. (See "Patient information: In vitro fertilization (IVF) (Beyond the Basics)".) Intracytoplasmic sperm injection (ICSI) — ICSI is a procedure that is performed in conjunction with IVF. With ICSI, a single sperm from the male partner is injected directly into a woman's egg (oocyte) in the laboratory. (See "Intracytoplasmic sperm injection".) This technique can be useful in many cases of low sperm count. The pregnancy rate with ICSI is approximately 20 to 40 percent per cycle, although the technique is expensive. Testicular extraction of sperm (TESE) — If a man's semen completely lacks sperm in the ejaculate (azoospermia), sperm can sometimes be directly removed from the testes. This is done in a minor surgery or by using a needle to aspirate semen under local anesthesia. If sperm can be found < extracted from the testis, the sperm will be used for ICSI and the fertilization rate of the oocyte is not very different from IVF. Thus, men with no sperm in the ejaculate can have a potential of fathering a child using these techniques. Risks of ART — Most patients who undergo ART have no major complications. There are few to no risks for men, depending upon the procedure used to obtain sperm. Men who must undergo a procedure to retrieve sperm have a small risk of bleeding, damage to the testes, and infection. Risks of ART for women include infection and damage to blood vessels, reproductive, or surrounding organs. The ovarian hyperstimulation syndrome (OHSS) is a potentially life-threatening complication that can occur during the process of IVF. (See "Patient information: In vitro fertilization (IVF) (Beyond the Basics)".) There is some evidence that children of couples who become pregnant after IVF or ICSI have a slightly higher rate of chromosomal or congenital (birth) abnormalities and may have a higher rate of lower birth weight. This potential risk should be discussed with an infertility specialist. For now, couples can be reassured that these conditions are rare and the absolute risk of having a child with a congenital anomaly is low (the population baseline risk is 2 to 4 percent, which is potentially increased by about one-third with ART). WHEN INFERTILITY CANNOT BE TREATED — Some treatments for male infertility fail, and some cases of male infertility simply cannot be treated at this time. If this is this case, an infertility specialist can advise the couple of available alternatives. Each couple's choice is a very personal one. Men with irreversible infertility and testosterone deficiency may benefit from testosterone treatment. Although this treatment may not address a couple's goal of having a child, it can improve the male partner's sexual function and mood and help increase and maintain bone and muscle mass. (See "Patient information: Sexual problems in men (Beyond the Basics)".) Artificial insemination with donor sperm



some couples affected by irreversible male infertility consider artificial insemination of the female partner with donor sperm. Donor sperm may be obtained from a sperm bank, which screens men for infections, certain genetic problems, and provides a complete personal and family history. Most sperm banks keep the identity of their donors confidential; some banks give donors the option to be contacted by the children conceived with their sperm. The decision to use donor sperm, whether from a known or unknown donor, can be complicated and difficult for a couple. Counseling may be helpful to help both partners discuss their feelings and the potential implications of using donor sperm. The American Society for Reproductive Medicine recommends that parents discuss their child's genetic origins with the child. The optimal age for this discussion is not known, although most experts recommend that the child be told before he or she is an adolescent (before approximately age 13) [2]. The use of donor sperm has a high success rate; pregnancy rates are about 50 percent after six cycles of insemination. Insemination may be done without the use of infertility medications or monitoring in women who have no infertility. Women who have difficulty conceiving may require intrauterine insemination or in vitro fertilization. (See "Patient information: Infertility treatment with gonadotropins (Beyond the Basics)".) Adoption — Some couples affected by irreversible male infertility consider adopting a child. A healthcare provider or social worker can suggest resources for couples who decide to pursue this option. Approximately 2 to 4 percent of American families include an adopted child. Childlessness — Some couples affected by irreversible male infertility decide to remain childless. Couples who decide to remain childless often face questions from friends or family regarding their decision. These questions can be hurtful for couples who have struggled with infertility. Couples often benefit from counseling after they decide to stop infertility treatments; communicating openly is important to maintain a healthy relationship.

