Diagnosis and Treatment of Common Diseases
Endometriosis is when endometrial tissue which lines the uterine cavity exists outside of the uterus, many times overlying pelvic organs. Although it is relatively common, the cause is still unknown.
Between 15 and 20 percent of all women experience endometriosis. For 25 to 35 percent of women experiencing infertility, endometriosis may be the reason.
Laparoscopic surgery is necessary to confirm a diagnosis of endometriosis. This surgery allows your physician to know the level of your condition and then discuss options for treatment.
Polycystic ovarian syndrome (PCO or PCOS)
A very common cause for irregular ovulation and infertility is PCOS. It affects 5 to 10 percent of all reproductive-age women.
Indications of PCOS include the inability to ovulate (irregular menstrual cycles), the presence of ovarian cysts and an elevated level of male hormones in the body. In addition to infertility, these women may also experience heavy, irregular or no menstrual cycles, excess facial or body hair, acne, obesity and male pattern balding.
The cause of PCOS is unknown, though it appears heredity and insulin metabolism are important factors.
To diagnose PCOS your doctor will take a look at your complete medical history and perform a physical exam. Sometimes additional testing is needed such as endometrial biopsy, hormone level assessment and ultrasound.
There is no cure for PCOS, however its symptoms can be managed to reduce or eliminate its effects on fertility and long-term health.
Recurrent pregnancy loss
One out of five pregnancies ends in miscarriage, and most happen within the first 12 weeks of pregnancy. Recurrent miscarriage is a term typically applied after three successive miscarriages; however testing for potential causes is often offered after a woman has suffered two losses.
The causes are often unknown but structural defects, genetic defects and medical conditions of the couple or chromosomal abnormalities of the embryo can be involved. Exposure to toxic substances such as drugs, cigarette, alcohol and caffeine or environmental hazards have been known to play a role as well.
Diagnosis of recurrent pregnancy loss starts with a medical history review and physical exam.
Other testing or screens may include:
- Chromosome mapping
- Auto immune disorders
- Hormone level
- Ovum tracking
- Endometrial biopsy
Miscarriage can be incredibly heartbreaking for a couple, but the good news is that the odds are eventually in your favor. 70% of women who've had a successful pregnancy prior to recurrent miscarriage will have another successful pregnancy. 60% of women who've never had a successful pregnancy, eventually will.
Male factor infertility
The cause of a couple's infertility is just as often due to male factor fertility or a combination of the both.
Male infertility often relates to sperm production, structural issues or immunological response. These disorders may be genetic or caused by exposure to radiation, medications, infection or trauma. Hormonal imbalance can also be a factor.
Typically, diagnosis is based on semen analysis. The lab will evaluate sperm count, movement and shape. If one or more of those parameters are found to be abnormal, it's time to discuss options for treatment. If that analysis is normal, further testing can be done for hormone imbalance and genetic defect.
When a woman is having a hard time becoming pregnant, a HSG is often performed. This x-ray test looks inside the uterus and fallopian tubes as well as the area around them. During the procedure, a dye is put through a thin tube into the vagina and uterus. As the dye travels to the fallopian tubes, pictures can be taken and show problems that might prevent an egg from moving through the fallopian tube to the uterus or keep sperm from moving into the tube. HSG can also find problems on the inside of the uterus that prevent a fertilized egg from implanting to the uterine wall.
There's a lot we can do when it comes to helping couples reach their goals of parenthood. Unfortunately in about 10 to 15 percent of cases, a diagnosis is not determined. Some causes still remain outside the realm of our current understanding. For couples facing infertility, this can be incredibly frustrating and heartbreaking.
The good news is, all hope is not lost. A detailed review of the entire infertility evaluation can reveal a something not noticed early on. It can also prompt further investigation into questionable fertility factors
Additional patient testing can also be done. Once everything is known and specialists can see the entire picture, treatment options can be pursued.
Keep in mind, just because your cause of subfertility or infertility hasn't been diagnosed doesn't mean you won't benefit from treatment. Several therapies such as ovulation induction, IUI and especially IVF have been shown to significantly improve the chances of pregnancy in couples diagnosed with unexplained infertility.