Friday, October 30, 2009

Laparoscopy using Ultrapulse Laser for Endometriosis and Pelvic Adhesions

Laparoscopy with Ultrapulse Laser for Endometriosis and Pelvic Adhesions

The Ultrapulse CO2 laser is the best surgical instrument for the treatment of endometriosis since it can vaporize undesired tissue (such as endometriosis or pelvic adhesions) without producing char (carbonization that results from charring or searing tissue with heat), with minimal risk of lateral thermal damage, and with little drying (desiccation) of treated tissue. Char, thermal damage (burn injury), desiccation of tissues, and damage to surrounding normal tissues will result in poor tissue healing, scar (adhesion) formation, increased inflammation with greater postoperative pain, and destruction of normal tissue that surrounds the tissue being treated.

The Ultrapulse CO2 laser is the gold standard surgical instrument used by Plastic Surgeons for the removal of skin scars (including burn scars), wrinkles, and damaged skin since it provides the best cosmetic results and postoperative skin tone. For more information on this laser see their website at http://www.aesthetic.lumenis.com/wt/page/ultrapulse.

The Ultrapulse CO2 laser has also been used for about 20 years for the treatment of pelvic endometriosis and pelvic scar tissue (adhesions) by many of the most experienced laparoscopic surgeons since the postoperative results following pelvic repair are similarly remarkable.

Many Reproductive Endocrinologists, including us, stress that endometriosis lesions must be removed in their entirety for longterm benefit.

Some of these surgeons claim that the lesions must be excised with scissors or other cutting instruments to insure that the base of the lesions are completely removed. The Ultrapulse CO2 laser is fully able to ablate abnormal tissue regardless of its depth or size with minimal lateral tissue damage. Manual excision with cutting instruments always damages underlying normal tissue since some of this normal tissue is removed along with the endometriosis lesion and the remaining tissue within the pelvis will have bleeding that must be controlled with cautery. Cauterization of bleeding vessels is designed to burn the bleeding vessels to form char, that then further damages the normal tissues surrounding the sites of excision and increases postoperative adhesion formation.

Other reproductive surgeons use instruments that are not as “delicate” for the surrounding tissues, including but not limited to the harmonic scalpel, monopolar or bipolar cautery devices, CO2 lasers with either continuous or superpulse waves (that cannot provide the same degree of safety and protection from lateral thermal damage when compared to the Ultrapulse CO2 laser), other non-CO2 lasers such as KTP or YAG lasers, and mechanical devices like scissors or cutting instruments.

The Ultrapulse CO2 laser is not available at most operating rooms, seemingly for a variety of reasons. The laser is extremely expensive and must be maintained properly so hospitals are very reluctant to purchase it. The laser requires significant time and experience by the surgeon in order to feel comfortable. Surgeons are often creatures of habit, so that when the surgeon becomes comfortable with a particular surgical tool it is inherently difficult to switch to a different surgical instrument.

Dr. Eric Daiter at The NJ Center for Fertility and Reproductive Medicine, LLC has been using the Ultrapulse CO2 laser routinely since the early 1990s and has extensive laparoscopic experience over thousands of surgical cases treating endometriosis. Results in terms of reduction of pelvic pain and improved fertility have often been remarkable. For more information, consider a consultation with Dr. Daiter at 908 226 0250 or visit us on the web at http://www.drericdaitermd.com http://www.infertilitytutorials.com or http://www.ericdaiter.com

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Monday, October 26, 2009

Laparoscopy for Pelvic Adhesions

Laparoscopy for Pelvic Adhesions

Pelvic adhesions (scars) develop as a normal tissue response to inflammation, which occurs whenever the tissue is damaged. Infertility surgeons make every attempt to limit or prevent pelvic adhesion formation following laparoscopy or laparotomy, and an experienced fertility surgeon may be able to significantly reduce the bulk of previously formed pelvic adhesions through meticulous care at laparoscopy.

