Women's Health

Qus & Ans: Secondary Fertility Problems

I am 33 years old and want to have a second child. My first child is now 10 years old, and I had no problem getting pregnant with him. About two weeks ago I had a laparoscopy with tubal lavuge and laser surgery, and the outcome was this: I have severe endometriosis and blocked tubes. I am also in a lot of pain. My doctors told me the only way I could get pregnant is through in-vitro fertilization. My husband and I cannot afford this procedure, so they are saying the only other solution is hysterectomy. (?!) Help! Is this really my only solution?

Qus & Ans: Polycystic Ovarian Syndrome (PCOS)

I am on a PCOS mailing list. Recently there has been mention that the use of Clomid for seven days (starting cycle day 1 instead of cd 3 or cd 5) instead of five days is better for PCOS women. Is this true? If so could you give me a link to some written information on the subject.

Qus & Ans: Miscarriage

Hello. I have had two miscarriages in the last six months. The second one resulted in a D&C on October 26th. I still have not menstated and my doctor has put me on Medroxy progesterone. My question is can we start trying after I get my period even though it was brought on by medication? Both my miscarriages were early in the pregnancy. Thank you -- Kelly Dear Kelly: Although I don't have a complete clinical history from you I can begin a reasoning process that could help us to feel more comfortable that you are doing the right thing.

Qus & Ans: Male Factor

ABNORMAL SEMEN ANALYSIS I have undergone 3 IUI's and all three showed white blood cells in my husband's semen. What could cause the white blood cells to be present even though there were no bacteria present and he does not have any abnormal symptoms? White blood cells in semen can result from an inflammatory or immune process. If there are no signs of infection, you doctor may want to evaluate him for an autoimmune mechanism. If there are a lot of white blood cells present, you should talk with your doctor about IVF with ICSI.

Qus & Ans: Inseminations

My husband has a low sperm count and low motility.(8.9 Mil after wash for IUI). This has progressively incresed since the first IUI we had done (2.8Mil after wash). He found out after the first IUI that he has low thyroid and he has begun medication, in the mean time, he has been taking Proxeed (male vitamin, supposed to help w/ motility) and we have started to see the increase. We got cocky after the second IUI (4.5 Mil) and he stopped taking the Proxeed. Obviously that one didn't work, or the third one.

Qus & Ans: Immune System Dysfunctions

I was wondering if you could answer a question for me. I have been through 7 IUI's and 2 IVF's, which have all failed. My AF has come early each time. During the IUI's.....I experienced a raised lymph node behind my ear at 8 or 9 days past the IUI. In the IVF's we used baby aspirin, and subsequently had no raised L.N. until after baby aspirin was stopped. In those cases the node raised a day or 2 past AF. During a break cycle I experimented with robitussin and baby aspirin and had light cramping and red spotting at 9dpo (apx), but no raised node.

Qus & Ans: High FSH Levels or Poor Egg Quality

Hello. I am 31 years old and my husband is 31 as well. Because of his semen analysis (low count, low morphology and low motility), we were advised to go through an IVF cycle with ICSI. Preliminary testing was done on me and nothing was of note except that my FSH on Day 3 was "10." Around the end of November, we had the retrieval. I had responded pretty well to the Lupron, Follistim and Repronex I was taking, and nine eggs were retrieved. Of the nine, only four were good enough to fertilize and only one actually did. The fertilized egg was returned, but I did not become pregnant.

Qus & Ans: Fibroids

I am a 33 years old indian woman. I have some problems in getting pregnancy.I give my full details here and I want some suggestions from you.I married in Aug'1996. I conceived once but it had aborted after 60 days.On the 48th day, HSG was taken as the gravindex was negative. Follicular tests were good.Is there any solution for this fibroid? It it curable by taking medicines? Is there any latest special injections to make the fibroid to shrink? Will the injection or medicine give any harmful problems? Is it any necessary to undergo any operation?

