Friday, October 16, 2009

Hysterosalpingogram or HSG


Infertility can be caused by either male of female factors. Female infertility involves ovulation dysfunctions or abnormalities of the female pelvis. The normal events that occur for successful human reproduction involve (1) sperm is placed within the vagina during intercourse, (2) some of this sperm will move into the cervical mucus (where it can normally reside comfortably for several days), (3) sperm travels from the cervical mucus through the uterine cavity into the fallopian tubes, (4) the sperm fertilizes a mature egg within the fallopian tube, (5) the fertilized egg (preimplantation embryo) continues to develop within the fallopian tube for 4-5 days, (6) the developing embryo enters the uterine cavity and it remains unattached for about a day, (7) the embryo becomes apposed to the uterine lining cells (endometrium) and initiates implantation into this lining, and (8) the implanted embryo continues to develop from nutrients obtained from the maternal uterus (womb). If there is any abnormality in this sequence of events, the success of human reproduction can be severely limited (and may result in infertility).

The hysterosalpingogram or HSG is a radiology test that uses the injection of a radio-opaque distention fluid under continuous fluoroscopy to allow the operator (usually a radiologist but sometimes an infertility doctor) to see the contour of the uterine cavity and the patency of the fallopian tubes. This test is highly informative, relatively inexpensive, generally safe, and quick to perform (mostly under 10 minutes for a skilled operator). The hysterosalpingogram allows the doctor to detect filling defects within the uterine cavity, possibly caused by endometrial polyps (organized abnormal overgrowths of the normal uterine lining cells), submucosal fibroids (smooth muscle tumors projecting into the uterine cavity), or intrauterine adhesions (synechia). The presence of structural abnormalities such as polyps, submucosal fibroids, synechiae, or blocked fallopian tubes can reduce fertility and cause female infertility. The hysterosalpingogram is also commonly thought to remove or “blow out” any material that might be obstructing the inside of the fallopian tubes and thereby the HSG may itself improve fertility.

A sonohysterogram (aka saline ultrasound or hysterosonogram) is a different radiological test that uses the injection of saline (salt water) into the uterine cavity while examining the uterus with a high resolution ultrasound. Sonohysterography is also safe, relatively inexpensive, and informative. A sonohysterogram allows the operator to visualize abnormalities of the uterine cavity (polyps, fibroids, scar tissue) with similar or sometimes greater sensitivity when compared to the hysterosalpingogram. However, the sonohysterogram usually has significantly less reliability when viewing the fallopian tubes, as compared to a hysterosalpingogram. Thus, we usually recommend starting with a hysterosalpingogram and if additional testing is required for abnormalities of the uterine cavity then we consider performing a sonohysterogram.

Many women have apparently had painful experiences with the hysterosalpingogram and therefore the procedure has a blemished reputation among infertility patients. At The NJ Center for Fertility and Reproductive Medicine, LLC, Dr. Daiter offers to personally perform every hysterosalpingogram (HSG) that he suggests for his patients since discomfort with the procedure is truly rare when he performs it. For an appointment to discuss your situation with Dr. Daiter, please call the office at 908 226 0250. Visit us on the web at or

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Saturday, October 10, 2009

Infertility Doctor

Can't afford infertility treatment? Dr. Eric Daiter is an infertility doctor who can help you.

A couple that is struggling with their attempt to become parents is often under significant stress. This stress may impact the very relationship that initially brought the couple together. Men and women generally expect to have the opportunity to have children and develop their own family as soon as they decide to do so. Concerns with infertility can be frightening, stressful, and ultimately destructive.

Medicine has developed a great deal of information about infertility, including a growing appreciation of the causes of infertility and effective treatments for these causes of infertility. Reproductive Endocrinologists are infertility specialists with special training in the useful tests and treatments for couples suffering with fertility problems. Consulting with an experienced infertility expert can be very helpful in several different ways: you can learn about (1) the normal physiological events that must occur for fertility to be successful, (2) the male and female infertility tests that are available to determine where a problem may exist, and (3) the infertility treatments that should improve your chances of conception.

Infertility treatments can vary in terms of their invasiveness (more or less natural), aggressiveness (more or less focused), cost (more or less expensive), or suitability for a particular couple (more or less customized to match the couple’s own unique personal desires for care).