Ideally, infertility surgery adheres to the principles of “microsurgical technique,” a set of surgical methods designed to reduce adhesion formation. Crush injuries to tissue can result in scar formation, so very gentle tissue handling is encouraged. Blood is very irritating to the lining cells overlying the pelvis, called peritoneum, so thorough control of even small amounts of bleeding and removal of any blood collected in the pelvis and abdomen is important. Identification of the proper tissue planes is important in order to avoid surgical damage to the tissues that are being separated so magnification should be available when needed. Tissues that dry out become damaged much more easily than tissues that are kept moist, and it is much easier to maintain adequate tissue moisture during laparoscopy as compared to laparotomy since the abdomen is essentially closed during the laparoscopy procedure. Infection should be avoided (and if inevitable then infection should be treated as early as possible) since a pelvic infection can rapidly destroy the very delicate reproductive tissues. Carbon deposits or char caused by the use (or overuse) of cautery to burn or sear abnormal tissues or control bleeding can result in adhesion formation and should be minimized whenever appropriate. Devascularization of tissue or ischemia can result from burn injuries that damage the blood vessels feeding tissues, so use of the ultrapulse CO2 laser is ideal for many infertility laparoscopy procedures since this tool allows vaporization of unwanted tissue with minimal lateral thermal damage to surrounding tissues.

Dr Eric Daiter at The NJ Center for Fertility and Reproductive Medicine, LLC has personally performed over a thousand laparoscopy surgeries using the ultrapulse CO2 laser for the treatment of pelvic adhesions during the past 20 years. He would be happy to help you. Contact the office at 908 226 0250 for an appointment. Also, visit us on the web at http://www.ericdaiter.com http://www.drericdaitermd.com or http://www.infertilitytutorials.com

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Sunday, October 25, 2009

Ovulation and Trying to Get Pregnant

Ovulation and Trying to Get Pregnant

When trying to get pregnant, a couple ideally should have frequent intercourse (hopefully increasing the chances of exposing the egg to active sperm) just before and around the time that the egg is released from the ovary (ovulation). Trying to get pregnant, rather than simply finding out that you are pregnant “by accident,” can seem unnatural for some couples and this can add stress to a relationship. Initially, keeping things as natural as possible may be beneficial, since stress is rarely helpful.

Ovulation generally occurs about 14 days (2 weeks) prior to the onset of the next menstrual flow. If the menstrual cycle intervals are normally 28-30 days, then ovulation usually will occur around cycle day 14-16. If the menstrual cycle intervals are every 60 days (2 months), then ovulation usually will occur around cycle day 46. If the menstrual cycle intervals are very irregular, then detecting when ovulation is occurring using tests like ovulation predictor kits, serial blood work, or serial ultrasound exams can be helpful.

If ovulation is rare or extremely irregular, then fertility medication may be helpful in inducing or enhancing ovulation. An infertility doctor should be considered when fertility medications are being selected and administered.

Dr. Eric Daiter at The NJ Center for Fertility and Reproductive Medicine, LLC is board certified in Reproductive Endocrinology and Infertility and he has extensive experience with ovulation problems and menstrual irregularities. Dr. Daiter would be happy to help. For an appointment to discuss your situation with Dr. Daiter, please call the office at 908 226 0250. Please visit us on the web at http://www.drericdaitermd.com http://infertilitytutorials.com and http://www.ericdaiter.com

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Friday, October 23, 2009

Ovulation and The Menstrual Cycle

Ovulation and the Menstrual Cycle

The onset of menstrual flow (menses) generally marks the beginning of the female reproductive cycle, during which an egg is matured and the uterine lining (endometrium) develops, to allow for embryo implantation and the development of a normal pregnancy. If no pregnancy occurs, then the endometrial lining is shed (the menstrual flow begins) and the cycle begins once again. Normally, menstrual cycle intervals are about every 28-30 days. Many fertile women have somewhat longer or shorter menstrual cycle intervals, suggesting that the egg quality at full maturity is somewhat independent of the time taken for the egg to develop fully.

