Category: Testing & Diagnosis

What is PCOS?

September is Polycystic Ovary Syndrome (PCOS) Awareness Month. To close out this month we are sharing some information on PCOS.

PCOS is a common hormone disorder in women that is also the leading cause of female infertility. According to Resolve, due to the wide variety of symptoms, most women don’t get diagnosed until they begin trying to conceive and seek help getting pregnant. PCOS is one of the most underdiagnosed diseases in the world, with less than 25% of women with PCOS being diagnosed.

PCOS is characterized by three common characteristics: irregular or absent periods, excess androgens (elevated testosterone and androstenedione levels), and multiple cystic areas on the ovaries.

Other seemingly unrelated PCOS symptoms that patients might experience include:

  • Infertility.
  • Heavy periods and spotting between periods.
  • Pelvic pain during or between periods.
  • Mood changes.
  • Weight gain.
  • Fatigue, or low energy levels.
  • Excess growth on the arms, face, back, chest, abdomen or hands and feet (also known as hirsutism).
  • Hair loss or male pattern baldness on the head.
  • Acne.
  • Insomnia or poor sleep.

Please contact Vios to schedule an appointment with one of our providers if you believe you have PCOS and need help conceiving.

Recurrent Pregnancy Loss: Moving Forward

The loss of a pregnancy is heartbreaking, but when this happens repeatedly, it can be devastating and confusing for the parents. A careful review of the circumstances and a comprehensive evaluation can often lead to a strategy with the outcome of a family.

Although random miscarriages are common, only 1-5% of people will suffer from repeated losses. According to American Society for Reproductive Medicine (ASRM), recurrent pregnancy loss (RPL) is defined as having three or more consecutive miscarriages. According to ACOG, about 5% of women have two or more consecutive miscarriages and 1% will have three or more. The risk of recurrent pregnancy loss is higher in women who are over the age of 35 or who have had a previous miscarriage.

What causes RPL?

Most recurrent pregnancy losses result from chromosomal or genetic abnormalities. The abnormality may come from the egg, the sperm, or the early embryo. Ovarian aging can also be associated with an increased risk of miscarriage, which is due to poor egg quality. As woman age their eggs decrease in quantity and quality.

Another factor could be an abnormality in the uterus. Some women may be born with an irregularly shaped uterus and some women may develop abnormalities with their uterus over time. Another possibility is scar tissue that has developed from previous procedures.

If you have suffered two or more miscarriages, you should talk with your provider. Your doctor might suggest one of these treatments to help reduce your risk for miscarriage.

Surgery

  • Surgery can fix some problems like extra tissue in the uterus, fibroids, or scar tissue. Correcting the shape of the inside of the uterus can often lower the chance for miscarriage.

Genetic screening

  • In about 5% of people, one of the parents has a chromosomal issue. The parents’ blood can be analyzed to see if this is a factor.

According to Dr. Mackenzie Purdy, MD, 60-70% of patients will go on to have a live birth. You can learn more about recurrent pregnancy loss here.

Contact us today to speak to a provider about recurrent pregnancy loss.

What is Male Infertiliy?

Infertility is a common problem among couples, and while we talk about it as a women’s issue, men deal with it too. Infertility due to the male partner is known as “male infertility.”

Fertility issues are just as likely to come from problems in men as they are in women. According to the Dr. Shannel Adams MD, FACOG, it is estimated that 30-40% of couples struggling with infertility have a contributing factor of male infertility. While it is estimated 20% of couple’s struggling with infertility male infertility is the only factor. Male infertility is defined as abnormal sperm count and lack of pregnancy after one year of trying. Usually, that inability to sustain a pregnancy is a problem with the sperm count, motility, or morphology. In addition to the number of sperm a man has, the shape and movement or swimming of the sperm is also important. A problem in one of these three areas can cause male infertility.

What is a normal sperm count?

A sperm sample should contain millions of sperm. Because of this, sperm is measured in ‘concentrations.’ Normal sperm concentration come in a wide range, but 15 million sperm per milliliter is a good benchmark.

What about sperm motility?

High ‘swimming’ sperm count is also important. A portion of your sperm will swim, and it is the swimming sperm that increase your chances of achieving a pregnancy.

