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Lifestyle factors such as diet, exercise, stress, and occupational and environmental toxins can all affect fertility in both men and women. The good news is that simple new tests can determine if these factors are negatively affecting your fertility:
Diet – Any diet that severely restricts—or promotes—the consumption of fats, carbohydrates or proteins can through off the body’s nutritional balance. Aggressive calorie-restricted diets can too. Insulin/glucose intolerance may also be a condition you may have developed that can impact fertility.
Exercise – Moderate exercise on most days of the week is a good rule of thumb for any healthy, active adult. However, excessive training forces the body to put more resources into “healing” and building muscle tissue than it would normally do otherwise.
Stress – Medicine has long noted a link between emotion and health. Job turmoil, the death of a loved one, even travel that results in jet lag and a lack of sleep can put undue stress on the body affect conception.
Toxins – The world we live in is full of toxins both on the job, in our recreational hours and in our diets. Auto mechanics, hair stylists, dry cleaning workers and anyone who works with glues or solvents are particularly at risk of suffering adverse affects. Hobbies that use glue, such as model builders or auto racers, are likewise prone to affected fertility. The use of drugs or alcohol, as well as excessive use of caffeine, can also negatively impact the ability to conceive a healthy baby.
New tests allow doctors to determine if lifestyle factors may be a cause of infertility.Dr. Zarutskie will be discussing this more in depth during a special presentation on Thursday, August 23 at 6 pm at the Zarutskie Fertility & Endocrine Institute. For reservations, call (949) 448-7818.
Pregnancy loss, or habitual miscarriage, can be defined as miscarrying more than twice in a row prior to 20 weeks. Repeated miscarriages indicate a woman's inability to complete a pregnancy and the need to undergo a series of tests under the care of a reproductive endocrinologist/gynecologist.
Women with no history of full-term pregnancies suffer from primary repeated miscarriage, which occurs in about one in six normal pregnancies. In most cases of repeated miscarriage, the cause can be identified but in a small percentage of cases, nothing is ever determined to be the definitive cause. Women who have suffered as many as six or seven miscarriages, however, can go on to have a successful pregnancy.
The causes of repeated miscarriage fall into 6 areas: infections (bacterial/viral), hormonal (luteal defects), structural (malformation/scarring/polyps/incompetent cervix), immunological (antibodies to pregnancy), medical conditions (diabetes/thyroid/ insulin resistance/glucose intolerance), and genetic (translocation defects/aneuploidy). Exposure to toxins can also contribute to repeated miscarriage, but these are usually discovered before a second miscarriage.
Tests to determine the causes of habitual miscarriage include various laboratory tests looking to identify hormonal, medical, immunological conditions, radiological test, a hysterosalpingogram,office evaluations, endometrial biopsy/ ultrasounds,and surgical evaluations, hysteroscopy/laporoscopy.
For more information, visit www.zinstitute.com
There is now a new technology that allows women to have more control over their fertility. Oocyte cryopreservation is a process through which a woman can freeze a quantity of her healthy, viable eggs for use in attempting pregnancy at some point in the future. Because the quality and quantity of a woman’s eggs deteriorates over time, oocyte cryopreservation allows a woman to defer pregnancy until she is ready to become a parent. This technology is especially useful for young women undergoing treatment for cancer or other conditions in which treatment may affect fertility.
There are important caveats for women considering oocyte cryopreservation. Because the fertilization and implantation rate utilizing frozen eggs is about half that for fresh eggs, achieving pregnancy will be more difficult. There also appears to be a higher risk of birth defects in babies conceived with cryopreserved eggs, and the long-term health effects in these children are not fully understood. Therefore, a woman must recognize that cryopreservation of her eggs may not achieve a viable pregnancy.
However, new cryopreservation techniques such as fast-freezing help circumvent the damage to eggs, leaving them more viable. Intracytoplasmic sperm injection (ICSI) helps facilitate the fertilization of thawed eggs.
The Zarutskie Fertility and Endocrine Institute is one of the few fertility centers in Orange County that is exploring offering this enhanced technology. If you feel could benefit from this technology, we can help you make an informed decision on whether oocyte cryopreservation is the right option for you.