Dr. Eric Daiter at The NJ Center for Fertility and Reproductive Medicine, LLC has extensive experience in the diagnosis and treatment of infertility and he would be happy to help you customize a management plan that fits your own lifestyle. For an appointment to discuss your situation with Dr. Daiter, please call the office at 908 226 0250. You can also visit us on the web at

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Friday, October 9, 2009

Laparoscopy for Endometriosis

Laparoscopy for endometriosis

Women frequently ask themselves “when should I consider a laparoscopy for endometriosis?”

Endometriosis may cause either infertility or pelvic pain. Endometriosis is usually effectively treated by laparoscopy. In most cases, a larger incision with a laparotomy is not required for the thorough treatment of endometriosis, which is fortunate since these larger incisions require a long recovery time and more discomfort than the smaller laparoscopy incisions.

Laparoscopy is a minimally invasive surgical procedure that usually does not require overnight hospitalization, which uses a lighted metal tube (laparoscope) to enter the abdominal wall through a small incision near the belly button to examine the reproductive organs of the pelvis. Laparoscopy can examine the gynecological organs for various problems, including but not limited to endometriosis, pelvic adhesions, ovarian cysts, uterine fibroids and infections.

Surgical ablation (removal) of endometriosis and pelvic repair often dramatically improves a woman’s fertility and it can also reduce pelvic and lower back pain. For most effective results, an experienced fertility surgeon should perform laparoscopy for endometriosis.

Dr. Eric Daiter at The NJ Center for Fertility and Reproductive Medicine, LLC has extensive experience in the treatment of endometriosis by laparoscopy and he would like to help you. For an appointment to discuss your treatment options with Dr. Daiter, please call the office at 908 226 0250. You can also visit Dr Daiter on the web at or

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Endometriosis Pictures

Endometriosis pictures can be taken during laparoscopy and these photos can reveal the many different appearances of endometriosis, which is a common problem of the female reproductive system.

Endometriosis often implants on the pelvic peritoneum, a membrane that lines the pelvic and abdominal cavities and covers most of the organs. The initial inflammatory reaction to the irritation of this peritoneum by endometriosis may be to form clear vesicles (look like blisters = “atypical endometriosis” see ). These endometriosis lesions can progress to red flame lesions (looks like strawberry jam = “atypical endometriosis” see ). Then these red flame endometiosis lesions can develop into brown or black lesions (look like powder burn marks = “classic endometriosis” see Finally, endometriosis lesions can become irregular white scarred lesions (“burned out endometriosis”). Endometriosis can also form ovarian cysts, called endometriomas or “chocolate cysts.” See for an example.

By examining endometriosis pictures one can become aware of the wide range of appearances of this potentially disabling problem. Endometriosis repair often improves fertility and relieves pelvic pain that is caused by this common problem. It is important to have an endometriosis expert treat the endometriosis from the onset for best results.

Dr. Eric Daiter at The NJ Center for Fertility and Reproductive Medicine, LLC has extensive experience in the treatment of endometriosis and would be happy to help you. For an appointment to discuss your situation with Dr. Daiter, please call the office at 908 226 0250. You can also visit us on the web at

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Monday, March 3, 2008

Egg Donation Part 1 – Qualifications for Donors

Many women are unable to have genetic children because of fertility problems related to egg production. As result of cancer, congenital absence of eggs, or early onset menopause these women no longer produce eggs that can successfully be fertilized. These women are usually candidates for an infertility treatment called in vitro fertilization with a third party egg donor. If you have considered becoming an egg donor but are unsure of the requirements to qualify as one here’s what you need to know.

In order to qualify to be an egg donor you need to be a female between the ages of 21 and 36 and who has given birth before. You need to be healthy and devoid of genetic disorders. Stable mental health is also a qualifier as a history of depression is contraindicated with some of the medications used in the process. Lactation can reduce the effects of the fertility drugs used which might result in lower egg production. If you are considering becoming a donor you will need to stop breastfeeding a few months before egg donation will be possible. If you have met these pre qualifiers here is what you can do next.