What is a normal sperm morphology?

Sperm are very tiny. Morphology refers to the size and shape of the sperm. Sperm must be a certain shape to penetrate an egg. You want 4% of your sperm count to be a normal shape.

To learn more about what is considered normal sperm watch Dr. Erica Louden, MD, PHD explain it all here!

A semen analysis will provide information on your sample discovering if there are any issues with count, motility, or morphology. A semen analysis is a laboratory evaluation of the semen after it has been collected at home or in the clinic. Learn more about a semen analysis and what a normal SA is here. Once results from the semen analysis are in, you and your physicians can discuss your options. Here are some available:

  • Sperm freezing can preserve high quality sperm.
  • Sperm donor
  • IVF and gestational carrier can provide an option for couples, especially same sex male couples, to have the families they’ve always dreamed of.

To learn more about male infertility or to get a semen analysis, contact us today!

Get a ‘Pulse’ On Your Fertility Health

Knowing your fertility health is an important step in your journey to start a family. As women age, the quality and quantity of their eggs decrease, this is known as Diminished Ovarian Reserve.

Diminished Ovarian Reserve presents no symptoms but nearly 10% of women suffer from it. The most common factor in a woman suffering is being over the age of 35. Other factors that can contribute include endometriosis, surgery for ovarian cysts or tumors, cancer treatments, and smoking.

The Vios Pulse Wellness Check Up provides an insight into your fertility healthy. For $99 you will receive bloodwork, an antra follicle ultrasound, semen analysis, and a consultation with a provider to go over your results

Schedule your Vios Pulse Fertility Wellness Check Up, contact us today!

Learn more about our Vios Pulse Wellness Check Up from Dr. Ellen Hayes and Dr. Mackenzie Purdy in the below video.

Miscarriage Treatment Options: Dr. MacKenzie Purdy Answers Your Questions

Miscarriage is a heartbreaking reality for many as they try to conceive and, sometimes, a woman can experience multiple miscarriages in a row.

Recurrent Pregnancy Loss (RPL) is defined by the American Society for Reproductive Medicine (ASRM) as two or more consecutive pregnancy losses. We know this is a heartbreaking loss and we are committed to helping our patients find answers and treatment options to help.

The first step is a series of diagnostic tests to understand what may be causing the miscarriages. There are some common causes of RPL including genetic, hormone imbalance, uterine abnormality, and undiagnosed medical conditions. Some reasons remain unknown despite the myriad of available testing options.

Dr. MacKenzie Purdy, a Vios physician in our St. Louis region, spoke with FOX2 in St. Louis about miscarriage and recurrent pregnancy loss. Watch for more information about diagnosis and testing as well as various treatment options for RPL.

After the interview, Dr. Purdy answered patient questions on the topic during a Facebook Live.

Ovarian Reserve and Your Fertility

As fertility specialists, we’re asked a lot about ovarian health and ovarian reserve – specifically egg quantity and quality.

A woman is born with all the eggs she’ll ever have. At birth, a baby girl typically has about 1 million eggs and by puberty this number has declined to 500,000. Each month, a handful of eggs are eligible to become mature but only one will be ovulated. (For a detailed description of this process, click here.)

Ovary with ovulation

Age is one of the most important factors in a woman’s fertility potential. Yet, there is no “magic” age and recent studies show that genetics and the environment also play an important role in egg and reproductive health.

Anti-mullerian hormone (AMH) and antral follicle count (AFC) are the most useful predictors of the number of eggs a woman has remaining. Bloodwork and ultrasound tests – along with a conversation with a reproductive endocrinologist and infertility specialist – can help you understand your current ovarian reserve.

Dr. Violet Klenov recently shared information about ovarian health, how to determine the number of eggs you may have, and how to improve egg quality with St. Louis’s Fox2. Watch the full story below.

Additionally, Dr. Klenov answered patient questions on this topic. Click below to watch the Q&A.

To schedule a consultation to take control of your fertility health, contact us today.

How to Treat Infertility

how to treat infertilityIf you are experiencing infertility, you are not alone. Many people wonder how to treat infertility, especially if they’ve received the diagnosis. You aren’t alone. One in eight couples experience trouble getting pregnant or carrying a pregnancy to term. Infertility is defined as being unable to achieve pregnancy after one year if a woman is under 35 years of age, and after six months if a woman is over 35 years of age. While published statistics tend to focus on the woman, it is important to note that infertility diagnoses are split evenly between men and women and there is an abundance of resources and support that are available to you.