The initial part of the menstrual cycle is often thought of as the “egg development” phase, and since the eggs develop within ovarian cysts called follicles this is usually referred to as the “follicular phase.” Ovulation normally occurs once a mature egg is developed. The final part of the menstrual cycle is the “luteal phase” marked by elevated progesterone production. The progesterone appears to modify the endometrium within the uterine cavity to allow for a 4-5 day “window of uterine receptivity” for embryo implantation, and if no pregnancy develops then the entire lining is shed about 14 days after ovulation. If a pregnancy does develop, then progesterone production normally remains elevated throughout the course of the pregnancy.

There are some problems with ovulation that can reduce fertility. Hormone imbalances involving thyroid hormone or prolactin can interfere with ovulation. If the egg is released from a follicle that has a smaller diameter than usual, then a relative progesterone deficiency may develop during the luteal phase of the cycle (luteal phase defect). Also, genetic or inherent problems with the egg can impact fertility.

At The NJ Center for Fertility and Reproductive Medicine, LLC, Dr. Daiter is experienced in identifying and treating ovulation dysfunctions that can result in reduced fertility. For an appointment to discuss your ovulation or fertility concerns with Dr. Daiter, please call the office at 908 226 0250. Visit us on the web at http://www.drericdaitermd.com http://www.ericdaiter.com or http://www.infertilitytutorials.com

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Thursday, October 22, 2009

Ovulation Detection

Ovulation Detection

Normally, a reproductive age woman will have regular menstrual cycle intervals every 28-30 x 4-5 days. Prior to the onset of the menstrual flow, premenstrual symptoms are common (including breast tenderness, headaches, abdominal bloating, and mood swings), which generally reflect the cycle’s normal changes in reproductive hormones. A history of regular menstrual cycle intervals with premenstrual symptoms is fairly strong clinical evidence that ovulation is occurring monthly.

Ovulation normally occurs about 14 days (2 weeks) prior to the onset of the next menstrual flow. In women with very regular menstrual cycle intervals, counting back 14 days from the expected next menstrual flow provides a rough estimate of the date of ovulation.

Ovulation tests include ovulation predictor kits that use test strips that are dipped in urine daily, which cause a chemical reaction that changes the color of the patient’s test result when LH is present. When a mature egg has been developed within the ovary, the body signals the ovary to get the egg ready for fertilization and to release the egg (ovulate) with a surge in the hormone LH. When the patient’s concentration of LH is great enough to suggest the LH surge (trigger to ovulate) then the patient’s test line on the test strip is often equal or darker than the test strip’s reference line. Since the egg normally will ovulate about 36 hours (one and a half days) after the onset of the LH surge, once the test strip is initially positive for the LH surge then ovulation can be expected within a day or so. These test strips are usually accurate for women, but sometimes they don’t seem to be reliable for (work effectively for) a particular woman.

Ultrasound examinations of the ovaries can determine the size of follicles (ovarian cysts that contain an egg) and serial ultrasound exams during the follicular phase of the menstrual cycle (egg development phase) can usually determine with high accuracy when a mature egg has developed. Once the egg is mature, ovulation can be triggered by administering the hormone hCG (human chorionic gonadotropin), which acts exactly like the LH surge to trigger ovulation. In this way, the timing of ovulation can generally be predicted accurately within a few hours.

Dr. Eric Daiter at The NJ Center for Fertility and Reproductive Medicine, LLC has extensive experience with ovulation problems and ovulation detection. He would be happy to help you. For an appointment to discuss your situation with Dr. Daiter, please call the office at 908 226 0250. Visit us on the web at http://www.drericdaitermd.com http://www.infertilitytutorials.com or http://www.ericdaiter.com

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Tuesday, October 20, 2009

Ovulation and Infertility

Ovulation and Infertility

Successful human reproduction normally requires the coordination of several different events, including ovulation (release of a mature fertilization capable egg from the woman’s ovary), sperm production and release (ejaculation of mature motile sperm within seminal fluid), fertilization of the egg in the fallopian tube (sperm moves through the uterine cervix and uterine cavity into the tubes), and implantation of the developing pre-implantation embryo inside the uterine cavity.