Contact an egg donation center and set up an assessment appointment. At this appointment they will obtain your medical history, give you a physical examination, and conduct a psychosocial evaluation. They will be trying to determine the health of the eggs to be donated, as well as the psychological impact on you, the donor, of giving up your eggs. They will also draw blood to test for infections. During your physical exam they will obtain cervical cultures to rule out sexually transmitted diseases. If your blood tests and cultures are negative for any infectious agents or STD’s they will check for normal levels of follicle stimulating hormone (FSH) in your blood. FSH in women stimulates the production of eggs. The normal level for FSH in a menstruating woman is between 5mlU/mL – 20mlU/mL. Having a normal level of FSH in your blood stream is required to be an egg donor. If you’ve met all of these qualifications the egg donation center will invite you to an informative counselling session about the ethical, legal, and financial side of donating your eggs. Some egg donation centers offer financial compensation for the donation of your eggs. At the end of this session, if you are still ready and willing to donate your eggs you will move on to the next phase in the process of egg donation.

Make a list of any questions or concerns you might have and don’t be afraid to ask. If you qualify as a donor then be sure to educate yourself about the procedure of egg removal and what your involvement will be in the process. Donating your eggs can bring about the hopes and dreams of yourself and others.

About the Author: Eric Daiter has been sponsored by The NJ Center for Fertility and Reproductive Medicine, LLC, a leading provider of infertility treatment, to explain in vitro fertilization in plain language. To review this information, please visit

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Sunday, March 2, 2008

Coping With Infertility

If you are one of the many couples dealing with fertility problems you may be wondering how to cope with the wave of emotions that has arisen. Family and friends don’t always understand what it’s like to struggle with conceiving and the overwhelming disappointment you feel each month when the pregnancy test comes back negative or the grief and loss felt with each miscarriage. Here are few ways to help you and your partner cope with infertility.

Do not blame yourself or your partner. It is not uncommon for one or both partners to feel that it is their fault they are unable to get pregnant. Blame may stem from past choices or circumstances that may have had an effect your ability to conceive, or be directed toward your partner for wanting to wait until later to start a family. The blame game is always a lame game. Blaming is never helpful or constructive. It is be hurtful and creates stress that can further distance you from your goals. Instead, acknowledge that there are things that may have influenced your chances of having children, but you cannot change the past. Look forward to the future and what you can do together now. Work as a team to determine your options.

Continually educate yourself about infertility. Uncertainty or fear of the unknown plays a big part in how you respond or cope with feelings. The more you understand about infertility and infertility treatments available the better you and your partner are able to plan for what lies ahead. This can be a great source of hope. You will know what to expect from different types of treatments and how much they will cost. You’ll also feel more comfortable talking to family and friends about your situation.

Give yourself permission to talk about your feelings. Be open and honest with your partner about how you are feeling and you may find they are feeling some of the same emotions. Set a time limit for how long you and your partner talk about frustrations, sadness, and further plans, since it can be draining or amplify those negative feelings. Find a support group for couples who are struggling with fertility problems. Your doctor’s office should be able to recommend groups that meet in your neighbourhood. There are support groups available online where you can chat with others who are experiencing the same things you are and be encouraged by couples who have been through it and have had a successful pregnancy.

Don’t give up hope. Whatever type of infertility treatment you and your partner choose there may be disappointments, but be encouraged. There is always someone who has walked the same road and can share their experience, strength and hope.

About the Author: Eric Daiter has been sponsored by The NJ Center for Reproductive Medicine, a leading provider of infertility treatment, to write information about male infertility. For more information, please visit

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Sunday, January 13, 2008

A Silent Epidemic

Billboards, television ads, and 7th grade health teachers all proclaim the message of safer sex, yet the U. S. Department of Health and Services estimates that 13 million people become infected with a sexually transmitted disease every year. According to the Center for Disease Control, Chlamydia is the most common sexually transmitted disease in the United States with 3 million new cases occurring each year. This article will talk about signs and symptoms of Chlamydia, how to treat it, and how to avoid it.

