embryo.net

When a woman has three or more clinical pregnancy losses she is considered to have recurrent pregnancy loss  (RPL). Biochemical pregnancies are not included in the definition. Below is some general information on this condition and what to expect if it occurs.

Causes of Recurrent Pregnancy Loss

There can be many causes of RPL, but in about 50 percent of couples with RPL no cause is found.

Causes include genetic etiology such as if one partner is a carrier of a balanced translocation or the woman is of advanced maternal age which increases the chances of a genetic issue with the conceptus. Other causes can be abnormal anatomy such as a uterine septum or congenital malformation or large uterine fibroid. Another proven cause for recurrent miscarriage is an acquired syndrome called antiphospholipid antibody syndrome which can make a woman more susceptible to developing blood clots and miscarriages. This syndrome is diagnosed via clinical history and some blood tests. Other less common causes include inherited thrombophilas (clotting disorders), immunologic disorders and infections.

Treatment of Recurrent Pregnancy Loss

In couples where the cause of RPL is diagnosed to be due to a balanced translocation, they can undergo in vitro fertilization (IVF) with pre-implantation genetic diagnosis (PGD) to identify and transfer only normal embryos during the IVF process. Anatomic causes of RPL can often be surgically corrected. For antiphospholipid antibody syndrome and thrombophilias the treatment is usually baby aspirin and heparin started when pregnancy is diagnosed. For immunologic causes the treatment is still controversial and therapy with immunoglobulins such as IVIG cannot be recommended to be of benefit based on the data at this time. Infectious causes may be amenable to treatment with antibiotics.

The good news is that in many couples with RPL, if no specific cause is found, they have a high likelihood of successful pregnancy with the next conception. Even after 3 miscarriages, there is a greater than 60 percent chance that the next pregnancy will be viable.

All of our four board certified Reproductive endocrinologists have experience and expertise in the diagnosis and treatment of couples with RPL. Appointments with our doctors are available in both the Bedford and Frisco locations.

Our Bedford office is close to Fort Worth, Dallas, Irving, Las Colinas, and the DFW airport. Our Frisco office is close to Plano, Richardson, McKinney, Lewisville, Allen, Denton, and Dallas. We encourage you to learn more about this condition and treatment options by scheduling a consultation without our Dallas / Fort Worth fertility specialists and doctors.

Endometriosis is a disorder where the cells from the lining of the uterus implant outside of the uterus in the pelvis. Some women with endometriosis suffer form significant pelvic pain and develop scar tissue or cysts on their ovaries (chocolate cysts or endometriomas). Other women with endometriosis have no symptoms. The only definitive way to diagnose endometriosis is to do a laparoscopy and look inside the abdomen with the help of a small camera inserted through the belly button.

Does endometriosis affect fertility?

The studies are unclear about the effect of mild endometriosis on fertility, but severe endometriosis is known to negatively impact fertility.

Can surgery help?

Yes, but mainly only in the cases of severe endometriosis causing distortion of anatomy. Most women will benefit from going straight to fertility treatments unless suffering from pelvic pain, in which case having a laparoscopy to treat the endometriosis lesions may be of benefit.

What kind of fertility treatments are options for women with endometriosis?

Each couple is different in their unique needs. Our physicians will make a thorough assessment of all factors that may contribute to your infertility and make the appropriate recommendations. Treatment options may range from the oral medication clomiphene to injectable medications with insemination to surgery or in vitro fertilization (IVF).

We encourage you to meet with our fertility doctors and specialists near Dallas / Fort Worth to learn more. We have two convenient locations to serve couples from anywhere in the metroplex. Our Bedford office is close to Fort Worth, Dallas, and the DFW airport. Our Frisco office is close to Plano, Richardson, McKinney, Lewisville, Allen and Dallas.

There are a number of different ovarian dysfunctions that can affect a woman's fertility. In the information that follows, we examine some of the different kinds of ovarian dysfunctions that women experience.

Polycystic Ovarian Syndrome (PCOS)

Polycystic ovarian syndrome (PCOS) is a syndrome that affects about 8-10 percent of reproductive aged women. It can have a wide variety of presentations, but most commonly women with PCOS suffer from irregular periods, increased facial or body hair, acne, and infertility. Many women with PCOS are also overweight and the excess weight can add to the symptoms of PCOS.

For the long run it is very important for women with PCOS to be regularly checked for diabetes and high cholesterol as they are more prone to developing these issues. Also, due to the risk of the lining of the uterus growing too thick, women with PCOS who are not having periods or have very irregular periods should be on birth control pills or other medication to induce a period at least once every three months. Those women trying to conceive may benefit from simple treatments such as the oral medication clomiphene citrate. Those women who have been diagnosed with type 2 diabetes or borderline diabetes may benefit from the medication glucophage (metformin).

All of our doctors are board certified reproductive endocrinologists and are well versed in the diagnosis and treatment of PCOS. We can see patients with PCOS both at our Bedford location (close to Dallas, Fort Worth, and DFW airport) and our Frisco location (close to Plano, Allen, McKinney, Lewisville, Denton, and Dallas).