Acupuncture has been used for thousands of years to help women
conceive and maintain healthy pregnancies. Modern research has shown that, when
done properly, acupuncture can more than double your chances of getting pregnant
with IVF. Research has also shown that acupuncture can increase uterine and
ovarian blood flow, increase uterine lining thickness, decrease the incidence of
ectopic pregnancies, reduce the risk of miscarriage and improve the response to
IVF medications.
How Many Sessions Do I Need?
During an IVF cycle, typical protocols range from two to ten
acupuncture treatments. The number of treatments varies according to your
medical history. To maximize your chances of success, we recommend addressing
any pre-existing imbalances prior to IVF. Because some imbalances may take
several months to correct, having a comprehensive evaluation well in advance of
your IVF cycle is advisable. Dietary and lifestyle changes may also be
necessary.
Are There Other Benefits?
Many patients report feeling more relaxed both during and after IVF
procedures. there are also frequent reports of improved energy levels and a
sense of well being. Side effects of IVF medications (e.g. headaches, bloating,
cramping, insomnia, etc.) are often minimized or alleviated.
The Zarutskie Fertility and Endocrine Institute is now offering
acupuncture in conjunction with infertility services. For more information, log on to www.zinstitute.com.
By Paul W. Zarutskie, M.D.
As new infertility treatments and technologies have emerged, so have ethical concerns about the status of the embryos that result from medical intervention. The debate is centered on the different points of view on when life actually begins: does it begin at conception, or at a later point in gestation?
Until the late 19th Century, the Catholic Church, for instance, followed THE BREATH of LIFE Doctrine in which the Soul goes through developmental stages from “nutritive”(as the unformed embryo), to a “sensitive” (development of physical form) to “rational” (recognizable human). The rule was that the fetus has no soul until “animation,” which typically occurs 4o days post-conception.
However, that view has changed in that scientists are using conception as the landmark for the beginning of life. This in turn could explain the condemnation of the creation of embryos, ART technologies, and stem cell research. One area of treatment in which these issues must be addressed is Preimplantation Genetic Diagnosis (PGD). Use of this scientific advancement---PGD—has brought the “beginning of life” issue to the forefront.
Arguments for PGD focus on the usefulness of PGD as a diagnostic tool for patients with poor ART outcomes (advancing maternal age, prior failed IVF, habitual miscarriages, male factor). PGD increase implantation rates and decreases incidence of spontaneous abortions. It also lowers the risk for delivery of a child affected by genetic abnormality
Arguments against PGD focus on the limitations of technology that lead to errors in defining abnormalities. There is also a risk of damage to biopsied embryos, as well as the fear that selection of embryos leads to a concept of “designer genes.”
Conclusions
The development of PGD technologies is spawning a moral debate on the role of technology in providing improved health care. It is the responsibility of the physician counseling patients to be a moral agent providing informed consent on the cost/benefit ratio, outcomes, and expectations of using a specific treatment modality. In addition, healthcare professionals, patients,and society in general must make decisions that promote the health and well-being of the patient and that honor the integrity of all participants in the decision making process.
By Paul W. Zarutskie, M.D.
Acupuncture and herbal medicine can have a profound impact on fertility results. The goal for each patient is to achieve conception, access healthy prenatal care in conjunction with Western specialists, and experience a successful postpartum recovery. Certain male factor infertility is also treated with much success, such as low sperm count, morphology, quality, and motility. Men as well as women experience stress, fatigue and seemingly unrelated issues which, if treated, can enhance fertility results.
Allopathic practitioners are seeing improved success rates in fertility, conception, pregnancy, and birth outcomes. This has opened the door for increased use of TCM in conjunction with the assisted reproductive technologies (ARTs). The successes have been extremely favorable and more study is both necessary and underway. Acupuncture and herbal medicine is multifaceted, treats the root cause of disease and focuses on imbalances within the whole person. This includes most causes of infertility, except structural problems such as uteine scarring.. The body's ability to correct imbalances is not yet fully understood by Western scientific thought. Although many TCM clinical studies are limited, many do demonstrate TCM's ability to affect infertility treatment.
