Monthly Archives: January 2009

Dietary Modification and Exercise

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The “EZ Diet” is a dietary modification plan that has been gaining momentum over the last few years. Many people are completely unaware that dietary modification can lead to weight loss and improved fertility. Weight loss has many other benefits including prevention of cardiac diseases, reducing the risk of diabetes, and improving a person’s mood and energy levels. Dr. Zeringue has been working with infertility patients struggling to lose weight for many years. After gaining a detailed understanding of how the body regulates weight and other diseases, the diet modification plan has evolved into its current form. Nicknamed the “EZ diet”, many people have very successfully lost weight and maintained this weight loss.

There is no magical formula for weight loss, but there is real science. By gaining a better understanding of what foods do to a person’s body, Dr. Zeringue has found that most people are more committed to sticking to the diet. Doctors already know that most any diet plan will work if people stick to the diet. Most people want to lose weight or eat better, but finding reliable information can be difficult. Dr. Zeringue has performed community service lectures to help educate the public about a healthy diet plan and long term compliance. These seminars are free to the public and there are no products to purchase and no sales gimmicks.

For more information visit: http://californiaivf.com/Diet-weight-loss-insulin-IGF.htm

Hyperinsulinemia & Insulin Resistance

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Diagnosis: The diagnosis of insulin resistance implies you have a disorder in tissues such as muscle are impaired in its ability to respond to the action of insulin. This leads to a situation where the pancreas produces extra insulin in an effort to overcome the resistance to insulin. This elevation in insulin is known as hyperinsulinemia, or high blood insulin. Insulin resistance is not the same as diabetes although it is considered an early form of diabetes. The main difference in the two disorders is that the person with insulin resistance is capable of producing excessive amounts of insulin to maintain blood glucose whereas the diabetic patient can no longer produce adequate levels of insulin. Insulin resistance can come about through more than one mechanism. Receptor defects and obesity appear to be independent risk factors that may appear alone or in combination. There appears to be a genetic link so a family history of adult onset diabetes is a risk factor. Hyperinsulinemia can also occur in situations where the the body is overproducing insulin but the tissues aren’t technically resistant to the effects of insulin. This occurs most commonly in the setting of excessive sugar intake. Insulin is a hormone which causes changes in different cells throughout the body. Excessive hormones can cause changes in the appearance of individuals. Polycystic Ovary Syndrome and Syndrome X are labels to describe a common appearance among patients with high insulin levels. Insulin resistance is the most likely the underlying metabolic abnormality when the appropriate testing is performed. Many tests focus on tissue resistance to insulin rather than the absolute level of circulating hormone. We have specialized tests designed to find these elevations in hormones. Treatment results can be quite impressive and can lead to pregnancy without fertility medications in many cases.

For more information visit: http://californiaivf.com/insulin-resistance.htm

Male Infertility

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Male infertility accounts for 30-40% of infertility. Male infertility is usually related to abnormal sperm production or function. Problems can occur anywhere in the production of sperm including hormonal regulation, storage, and transport of sperm. Genetic abnormalities can also contribute to decreased sperm or abnormal function. Fortunately, there are treatments that can help improve a couple’s chances of becoming pregnant. Intracytoplasmic Sperm Injection (ICSI) is one of the most commonly performed procedures for male infertility. Other procedures including aspirations, biopsies, and varicocele repair can also be useful. Once you have a diagnosis of male factor infertility, let California IVF help you in selecting the best options available.

For more information visit: http://californiaivf.com/male-infertility.htm

Intrauterine Insemination (IUI)

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The introduction of the sperm sample into the uterine cavity may be done to increase the number of sperm in the upper genital tract. In certain individuals this may increase the likelihood of conception. IUI may avoid cervical and vaginal factors preventing sperm entry or compensate for low sperm counts. Intrauterine insemination is sometimes called artificial insemination or therapeutic sperm insemination.

In order to introduce the sperm into the uterine cavity the semen has to be treated to remove chemicals in the liquid portion of the semen which may cause irritation of the uterus. The washing procedure takes about 1 hour. Sperm samples are most often collected in the clinic to assure a prompt delivery to the lab. Once in the lab, the specimen will be allowed to liquefy. Different types of special liquids called sperm media are used to rinse the debris and chemicals from the semen. The concentrated mixture that remains is made mostly of sperm. Gradient washes are often done to improve the concentration and selection of motile sperm. The washed sperm is now safe and ready for insertion into the uterus.

