GynoFiles

Many women successfully get pregnant with their own eggs and have children in their 40s.  We are born with 2 million eggs (1-4 million probably). We ovulate 400. Our eggs die at a predictable rate that is determined by genetics and other factors. Some women are able to be fertile until they are quite old, others are running out of usable eggs even though they are quite young. There are tests of the age of your ovaries, but then usually it's only fertility patients who get these tests; and while very interesting it doesn't typically change medical care to know whether you are still fertile unless you are seeking pregnancy. Some women become infertile in their mid 30s. Since the age at first birth in the USA is now 30, it is important to discuss fertility with our young patients so that they can plan pregnancies with an eye to this! We know that 1 in 5 women has not yet attempted to have a baby by age 35, so with the ages of motherhood and menopause potentially colliding,...

Getting pregnant has several critical steps. Even couples who are helped to ovulate, have a good sperm count, and time their conception perfectly may not conceive if the lining of the uterus is not healthy enough for implantation. Preparing the uterine lining has mostly been done with estrogen treatments. It's also important to be sure you don't have other problems with the uterus, including scaring, or infection, or polyps, but again, in the absence of these some women do not conceive. Hundreds of genes that are differently expressed at the time of implantation, as well as the immune system, play an active role during embryo-endometrium interaction Other than estrogen medicines like silenafil, aspirin and heparin have been tried with varying success. The lining is so complex that it takes the coordinated efforts of many hormones and the synchronization of literally hundreds of genes to establish a uterus with the proper place for  implantation so that coordination between...

Many couples planning pregnancy come in with similar basic questions regarding pregnancy planning and sexuality for pregnancy planning. Here are some basic questions answered. 1.  Have sex, don't worry about exact position. You must have sex. New data says more sex is better and you have a 37% chance if you have sex every day when fertile, and only a 33% chance if you have sex every other day. Only home one day a week? those couples only have about a 15% chance of getting pregnant. All sex positions work for conception. Being in missionary position, having a pillow under your hips, and having orgasms have been talked about to lead to more often getting pregnant, but no medical studies back these pieces of advice up! 2. Enjoy your time cuddling or whatever you want to do after conception sex, no true evidence to the various exercises you need to put your hips through to encourage sperm to swim to their destination. Laying still after sex to enhance pregnancy also...

ABC world news reported on the  first uterus transplant  performed in America! Since the story broke on 2/25, another  news story  was released today (2/26) regarding what this means for women. So, what does it mean for fertility? It means that women who have been born with out a uterus or don't have a uterus could potentially become pregnant some day after this transplant is performed.They will still need to have significant fertility help to become a mom, and the way the surgery is performed they will be treated with IVF to become pregnant.  Although with other research teams generating created organs by synthetic means, some day we may solve the problem of rejection in transplanted organs, for now rejection is still an issue. Women who receive a transplanted uterus have to take rejection medication in order to maintain the health of the transplanted organ. Unlike a kidney which is necessary for continuing life forever, the uterine transplants are designe...

Planning a pregnancy? Just how tight is your window, between those big work projects, your cousin's wedding, the bro trip he insists on, and then all the other things you are mulling over: the best birth date for astrology, the Indian calendar, or for setting swim records? There is a lot to consider, and the first question for your gyno is just what is going to get me pregnant the fastest. Her first question back, is lets get you the healthiest you can be, when should we stop contraception, are your vaccinations up to date, and lets get your nutrition bested, but all that medical fuss aside, eventually you just need to get down to sex. And the question is, really? Just sex, or sex aided by a bit of infertility treatment boost? Missionary position? Extra deep penetration? Sex with someone skinnier to get deeper penetration? Do you need to have an orgasm to get pregnant? Laying still for 15 minutes after sex! Conception Configuration: Best Position(s) For Conception 15 minutes ...

Nervous meaning "can I perform" can definitely impact conception. The alarms, bells, whistles, and sticks turning blue, signaling a woman's ovulation can be a fun game just so long. Then it gets to be a strai discuss sources of stress with your gyno as there are ways she can help you. n on the sexuality of many couples to the point that artificial insemination of partner's sperm may be necessary to just avoid the performance topic all together! We know that stress produces a variety of hormones that wreak havoc on our endocrine system. These stress hormones can produce derangement in the menstrual cycle, so affect ovulation, and derangement in our blood sugar and metabolism, affecting our weight, throw off our biological clock and affect sleep, so we always thought that there must be a link between cortisol levels and conception.In the late 1990s a research group in Australia looked at levels in epinephrine, norepinephrine and cortisol, and they really ...

It's not just an app that will help you get pregnant and get pregnant easily.  Many couples planning pregnancy come in with similar basic questions regarding pregnancy planning and sexuality for pregnancy planning. Here are some basic questions discussed from advice we give our patients at Women's Health Practice. 1.  Have sex, don't worry about exact position. All sex positions work for conception. Being in missionary position, having a pillow under your hips, and having orgasms have been talked about to lead to more often getting pregnant, but no medical studies back these pieces of advice up! 2. Enjoy your time cuddling or whatever you want to do after conception sex, no true evidence to the various exercises you need to put your hips through to encourage sperm to swim to their destination. Laying still after sex to enhance pregnancy also has not reliably been studied, but douching after intercourse does decrease your chance of conceiving. 3. Earlier is...