Normally, a reproductive age woman will produce one mature egg per month, which is released from the ovary during ovulation. The eggs mature in ovarian cysts called follicles and during the “follicular phase” (egg developing phase) of the menstrual cycle the hormone FSH (follicle stimulating hormone) has a primary role in stimulating the maturation of eggs. Once the egg is developed, then the hormone LH surges to trigger the release of the egg at ovulation. After ovulation, there is an increase in the ovarian production of the hormone progesterone, which modifies and enhances the endometrial lining in preparation for embryo implantation.

Many abnormalities of the menstrual cycle and ovulation can occur and any of these problems will generally reduce fertility or cause infertility. A Reproductive Endocrinologist can suggest a diagnostic evaluation and infertility treatments based on the findings of the diagnostic tests.

Dr. Eric Daiter at The NJ Center for Fertility and Reproductive Medicine, LLC has extensive experience with all types of ovulation problems and menstrual irregularities. Dr. Daiter would be happy to help you to determine the cause of an ovulation problem and suggest treatment options. For an appointment to discuss your situation with Dr. Daiter, please call the office at 908 226 0250. Please visit us on the web at http://www.drericdaitermd.com http://infertilitytutorials.com and http://www.ericdaiter.com

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Monday, October 19, 2009

semen analysis cost

Semen Analysis Cost (2009)

The semen analysis is a basic diagnostic test for male infertility that can determine whether the sperm that is produced within the semen (at ejaculation) has a normal appearance. Sometimes, the semen analysis is proposed as a “sperm function” test, such as when “strict morphology” is performed, but the reliability of a semen analysis to determine the ability of the sperm to fertilize an egg (it’s function) is low (it is unable to accurately predict function).

A semen analysis is a valuable and a relatively inexpensive fertility test. In our offices a basic semen analysis costs 100 dollars and determines the volume (of the total ejaculate), concentration (number of sperm per mL ejaculate), motility (percentage of the total sperm that are moving), and morphology (shape of the sperm) of the sperm. With this information, our Board Certified Reproductive Endocrinologist will be able to consult with you to further discuss useful diagnostic tests and infertility treatments. If a mild to moderate male infertility problem is suggested, starting infertility treatment with natural cycles and intrauterine insemination (IUI) is usually considered. If these are ineffective, more aggressive management is then considered.

Dr. Eric Daiter at The NJ Center for Fertility and Reproductive Medicine, LLC has extensive experience in the treatment of male infertility and he would be happy to help you. For an appointment to discuss your situation with Dr. Daiter, please call the office at 908 226 0250. Also, you can visit us on the web at http://www.drericdaitermd.com http://www.infertilitytutorials.com or http://www.ericdaiter.com

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Friday, October 16, 2009

Hysterosalpingogram or HSG

Hysterosalpingogram

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 http://www.drericdaitermd.com/ or http://www.ericdaiter.com/

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Wednesday, October 14, 2009

Male Factor Infertility

Male infertility

When a couple has been trying to get pregnant for a long time, the partners often try to figure out the reason for their lack of success. Statistically, the reason involves male infertility about one third of the time, female infertility about one third of the time, and a combination of male and female infertility factors the remaining one third of the time. Consulting with a Reproductive Endocrinology and Infertility expert can significantly help to determine the range of causes and develop an infertility treatment plan.

Male infertility can be due to difficulty in completing intercourse, an inability of the sperm to live within the female reproductive tract long enough to fertilize the egg within the fallopian tube, or a problem with the production of normal sperm.

Difficulty with completing intercourse can be due to an erectile or an ejaculatory problem. Sometimes these problems can be effectively treated with medication. When treatment is not possible, but the man is able to produce a semen sample into a container, then intrauterine inseminations (IUI) that are timed at ovulation are often effective.

