Category: Female Fertility

Understanding the Risk of Ovarian Hyperstimulation Syndrome

ovarian hyperstimulation syndromeAre you experiencing ovarian hyperstimulation syndrome with fertility treatment? As with any medicine or medical treatment, fertility medication comes with its own set of side effects that vary from person to person. In most cases, they’re on the minor side – issues like bloating, headaches, and mood swings, which are understandably uncomfortable, but nothing worse than what you’ve experienced around your period.

But in some cases, particularly with ovarian hyperstimulation syndrome (OHSS), the side effects can be severe, putting your overall health at risk. OHSS, which occurs when medication overstimulates and enlarges your ovaries, requires monitoring by your physician to ensure symptoms don’t get worse and to relieve you of any pain and discomfort you may be experiencing.

While ovarian hyperstimulation syndrome sounds scary, there’s no reason to panic! Only 10% of patients experience OHSS, and in most cases, the symptoms are mild. Your physician will go over all the details of OHSS and monitor you from day one to reduce your risk. But doing a little research first on your own can help you prepare for the unexpected.

What is OHSS and What Are the Symptoms?

Fertility drugs like gonadotropins were developed to stimulate your ovaries in order to produce an egg. But sometimes they can do too good of a job. Overstimulation can lead to ovarian hyperstimulation syndrome, causing the ovaries to swell and fluids to leak into the belly and chest. If you get OHSS, you may notice one or more symptoms:

  • Weight gain
  • Decreased urination
  • Problems breathing
  • Bloating and abdominal comfort
  • Nausea or vomiting

In severe cases, ovarian hyperstimulation syndrome can lead to blood clots, kidney dysfunction, twisting of an ovary, fluid collections in the chest, stroke, and rarely death. But again, severe instances are uncommon with only one percent of OHSS patients requiring hospitalization or invasive treatment.

Women who have a low body weight, have polycystic ovarian syndrome (PCOS), or have an excessive number of ovarian follicles develop are at a higher risk of developing OHSS.

What Happens When You’re Diagnosed with OHSS?

ovarian hyperstimulation syndrome symptoms appear a few days after ovulation is triggered and usually go away within a week or two unless  pregnancy occurs. If you do become pregnant, you can expect your symptoms to stick around for a few more weeks until they resolve on their own.

OHSS requires close monitoring by your medical team, which can include ultrasounds, blood tests and medical evaluations. If symptoms become too severe, certain medications can help treat the condition. If OHSS doesn’t resolve or becomes worse, treatment cycle will need to be canceled to protect the health of mom and her future baby.

How is OHSS Treated?

There’s no cure for ovarian hyperstimulation syndrome. The best way to alleviate the symptoms is good old rest and plenty of salty snacks. Before taking any of the following steps, it’s important to get clearance from your physician first:

  • This is one time where you can lose the eight glasses a day of water rule. Stock up on fluids with electrolytes and salt, such as Gatorade and V8, and salty foods like tomato soup, pretzels and (yes!) potato chips.
  • In addition to drinking plenty of fluids, eat raw fruits and vegetables and high-fiber cereals to avoid constipation.
  • Avoid bed rest during the day and do some light physical activity, such as taking a slow walk. Pass up activities like running or jumping, don’t lift anything over five pounds, and keep kids and pets from pushing on your stomach.
  • Maintain pelvic rest and skip out on sex for now. If you end up in the emergency room for any reason, do not allow anyone to perform a pelvic exam before talking to your physician first.
  • Keep an eye out for signs of severe OHSS, including extreme bloating, reduced or dark urine, constipation lasting three or more days, nausea and/or vomiting, shortness of breath, and pelvic pain.

The journey to become pregnant doesn’t always offer the easiest path. During your care, you may experience a variety of side effects along the way you can’t always control, but can possibly monitor and treat. To help prevent ovarian hyperstimulation syndrome, be sure to follow all of your physician’s instructions and let them know right away if anything feels “off” once your medication kicks into action.

Ready for Help with Fertility?

If you still have questions, we are here to help and take away the uncertainty and stress that can make daily life challenging when you want a baby and it’s not happening. Contact us today to schedule an appointment.

Why Can’t I Get Pregnant Now?

get pregnant now

If you and your partner have been trying to conceive and feel frustrated and confused about you can’t get pregnant now, we’re here to help ease your stress by sharing valid medical information and helpful tips. We want you to know our family of fertility doctors is here for you if you need us.

If you’re panicking and asking yourself, “Why can’t I get pregnant now?” there are several factors that may give you some peace of mind. One is that even when both partners are young and healthy it’s not always easy to conceive.

There is a common misconception that it’s easy for women to get pregnant on the first or second try, and that is not the case. It takes the average couple six months to a year to get pregnant.

