Month: January 2020

Miscarriage and Recurrent Pregnancy Loss

recurrent pregnancy lossWhen most women think of fertility specialists, they about difficulty conceiving a pregnancy, but fertility specialists (also known as Reproductive Endocrinology and Infertility Specialists) also see women who can get pregnant but have difficulty staying pregnant because of miscarriage or recurrent pregnancy loss.

Egg Health

As women age, the number of eggs in their ovaries decreases and the quality of those remaining eggs can also decline. Eggs that are less healthy have a higher chance of fertilizing incorrectly, leading to an embryo that has either too many or too few chromosomes to produce a viable pregnancy. This change in the eggs over time is why miscarriage risk goes up with the age of the woman. The risk for miscarriage is approximately 25% of pregnancies in women age 35-39, 50% in women age 40-44, and as high as 90% in women 45 or older.

Diagnosing Recurrent Pregnancy Loss

Because having one miscarriage is so common, the diagnosis of recurrent pregnancy loss (RPL) is made after a woman experiences two or more miscarriages that are far enough along to either see the pregnancy with an ultrasound or confirm the pregnancy by looking at the tissue under a microscope. This means that very early, or biochemical, pregnancies that stop developing before this stage don’t technically count toward making the diagnosis of RPL.

If a woman is diagnosed with recurrent pregnancy loss, it’s important to have a thorough evaluation done to check for preventable reasons for the miscarriages and improve the chance that the next pregnancy will be healthy. Some of the tests that may be done include blood tests for genetic, autoimmune, or hormonal issues as well as a 3D ultrasound of the uterus to check for any anatomic problems like a uterine septum or scar tissue in the uterus. If an infection of the uterus is suspected, testing for that will be recommended as well. It is also important to screen the male partner for certain genetic or sperm quality concerns that may be contributing to the pregnancy losses.

October is Infant and Pregnancy Loss Awareness Month and a good opportunity to discuss miscarriage openly. It is not something to be ashamed of or kept secret. In fact, once the miscarriage conversation is started, you realize how many women have been affected. Having a miscarriage can be incredibly difficult emotionally and having multiple miscarriages can feel devastating. It is important to know that help is out there and many reasons for miscarriage are treatable. Most women will go on to have a successful pregnancy! The first step toward success is seeking help.

There is Hope and Help

If you have questions about recurrent pregnancy loss and miscarriage and would like to learn more about the many options in the fertility process, contact us today to schedule an appointment. Our experienced, caring physicians at Vios are here to help.

Debunking the Myths: Top 5 Facts Men Should Know About Male Infertility

male infertilityMyths about male infertility are varied and widely believed. If you’re trying to become a parent, do you believe having sex daily with your partner will increase your odds of conception? Are you convinced boxers will boost your sperm production? Maybe you think difficulty conceiving is related to a female fertility problem.

The reality is that out of all cases, infertility can be due to the woman, the man, or a combination of the two. In fact, 1 in six couples have problems conceiving, and male infertility makes up about 50% of all infertility cases. However, most men don’t go in for a noninvasive diagnosis until their partner has  had extensive evaluations. Male comprehensive tests, including hormonal testing, semen analysis, and testicular ultrasounds, are painless and straightforward.

Here are some other facts that debunk other common myths. How many of them do you know?

1 – Daily Intercourse will not Improve the Odds of Conception

Most people believe that the more you try, the higher the odds of becoming pregnant. The truth is you should look at the timing. A man’s sperm can live for 48 to 72 hours inside a woman’s reproductive tract. For those trying to conceive timing intercourse to match a woman’s fertile window, the five to six days before ovulation, is vital

2 – Boxers or Briefs? It Doesn’t Matter!

The choice of underwear doesn’t affect male fertility. Research has shown that while the testicles need to stay a few degrees cooler than the body’s core temperature for proper sperm production, wearing snug underwear doesn’t seem to have much impact. On the other hand, experts recommend staying out of hot tubs to avoid unnecessary heat exposure.

