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Polycystic Ovarian Syndrome
Women with polycystic ovary syndrome usually have at least several of the many signs and symptoms associated with PCOS, including:
- Irregular or no menstruation. This is the most common characteristic. Irregular menstruation means having menstrual cycles that occur at intervals longer than 35 days or fewer than eight times a year. The condition may begin in adolescence with the onset of menstruation, or it may appear later after a weight gain.
- Signs of excess androgen. Elevated levels of male hormones may result in physical signs, such as long, coarse hair on your face, chest, lower abdomen, back, upper arms or upper legs (hirsutism); acne; and male-pattern baldness (alopecia). However, not all women who have polycystic ovary syndrome have physical signs of androgen excess.
- Enlarged ovaries with multiple cysts. Your doctor may detect ovarian cysts by ultrasound. However, you may have ovaries with multiple cysts but still not have polycystic ovary syndrome. And you may have PCOS but have ovaries that appear normal.
- Infertility. Polycystic ovary syndrome is the most common cause of female infertility in the United States.
- Obesity. It's estimated that about half of women with polycystic ovary syndrome are obese.
- Skin tags. These small, excess growths of skin that are usually found on your neck or in your armpit are common in women with PCOS.
- Prediabetes or type 2 diabetes. The ability to use insulin effectively is impaired in PCOS and can result in high blood sugar levels and diabetes. Prediabetes is also called impaired glucose tolerance.
- Acanthosis nigricans. This is the medical term for darkened, velvety skin on the nape of your neck, armpits, inner thighs, vulva or under your breasts.
In Vitro Fertilization (IVF)
In Vitro Fertilization is probably the best
known assisted reproductive technology (ART) procedure. It
can be a good option for couples if treatments such as fertility
drugs, sperm injection, and surgery have not been successful. Good
candidates also include couples in which: the woman has endometriosis
or fallopian tube problems; the man has a low sperm count, sperm
motility problems, or an autoimmune response that destroys sperm;
or when the cause of infertility is unknown.
We begin the IVF procedure by administering
fertility drugs to the woman. The drugs enable her to produce multiple
eggs at once instead of only one. We use ultrasound technology
and hormone testing to determine when the eggs are ready to be harvested.
At that time, we remove them in a process known as follicular aspiration.
This is usually accomplished with only local anesthesia. The eggs
are then placed with the man's sperm in the laboratory, where fertilization
occurs. We then place several pre-embryos back inside the woman's
uterus through her cervix. We should know whether or not she is
pregnant within two weeks. Women who undergo IVF have about the
same chance for pregnancy as a fertile couple would have in the
same month.
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Intra-cytoplasmic Sperm Injection
Many couples wish to have children of their
own but are unable to because of a low sperm count, insufficient
sperm movement, or sperm that are too weak to penetrate the wall
of the egg. ICSI is a revolutionary new process that drastically
improves the chance of achieving pregnancy. Like IVF, we begin by
prescribing fertility drugs for the woman. Once the eggs are at
the proper stage, we extract them by follicular aspiration. After
the eggs are taken from the ovaries, they are brought to the laboratory
and placed into an incubator dish. Normally, cumulus-corona cells
surround the female's egg(s). During ICSI, we remove these cells
in order to properly view the egg and inject the sperm.
We then place the eggs in either a petri
dish or on a glass slide with a slight depression in the middle. The man's active sperm, which has been collected several
hours before, is placed into a small amount of solution. The sperm
and solution are then placed in a viscous medium (e.g. mineral oil).
This viscous medium slows the sperm's movement, making it possible
for the infertility specialist to locate the sperm and ensure that
no damage occurs when they are drawn into the injecting needle.
The needle is then inserted into the egg and the sperm is injected
directly into the egg's center. When the needle is withdrawn, it
only takes a minute for the egg to retake its normal shape. The
fertility clinic monitors the egg for the first 15 hours to see
whether or not fertilization has taken place. Early cell division
begins within the first 24 hours. In some instances, assisted hatching
must be performed in order to ensure proper cleavage (the early
divisions of the fertilized egg).
Once the embryos have developed sufficiently,
the patient returns to the office where they are reinserted into
the woman's uterus. To facilitate this process, the embryos
are placed in a small amount of fluid and inserted through the cervix
and then into the uterus. The woman is then given blood tests, urine
tests, and ultrasound exams to monitor whether or not pregnancy
has occurred. The chance of becoming pregnant depends on a number
of factors, including the number of eggs extracted, the age of the
female patient, and the male sperm count.
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Artificial Insemination
Artificial insemination is a process in
which sperm are injected directly into the woman's cervix or uterus. When the sperm are placed inside the uterus, the process
is also known as intrauterine insemination, or IUI. The procedure
can be used for male factor problems, including low sperm count
and poor sperm motility. It can also be used when the woman has
problems with her reproductive structures or her cervical mucus.
Finally, if the male partner's sperm is unable to fertilize the
egg, artificial insemination can insert donor sperm into the woman's
uterus.
To begin the process, sperm must be collected
from the male. This is usually accomplished through masturbation.
We then wash the sperm before inserting it into the woman's uterus
through a catheter. We then ask the woman to lie down for 15-30
minutes to allow the sperm to reach the egg more easily. IUI can
be repeated if pregnancy does not occur after the first attempt.