horomonal therepy for childless women

Chemical Pregnancy A chemical pregnancy happens when a fertilized egg does not attach itself to the uterine wall. This is also known as a very early miscarriage. According to ACOG, the American College of Obstetricians and Gynecologists, chemical pregnancies account for 50-75% of all miscarriages. Unlike miscarriages, which typically occur before the 20 th week of gestation, chemical pregnancies occur just after implantation. In cases where the woman is not expecting to become pregnant, she may not realize she was since menstruation bleeding usually occurs around the same time. If she is expecting and takes a test, it could lead to false positive pregnancy test results.
In the past, sensitive pregnancy tests were administered by doctors via blood tests. Nowadays, there are several over-the-counter products that are able to detect pregnancies almost a week before menstruation is due. This could be why so many women are realizing they are pregnant, only to learn the pregnancy resulted in a chemical pregnancy or early miscarriage. Research has shown up to 70% of all conceptions end in miscarriage. Health care providers do not clinically confirm a pregnancy until it is detected on an ultrasound. First ultrasounds are typically given between the 4 th and 6 th weeks of gestation.
Signs and Symptoms of a Chemical Pregnancy
In most cases, women have no symptoms of a chemical pregnancy. In actuality, most women do not know they were ever pregnant. Some women report mild abdominal cramping and mild spotting a week before their period is due, but there are usually no pregnancy symptoms such as fatigue or nausea, since the fertilized egg did not implant itself to the uterine wall. Vaginal bleeding will occur after a positive pregnancy test and blood tests may reveal low hCG levels that decrease instead of increase. Menstruation cycles are typically on time or a couple days late.
What Causes a Chemical Pregnancy?
Experts have no conclusive evidence stating what causes a chemical pregnancy. However, most experts believe it happens for the same reasons why other miscarriages happen- abnormal chromosomes in the developing embryo. Abnormal chromosomes can be the result of many factors such as poor quality of the sperm or egg, genetic abnormalities of the mother or father, or an abnormal cell division of the fetus. Experts believe half of all chemical pregnancies are due to some form of chromosomal abnormality. Additional potential causes may include the following:
Infections such as toxoplasmosis, chlamydia, genital herpes, or syphilis Systemic illnesses such as untreated thyroid disease Uterine abnormalities (congenital and acquired) Abnormal hormone levels Luteal phase defect Inadequate uterine lining
Treating and Preventing Chemical Pregnancies
Unfortunately, chemical pregnancies can not be prevented, nor is there a specific type of treatment method. Women who experience a chemical pregnancy are encouraged to follow-up with tests to ensure their hCG levels return to normal. There is no evidence suggesting chemical pregnancies will affect future pregnancies, as many women go on to have healthy pregnancies, labors and deliveries. For some couples, treatment may involve treating the emotional side of a chemical pregnancy, especially for those who are hopeful to conceive. Seeking counseling can help you cope with the pregnancy loss. Treatment for recurrent chemical pregnancies may include the following:
Progesterone cream Vitamin B6 (minimum 50mg per day) Baby aspirin Antibiotics may be prescribed if an infection is present Genetic counseling for those who experience several early miscarriages
If you are anxious to ‘try again,’ it is recommended that you wait at least one regular menstrual cycle. Talk with your doctor or midwife about an appropriate treatment plan for you.

polycystic ovary syndrom

If you have polycystic ovary syndrome (PCOS) and worry about your weight, you may be interested in learning some PCOS diet strategies.
Polycystic ovary syndrome (PCOS) is the most common reproductive hormone disease among premenopausal women. Women with PCOS often struggle with the following three symptoms:
1. Obesity and trouble losing weight 2. Excessive hair growth and skin problems (acne) 3. Infertility and/or irregular periods
If you have PCOS and are trying to lose weight, we offer you the following helpful PCOS diet tips. PCOS Diet Tip 1: Stop deprivation dieting. What does the word “diet” mean to you? The real definition of “diet” means nourishment or nutrition. This implies health and wellness—not starvation. Yet so many popular diets today are associated with pain and distress. On the contrary, healthy eating can and should be enjoyable.
Visit your local health food store for ideas on how to incorporate delicious natural foods like lentils, vegetables, and local, organic ingredients into your daily meals. Many health food stores offer delis and take-home fresh food items that can make your PCOS diet food preparations easier.
PCOS Diet Tip 2: Control your blood sugar. Weight gain with PCOS can be linked to abnormalities in insulin and glucose metabolism. Insulin’s main job is to control your blood sugar. But insulin also signals your body to store fat. High levels of insulin increase the production of androgens, which can worsen PCOS symptoms.
With insulin resistance (IR), your blood sugar levels rise in spite of high levels of insulin. Eventually type 2 diabetes may result. Yet positive changes in diet and exercise may postpone the development of diabetes. A PCOS diet reducing the amount of sugary carbs that you eat may offer the weight-loss benefits you seek.
To make these healthy PCOS diet changes, cut out white breads, pasta, potatoes, cereals, and some fruits and snack foods. Replace those items with healthy PCOS diet options like the following:
Nutrient dense, high-fiber carbs Foods high in protein (lean meats, legumes) Foods containing healthy fats (olive oil, nuts, fish)
Ask your doctor or a registered dietitian for a list of foods to try and a list of foods to avoid. And try to eat mini-meals throughout the day to keep your blood sugar levels even.
PCOS Diet TIP 3: Exercise daily. OK, we know that exercise is not a diet tip, but if you are looking to burn calories, you must exercise every day! Check in with your doctor first, and once you have the go-ahead, get moving. Exercise is a perfect accompaniment to a PCOS diet, especially for women with PCOS and insulin resistance or type 2 diabetes. Regular exercise is wonderful and necessary for all of us, and here are some reasons why.
Exercise:
Regulates blood glucose levels Offers a mood boost Increases endorphins (the body’s natural opioids) Gets us in top physical shape for pregnancy Increases weight loss
Also, being physically fit may help you carry a healthy baby to term and have an uncomplicated delivery.
PCOS Diet Tip 4: Evaluate your relationship with food. If you live to eat and want to be successful with a PCOS diet…you must rethink your relationship with food. Some women use food as a reward for an accomplishment or for emotional solace when they feel lonely or blue. Other women live for the next meal at their favorite restaurant or use food as a way to bring family and friends together.
To lose weight on a PCOS diet, reframe your thinking to eating to live, not living to eat. Choose foods that are filling and nutrient dense. Instead of party food, junk food, or comfort food that only adds more fat and pounds, eat food that will nourish your body. Having said that, it is perfectly fine to enjoy delicious, rich foods on occasion, but only in moderation! And certainly not every day. If you have an unhealthy relationship with food, like binge eating, purging, or starving yourself, help is available.
PCOS Diet TIP 5: Ask about metformin. Metformin (Glucophage) is a drug that was developed for type 2 diabetes and is often prescribed “off label” for obesity and PCOS. Metformin may help women seeking a PCOS diet by offering the following benefits:
Helping with weight loss Lowering blood pressure Improving cholesterol levels Decreasing levels of androgens Restoring normal periods Improving sensitivity to fertility drugs
Remember, no one is to blame for PCOS. It is in your hands to work with your doctor to find PCOS diet solutions and to learn how to live healthily with this common hormonal problem.