3 – Not All Men Have Sperm in Their Semen

An absent sperm count affects approximately 1% of the male population. There may be a problem even if the ejaculate looks normal since most of the ejaculated fluid isn’t sperm. The best way to know for sure is to have a semen analysis, or sperm count, to test the health and vitality of the sperm. Testing is simple and painless and there are treatment options if a problem is diagnosed.

4 – Age Can Affect Your Sperm

While men can still procreate well into their later years, their sperm numbers decline along with their testosterone. Also, research has found older sperm can contribute to conditions like autism and schizophrenia in children who are conceived after their father turns 50.

5 – Self-Exams and Check-ups Are Important for Male Fertility

Examining your scrotum monthly not only helps you identify the early stages of testicular cancer but also possible varicoceles, enlarged veins in the scrotum that can cause future infertility. A yearly check-up with a urologist can keep you better informed about your reproductive health as well.

Although some causes of male infertility are out of your control, it is important to live a healthy lifestyle with good nutrition, exercise, and lower stress. By doing so, you will have a head start in addressing all the aspects of male fertility that you do have control over. Learn more in our articles: What is Male Infertility and What Causes Infertility in Men.

Conception is Our Life. Vios Cares About Making Your Dreams of Parenthood Come True

If you are struggling with male infertility, you are not alone. Comprehensive tests, including hormonal testing, semen analysis, and testicular ultrasounds, are painless and straightforward. Vios Fertility Institute offers you a team of compassionate doctors and state-of-the-art testing and treatment options to help you along your unique fertility journey.

Take control of your fertility health and contact us today to schedule a consultation!

Nutrition and Fertility

pregnancy dietIf you are currently trying to get pregnant or planning to try for pregnancy in the next several months, it’s time to start thinking about your nutrition. A healthy pregnancy diet can improve your chance for pregnancy as well as shorten the time it takes to get pregnant.

Importance of Body Mass Index

By now we have all heard that having a normal body mass index, or BMI, gives you your best chance for getting pregnant and your lowest risk for miscarriage. What you may not know is that regardless of your BMI, making healthy dietary changes can still have a very beneficial effect.

Standard American Diet

Unfortunately, most Americans eat what is called the Standard American Diet that includes high amounts of meat, dairy products, and processed foods while consuming too few fruits, vegetables, and whole grain carbohydrates. Over time, this type of diet and can lead to chronic inflammation throughout the body that is thought to be the starting point for many diseases. The Standard American Diet has led to not only obesity, cancer, heart disease, and type 2 diabetes, but can also contribute to fertility problems in men and women.

Choosing the Best Pregnancy Diet Food

There are a few simple changes that you can make that can start you on the path to better health and improved fertility.

  • Increase your consumption of whole grains like whole wheat bread, quinoa, and brown rice
  • Add more fruits and vegetables to your plate and try to mix it up so you get a wide variety of colorful food for maximum phytonutrients
  • Try to get most of your daily protein from vegetables (yes, veggies have protein!) or low mercury-containing fish rather than from meat and dairy
  • Avoid processed foods and choose healthy snacks like nuts instead
  • Limit refined sugar and simple carbohydrates like white rice and white flour
  • Eliminate sugary beverages! This includes soda, sweetened tea or coffee drinks, and juices
  • If you’re craving a treat, 2 small squares of dark chocolate per day is good for you!

Prenatal Vitamins

Now of course one final thing to mention is the importance of starting a prenatal vitamin a few weeks before you conceive. Starting your vitamin early means that you will have the best chance for adequate folic acid levels to reduce the risk for certain birth defects that can start developing before you even know you’re pregnant.

Check my Instagram discussion of fertility nutrition and wellness @healthyfertilitymd

What Causes Infertility in Women?

infertility in womenAn estimated 10 to 18 percent of couples have trouble getting pregnant, staying pregnant, or having a successful delivery. Female infertility, defined by a woman that is unable to get pregnant after one year of trying (or six months if a woman is 35 or older), effects as many as 6.1 million women according to the CDC.