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Donor Egg and Sperm
In some cases, the woman may be unable to
produce eggs for an assisted reproductive technology (ART) procedure
or the man's sperm may be unable to fertilize her egg. In
these situations, egg and sperm donors can provide a solution. Choosing
a donor is a sensitive process that should be done with care, planning,
and patience. We help match donors with patients. Our experience
enables us to account for all of the legal and emotional issues
at stake.
The process begins when we retrieve the
egg or sperm from the donor. For the female donor, this is done
through follicular aspiration, a relatively painless process that
removes the egg through the cervix. The male usually collects
sperm through masturbation. The egg is usually used for an ART procedure,
while the sperm is often used for artificial insemination. The best
egg donor candidates are young -- ideally in their early twenties.
Chances for a successful pregnancy vary, so please contact us for
more information.
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“Become an Egg Donor - Help complete a family!
Why Should I Donate?
Becoming an egg donor is a unique opportunity to assist others in fulfilling their dream of becoming parents. Many individuals and couples cannot become pregnant without the assistance of an egg donor. You may know someone who has struggled with infertility and felt hopeless. There are thousands of couples desperately searching for an egg donor like you who will give them that hope. Your generous donation of eggs will give someone who is experiencing infertility the opportunity to create a child of their own and experience the joy of parenthood. Giving the gift of life takes only a small amount of your time, but will provide the recipients a lifetime of happiness.
In addition to the personal satisfaction you will have knowing you have helped create a family, you will receive compensation for your inconvenience and time, and all of your expenses are paid by the recipients, including travel expenses if required. There is absolutely no cost to you.”
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Cryopreservation of Embryos, Sperm, and Eggs
Our clinic uses cryopreservation to freeze
embryos, sperm, and eggs for later use. This can be especially
helpful for women who plan to have children at an older age, or
when one member of the couple faces a fertility-threatening illness.
Embryonic freezing is a modified form of
IVF. For cryopreservation, once the sperm fertilizes the eggs, we
allow the embryos to develop for several days. We then place
the embryos in our specially designed facilities, where they are
frozen for future use (rather than being placed back inside the
woman's uterus immediately). When a woman decides to become pregnant,
she returns to our clinic and the embryos are then reinserted into
her uterus. The pregnancy success rate per frozen embryo stands
at roughly 30%, slightly lower than with normal IVF.
Sperm freezing is often an excellent choice
for men who have to undergo chemotherapy and want to have their
own children later in life. The man supplies a sperm sample
that is frozen and placed into our clinic's specially designed facilities.
This procedure may also be ideal for men who have little sperm in
their ejaculate and wish to undergo an operation to extract sperm
for future use. The sperm are collected through sperm aspiration.
During this procedure, sperm are retrieved from either the epididymis
(the tubule that connects the testis to the vas deferens) or the
testicles. In many cases, a small number of sperm can be found in
these locations and successfully extracted. To achieve fertilization,
the woman's eggs are extracted and the sperm and egg are placed
together in the laboratory. Intra-cytoplasmic Sperm Injection (ICSI)
often provides the greatest chance for pregnancy.
Egg freezing is ideal for women with serious illness, cancer, or
for those who are unable to undergo the IVF process. The process
may also benefit women who wish to have children later in life.
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Laparoscopic Surgery
A significant technological advance, laparoscopic
surgery allows us to view the inside of a patient's abdomen, including
the reproductive organs, through a small, tube-like device known
as a laproscope. The laproscope functions like a lighted
telescope inside the patient's body. It allows us a clearer view
of the internal organs in a minimally invasive way. Laparoscopy
is usually performed under general anesthesia. The abdomen is filled
with a carbon dioxide gas, and the laparoscope is inserted through
a small incision. The gas is removed after the procedure is completed,
and the incision is stitched. One common use of laparoscopic surgery
is for diagnosing endometriosis, but it has other uses as well.
To learn more about how we use this technology to derive information
and achieve the best results for our patients, please contact us
today!
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Endometriosis
Endometriosis is a disease that occurs when
uterine lining tissue grows outside the womb, where it cannot be
shed. It often adheres to the ovaries, fallopian tubes, or
other reproductive organs. The abnormal tissue growth can cause
cysts, scar tissue, and tumors (usually benign). Endometriosis is
often a painful condition, especially when the woman is menstruating.
The disease can cause infertility.
We offer treatment options for women with
endometriosis, beginning with laparoscopic diagnosis. Hysterectomy
is often the treatment method recommended for women who do not wish
to have children, but there are more limited surgical techniques
available that may help women hoping to become pregnant. We can
remove the excess endometrial tissue and increase a woman's odds
of becoming pregnant significantly--sometimes up to 40%. Contact
us for more information about treatment options for endometriosis.
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Fibroid Treatment
Uterine fibroids are growths of smooth muscle
and connective tissue that occur along the uterine wall.
Their size may vary from that of a needle's point to that of a volleyball.
Although uterine fibroids are not life-threatening, they can cause
heavy menstrual bleeding, pain, and a heavy sensation. They can
sometimes interfere with pregnancy or cause infertility. The cause
of uterine fibroids is not known.
We offer surgical treatment for uterine
fibroids. Until recently, the only option was a hysterectomy.
Today, we offer alternative procedures, including laproscopic surgery.
For a full description of treatment options, please contact our
office!
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Injection Classes for Fertility Drugs
We can teach you how to administer your fertility drugs to achieve
optimal results.
Injection Services
Squeamish about giving yourself (or your partner) fertility drug
injections? Let us do it for you.
Save hours traveling!
We will do your ultrasounds and blood work
and fax results to your fertility center!
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IVF
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