It takes the average couple at least six months to become pregnant. Before seeing a specialist, it is recommended that couples try on their own first. For couples where the woman is under 35, it is recommended that you try for one year. In couples where the woman is over 35, it is recommended that you try for six months.

While these are general guidelines, there are situations where immediate consultation is warranted. If you have irregular or no menstrual cycle, are experiencing heavy, painful periods, or abdominal pain you should schedule an appointment immediately. If you are approaching your mid-30’s and want to have several children a fertility consultation will allow a specialist to project your chances of conceiving at an advanced age based on when you would be trying to conceive subsequent children.

Fertility Treatments

Diagnosis comes before treatment. Read our blog article Common Infertility Diagnoses for more information on common diagnoses couples receive, or visit our Diagnostic Testing page to understand what different testing entails.

Our physicians work with you to understand your goals and develop a plan to meet them. Infertility treatments can take on many forms, and while most people think “IVF” when someone says, “infertility treatments,” there are many varying degrees of how to treat infertility.

From the basic treatments to the more advanced treatments, there are several different options with several varying protocols that can be tailored to your specific situation to help you grow your family. Treatment paths can also include the use of 3rd party reproduction options or those looking to preserve their future fertility for social or medical reasons.

Basic Infertility Treatments

Timed intercourse is the simplest answer to how to treat infertility that a couple can receive. With a limited timeframe for fertilization to occur, it is important to have intercourse at the appropriate time. Monitoring occurs to track approximately when you will ovulate, so you have a greater potential for fertilization.

If a woman’s menstrual cycle is irregular, she may not be ovulating on a consistent basis or even at all. Ovulatory disorders are one of the most common causes of infertility and account for infertility in 25% of couples. If a woman is not ovulating, we can use a combination of ovulation induction (fertility) medications to help grow follicles and time the release of the egg so that intercourse can be planned to increase the chances of fertilization.

Intrauterine Insemination (IUI), formerly called artificial insemination, is accomplished by placing highly concentrated sperm directly into the uterus to increase the chance of conception by increasing the number of sperm that reach the fallopian tubes. An IUI is the first step in fertility treatment for many couples. It is a less costly and more conservative fertility treatment option that works for a lot of couples. This form of treatment is commonly used for couples with unexplained infertility issues, ovulation disorders, mild endometriosis, and mild male infertility issues with sperm or erectile dysfunction.

Advanced Infertility Treatments

In vitro fertilization (IVF) is an assisted reproductive technology in which eggs are retrieved from a woman and inseminated with sperm from a man in a laboratory to create embryos. After closely monitoring embryo development, one or multiple embryos are transferred to the uterus of a woman. Since the first successful procedure in 1978, over 5 million babies have been born worldwide through IVF treatments. In vitro fertilization is the most common fertility treatment utilized by patients today.

Fertility preservation is an option individuals or couples can choose for social reasons (waiting to have children) or when medical treatments or procedures may harm one’s fertility. Fertility preservation options include egg freezing, sperm freezing, or embryo freezing. Women and men may consider fertility preservation for medical reasons for one of the following circumstances:

  • Cancer Diagnosis – For women and men who have been diagnosed with cancer, egg freezing, sperm freezing, or embryo freezing are options that can protect one’s eggs and sperm prior to chemotherapy, radiation or surgery, all of which can be toxic to both eggs and sperm.
  • Premature Ovarian Insufficiency (POI) – For women who have been diagnosed with premature ovarian insufficiency, early menopause, or have a genetic predisposition to early menopause, fertility preservation is another option to preserve viable eggs or embryos for future use.
  • Autoimmune Disease – Women with chronic autoimmune diseases such as rheumatoid arthritis and lupus may choose fertility preservation due to medications that they need to use, that could potentially harm the ovaries and cause infertility.

At Vios, Conception is Our Life

At Vios, we are here to make your dreams of parenthood a reality. 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 what infertility treatments may be best for your situation, contact us today to schedule a consultation.