Some women are able to be fertile until they are quite old, others are running out of usable eggs even though they are quite young. There are tests of the age of your ovaries, but then usually it's only fertility patients who get these tests; and while very interesting it doesn't typically change medical care to know whether you are still fertile unless you are seeking pregnancy. Those wondering how close to menopause you are, or even more interestingly, when to time having a baby. You might make a different decision if you know your ovaries are running out of eggs, rather than if you had plenty of eggs and could easily postpone while you work on that job change, that new marriage, or that bucket list. And that was one of the questions a recent Practice Committee of the American Society for Reproductive Medicine opinion tried to answer for you: how to use tests of ovarian aging . Generally speaking, the most eggs we will ever have is during the 4th or 5th month of fetal life! ...

When are you going to have a baby is the first step in planning your pregnancy. In Mexico the average age of first pregnancy is just over 21, in the UK it's closer to 29 on average, in the US we are something between those two, so think over your reproductive life plan, how are you going to fit baby into your school, job, or marriage plans if any. Then get physical and get ready to do what it takes to get ready for the conception, prenatal days, the birth and the life with baby. Planning your pregnancy by some simple tests to insure your health, and relatively simple steps is more likely to result in getting pregnant more quickly and having a healthier baby and pregnancy. A new study says that preconception care has potential for return on investment. Women with chronic illnesses have the most to gain from planning their pregnancies, and yet they the least likely to plan their pregnancy according to this new study, and thus enter pregnancy less likely to maximize their chance for ...

Birth control risks vary according to your age. If you were safely using your pill, and now you have your 35th birthday, you may be surprised to know your gyno may view your risks in a whole different category. For most all women on oral contraception the risks are low, and it is acceptable to use your pills until menopause, and even into early menopause for some. If you smoke, if you become ill with a medical condition that is a contraindication to pill use , or have special considerations from your gynecologist, you may indeed have to be taken off the pill prior to the time of menopause, but women in their late 30s and 40s can most likely stay on a contraceptive pill that is working for them. Smokers should not be on the pill after the age of 35. The CDC talks about contraceptives and their risks in benefits in their publications, the last being in 2013 . If you have migraines you may also need to come off your combination oral contraceptive pills if you are over the age of 35. It...

1. Felt midcyle unilateral pain that corresponds to an egg being released 2. Had mittlesmertz, or the accompanying rupture of the follicular capsule that has bleeding at the time of the pain 3. Had temperature shift on your basal body temperature chart (BBT) 4. Temperature on BBT, when taken first thing in the morning, remained elevated relative to the early part of your cycle after it elevated 5.Your urine ovulation predictor test (OPK) test is positive 6. Follicle collapsed on ultrasound monitoring 7. Corpus Luteum appeared on ultrasound, this is the progesterone producing structure the follicle becomes after it ovulates 8. Mucus discharge from cervix increases, usually this occurs in the few hours around ovulation, for some women it may be a day, for others a few hours 9. Spinbarkite of mucus increases, this is a word that means stretchy, like egg white 10. You don't get a period and have a positive pregnancy test!

Women speak of their guy's sperm count, their gyno speaks of the guy's semen analysis. In medicine we like facts and figures, and there's more to getting a healthy guy to mate with than just that sperm number. And we've been in the past content to say go ahead and get pregnant if the count is good. Now we want more. We want a guy with a good blood pressure, not on any unusual supplements, with good cholesterol and good BP as well as no STDs or genetic defects. So it takes a bit more to get ready for pregnancy (although good sperm count is a great place to start), and getting into the gyno for a talk before the couple gets pregnant is what we recommend.  World Health Organization reference values for human semen characteristics.   Cooper TG; Noonan E; von Eckardstein S; Auger J; Baker HW; Behre HM; Haugen TB; Kruger T; Wang C; Mbizvo MT; Vogelsong KM  Hum Reprod Update. 2009 Dec 4.

New data on infertility treatments from the CDC was just released. I've seen reports that headline less women seeking treatment and other reports headlining that more women are seeking treatment. Infertility is caused by a variety of conditions affecting the cervix, the uterus, the ovary itself, ovulation, and genetics; or in the males the semen and sperm count, and genetics. Sexuality is a factor, and those with performance issues may or may not have problems with fertility as well. Having a baby is even more complex with factors of job, finances, social situation, psychological readiness as well as literally just wanting another or your first child. The CDC report just out has discovered that significantly fewer women ages 15-44 are seeking help in treatment of infertility. About 17% overall seek treatment, and 20 used to seek treatment in 1995. In more narrower age ranges some treatments are actually increased. And What the next question is, why? Do women realize they have tre...