chemical pregancy understanding

Chemical Pregnancy A chemical pregnancy happens when a fertilized egg does not attach itself to the uterine wall. This is also known as a very early miscarriage. According to ACOG, the American College of Obstetricians and Gynecologists, chemical pregnancies account for 50-75% of all miscarriages. Unlike miscarriages, which typically occur before the 20 th week of gestation, chemical pregnancies occur just after implantation. In cases where the woman is not expecting to become pregnant, she may not realize she was since menstruation bleeding usually occurs around the same time. If she is expecting and takes a test, it could lead to false positive pregnancy test results. In the past, sensitive pregnancy tests were administered by doctors via blood tests. Nowadays, there are several over-the-counter products that are able to detect pregnancies almost a week before menstruation is due. This could be why so many women are realizing they are pregnant, only to learn the pregnancy resulted in a chemical pregnancy or early miscarriage. Research has shown up to 70% of all conceptions end in miscarriage. Health care providers do not clinically confirm a pregnancy until it is detected on an ultrasound. First ultrasounds are typically given between the 4 th and 6 th weeks of gestation. Signs and Symptoms of a Chemical Pregnancy In most cases, women have no symptoms of a chemical pregnancy. In actuality, most women do not know they were ever pregnant. Some women report mild abdominal cramping and mild spotting a week before their period is due, but there are usually no pregnancy symptoms such as fatigue or nausea, since the fertilized egg did not implant itself to the uterine wall. Vaginal bleeding will occur after a positive pregnancy test and blood tests may reveal low hCG levels that decrease instead of increase. Menstruation cycles are typically on time or a couple days late. What Causes a Chemical Pregnancy? Experts have no conclusive evidence stating what causes a chemical pregnancy. However, most experts believe it happens for the same reasons why other miscarriages happen- abnormal chromosomes in the developing embryo. Abnormal chromosomes can be the result of many factors such as poor quality of the sperm or egg, genetic abnormalities of the mother or father, or an abnormal cell division of the fetus. Experts believe half of all chemical pregnancies are due to some form of chromosomal abnormality. Additional potential causes may include the following: Infections such as toxoplasmosis, chlamydia, genital herpes, or syphilis Systemic illnesses such as untreated thyroid disease Uterine abnormalities (congenital and acquired) Abnormal hormone levels Luteal phase defect Inadequate uterine lining Treating and Preventing Chemical Pregnancies Unfortunately, chemical pregnancies can not be prevented, nor is there a specific type of treatment method. Women who experience a chemical pregnancy are encouraged to follow-up with tests to ensure their hCG levels return to normal. There is no evidence suggesting chemical pregnancies will affect future pregnancies, as many women go on to have healthy pregnancies, labors and deliveries. For some couples, treatment may involve treating the emotional side of a chemical pregnancy, especially for those who are hopeful to conceive. Seeking counseling can help you cope with the pregnancy loss. Treatment for recurrent chemical pregnancies may include the following: Progesterone cream Vitamin B6 (minimum 50mg per day) Baby aspirin Antibiotics may be prescribed if an infection is present Genetic counseling for those who experience several early miscarriages If you are anxious to ‘try again,’ it is recommended that you wait at least one regular menstrual cycle. Talk with your doctor or midwife about an appropriate treatment plan for you.