The sperm normally fertilizes the egg within the woman’s fallopian tube. There is usually a tremendous decrease in the number of motile sperm along this journey from the initial placement within the vagina (where sperm is usually destroyed within about one hour due to a difference in acidity between the semen fluid and the vaginal vault) to residing within the uterine cervical mucus (where sperm can usually survive comfortably for several days) to passage through the uterus and into the fallopian tube. Generally, it is estimated that if 50 million sperm are placed within the vaginal vault during intercourse only a few thousand of these sperm ever reach the fallopian tube, where they have a chance to fertilize the egg. When this type of male factor is a cause of infertility, then IUI (intrauterine insemination) procedures to place the sperm near the egg at the time of ovulation can be helpful.

The semen analysis is the most common test to determine whether normal sperm are being produced. The major variables that are tested include volume (amount of semen in the ejaculate), concentration (number of sperm per unit volume of semen), motility (percent of sperm that are moving), and morphology (shape of the sperm present). When these numbers fall within the normal range for semen analysis, the sperm is thought to be “good.” But really only a history of proven fertility, such as having achieved a pregnancy with someone in the past or having fertilization at IVF (in vitro fertilization), demonstrates that the sperm is actually capable of fertilizing a human egg. For most mild to moderate male infertility problems involving the production of normal sperm, IUI (intrauterine insemination) is a reasonable treatment alternative. If there is a severe male infertility problem with the sperm, then ICSI (intracytoplasmic sperm injection, which is a form of assisted fertilization) or the use of donor sperm may need to be considered.


Dr. Eric Daiter at The NJ Center for Fertility and Reproductive Medicine, LLC has extensive experience with male infertility and has personally performed thousands of semen analyses. He would be happy to help you. For an appointment to discuss your situation with Dr. Daiter, please call the office at 908 226 0250. Visit us on the web at http://www.drericdaitermd.com/or http://www.ericdaiter.com

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Tuesday, October 13, 2009

Female Pelvic Pain

Female Pelvic Pain

Most women will occasionally have some sort of pelvic pain, which can be alarming. Pelvic pain can be caused by many different problems, most of which are transient (short lived and resolve spontaneously). Some causes of pelvic pain represent ongoing long-term problems within the pelvis, most of which can be successfully repaired.

The sudden onset of moderate to severe female pelvic pain during the reproductive years can be caused by gynecological, gastrointestinal, urological or musculoskeletal problems. Gynecological problems include menstrual cramps, pelvic endometriosis, ovarian cysts, degenerating fibroids, pelvic infections, pelvic adhesions (scar tissue), and pregnancy (including ectopic pregnancy). Temperature with a thermometer, a pregnancy test, and bouncing on the heels to gently jar the abdomen can suggest the cause. Any history of fever, positive pregnancy test, or generalized pelvic pain with bouncing on the heels should be reported to your Gynecologist immediately. If there are problems with nausea, vomiting, diarrhea or other intestinal symptoms then you should report this to your primary doctor or Gastroenterologist. If there are problems with urination or bloody urine then this should be reported to your primary doctor or Urologist. If there are problems with moving your legs or back then you should report this to your primary doctor or Orthopedic doctor.

Sometimes the female pelvic pain will last for longer periods of time, such as several months or years. When this is the case, gynecological problems such as endometriosis, pelvic adhesions, persistent nonfunctional ovarian cysts and fibroids are common causes. When the discomfort reaches a level where further investigation and treatment is desired, then a laparoscopy should be considered. Finding an experienced laparoscopic surgeon, and ideally finding a Reproductive Endocrinology and Infertility doctor with specialization in pelvic repair, often allows effective treatment to be completed with only one minimally invasive day stay surgery (laparoscopy).

Dr. Eric Daiter at The NJ Center for Fertility and Reproductive Medicine, LLC has extensive experience with laparoscopy and pelvic repair. He would be happy to help you. For an appointment to discuss your situation with Dr. Daiter, please call the office at 908 226 0250. Visit us on the web at http://www.drericdaitermd.com/or http://www.ericdaiter.com/

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Monday, October 12, 2009

IUI cost

IUI, Artificial Insemination, treatment cycle cost (2009)

IUI (intrauterine insemination) is ideally performed just prior to ovulation (the release of a fertilizable mature egg). The sperm may survive and be able to fertilize a mature egg for several days following artificial intrauterine insemination (IUI) but the mature egg is probably only able to be fertilized for 1 to 2 days after ovulation.

