Advancing age (beyond 40 years) is by far the most common reason why American women elect to work with an egg donor. The second most common indication for OD – and one that usually ties in with advancing age beyond 40 years – is declining ovarian function. In a select, but nevertheless significant percentage of … Read more

There are a variety of tests that can be performed to evaluate various types of infertility. A Comprehensive Workup Preparatory Tests In-Office Assessments Tests on the Male Partner Immunologic Testing

Tubal Infertility Causes and Treatment – IVF vs. Tubal Reversal Damage to the fallopian tubes as a result of prior infection, endometriosis or previous pelvic surgery is one of the most common causes of infertility.  Tubal blockage can occur in several locations.  Often the ends of the tubes are obstructed, while the openings into the … Read more

A woman is born with all the eggs she will ever have. After menstruation starts, a monthly process of using up numerous eggs continues until the menopause, when most of her eggs have been used up, and both ovulation and menstruation cease. When the number of eggs remaining in the ovaries falls below a certain … Read more

Pelvic Inflammatory Disease (PID) refers to conditions that affect pelvic structures including the uterus, fallopian tubes, ovaries, bowel, and the smooth membrane that lines the surface of the pelvic cavity (the peritoneum). PID follows infection which reaches pelvic structures as a result of: sexual transmission via the vagina and cervix contamination from other inflamed structures … Read more

A simple analogy that we refer to as the “Seed/Soil Relationship” can help shed light on embryo implantation. Just as a successful garden needs a ”good” seed properly planted in fertile soil to produce healthy plants, successful embryo implantation requires a good seed (genetically “normal” embryo) and fertile soil (receptive uterine lining) to make a healthy … Read more

Currently, with few exceptions, practitioners of assisted reproduction tend to attribute “unexplained” and/or repeated IVF failure(s), almost exclusively to poor embryo quality, advocating adjusted protocols for ovarian stimulation and/or gamete and embryo preparation as a potential remedy. The idea that, having failed IVF, all it takes to ultimately succeed is to keep trying over and … Read more

What Is PCOS? and How It Can Affect Fertility? Polycystic ovarian syndrome (PCOS) is the most common hormonal disorder in reproductive age women. Depending on nationality, it is present in up to one-in-five women and even more frequently in women with fertility problems.  PCOS is also one of the most common causes of menstrual irregularities, … Read more

Diagnosis Of Endometriosis and Treatment With a Sher Reproductive Endocrinologist Endometriosis is a condition where the uterine lining (endometrium) grows on pelvic structures outside the uterine cavity. In early-stage endometriosis there is usually little, if any, visible evidence of anatomical distortion sufficient to compromise the release of an egg (ovulation) or its transportation from the … Read more

The uterus is composed of a thick layer of smooth muscle (myometrium) surrounding thin lining (the endometrium) into which the embryo implants and which serves to protect and nourish a growing pregnancy.  Approximately 20 to 40% of all reproductive age women will develop benign growths of the myometrium, referred to as fibroid tumors (leiomyomata).  These … Read more

Though many people assume that infertility is largely a female problem, the truth is that approximately half of infertility cases involve the male to some extent.  The good news is that male infertility can be treated effectively in the overwhelming majority of cases. The treatment of male factor infertility is one of the true success … Read more

Most fertility specialists would agree that IVF is the treatment of choice for almost all forms of tubal infertility.  One exception that is commonly cited involves surgical reversal of tubal ligation.  It is correctly argued that the chance of having a baby being born within a year of such surgery is about 50%.  Those who … Read more

There are several important factors that predispose women towards developing PID: First is exposure to an infected partner. Second is exposure to infection immediately prior to menstruation. Menstrual blood provides an excellent growth medium for bacteria, promoting their proliferation and passage via the uterine cavity into the fallopian tubes. Third is relative ill health and poor nutritional status. … Read more

Acute PID Pelvic inflammatory disease may present as an acute illness with fever, severe lower abdominal pain, accompanied by a yellow or blood-stained, non-irritant vaginal discharge and vomiting, which usually prompts the woman to seek urgent medical attention.   Subacute PID More commonly, the onset of PID is gradual, less severe, and often goes unnoticed … Read more

An immunologic work-up may be required in certain cases of female infertility or where there is a past history of recurrent pregnancy loss. This usually requires tests for the measurement of:   Antinuclear Antibodies (ANA) Antiphospholipid Antibodies (APA) Antithyroid Antibodies (ATA) Natural Killer Cell Activity (NKa) Blood should be sent to a specialty lab like … Read more