clomid is treatment for women who are not producing egg

CLOMID FOR OVULATION INDUCTION Clomid (Clomiphene Citrate) is a fertility drug used for the treatment of ovulation disorders. Clomid may be used to treat women with complete failure to ovulate or for the treatment of luteal phase defect. Clomid acts by causing the pituitary gland to produce a higher level of the hormones (FSH and LH) that control ovulation. Clomid is taken in pill form from the 5th through the 9th day of the menstrual cycle - day 1 is the first day of full menstrual flow. The dose of Clomid may vary from 1 to 4 tablets per day depending on individual patient response. The usual starting dose is 1 tablet per day. Clomid may be taken at any time of day and if more than 1 pill is prescribed, the total dose may be taken all at the same time. As Clomid treatment is started we will often see you for a “mid cycle scan.” At that appointment we will perform a sonogram to see how your ovaries are responding to the drug – how many eggs have developed. In a small percentage of patients, Clomid interferes with endometrial development (the uterine lining) or with cervical mucous development. We will check those things as well. Clomid may delay ovulation by 1-3 days – relative to your usual cycle. At mid cycle you may be given human chorionic gonadotropin (hCG). hCG is a hormone, given by injection, that mimics the pituitary gland message to the ovary to release the egg. It is helpful in timing intercourse or artificial insemination. It also has a beneficial effect on hormone production during the luteal phase (the second half of the ovarian cycle). Occasionally, women taking Clomid have side effects. Common side effects include: headache, abdominal fullness or bloating, hot flashes, blurred vision. These side effects are usually temporary and are mild. There are several case reports of persistent blurred vision after clomiphene treatment. Occasionally Clomid causes moodiness or even mild depression. Clomid is highly effective in stimulating ovulation. Approximately 80% of women who are treated with clomiphene will ovulate. Pregnancy rates vary depending on other factors - sperm count, etc. Many clomiphene pregnancies occur within 3 or 4 treatment cycles. There are two recognized risks of Clomid treatment: multiple pregnancy and ovarian cyst formation. Approximately 8% of Clomid conceptions are multiple -twins or more. This may occur even on the lowest dose of Clomid. Approximately 10% of women who are treated with clomiphene will develop an ovarian cyst. For this reason, a pelvic examination is performed at the end of each treatment cycle - around the time of your menstrual period. If an ovarian cyst is detected, clomiphene treatment is withheld during the following cycle. The ovarian cyst usually resolves without further treatment. Clomid has been in clinical use for over 30 years. There is a large amount of data that suggests that babies born as a product of clomiphene treatment have a normal risk of congenital anomalies - not higher and not lower. Clomid is widely used and is generally accepted as a safe drug in this regard. There have been a variety of serious illnesses reported in association with Clomiphene treatment. Their frequency is rare or extremely rare and in some cases a proven link to Clomiphene treatment as the cause is not clear. There have been at least two publications suggesting there may be a link between Clomid treatment and increased risk of ovarian tumors. The first publication was in 1993 and noted that women who took " fertility drugs” seemed to be at increased risk of developing ovarian cancer -particularly if they never conceived a pregnancy. A second study was published in 1994 with long-term follow-up of a large number of infertility patients. This study showed an increased risk of ovarian cancer in women using clomiphene citrate for treatment of ovulation. The increased risk was noted only in women using the drug for 12 or more treatment cycles (that is - 12 total cycles not necessarily consecutive). Since these initial publications, there have been several larger studies of this issue, which have concluded that there is not a link between Clomid (or any other fertility drug) and an increased risk of ovarian cancer. Making Clomid follow up appointments: a follow up to check for ovarian enlargement is performed either a week before the period is due (allowing for a blood test to check progesterone level) or at the end of the cycle. We call these appointments “ovary checks.” Your fertility specialist will tell you what to schedule. KEY POINTS ABOUT CLOMID IN SUMMARY: Cycle day 1 is the first day of full menstrual flow. Intercourse on the day of ovulation predictor kit change and/or the following day or every other day 10 thru 20. Pelvic exam/”ovary check” at the end of the cycle or one week after ovulation if a blood test for progesterone is planned.