The insemination is a relatively simple procedure similar to obtaining a Pap smear, which can be accomplished in the clinic without anesthesia.

For more information visit: http://californiaivf.com/insemination.htm

Treatment Options

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Once your initial evaluation has been completed, Dr. Zeringue will meet with you to discuss the findings and make individual recommendations. Since there is tremendous variability in the exact treatment that individuals receive, this section will be divided into generalized treatment categories. Below is a brief description of the different types of treatment. Click on the title to go to the page of interest where you will find more specific information.

Some couples complete their testing without any abnormalities identified. While this may be frustrating to be diagnosed as unexplained infertility, all hope is not lost. This simply means you have reached a point in your evaluation that the more common causes of infertility have been ruled out and the best course of action is to begin a coordinated attempt at pregnancy rather than continue to look for reasons why you are not pregnant. Without identified abnormalities during your evaluation you will likely have a very good chance of becoming pregnant.

For more information visit: http://californiaivf.com/treatment.htm

Tubal Reversal Surgery / Bilateral Tubal Reanastomosis (BTA)

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A woman who has had a previous tubal ligation by clips, rings, or fulguration may be a candidate for a tubal reanastomosis. In this procedure an incision is made into the abdomen to gain access to the fallopian tubes. The ends of the fallopian tubes are then incised to expose the lumen, or opening of the tube. The two lumens of the tube are then carefully reattached under the microscope. Once the tubes themselves are reattached, the outer covering, or serosa, of the tubes are brought together over the top of the inner portion of the tube. Colored dye is then used to test the repair and patency of the fallopian tube.

Pregnancy rates with reanastomosis procedures depend on several factors. The fallopian tubes must remain open, or patent. The next factor is based on a woman’s age and other factors that may affect overall fertility. More than 75% of women will be able to conceive following a successful reanastomosis. This number may be higher or lower depending on your individual circumstances. Peak pregnancy rates occur within several months following tubal reversal procedures. An HSG may be used 6 months or more after a reanastomosis to test the tubes to be sure they are still open.

The procedure usually involves an overnight stay. If the admission is below 24 hours, the stay can be called a 23 hour observation and usually represents a significant cost savings. Dr. Zeringue has extensive experience performing tubal reversals. Since 1995, he has been helping women get pregnant through microsurgery. While serving in the Air Force, Dr. Zeringue performed tubal reversals on women from across the United States and even overseas. His perfected technique results in a very high success rate for both completion of surgery and subsequent pregnancy rates. This success combined with minimal discomfort makes tubal reversal an excellent alternative to IVF for many women.

For more information visit: http://californiaivf.com/tubal-reversal.htm

Donor Oocytes (eggs)

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This post is intended for egg recipients

Getting Started: If you elect to participate in the anonymous oocyte recipient program this information will be held in confidence. At the completion of your cycle your donor will not be informed of the outcome of the cycle. It will be up to you and your partner to decide with whom to share this information, including your obstetrician, should you conceive. We recommend that you consider who you will inform and the potential consequences of this decision prior to beginning a cycle of receiving anonymous oocytes. The oocyte donor’s identity is also protected and you will not be given any information about her. We will discuss our screening and matching procedures with you and make an attempt to incorporate any special requests that you may have in the selection of your donor. If you should use a known donor, she must meet the same screening criteria as our anonymous donors. Charges for the cycle with either anonymous or known donors is the same with the possible exception of donor compensation. It is your decision to choose whether or not you want to compensate a known donor.

A medical and genetic history form needs to be completed by you and your partner. This information will need to be returned to us before we can begin the matching process. In this form you are asked to provide physical characteristics (height, weight, hair and eye color, and blood type) and genetic/medical history of both partners. Donors are matched with these characteristics as closely as possible. We also require that both partners have screening lab work obtained prior to beginning a cycle. The evaluation will also include an assessment of the uterine lining as well as other general health information. If your partner’s sperm is being used, a semen analysis will also need to be performed.