Acupuncture
The use of acupuncture as an adjunct treatment for infertility has gained popularity in the last decade, although its role is the subject of much discussion. Acupuncture enhances infertility treatment in three primary ways: it lowers stress, improves blood flow to the ovaries and the uterus helps regulate hormones, which improves egg quality. A recent study also demonstrated that acupuncture, in conjunction with IVF, significantly increased birth outcomes, significantly decreased ectopic pregnancies and miscarriage rates, demonstrating that patients with a good prognosis may also benefit from acupuncture.
Chinese Herbs
Herbs can be safely used during conception, pregnancy and post–partum recovery. The goal is to work with Western medicine to fortify, balance and strengthen the body. Many studies demonstrate the effectiveness of herbs for various purposes for infertility, and maximum health. They can also lead to improved egg quality when taken over a period of time.
By Paul Zarutskie, M.D.
Infertility affects both men and women equally, with about half of all cases of infertility attributed the male partner, and about 20 percent of all cases are caused by a combination of male and female factors. Effective diagnostic and treatment techniques can improve the chances of conception for those couples where male infertility is a factor.
Causes
A variety of conditions can lead to male infertility, including problems with sperm production, blockages of the vessels that deliver sperm, hormonal disorders, and problems within the testicle itself.
A man's health history and lifestyle can also affect his fertility. A history of drug, alcohol or cigarette use, viral infections after puberty, previous urologic surgery, prostate infections, a history of sexually transmitted diseases and current medications can all impact sperm production or delivery.
Diagnosis
The following diagnostic steps are used to assess a man’s fertility:
1. A complete history and physical exam
2. Computer-Assisted semen analysis
3. Blood tests to measure hormone levels
4. Genetic assessment of the male, looking for specific gene defects
5. Sperm decondensation/fragmentation testing
Treatment
Treatment will depend on the causes of the man's infertility. Surgical therapy, treatment with medications, and assisted reproductive technologies (ART) can all help achieve pregnancy.Some useful ART techniques include:
Intrauterine Insemination (IUI) - IUI involves the placement of large numbers of healthy sperm inside the uterus during the most fertile time of the woman's cycle. It is performed in a physician's office without anesthesia.
In Vitro Fertilization (IVF) - IVF involves placing the couple's sperm and egg together in a laboratory dish to fertilize in vitro, or outside the woman's body. The fertilized eggs are then placed back into the uterus.
Intracytoplasmic Sperm Injection (ICSI) - This laboratory technique injects a single sperm into the woman's egg, bypassing the need for sperm to swim through the reproductive tract, locate the egg and penetrate it. This technique is useful for men with a low sperm count.
Sperm Aspiration Techniques MESA/PESA/TESA - These procedures require surgical recovery of the sperm from the male and can recover sufficient number of sperm for ICSI.
For more information or an appointment, please call (949) 448-7818.
At the Z Institute, we believe good communication is key to providing high quality patient care. That is why we have created this blog: to allow current and future patients to get a sense of who are and what our philosophy of care really is. Here is how we have recently defined our Comittment to Patients:
At the Zarutskie Fertility and Endocrine Institute, we are committed to providing the highest level of compassionate care to our patients and providing a full range of treatment and family building options. We accomplish this by:
- Conducting a thorough medical evaluation for every patient in order to create an individualized treatment plan to help our patients become parents
- Empowering patients to make informed treatment decisions by providing accurate information and education on all aspects of their care
- Providing the highest level of patient care delivered by our knowledgeable, compassionate and caring team of medical professionals
- Adhering to the highest medical ethics and standards for privacy and disclosure of success rates
- Maintaining participation and full accreditation and compliance within the reproductive health community.
- Treating patients, visitors, vendors and fellow employees with dignity and respect
- Maintaining the highest level of compliance with practice policies and procedures
We encourage our patients to ask questions about any aspect of their treatment. Our goal is to assist couples who are struggling with infertility to become parents, and to help those who are dealing with reproductive health issues such as endometriosis or PCOS to live more normal lives.
Call us at 949-448-7818! We look forward to hearing from you.
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