When to See a Fertility Specialist

Posted by Brigham and Women's Hospital April 23, 2013

Dr. Elena Yanushpolsky

Today’s post was written by Dr. Elena Yanushpolsky. Dr. Yanushpolsky is an infertility specialist with the Center for Infertility and Reproductive Surgery at Brigham and Women’s Hospital (BWH) and the Director of the BWH Center for Infertility and Reproductive Surgery at South Shore Hospital in South Weymouth. She discusses when its time to see a fertility specialist.

As a couple, you’ve been trying to conceive for several months without success. Should you keep trying or should you consult a fertility specialist? The correct answer is that it depends. Here are some things that can help you determine how soon to see a specialist:

  • Getting Ready:  It’s important for both partners to have a general health evaluation with a primary care doctor before seeking fertility evaluation and treatments. Many illnesses can have an impact on a couple’s fertility.

I also recommend that my patients maximize their chances for conception by using urine ovulation predictor kits which can be purchased over the counter. Other ovulation detection methods, such as basal body temperature measurements and cervical mucous evaluations can be used, though they are less precise than urine ovulation predictor kits.

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Fertility Treatment Options for Women with Endometriosis

Posted by Brigham and Women's Hospital March 13, 2013

Dr. Marc Laufer, founder of the Boston Center for Endometriosis

March is Endometriosis Awareness Month. Today’s post is written by Dr. Marc Laufer, a senior gynecologist in the Center for Infertility and Reproductive Surgery, Brigham and Women’s Hospital. He also founded the Boston Center for Endometriosis in 2012. This post also appeared on the blog of RESOLVE New England, a nonprofit organization helping patients facing fertility issues.

Recently, I saw 37-year-old woman who was concerned about her difficulty becoming pregnant after she and her husband had been trying for four months. Though her pelvic ultrasound was normal, she mentioned she had significant pain during her periods and some pain with sex. She had experienced this pain for many years. Given her history, I suspected she might be suffering from endometriosis.

Endometriosis occurs when the cells that normally line the inside of the uterus (endometrial cells) are found in other parts of the body, usually in the abdomen or pelvic cavity. Endometriosis can cause severe pain and, if undiagnosed or untreated, can result in fertility problems. There is no correlation between the amount of disease and the amount of pain experienced. Some women have a small amount of disease but experience significant pain, while others have no pain but still experience fertility problems. The more advanced your endometriosis, the more difficult it may be to become pregnant.

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Lasers, Robots, and a Cast of Thousands

Posted by Brigham and Women's Hospital January 4, 2013

Dr. Gargiulo demonstrates his robotic technique to an audience of more than 1,000 surgeons.

Dr. Antonio Gargiulo, Medical Director of Robotic Surgery at the Brigham and Women’s Hospital (BWH), has performed hundreds of computer-assisted laparoscopic surgeries, but the one he performed on October 22, 2012, was very special.

The surgery, a robotic myomectomy to remove a uterine fibroid tumor in a 29-year-old patient, was beamed live from Brigham and Women’s Faulkner Hospital (BWFH) to an audience of more than 1000 fertility surgeons attending the 68th Annual Meeting of the American Society for Reproductive Medicine (ASRM) meeting in San Diego, California. Over the course of two hours, Dr. Gargiulo narrated the ongoing surgery while answering a steady stream of questions from the audience via three moderators.

Dr. Gargiulo and members of the robotic team at the Center for Infertility and Reproductive Surgery (CIRS)  were chosen by ASRM to broadcast the procedure based on their innovative work in robotic reproductive surgery, such as performing the first single incision robotic myomectomy in 2012.

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New Research Sheds Light on Link Between Obesity and Fertility in Women

Posted by Brigham and Women's Hospital November 1, 2012

Obese women are more likely to have egg abnormalities associated with infertility.

Modern reproductive science has unlocked the key to a vast array of fertility problems, and researchers at Brigham and Women’s Hospital have now discovered a possible link between obesity and egg quality.

Obesity has long been associated with poor reproductive outcomes, but the reason has largely been unknown. With one-third of all American women of childbearing age battling obesity, it is a major barrier for many wishing to grow their family.

A new study released earlier this month shows that severely obese women are more likely to have abnormalities in their eggs that can make it impossible for them to be fertilized normally. The abnormalities involve the spindle, a critical egg structure responsible for normal arrangement of the chromosomes. A normal egg must have one spindle organized in a very specific way, with the chromosomes lined up correctly. The study showed that severely obese women have a much greater chance of having eggs with multiple spindles and disorganized chromosomes.

“This study is the first to shed light on how BMI (body mass index) might adversely affect egg quality in women,” said study lead, Catherine Racowsky, PhD, Director of the Assisted Reproductive Technologies Laboratory at Brigham and Women’s Hospital.

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