For more information visit: http://californiaivf.com/donor-eggs.htm

Becoming an Egg Donor

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Getting Started
Thank you for your interest in becoming an Oocyte (egg) donor at California IVF. The goal of our program is to provide eggs anonymously to women with unable to produce quality eggs on their own. Ovarian failure is one of the leading causes of infertility and may occur for many reasons. Delayed child-bearing, radiation or chemotherapy therapy for cancer, autoimmune diseases and surgical removal of the ovaries are a few of the causes of ovarian failure. Women of advanced age are also candidates for donor oocytes. Donor oocytes provide couples with little or no chance of achieving a pregnancy a > 65% chance of conceiving each cycle.

Donating eggs is not an easy process and will require a commitment of time and energy. Couples with whom you may be matched will be investing a large amount of money for each cycle. In addition to their financial investment, people become emotionally committed to their treatments. It is extremely important that you are willing to complete the process once begun. Please let us know if at any time you decide that you are unwilling to participate in this program and your profile can be removed from the registry.

Once you are given an introduction to the screening and treatment process, you will be given the opportunity to proceed. The screening process will involve blood work, an ultrasound, and a psychological evaluation. For the psychological evaluation, you will meet with a psychologist who will talk with you about why you want to be a donor, and her staff will administer a psychological test called the MMPI. The interview and test are not difficult or threatening. Additional tests may be required in certain circumstances. You will not have to pay for any of the testing or screening procedures. We do however, encourage you to use your current health benefits to receive your annual Pap smear screening and routine gynecological exam. Copies of this information should be requested and brought with you to your initial appointment.

For more information visit: http://californiaivf.com/Egg-Donor.htm

Adoption Resources

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Many people will find great joy and satisfaction through growing their family with adoption. There are many resources and types of adoption that may be available to couples. It is unfortunate that many adoption agencies make the adoption process very difficult, expensive, and time consuming. Everyone understand the need to ensure the safety and well being of the children, but many people find the process extremely difficult. Better understanding the various options for adoption will help avoid some of this frustration.

Private adoptions can happen when a mother desires to relinquish rights to the baby before the state or other adoption agencies are involved. These types of adoption are usually less cumbersome but are also more difficult to find. There are mailing lists and agencies that will work with you to increase your visibility to mothers that may wish to give their baby up for adoption.

Adoption agencies are regulated by the state and have to adhere to strict guidelines. The various agencies will have their own requirements including visits with a psychologist, a home study program (inspection), and often age restrictions. There are programs that make the process much easier than other agencies. Overseas adoptions offer many hopeful parents the chance to grow their family. The number of overseas programs are growing and there is a wider range of options than ever before. Adoptive parents are encouraged to thoroughly investigate the different agencies and programs.

For more information visit: http://californiaivf.com/adoption.htm

In Vitro Fertilization (IVF)

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IVF is a procedure involving the stimulation of multiple ovarian follicles using gonadotropins. These follicles are then retrieved at the appropriate time. After fertilization in the lab, the subsequent embryos are transferred into the uterus where implantation can occur. This process bypasses the fallopian tubes and increases fertilization rates when there are problems with low sperm counts.

 

Candidates
In vitro provides many people with the opportunity to attempt pregnancy in the face of one or more factors that may otherwise decrease their chances. There are several reasons why you may be better off with IVF. Reasons for undergoing IVF include:

  • Significant adhesions (scar tissue)
  • A history of damage to the fallopian tubes
  • Endometriosis
  • Unsuccessful attempts with other types of infertility treatment
  • Low or abnormal semen assays Intra Cytoplasmic Sperm Injection
  • Reduced risk of pregnancies greater than twins 

Our facility does not select out patients or decline patients that may not be likely to conceive. There are no attempts to turn away couples in hopes of maintaining good statistics. With this said, however, realistic expectations need to be established. Your physician will need discuss your individual situation with you.

Prior to becoming eligible for treatment in an IVF cycle you will need to complete the tests recommended for you by your physician, have to have current infectious disease testing (good for 1 year), and your consent forms must be signed and returned before starting each cycle.

For more information visit: http://californiaivf.com/ivf.htm