The IUI procedure requires that the semen sample be prepared (washed) to remove the sperm (the male reproductive product that contains the potential father’s DNA) from the semen (liquid secreted from the seminal vesicles that contains prostaglandins). If prostaglandins are placed within the uterus, as would be the case if IUI were performed without washing the sample free of semen, then the woman would suffer terrible uterine cramps for several hours. Generally, in New Jersey IUI costs roughly 200-400 dollars and the washing procedure costs roughly 150-300 dollars.

The total cost of an IUI treatment cycle varies considerably depending on whether fertility ovulation enhancing medications are used. These medications can be expensive and the monitoring that is required for their safe use is also potentially expensive.

In natural ovulation cycles with IUI, where no fertility medications are used, the woman allows her egg to mature on its own and an IUI is performed at the time of ovulation. When a woman has highly predictable menstrual cycle intervals then ovulation can be predicted fairly accurately to occur about 14 days before the onset of the next expected menstrual flow. This timing can be confirmed with an ovulation predictor kit, which generally uses LH detection to determine when the LH surge occurs (the LH surge triggers the release of the mature egg at ovulation). LH ovulation predictor kits often contain several LH detection sticks (one test stick is used each day) and cost about 25-50 dollars per kit. Sometimes, several ovulation predictor kits are required per month if the timing of ovulation is less predictable. If the available ovulation predictor kits are not reliable for a particular woman or if additional accuracy is necessary, then serial ultrasound exams and blood work (for estradiol and LH concentrations) usually is able to determine follicular development more accurately. Often 2-4 ultrasound exams and blood tests are required per cycle. Each ultrasound exam costs roughly 150-350 dollars and blood work at Quest Diagnostics or LabCorp for these hormones can also be a few hundred dollars.

Clomiphene citrate (Clomid) is an ovulation inducing medication that may be effective to regularize or shorten the menstrual cycle intervals if a woman has very irregular menstrual cycle intervals. Clomid often costs less than 100 dollars per cycle and a few ultrasounds or blood tests may be suggested to monitor egg development.

Controlled ovarian hyperstimulation to produce many mature eggs per cycle provide “more targets” for the sperm to attempt to fertilize at IUI and provide a greater per cycle success rate. The medications used for controlled ovarian hyperstimulation are expensive, since each ampule of medication costs 35 – 80 dollars and a woman may use 2 - 6 amps of medication a day for up to 7-10 days (1,000 to 4,000 dollars a cycle depending on medication requirements). Monitoring egg development using 2-5 ultrasound examinations per cycle and blood work 2-5 times per cycle is required to safely administer these medications.

You can save a considerable amount of money as well as increase your chances for success if you consult a Reproductive Endocrinologist (infertility expert) early on to review the range and cost of infertility treatments that may be effective for your unique situation.

Dr. Eric Daiter at The NJ Center for Fertility and Reproductive Medicine, LLC has extensive experience with all types of infertility, the appropriate use of IUI, and he would be happy to help you. For an appointment to discuss your situation with Dr. Daiter, please call the office at 908 226 0250.
For more information please visit us on the web at http://www.drericdaitermd.com/or http://www.ericdaiter.com/

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IUI (artificial insemination)

IUI (Artificial Insemination)

Artificial insemination within a New Jersey fertility office usually includes an IUI (intrauterine insemination). IUI is an office procedure that involves the collection of a semen sample, the washing of the semen sample to remove the semen component, the resuspension of the sperm in a buffered inert medium (often a modified human tubal fluid), and the placement of the washed sperm sample into the woman’s uterus using a thin flexible catheter.

The IUI procedure is relatively inexpensive (generally 200-400 dollars), painless (sometimes slight cramping may occur), and risk free (minimal bleeding and cramping may occur, infection is very rare, and trauma to the uterus is also rare).