Premature Ovarian Failure (POF)

Premature ovarian failure (POF) is diagnosed when a woman under the age of 40 starts having no periods or infrequent periods along with a significant increase in the FSH hormone produced by the brain, suggesting failure of the normal function of the ovaries. POF is though to affect about 1-5 percent of women. Sometimes the cause is genetic, other times it may be viral, autoimmune, prior pelvic surgery, or often unexplained. Early recognition and prompt initiation of treatment are important if fertility is an immediate consideration. There are various treatment options available based on the severity of the case in an individual patient. Our board certified reproductive endocrinologists are well versed in the diagnosis and treatment of women suffering from premature ovarian failure. In some cases the woman may be able to successfully achieve a pregnancy with her own eggs, while others may need to undergo egg donation. We see patients with POF in both our Bedford and Frisco locations. Our Bedford and Frisco offices can be conveniently accessed by patients in the greater Dallas and Forth Worth area, including Denton, Lewisville, Carrollton, Irving, Las Colinas, Richardson Plano, McKinney, and Allen.

Diminished Ovarian Reserve (DOR)

As a woman ages, both the quantity and quality of eggs in the ovaries declines over time. Women are born with a finite set of eggs which grow and perish in waves. The eggs are always going through phases of growth and death irrespective of the regularity of menstrual cycle. In some women the process of loss of eggs may be accelerated, or perhaps they were endowed with a smaller number of eggs at birth. Diminished ovarian reserve (DOR) refers to decrease in the number of eggs in the ovaries. This can be assessed by the appearance of number of small follicles on the ovaries early in the menstrual cycle, by measurement of the ovarian volume, hormone tests such as Day 3 FSH and estradiol or serum AMH (antimullerian hormone). Several of these factors put together help make the diagnosis of diminished ovarian reserve. Once diagnosed, DOR warrants prompt attention and institution of treatment for infertility since the condition worsens over time. DOR combined with advanced reproductive age often yields a poor prognosis for successful pregnancy. Our doctors in Bedford (close to DFW airport, Fort Worth, Dallas, Irving, and Las Colinas) and in Frisco (close to Plano, Richardson, McKinney, Allen, Lewisville, and Denton) have expertise to help.

Oligomenorrhea

Oligomenorrhea refers to infrequent periods. If a woman has less than 9 periods a year or greater than 35 days in between periods, she is considered to have oligomenorrhea. Sometimes this can be caused by imbalances in hormones such as thyroid and prolactin; sometimes it is due to PCOS, POF or DOR. Obesity and high insulin levels can also cause menstrual irregularity. Sometimes to direct cause is found. Depending on the age of the patient, cause of the oligomenorrhea and other factors pertaining to fertility, there are many possible treatment options ranging form the oral medication clomid to daily hormone treatments to in vitro fertilization (IVF) or egg donation if pertinent.

Our reproductive endocrinologists at the Center for Assisted Reproduction can help diagnose and guide you toward the appropriate treatment modality. We have two easily accessible locations for your benefits one in Bedford which is easily accessed by patients in both Dallas and Fort Worth, the other in Frisco which is easily accessible from Plano, Richardson, McKinney, Allen, Lewisville, Denton, and surrounding areas.

About 15 percent of all couples will experience some level of infertility when trying to conceive. Many of the couples who are experiencing infertility turn to procedures like in vitro fertilization (IVF) to conceive a child. If you are considering IVF you should educate yourself on the procedure before electing to have it. The following frequently asked questions about IVF and infertility will get you started.

What is infertility?

Infertility is a disorder of the reproductive system that prevents a couple from conceiving a child. Conceiving a child is far more complex than one might think, and the slightest malfunction of the reproductive system can lead to infertility. A couple is classified as infertile when they have tried to conceive unsuccessfully for one year’s time.

What is in vitro fertilization (IVF)?

In vitro fertilization (IVF) is a procedure in which an egg is fertilized by sperm in a laboratory. The process has many steps involved. Eggs must be retrieved from a female and sperm from a male. After the two specimens are joined in a petri dish they are incubated until cell division takes place. Once cell division takes place an embryo has been created, and that embryo can be transferred to the woman's uterus via a catheter through the cervix.

How much does in vitro fertilization (IVF) cost?

Many people feel overwhelmed at the prospect of getting treatment for infertility because of the cost. The average cost of a total IVF cycle in the United States is about $12,000. Naturally, the cost of IVF is based on a number of variables including geographic location, the skill of the physician, and a couple's individual medical problems. Some insurance companies cover treatments for infertility. In fact, states like Arkansas, California, Connecticut, Hawaii, Illinois, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas, and West Virginia all require by law the insurance companies cover some infertility treatment or diagnosis. For more information on in vitro fertilization as well as other fertility treatments such as egg donation and donor eggs, preimplantation genetic diagnosis (PGD), it is important to contact a fertility and IVF center near Dallas, Texas.