Chlamydia is caused by the bacterium Chlamydia trachomatis and is transmitted through vaginal, anal, or oral sex. It can also be transmitted to a new born baby as it passes through the birth canal of the infected mother. 50-75% of women infected with Chlamydia show no signs or symptoms and have no idea they are infected, which is why it is sometimes referred to as “the silent epidemic”. Chlamydia, when untreated, can cause pelvic inflammatory disease. This puts the woman at risk for infertility, endometriosis, and damage to the reproductive system. Endometriosis symptoms can be extremely painful, and if considering conception, may require infertility treatment. Common symptoms of Chlamydia include unusual vaginal bleeding or discharge, pain in the abdomen, fever, and painful urination. In order to diagnose Chlamydia a culture swab must be obtained

Once detected, Chlamydia can be cured with antibiotics. The most commonly used antibiotics in treatment of Chlamydia are Azithromycin, Doxycycline, Tetracycline, and Erythromycin. Antibiotics must be prescribed by a physician and are administered orally according to the doctor’s specifications. It is also important to complete your course of medication completely in order to recover from the infection. It may be a good idea to return to your doctor for Chlamydia testing every year, as it is possible to be re-infected with the disease even after treatment. Abstain from sex while being treated for the disease even if you no longer have symptoms. You can resume sexual activity once your course of antibiotics is finished.

The risk for transmission is dramatically reduced with the use of condoms with a water based lubricant, such as K Y Jelly. Petroleum based lubricants, such as Vaseline, should not be used because they break down latex (the material the condom is made of). The only sure way to avoid becoming infected with Chlamydia is abstinence (not having sex) or monogamy with an uninfected partner.

It is important for partners to discuss their sexual history before having sex and have STD tests done. Essential to prevention for sexually active individuals is an understanding of sexually transmitted diseases and how they are spread.

Eric Daiter has been sponsored by The NJ Center for Reproductive Medicine, a leading provider of infertility treatment, to write information about endometriosis symptoms. For more information, please visit

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Monday, December 31, 2007

The Pain of Endometriosis

Endometriosis is a condition where tissue found in the lining of the uterus attaches to organs and other areas outside the uterus. It is thought to occur in 10-20% of women between the ages of 20 and 45. While the cause of endometriosis is still unknown, there is a relationship between hormone estrogen and immune system dysfunctions.

During a women’s menstruation the lining of the uterus bleeds and sheds and is forced out of the uterus by small uterine contractions. Uterine tissue, called endometrium, that is shed makes its way into the pelvic cavity. This is referred to as retrograde menstruation. This displaced tissue may then implant on the ovaries, fallopian tubes, and on top of the uterus or its supporting ligaments. Other areas of occurrence are the abdomen, the area between the vagina and rectum, bowel, bladder, vagina, cervix, vulva, and in abdominal surgical scars. In rare circumstances they can be found in the lungs, arms, or thighs.

Women who suffer from endometriosis have been found to have excess levels of estrogen in their system. Studies have proposed that women with excessive levels of estrogen are at higher risk for endometriosis. This is because estrogen stimulates cell growth. Normally, the immune system is able to take care of any endometrial tissue that finds its way in to the pelvic cavity via retrograde menstruation. However, high levels of estrogen counteract the body’s ability to cope with the invading tissue. The immune system is overwhelmed and the implanted tissue grows and flourishes. This tissue will continue to respond to the hormonal cycle, and the shedding and bleeding causes inflammation and scarring.

One difficulty in diagnosing endometriosis is that the symptoms mimic several other medical conditions, such as ovarian cysts, pelvic inflammatory disease, ovarian cancer, colon cancer, fibroid tumors, or irritable bowel syndrome. The most common of endometriosis symptoms is pain. However, some women may experience no symptoms at all. Other symptoms include pain in the abdomen and lower back associated with the changes occurring during the menstrual cycle, pain experienced during intercourse, heavy or irregular periods, painful bowel movements and urination, diarrhoea or constipation, fatigue, and general chronic pain at any time. Additionally, endometriosis will cause infertility in 40% of women affected.

Treatment of endometriosis is the subject of some controversy, as the exact causes of the condition are unknown. Some treatments may focus on eliminating or reducing the amount of estrogen a woman’s body produces. Laparoscopy is a common infertility treatment when endometriosis affects a woman’s ability to become pregnant. Less obtrusive treatments suggest changes in diet and exercise routine, thereby strengthening the body’s muscles and immune system which help the body naturally fight the condition.

About the Author:

Eric Daiter has been sponsored by The NJ Center for Reproductive Medicine, a leading provider of infertility treatment, to write information about endometriosis symptoms. For more information, please visit

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