IUI (artificial insemination) is an effective treatment when there is a mild to moderate male factor (abnormality in the semen analysis), difficulty completing sexual intercourse (erectile or ejaculatory dysfunction), female domestic partners, an abnormal postcoital test (sperm mucus interaction problem including hostile mucus), or in conjunction with ovulation enhancing fertility drugs (clomiphene citrate = clomid or menotropins including Bravelle or Menopur).

Dr. Eric Daiter at The NJ Center for Fertility and Reproductive Medicine, LLC has extensive experience in IUI 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.
For more information please visit us on the web at http://www.drericdaitermd.com/or http://www.ericdaiter.com/

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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 http://www.drericdaitermd.com/or http://www.ericdaiter.com/

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What is Endometriosis?

What is endometriosis?

“What is endometriosis?” is a common question since endometriosis occurs in roughly 10-15% of all reproductive age women.

Endometriosis is an abnormal condition that afflicts women, in which tissue that normally lines the cavity of the uterus (called endometrium) implants and develops in other areas of the body.

Endometriosis can cause pelvic pain, including but not limited to dysmenorrhea (painful and sometimes disabling pelvic or lower back pain during the menstrual flow), persistent pelvic pain (pelvic or lower back pain that occurs throughout the menstrual cycle), chronic pelvic pain (pain in the pelvis or low back that has persisted for over 6 months), dyspareunia (pelvic and lower back pain with sexual intercourse), dyschezia (painful bowel movements) or dysuria (discomfort with urination).

Endometriosis can also cause reduced fertility or infertility. All stages of endometriosis, from minimal endometriosis (stage I) to severe endometriosis (stage IV), cause a problem with becoming pregnant. Infertility caused by endometriosis is best treated with surgical removal (ablation) of the endometriosis implants. Medical management of endometriosis has been shown to be useful in controlling pain caused by this disorder but has not been shown to be useful in enhancing fertility.

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 http://www.drericdaitermd.com/or http://www.ericdaiter.com/

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Friday, October 9, 2009

Infertility Treatment Cost

The cost of some infertility treatments can be unaffordable, or they may place a significant financial burden on a couple. Fortunately, there are usually a range of different infertility treatment alternatives that could be effective for a couple, based on the results of specific male and female infertility tests. Some of these infertility treatments may be covered by insurance or less expensive in general. Often, an infertility expert can help you to develop a management plan that is both effective and affordable.

It is important to understand your specific medical insurance benefits as well as the costs of different infertility treatments. At The NJ Center for Fertility and Reproductive Medicine, LLC your insurance benefits are checked before your initial appointment so that you know whether you have any out of pocket costs for your infertility treatment. During your initial consultation, Dr. Eric Daiter fully reviews your situation and the full range of appropriate and effective infertility treatments. Throughout your care, you actively participate in deciding on an infertility treatment management plan that you are comfortable with.

For more information, see our website at http://www.drericdaitermd.com/or http://www.ericdaiter.com/

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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 http://www.drericdaitermd.com/ or http://www.ericdaiter.com/

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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 http://www.thenewjerseyfemaleinfertilitycenter.com/p_ovary_03.php ). These endometriosis lesions can progress to red flame lesions (looks like strawberry jam = “atypical endometriosis” see http://www.thenewjerseyfemaleinfertilitycenter.com/p_pelvic_cavity_02.php ). Then these red flame endometiosis lesions can develop into brown or black lesions (look like powder burn marks = “classic endometriosis” see http://www.thenewjerseyfemaleinfertilitycenter.com/p_ovary_04.php). Finally, endometriosis lesions can become irregular white scarred lesions (“burned out endometriosis”). Endometriosis can also form ovarian cysts, called endometriomas or “chocolate cysts.” See http://www.thenewjerseyfemaleinfertilitycenter.com/p_ovary_05.php 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 http://www.drericdaitermd.com/or http://www.ericdaiter.com/

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