what is pcos

What is PCOS? Polycystic Ovary (Ovarian) Syndrome (PCOS) is a hormonal disorder. Sometimes PCOS is described as an ‘endocrine’ disorder, it’s the same thing. Overseas research suggests its affects between 5 and 10% of all women of childbearing age regardless of race or nationality. However a Melbourne study published in February 2005 suggests the figure could be much higher, at 12-18% of Australian women or one in eight women. This equates to around half a million Australian women and teenagers!
It’s an unfortunately named syndrome, as people often think of large grapefruit-sized cysts when they hear the term ‘polycystic ovaries’. In the case of PCOS, the cysts are tiny. Using an ultrasound, they look like black dots on an ovary. These cysts are eggs that have failed to properly mature and release from the ovary.
PCOS symptoms usually present themselves during puberty but may also begin in the early to mid 20s. Certain symptoms are life-long, others will cease at menopause.o
Syndrome m eans this is a condition that has a number of diagnostic sy mpto ms with no simple hard and fast diagnostic test. Each woman presents with a different number of symptoms and together they make PCOS. It’s rare that two women share exactly the same symptoms. The following is a list of some of the possible symptoms:
Hirsuitism (excessive hair growth on the face, chest, abdomen, etc.) Hair loss (androgenic alopecia, in a classic "male baldness" pattern) Acne Polycystic ovaries (seen on ultrasound) Obesity Infertility or reduced fertility Irregular or absent menstrual periods
In addition, women with PCOS appear to be at increased risk of developing the following health problems during their lives:
Insulin resistance Diabetes Cholesterol and blood fat abnormalities Cardiovascular disease (heart disease, heart attacks and stroke)
Endometrial carcinoma (cancer) Although polycystic ovaries can be one of the symptoms, they aren't present in all sufferers, making the most common name of the syndrome confusing. In addition many women without PCOS have polycystic ovaries but none of the other symptoms and there for it is important to understand the difference between the syndrome and having only polycystic ovaries.
PCOS develops when the ovaries overproduce androgens – male hormones, like testosterone. The overproduction of Androgen usually triggers overproduction of LH (lutenizing hormone), which is produced by the pituitary gland.

Research suggests the cause of the overproduction of testosterone by the ovaries is due by a woman’s inability to process insulin effectively. This is called Insulin Resistance or Hyperinsulinemia (both pre-diabetic conditions). When insulin levels in the blood are too high, the ovary reacts by producing more testosterone. This triggers a cascading effect of other conditions like excess hair growth, scalp hair loss and acne. The inability of the woman to process this excess insulin can also lead to obesity. But not all PCOS are obese –even though in the past being excessively overweight was considered a diagnostic symptom. Research over the past 10 years has found that PCOS can affect women who are underweight and of normal weight. These so called "thin" sufferers can also have impaired insulin processing.

When Karen Smith first began trying to get pregnant, she was 23 years old and menopause was the last thing on her mind. "I figured I wouldn't have a problem because I was in my fertile prime," she said. After a few months of trying, Karen went to see her ob-gyn, who gave her a clean bill of health, even after Karen told him that ovulation predictor kits showed that she was ovulating every few months. "The doctor told me to just keep trying," she recalls. Finally, after three years of trying, Karen went to see a reproductive endocrinologist. The endocrinologist did some tests and found that Karen had the estrogen levels of a menopausal woman. "It turns out that infertility is often the only sign of early menopause. I didn't have hot flashes or any other symptoms; my estrogen was just extremely low," Karen says. Karen was given hormone injections and intrauterine insemination (IUI), but after three procedures, the physician told her that her only options for pregnancy were adoption or IVF with donor eggs. "I figured I wouldn't have a problem because I was in my fertile prime." "It was a really tough decision," Karen says today. "On the one hand, we could adopt. It might be difficult and take a long time, but at the end of the road we could be pretty sure of having a child. If we tried donor eggs and IVF, it might not work. And it costs so much money!" After a lot of soul searching, Karen decided that she wanted the experience of carrying and bearing a child, so she went ahead with IVF using donor eggs. She and her husband had to take out a loan to be able to afford it. She recalls, "I had to sit down and write a $23,000 check to the hospital." They were lucky because donated eggs became available relatively quickly. But the process was still daunting. "They want to make sure you understand that the whole thing might not work," Karen explains. "They reiterate that again and again, so the whole time, I was sure it wasn't going to happen. It wasn't until the day of the procedure that the doctor told me, 'This is going to work.' That was the first time I felt a little hopeful." After the procedure, Karen had to wait two weeks to have a pregnancy test. "We went home after the test and played video games, just waiting for the phone to ring," says Karen. "Finally, it rang, and the nurse said, 'Congratulations,' and I gave my husband the thumbs-up. We just couldn't believe it." Audrey was born at just 35 weeks, small but robust. After her birth, Karen didn't use birth control, convinced that she'd never get pregnant without intervention. But eight months after Audrey was born, Karen discovered she was pregnant again. "I was shocked, amazed, and happy," she says. "My reproductive endocrinologist told us that a pregnancy will sometimes reset your system and normalize your hormones. That seems to be what happened to me." Karen advises women who are going through infertility to try to avoid making pregnancy their entire focus. "If you can, find something else to concentrate on," she says. "You need to have another hobby or interest besides getting pregnant. I should have followed that advice, but it was all I could think about and it was terrible -- it took over our lives." As for what surprises her the most about motherhood, Karen says, "You just don't realize how fun it will be and how much you'll laugh

horomonal threphy to get preganant

. Herbal Therapies

There are many herbs that have been traditionally used to help support fallopian tube health. Below are actions that herbal therapies may have and below that is a section on herbs that have been found to have those actions. We are looking at 4 key actions which work to reduce infection, inflammation, promote healthy circulation and work to support hormonal balance.