Before understanding the causes of infertility in women, it can be helpful to understand what is needed for a woman to become pregnant. The following must occur, her:

  • Ovaries must release a mature egg during ovulation
  • Fallopian tubes must be open to allow the sperm to fertilize the mature egg, creating an embryo
  • Uterus must be healthy and unobstructed to allow the embryo to implant and to support the developing fetus

Causes of Female Infertility

Female infertility can be difficult to diagnose. In women, several factors can disrupt this process, resulting in infertility. The most common reason why women experience infertility is due to ovulation disorders. If you have an ovulation disorder, you may ovulate (a mature or immature egg) infrequently or not at all. Symptoms of ovulation disorders can include irregular or absent menstrual periods.

Problems with the regulation of reproductive hormones, such as with polycystic ovarian syndrome (PCOS), can also cause issues with ovulation. PCOS is the most common cause of female infertility. Problems in the ovary can cause ovulation disorders, such is the case with primary ovarian insufficiency (POI), in which a woman’s ovaries stop functioning normally before she is 40.

Less common causes of fertility problems in women include:

  • Blocked or damaged fallopian tubes – This can be due to several factors, including:
    • Pelvic inflammatory disease, an infection of the uterus and fallopian tubes due to chlamydia, gonorrhea or other sexually transmitted infections.
    • Surgery in the abdomen or pelvis, including surgery for an ectopic pregnancy.
    • Endometriosis, when uterine lining tissue develops outside the uterus, which can damage the fallopian tubes. Surgery to remove tissue outside of the uterus to alleviate pain can also cause scarring. Endometriosis can also disrupt the implantation of the fertilized egg in the uterus.
  • Physical problems with the uterus or cervix, due to:
    • Uterine polyps or tumors (fibroids or myomas), which are non-cancerous clumps of tissue and muscle on the walls of the uterus.
    • Uterine abnormalities present from birth, such as an abnormally shaped uterus.
    • Abnormal cervical mucus which can hinder how sperm travels through the cervix into the uterus.
  • Unexplained causes – Some fertility challenged couples will be told there is no explanation for why they can’t conceive. It may be important to note, however, that in many cases, the odds of conceiving on your own may be higher than it is for most infertility diagnoses.

Small Changes Can Make a Big Difference

Risk factors that are a result of certain lifestyle choices may put you at a higher risk of infertility. You can increase your chances of conception by following advice regarding basic lifestyle choices. These include:

  • Maintain a healthy body weight. Overweight and underweight women are at increased risk of ovulation disorders.
  • Exercise moderately. Overly excessive exercise has been associated with decreased ovulation.
  • Quit smoking. See Can Smoking Really Affect My Chances of Getting Pregnant for more info.
  • Avoid alcohol.
  • Avoid illicit drugs.
  • Reduce stress. Stress can make it more difficult to conceive and even affects men too. For more, read our Stress and Conception.
  • Limit caffeine. Reduce consumption to 1 to 2 cups of coffee per day or eliminate completely.

The main risk factor that you can’t control? Age. The quality and quantity of a woman’s eggs begin to decline with increasing age. For more information, read our article How Does Age Affect A Woman’s Ability to have a Baby?

Conception is Our Life

At Vios, we care about making your dreams of parenthood a reality. Not being able to conceive a child can be stressful and frustrating, but we are here to help and have a variety of infertility diagnostic tests and treatment options available.

To understand what infertility treatments may be best for your situation, contact us today to schedule an appointment.

Common Causes of Infertility

causes of infertilityAccording to The American Society for Reproductive Medicine, infertility is defined as the inability of a sexually active couple who are not using birth control to get pregnant after one year of trying, and for women who are 35 or older, that window shortens to 6 months. Causes of infertility can be due to the woman, the man, by both the woman and man, or due to unknown problems.

Out of the 15% of couples that have trouble getting pregnant, female infertility affects about 10% of women of reproductive age and approximately 7% of all men.

Common Causes of Infertility in Women

The most common cause of infertility in women is due to ovulation disorders, accounting for about 1 in 4 infertile couples. Every month during the female menstrual cycle, an egg is released from the ovaries into the fallopian tubes in a process called ovulation. Prior to being released, follicles – each containing an immature egg – in the ovaries must grow and develop into mature eggs. While a woman’s body has many immature follicles, each month only one becomes the dominant follicle that matures and is released during ovulation. For conception to be achieved, ovulation must occur.