Endometrial biopsies are used to diagnose irregular bleeding, to check for cancer of the uterus and to help infertility patients be diagnosed with luteal phase defect. Women who are tying to get pregnant are often offered several tests of their fertility, endometrial biopsy would only be one of the tests. One test is to check your for ovulation, one is to test to see if your fallopian tubes are open, and other test checks to see if your partner is fertile as well (At Women's Health Practice call to schedule affordable sperm counts). The lining of the uterus needs to be thick and lush for an embryo to implant. the lining is shed each month to allow for a newly constructed home for an embryo to implant. The process by which this develops is much like the orderly progression of a flower unfolding or a fruit forming on a tree. It occurs step by step. For a long time we have felt that poor progesterone in the latter half of the cycle made for a specific problem that would ...

If you are planning pregnancy and discover you have a uterine fibroid, the decision is to treat or wait until after you have children to treat. Often women don't have the choice and the first sign of a fibroid is on a prenatal ultrasound. If you have had preterm labor or a miscarriage, then generally many gynos will say removing the fibroid or fibroids will improve pregnancy success. However, if you just have not yet conceived, should any fibroids discovered be removed? This is debated. In 1917 the renown gynecologist Hofmeier stated uterine fibroid did not cause infertility. Almost that same year in a contrasting paper Olshausen stated that almost 1/3 women with fibroids had infertility. We currently think that the 1/3 women figure is probably a bit high. In a landmark paper written in the early 1980s Victor Buttram reported that infertility, due only to uterine fibroids, only occurs in about 10% of cases. What we think is that large fibroids, or ones that obstruct the fallopian...

We mentioned the fertile window briefly in the post on how to get pregnant , but thought that we would review it again. Sperm are now thought to be able to live in a woman's body, after sex, for about 6 days if she has well-estrogenized cervical mucus. Eggs however live for about a day, or in some cases less. Newest research states that intercourse daily during the fertile window does help women get pregnant. For the woman who has a typical 28 day menstrual cycle, her fertile window is those 6 days ending on the day of ovulation. For this typical woman the best days to get pregnant are day 10-17 of your cycle, counting the first day of bleeding as your first day. You are not likely to be fertile if you wait for sex until after ovulation. Once a woman ovulates, there typically is not enough time for sperm to get to the egg as the egg survives for such short periods of time. No one has established how long you have to wait without sex before having your fertile sex. Some experts s...

Love Locks, Prague, Czech Republic Fertility forced sex is not as fun as functional, and anything that causes the function to be improved definitely helps the sex lead to a baby. As fertility physicians discovered: getting pregnant is directly related to having more sex! And if not other experts say we will just turn to test tube babies by 205 0. But before we panic, first do what you can to make sure you are healthy for a pregnancy , and visit your gyno for that. Next do what you can to optimize your natural fertility . Do try all your best moves, and if wetness is a problem: no worries, try lubricants! About a fourth of us used lubricants for sex in the past month. So fertility patients trying to have sex should they be concerned that these lubricants can decrease the viable sperm count? The research shows that when sperm and sex gel meet in a dish the common lubricants like KY Jelly, Astroglide can stop sperm in their tracks. Some women use coconut oil and that really has ...

In Cordoba , Argentina Dr. Conrado Avendaño working with the Department of Obstetrics and Gynecology at Eastern Virginia Medical School decided to look at the consequences of laptops and Wi-Fi on human spermatozoa. For a few years it has been thought that environmental factors like radio waves and low grade electromagnetic fields could account for the reported world wide decrease in male fertility over the past several decades. These energy waves can produce factors, known as free-radicals, that can induce breaks in the DNA. A sperm with broken DNA...yes, you guessed it...can swim crooked, and just not get where it's going, and not be fit to fertilize an egg even it it gets there. The fertility researchers concluded that exposure to the lap tops caused serm DNA damage. Now to be fair, there were no incubating testicles in their study as reported in Fertility and Sterility in January 2012. In this study they studied the radio signals that are emitted by a laptop when it's...

A new study questions whether it is best Essentially gynos thought that it really was not likely for a woman without periods to get pregnant easily, because most likely she won't be ovulating, so it would be impossible to conceive. So traditional thinking has us kick starting ovulation by either bringing on a period, or bringing on a period followed by giving ovulation inducing medicine like clomid or follistim or similar medications. Many women who do not have regular period,s but still want a baby, liked this system, thinking that shedding off that lining with a period take fer is a way of getting a fresh start to one's cycle and therefore the best way to get pregnant. In a newly published large NIH/NICHD grant study that whole premise has been challenged. The study, headed up by Dr. Michael Diamond, looked at women with polycystic ovarian syndrome (PCOS). These women were given progesterone to make them bleed or just given the fertility medicine right away without waiting...

Sometimes sperm just need to be nudged along their path in order to help a couple get pregnant. For the most part this has been a fairly straight forward technique of separating the sperm from the semen, placing it in a special physiologic solution, and then, at the perfect time in the cycle, placing these sperm directly into the uterus. This is a fairly rapid technique and some sperm will be found within the uterus within minutes of the procedure. Most gynos who do this technique will advocate trying once or twice during the cycle. However, there may be a new way to do the insemination. The makers of a new infusion pump for intrauterine sperm insemination think that slower release of the swashed an prepared spermatozoa will enhance conception for infertility patients. The makers of the pump feel that it is more natural for sperm to swim in less crowded lane lines, and so instead of the usual swoosh of the intrauterine insemination catheters, the pump release...