Antibiotic: The antibiotic acting herbs help to clear out any infection that may exist in the reproductive system or fallopian tubes. Supporting immune function with antibiotic herbs may be important if there is a history of PID, STD’s, abdominal surgery, or endometriosis.

Anti-inflammatory: Anti-inflammatory herbs help to reduce inflammation, which in turn reduces pain and works to reduce further scar tissue production. If inflammation persists in or around the fallopian tubes, scar tissue may form.

Circulatory: There are herbs that help to increase blood flow through the reproductive organs. Healthy circulation to the reproductive organs is vital to healing the fallopian tubes. This is because fresh healthy blood will bring in vital nutrients, enzymes and oxygen for healing cells. Once the cells have used up what they need and have renewed or have replaced old damaged or unhealthy cells, the metabolic waste (damaged tissues) is removed from the body.

Hormone Balancing: Remember that hormonal balance is essential for proper fallopian tube function. When working to support fallopian tube health, we always want to include some herbs that support hormonal balance.

-Goldenseal root (Hydrastis canadensis): This herb is extremely antibiotic, antimicrobial and anti-inflammatory. It works to heal any infection in the reproductive system, while also reducing pain and inflammation from foreign tissue growth. Reduction in inflammation may help to prevent scar tissue and adhesion. Goldenseal may help to protect the fallopian tubes from damage due to an infection. Also supports health of mucous membranes.

-Ginger Root (Zingiber officinalis): A wonderful herb used to increase circulation and promote blood flow to the reproductive organs. The increased circulation also helps to reduce inflammation of the uterus, ovaries or fallopian tubes.


-Dong Quai root (Angelica sinensis): One of the best herbs for promoting circulation to the reproductive organs. Dong Quai acts on the circulatory system and lymphatic system reducing tissue congestion. It has both pain reducing and anti-inflammatory properties.

-Hawthorn (Crataegus officinale): Works to reduce abdominal congestion. Hawthorn is extremely high in antioxidants, improves the integrity of blood vessel wall, aids the body in proper oxygen use and improves blood flow.

-Peony Root (Paeonia officinalis): Peony has been found to aid in increasing progesterone levels, lower testosterone and balance estrogen. Overall this herb has excellent hormone balancing support. It also aids in pain reduction and relaxation.

-Wild Yam root (Dioscorea villosa): Helps to promote normal hormone levels and overall balance within the reproductive system.

-Uva Ursi (Arctostaphylos uva ursi): One of the best herbs to reduce fluid retention and congestion. This herb has been shown to be effective for combating vaginitis, due to its antimicrobial activity. Uva Ursi aids the body in removal of excess fluids for proper daily detoxification.
All of these herbs can be foun

pcos myths

PCOS Myths & truths Some common myths surrounding Polycystic Ovary Syndrome (PCOS):

Myth 1: All women with PCOS have polycystic ovaries Fact: 25% of the female population has polycystic ovaries on ultrasound, yet only half of them are diagnosed with PCOS symptoms. And some PCOS patients don’t have any cysts at all. Most doctors will check if you have polycystic ovaries as part of their investigation into PCOS. But even if they aren't present you may still have the syndrome.
PCOS is diagnosed using symptoms and blood tests, but an ultrasound is not always necessary, as the presence or absence of polycystic ovaries does not matter for diagnosis.

Myth 2: You will never have children This is wrong, wrong, wrong. Don’t believe the doctor who tells you this. Many women are incorrectly told they’ll never have children because PCOS causes infertility. Some patients use the information as their only form of contraception, and have found out it is wrong! Some women with PCOS do fall pregnant naturally and others will need medical assistance to get pregnant. If you aren't planning on having children just yet, still use some form of contraception as there is a chance that you may fall pregnant.


Myth 3: All women with PCOS are fat/obese Many women with PCOS do have an excess weight problem but there are also quite a few who don't. Even countries with traditionally slim people, like Asian countries, experience PCOS. Most studies have been done with women who are obese and therefore the focus has been on that group of women with PCOS. This misconception can even be held by your doctor who may not initially consider a diagnosis of PCOS if you don't have a weight problem.

Myth 4: Lose weight and everything will be better Obesity can cause fertility problems but telling a woman with PCOS to ‘lose weight and all will be better’ is simply not enough. For women with PCOS, losing some weight, as little as 5% helps balance hormone levels, improve symptoms and may help restore or boost their fertility. Losing weight with PCOS is not a simple thing and many women with PCOS find it extremely hard to lose weight on traditional diets as a result of their condition.