When to Seek Help

If the female partner is less than 35 years old and you have been trying for 12 months, or if she is greater than 35 years old and you have been trying for 6 months, or if there is reason to suspect an issue with ovulation, fallopian tubes/uterus, or sperm, it is recommended you seek a fertility evaluation. When seeking a fertility consultation, first, take a deep breath and know that there is hope – there are plenty of avenues to pursue in your quest to build your family. You are not alone on this journey.

Approximately 7.4 million women in the U.S. experience infertility. While published statistics tend to focus on women’s infertility, it is important to note that infertility diagnoses are split evenly between men and women.

Most Common Reasons for Infertility

Let’s examine the most common reasons behind why you may be having trouble getting pregnant. As you will see, many of these reasons pertain to men and women.

  • Irregular or absent periods
  • You don’t ovulate, or you have polycystic ovary syndrome (PCOS) which affects 5-10% of women
  • Being overweight, obese, or underweight
  • Endometriosis (causes infertility in 30-50% of women)
  • Prior fibroid diagnosis
  • A thyroid issue
  • Smoking and unhealthy lifestyle habits
  • Prior surgical history on the tubes, ovaries, or uterus
  • Age – egg counts are constantly diminishing, making it harder for a woman in her mid to late 30s or early 40s to get pregnant
  • Infection or inflammation in the prostate glands
  • Prior surgical history on the testes
  • Issues with erection or ejaculation
  • Family history of genetic disease
  • Male partner is undergoing testosterone treatment
  • Repeated pregnancy loss or miscarriage
  • A vasectomy or tubal ligation has been performed

Next Steps to Conception

In our practice, we recommend couples under the age of 35 keep trying for a year. There are ovulation calendars and kits that can help you track your cycle and know when to time intimacy. And, yes – it’s okay to have sex daily if you want, but it’s not necessary to conceive. There is a myth that daily intercourse lowers your chances, and it is just that – a myth.

Other options to optimize men’s and women’s fertility include:

  • Track your cycles – there’s an app for that! We recommend Glow, an app for fertility and more.
  • Eat a well-balanced diet.
  • Get daily exercise.
  • Start folate supplements 2-3 months BEFORE you try to conceive.
  • Limit alcohol and caffeine.
  • STOP SMOKING (associated with a list of infertility problems).
  • If you are overweight, losing just 5-10 pounds can make a difference.
  • Get a physical; check blood work for thyroid, anemia, or other issues.
  • Make sure vaccines are up to date.
  • Lower stress as much as possible

And lastly, try not to make everything about getting pregnant. It will create stress in your relationship and in your life. Go about your days as normally as possible, with an emphasis on self-care and spending quality time with your partner without it having to end in sex. Taking time to get a massage or treating yourself to a relaxing bath can go a long way to lowering stress so your body can function at optimal levels.

Ready for Help with Fertility?

If you are younger than 35 and aren’t pregnant in a year, over 35 and aren’t pregnant in 6 months, or if you’re having irregular cycles, plan to see your doctor. Around 85% of couples who are trying will be pregnant within a year, so if you can’t get pregnant now, it could be a sign that something medical is preventing you from conceiving and you may need extra help to achieve your goals of a family.

Fortunately there are fertility specialists, like all the physicians at Vios, who have received special training to help couples conceive. Treatments range from pills and shots to inseminations and in vitro fertilization. Most couples can conceive without IVF, so don’t let that be a barrier to seeking a medical evaluation.

If you still have questions about why you can’t get pregnant now, we are here to help and take away the uncertainty and stress that can make daily life challenging when you want a baby and it’s not happening. Contact us today to schedule an appointment.

What’s the Difference Between a Traditional Surrogate and a Gestational Carrier?

gestational carrierMany people have heard the term “surrogate” when it comes to family planning, but few are familiar with the term “gestational carrier.” In both cases, a woman is using her uterus to carry a child for another family, but there’s a big difference between the two.

Surrogates and gestational carriers may be different, but they have two incredible things in common – a generous heart and extraordinary selflessness to grant a family facing infertility the gift of a child of their own.

Why a Family Needs a Surrogate

If a couple is unable to conceive or the woman is unable to carry a baby, a surrogate can step in to help them become parents. Prospective moms and dads may reach out to a friend or loved one to carry their child, but in most cases, they’re connected to a surrogate through an agency. All surrogacy agencies provide extensive screening of potential candidates through medical and psychological testing, and in fact, almost 98% of women who apply are rejected for various reasons.

What is a Traditional Surrogate?

The type of “surrogate” most people think of and a potentially more affordable option for parents-to-be is a traditional surrogate in which the surrogate donates her egg AND carries the pregnancy. With a traditional surrogate, pregnancy can often occur with intrauterine insemination (IUI), in which the male partner’s sperm is injected into the surrogate’s uterus.