Qus & Ans: Cervical Fluid Conditions & Post-coital Tests

Dear Doctor,

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Fertility: General Questions and Answers Part 2

Estrogen Level and Egg Development Q: I am undergoing medicated IUI cycles and have 3 mature eggs ranging from 18-22mm. I've heard that the estrogen level should be around 200 for each mature follicle, but my estrogen level is only 337. Does this mean that some of the eggs are not mature? Thank you.

Fertility: General Questions and Answers

SEEING A SPECIALIST Q: I am wondering if it is possible to conceive with PCOS, thyroid disease, and Factor 5 blood disorder in a fairly reasonable time. We have been trying for a year and have now been referred to a specialist. I have two other children but have never had to see a specialist. I don't think I can handle the ups and downs of infertility much longer - what can a specialist do that my regular doctor can't?

Hostile Cervical Fluid (Mucas)

Part of what makes understanding fertility so difficult is that there are so many aspects that need to be considered, from sperm motility to egg quality and everything in between. Cervical mucus, a jelly-like substance produced by glands in the cervical canal, is a factor in a woman's fertility. Just how important a factor it is remains controversial.

Immunological Testing and Treatment for Infertility

A new ELISA-based hormonal test, measuring the levels of Inhibin B in serum on day 3 of the menstrual cycle. Since only the Follicular Granulosa cells secrete this hormone, its level reflects on the potential of the ovary to grow follicles, which physicians refer to as 'ovarian reserve'. Women with low levels of the hormone were found to have more impaired ovulation in the course of the IVF cycle, lower pregnancy rates, higher cancellation rates and higher abortion rates. Inhibin B is secreted by the granulosa cells while estradiol is secreted by several other cell types in the ovary.

Ureaplasma and Mycoplasma

When you complain of burning on urination, feeling like you have to urinate all the time, getting up in the night to urinate or having urgency to urinate when your bladder is full because it hurts so much, you usually have a urinary tract infection. Sometimes, your doctor will order a culture and if the culture grows no bacteria, that usually means no infection or that you have interstitial cystitis.

Hyperprolactinemia (High Prolactin) Causes

Normal ovulation is a complex process that requires many things to happen properly and at the correct time with the proper hormone levels. Often subtle hormonal imbalances or ovulation abnormalities result in decreased fertility. One hormone imbalance that can affect fertility is prolactin levels. Excessive prolactin levels in nonpregnant women is known as hyperprolactinemia.

Hypothyroidism

Hypothyroidism is a disorder in which there is a lack of normal thyroid production or secretion of thyroid hormone. In other words, the thyroid gland is underactive so there follows an underproduction of thyroid hormone. Your thyroid is a small bowtie or butterfly-shaped gland, located in your neck, wrapped around the windpipe, and is located below the Adam's Apple area. The thyroid produces several hormones, of which two are key: triiodothyronine (T3) and thyroxine (T4).

Turner's Syndrome

Turnerîs Syndrome is a chromosomal condition causing short stature and infertility in women and girls. Other manifestations of this syndrome include: webbing of the skin of the neck, absent or retarded development of secondary sexual characteristics, absence of menstruation, coarctation (narrowing) of the aorta, and abnormalities of the eyes and bones. The condition is either diagnosed at birth because of the associated anomalies, or at puberty when there is absence of menses and delayed development of normal secondary sexual characteristics.

Hydrosalphinx

Hydrosalpinx is yet another cause of infertility. A hydrosalpinx occurs when a damaged fallopian tube fills with fluid. In a normal functioning fallopian tube, fluid is both secreted and then later reabsorbed. As tubes become damaged they are still able to secrete fluid but can no longer reabsorb it. In general, a hydrosalpinx occurs when the very end of the tube is blocked and then the tube fills with clear, watery fluid. Causes

Stress and Infertility

-Relax.° -Take a vacation.° -Stop trying so hard.° -Adopt.° These are among the well-intended suggestions from family and friends heard often by infertile couples. Frequently, infertility causes couples to struggle with feelings of inadequacy and failure. To suggest that they are to blame for their infertility because of an attitude or difficulty coping with the stress of the process causes couples undue pain and guilt.