Myth 5: Low fat/high carbohydrate diets are the way to go In the past when PCOS patients were told to lose weight, they were given a low fat/high carb diet. All this did was made the PCOS patient gain more weight. Research over the past decade has shown the most likely underlying cause of PCOS is an impairment of the woman's body to process insulin. Therefore a diet like those prescribed to a diabetic patient – that focuses on foods with low glycemic indexes, is likely to be more helpful than the traditional low fat/high carb diet.

In 2004, Professor Jennie Brand-Miller and Sydney dietitian Kate Marsh together with Professor Nadir R Farid published a book called “The New Glucose Revolution: Managing PCOS”. This book, published by Hodder, has become a bible for many PCOS women. However, there is still not enough research about which sort of diet is best for women with PCOS. At the moment, the studies show that any calorie-controlled, healthy diet will help women lose weight and improve their symptoms (e.g., low GI, low fat, etc).

Myth 6: PCOS is a great syndrome to have... This is absolute rubbish. An endocrinologist told one POSAA member that: “if she (the patient) had to pick a disorder to have, PCOS was actually a pretty good one to have". Trivialising the disorder is not in the patient’s best interests. Some women might envy the fact that PCOS women sometimes have very few periods. But this is due to their lack of ovulation and this is a very important process for every woman.

PCOS is associated with a number of significant health risks and unpleasant symptoms. No woman who has PCOS would choose to have a syndrome which increases their chances of heart disease, increases their chances of developing diabetes, impairs their fertility and increases their chances of developing uterine cancer.

Myth 7: My aunt had a cyst on her ovary and had 8 children There are many different types of cysts that ovaries can have and because someone may have a relative that had a certain type of cyst and went on to have many children doesn't mean that the aunt had anything like PCOS. If a woman with PCOS has cysts (and they aren't compulsory) then they are follicular cysts from unreleased eggs. Other women (and even those with PCOS) can experience other types of cysts which may not affect their fertility.

chemical pregancy understanding

Chemical Pregnancy A chemical pregnancy happens when a fertilized egg does not attach itself to the uterine wall. This is also known as a very early miscarriage. According to ACOG, the American College of Obstetricians and Gynecologists, chemical pregnancies account for 50-75% of

all miscarriages. Unlike miscarriages, which typically occur before the 20 th week of gestation, chemical pregnancies occur just after implantation. In cases where the woman is not expecting to become pregnant, she may not realize she was since menstruation bleeding usually occurs around the same time. If she is expecting and takes a test, it could lead to false positive pregnancy test results. In the past, sensitive pregnancy tests were administered by doctors via blood tests. Nowadays, there are several over-the-counter products that are able to detect pregnancies almost a week before menstruation is due. This could be why so many women are realizing they are pregnant, only to learn the pregnancy resulted in a chemical pregnancy or early miscarriage. Research has shown up to 70% of all conceptions end in miscarriage. Health care providers do not clinically confirm a pregnancy until it is detected on an ultrasound. First ultrasounds are typically given between the 4 th and 6 th weeks of gestation.

Signs and Symptoms of a Chemical Pregnancy

In most cases, women have no symptoms of a chemical pregnancy. In actuality, most women do not know they were ever pregnant. Some women report mild abdominal cramping and mild spotting a week before their period is due, but there are usually no pregnancy symptoms such as fatigue or nausea, since the fertilized egg did not implant itself to the uterine wall. Vaginal bleeding will occur after a positive pregnancy test and blood tests may reveal low hCG levels that decrease instead of increase. Menstruation cycles are typically on time or a couple days late.

What Causes a Chemical Pregnancy?


Experts have no conclusive evidence stating what causes a chemical pregnancy. However, most experts believe it happens for the same reasons why other miscarriages happen- abnormal chromosomes in the developing embryo. Abnormal chromosomes can be the result of many factors such as poor quality of the sperm or egg, genetic abnormalities of the mother or father, or an abnormal cell division of the fetus. Experts believe half of all chemical pregnancies are due to some form of chromosomal abnormality. Additional potential causes may include the following:

Infections such as toxoplasmosis, chlamydia, genital herpes, or syphilis Systemic illnesses such as untreated thyroid disease Uterine abnormalities (congenital and acquired) Abnormal hormone levels Luteal phase defect Inadequate uterine lining

Treating and Preventing Chemical Pregnancies

Unfortunately, chemical pregnancies can not be prevented, nor is there a specific type of treatment method. Women who experience a chemical pregnancy are encouraged to follow-up with tests to ensure their hCG levels return to normal. There is no evidence suggesting chemical pregnancies will affect future pregnancies, as many women go on to have healthy pregnancies, labors and deliveries. For some couples, treatment may involve treating the emotional side of a chemical pregnancy, especially for those who are hopeful to conceive. Seeking counseling can help you cope with the pregnancy loss. Treatment for recurrent chemical pregnancies may include the following:
Progesterone cream Vitamin B6 (minimum 50mg per day) Baby aspirin Antibiotics may be prescribed if an infection is present Genetic counseling for those who experience several early miscarriages
If you are anxious to ‘try again,’ it is recommended that you wait at least one regular menstrual cycle. Talk with your doctor or midwife about an appropriate treatment plan for you.