The surrogate’s medical expenses are covered by the intended parents and, depending on the situation, she is compensated for carrying the pregnancy. While it can be less expensive, traditional surrogacy can open the intended couple up to heartbreaking legal ramifications. The surrogate is the biological mother of the child she carries, and if she decides she wants to keep the baby, the intended parents may have no legal recourse. Even if a legal contract is in place prior to conception (which we require), laws in many states may allow for the surrogate to fight for custody of the child. For this reason, we strongly advise patients to use a gestational carrier instead of a traditional surrogate.

What is a Gestational Carrier?

In a gestational carrier situation, the egg can come from the intended mother, be donated by a loved one, or acquired through an egg bank. The egg is fertilized with the male partner’s sperm or with donor sperm before it’s transferred to the carrier’s uterus through in vitro fertilization (IVF). Because the egg is another woman’s, the carrier has no genetic relation to the baby she is carrying.

More and more couples are turning to a gestational carrier to make their dream of parenthood come true. According to the Society for Assisted Reproductive Technology (SART), the number of babies born to gestational carriers grew 116 percent between 2004 and 2011.

As with traditional surrogates, the gestational carrier’s medical expenses are covered by the intended parents and the carrier is usually compensated for carrying the pregnancy.

To protect all parties involved, we require all intended parents and gestational carriers to seek legal counsel from a reproductive lawyer. A contract is drawn up with the expectations and rights of each party, as well as details on the delivery and future contact. The reproductive lawyer will also provide guidance on what states have laws regulating surrogacy and what states should be avoided due to negative or non-existent statues. It is strongly encouraged that the gestational carrier and intended parents have separate reproductive lawyers to minimize potential conflicts of interest.

Ready for Help with Fertility?

If you have questions about surrogacy or would like to discuss your options with a reproductive endocrinologist and infertility specialist, contact us today to schedule a consultation.

Why Choosing a Reproductive Endocrinologist and Infertility Specialist May be the Best Decision for You

reproductive endocrinologistWhen it comes to your family, you only want the best. And when it comes to starting a family, your best option is a fellowship trained, board eligible/certified Reproductive Endocrinologist and Infertility Specialist, or REI.

For individuals and couples facing infertility – those who still aren’t pregnant after 6-12 months (depending on the woman’s age) or facing multiple miscarriages – an REI can provide the hope and experience to help get them closer to parenthood. Highly specialized and trained, REIs combine 11 years of post-graduate instruction with ongoing education in the latest fertility treatments and technologies to deliver the ultimate in patient care.

If you’re considering taking the next step in your fertility treatment, learn why you need to add an REI to your team.

What Exactly is a Reproductive Endocrinologist & Infertility Specialist?

As an experienced fertility specialist, an REI focuses on the causes and diagnosis of a variety of fertility issues, ranging from polycystic ovary syndrome (PCOS) to endometriosis, and offers cutting-edge treatment options, including in vitro fertilization and intrauterine insemination.

In addition, an REI can offer preimplantation genetic diagnosis and screening to help lower the transmission of a life-altering genetic condition as well as egg freezing and preservation to give patients a greater chance of conception if they wish to wait to become parents.

How Much Training Does a Board-Certified REI Receive?

The road to becoming an Reproductive Endocrinologist and Infertility Specialist is a long one, but the end benefits to the patients are worth every long day and late night.

After graduating medical school, an REI completes a four-year residency in Obstetrics and Gynecology. Only then can they compete for a highly-coveted, three-year intensive fellowship in Reproductive Endocrinology where they receive rigorous training focused on the female reproductive system and the issues that can affect it. To receive their board certification, they must pass both an oral and written REI sub-specialty examination, the gold standard in their field.

Even when a physician becomes board-certified, the training doesn’t end. All board-certified REI’s must complete the Maintenance of Certification (MOC) program every year as well as pass a written exam every six years to ensure they’re on top of the latest scientific and technological advancements in fertility treatment. Research has found that physicians who complete their MOC every year communicate better with their patients and deliver higher quality care.

So, Why Go with an REI Instead of an OB/GYN for Continued Treatment?

An OB/GYN is multi-faceted, offering medical and surgical treatments for a number of conditions as well as prenatal and postnatal care. However, most OB/GYNs have received only a minimum amount of infertility training during their residency. They can prescribe medications, like Clomid, and in some cases, offer IUI services. But in most instances, when treatment doesn’t result in pregnancy, the next step is a referral to an REI. Together, your OB/GYN and Reproductive Endocrinologist and Infertility Specialist will work in conjunction to help deliver the best result for your treatment, in this case, a healthy, full-term pregnancy.

Connecting You to A Qualified REI

Each of Vios Fertility Institute’s clinics is staffed with experienced REIs dedicated to your care and treatment. To schedule a consultation, contact us today!