If you have an ovulation disorder, you may have irregular or absent menstrual periods, meaning there is no egg (or an immature egg) available to be fertilized.


Polycystic ovary syndrome (PCOS) is the most common cause of infertility in women and is responsible for 70% of infertility issues in women who have difficulty ovulating. The condition is caused by problems with the regulation of reproductive hormones that results in a series of small cysts on the ovaries. PCOS is defined by an erratic menstrual cycle, meaning your periods can be irregular or even no period at all for a few months at a time. According to the PCOS Foundation, 10 percent of women of childbearing age are affected, but less than half are diagnosed.

The ovulation-inducing oral medications clomiphene citrate (also known as clomid) and letrozole are the principal treatments used to promote ovulation. For women not responsive to these medications, even with diet and lifestyle modification, there are additional treatment options available such as stimulating the ovaries to produce eggs with follicle-stimulating hormone (FSH) injections followed by an intrauterine insemination (IUI) or in vitro fertilization (IVF).


Problems in the ovary can also cause ovulation disorders, such as with primary ovarian insufficiency (POI), in which a woman’s ovaries stop functioning normally before she is 40. It’s less common than PCOS, affecting 1 in 100 women younger than 40, and the main cause is from hormonal imbalances. The first sign of POI is usually menstrual irregularities or missed periods. Additionally, some women with POI have symptoms like those experienced by women who are going through natural menopause.

For patients diagnosed with POI, the most common fertility treatment includes donor eggs. For young patients who are beginning to experience the symptoms of POI, fertility preservation may be an option.


Endometriosis is a disorder where uterine lining tissue develops outside of the uterus on the pelvic organs. The uterine lining continues to function like it would in the uterus by thickening and breaking down with each menstrual cycle. However, this displaced tissue has no way to exit your body which leads to pain, adhesions, and scarring. Endometriosis can affect the fallopian tubes, ovaries and other pelvic tissue which can affect your chances of conceiving. This can also disrupt the implantation of a fertilized egg in the uterus.

For women with endometriosis, there are different treatment options based on the severity of their disorder. It is also important to note that endometriosis may worsen with time and a consultation with a fertility specialist at a younger age can help guide the patient on their chances of success as they age.

Common Causes of Infertility in Men

Causes of infertility in men is usually due to deficiencies in the semen, such as low sperm production, abnormal sperm function or blockages that prevent the delivery of sperm. The following are some common male fertility conditions:

  • Varicocele – The most common (and reversible!) cause of male infertility is varicocele – a condition of swollen testicle veins that is present in about 15% of all men and in about 40% of infertile men.
  • Klinefelter Syndrome – a chromosomal defect that occurs in males early in the womb that results in smaller testes which reduces the levels of testosterone and sperm production that naturally occurs.
  • Immune infertility related to antisperm antibodies – when the immune system mistakes sperm for a harmful intruder cell and tries to destroy them is considered the cause of infertility in roughly about 20% of infertile couples.

There are several ways in which a male’s sperm production can be considered abnormal, the most common being:

  • Oligospermia – when there is a low concentration of sperm in the semen. Often, exhibiting a higher percentage of abnormal sperm cells.
  • Azoospermia – when there is no measurable level of sperm in the semen.
  • Necrospermia – when the sperm is either immobile or dead.

While published statistics tend to focus on the woman, it is important to note that male infertility diagnoses are just as common. In most cases, there is no obvious sign that a man is infertile without testing.

Unexplained Causes

Approximately 1 in 4 fertility challenged couples will be told there is no explanation for why they can’t conceive. It may be important to note, however, that in many cases, the odds of conceiving on your own may be higher than it is for most infertility diagnoses.

At Vios Fertility, Conception is Our Life

At Vios, we are here to make your dreams of parenthood come true. Not being able to conceive a child can be stressful and frustrating, but a number of infertility diagnostic tests and treatments are available. We work with you to show you your chances of success utilizing different treatment plans based on your specific medical situation. During your consultation, we will discuss your goals for family building, your medical history, and review needed fertility testing to determine the best treatment path for you.

To understand your specific options concerning fertility diagnosis and treatment paths, schedule a consultation today.