> ionfs Ovulation Predictors Saliva hFertOvulation MicroscopeInstructions Saliva Ovulation Predictors (Saliva Fertility Tests) When a woman is about to ovulate, her saliva begins to form a distinct fern-like pattern due to an increase in the level of salt and estrogen. This visible ferning pattern begins to appear around 3 to 4 days prior to ovulation. Ovulation microscopes - or saliva fertility tests - allow you to predict ovulation by viewing the changes in the make up of your saliva prior ovulation With the saliva-based ovulation fertility tests, just add a drop of saliva to the lens and let the sample dry. In five minutes, view the sample through the microscope. Note for new users: Remember that you need to press the LED light button and focus by turning the eyepiece othe microscope. If you are ovulating - or about to ovulate - a ferning, crystal-like pattern can be identified when examined under the power of the microscope, helping you predict fertile or infertile times in your cycle. Image 3 indicates peak fertility. Compact and easy to use, ovulation microscopes are reusable and allow women to see a unique pattern in their saliva called "ferning" (due to the fact that the crystal patterns look like ferns leaves). Based on the increase or decrease of the hormone estrogen, this ferning pattern looks like frost on a windowpane (see image). This pattern develops in saliva around the time of ovulation. A woman simply places a drop of saliva onto the microscope lens, allows it to dry, and reads the result. Kathleen Fry, M.D., president of the American Holistic Medical Association states: "This new and exciting system works." And Christiane Northrup, M.D., gynecologist and the author of the best-selling book "Women's Wisdom, Women's Bodies," reports, "This simple and empowering tool allows women to learn about and take charge of their own fertility. I recommend it highly." Fertility expert Amos Grunebaum, MD, also endorses the ovulation microscope as an instrumental tool to augment fertility and bbt charting. Saliva Ovulation Fertility Predictor Instructions: #1 Test first thing in the morning. Never test after eating, drinking, smoking, or brushing teeth. Tip #2 Clean the lens before using the test. Place a drop of saliva from under your t on the lens surface. Leave it to dry for at least five minutes. Tip #3 Remember to take off your glasses when viewing the test - and remember the lens can be focused by rotating the eye-piece.

- Carefully remove the lens by pulling it out of the casing. 2 - Place a drop of saliva on the surface of the lens. Avoid creating air bubbles. 3 - Allow the saliva sample to dry for at least five minutes and replace the lens into the housing. The saliva must be dry before viewing. 4 - Look into the lens and push the light button to observe the test result. Rotate the lens while bringing it close to the eye (remember to remove eyeglasses). Adjust the eyepiece to focus and push the light to observe test results. 5 - Clean the lens after every use (with a clean soft cloth or lens cleaner). Advantages of Ovulation Microscopes According to research studies, saliva ovulation predictor tests are 98% accurate. Other advantages of saliva fertility tests? They are reusable, discreet, and easy-to-use. Testing takes about five to ten minutes and reading results is just a focus away. Questions and Answers about the Ovulation Microscope How do Ovulation Microscopes work? Ovulation microscopes detect hormone changes that occur prior to and during ovulation. As estrogen increases, "ferning" or crystal patterns can be viewed in dried samples to


saliva (seen through the saliva fertility test). These patterns will indicate that ovulation is about to take place - or taking place. The duration of your most fertile time lasts from several days before ovulation to 24 or so hours after ovulation. When do I begin testing with the Saliva Ovulation Predictor? It is recommended to use the saliva ovulation test on a daily basis and record results on your fertility chart. Ovulite includes a Saliva Ovulation Tester Card for monitoring results and determining fertility patterns. When and how do I test for ovulation? Test first thing in the morning - but never after eating, drinking, or brushing your teeth. to to


activites may interfere with results. Are Saliva Fertility Tests accurate? When instructions are followed, ovulation microscopes are 98% accurate for predicting ovulation. Can Ovulation Microscopes be used as a contraceptive device? While other sites advertise saliva fertility tests as a means of contraception, Early-Pregnancy-Tests.com does not advocate the use of any ovulation test as an effective contraceptive. Ovulation microscopes should not be used in this context. See your doctor if you have any questions. > For more information on ovulation testing, microscopes, and fertility, please click here. > To visit our fertility monitor page, click here.