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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Sunday, January 13, 2008

Infertility Treatment Articles: Polycystic Ovary Syndrome

Polycystic Ovary Syndrome (PCOS) is a medical condition characterized by high levels of androgen hormones, missed or irregular periods, and multiple cysts on the ovaries. Researchers estimate 1 in 10 women have PCOS, although many are unaware they have it. Because of the confusing nature of the disease and the extensive list of symptoms, coping with PCOS poses a significant emotional and physical challenge.

While researchers have been aware of polycystic ovary syndrome for over 75 years, the exact causes are unknown. Some scientists suspect genes to be the cause. Often women who have PCOS will also have a sister or mother with the disease. Another theory is based around insulin. Women whose bodies have difficulty utilizing insulin end up with higher than normal levels of insulin in their system. Excess insulin increases the production of androgens, male hormones, which may lead to acne, facial hair growth, weight problems, and cysts on the ovaries. Other symptoms may include male pattern baldness, oily skin or dandruff, high blood pressure and cholesterol, infertility, chronic pelvic pain, and sleep apnea. Many women also experience bouts of depression related to their appearance or inability to conceive.

PCOS is one of the most common causes of female infertility. Clinical studies show approximately 70% of infertile women with an ovulation problem have PCOS. High levels of insulin stimulate the ovaries to produce testosterone. This excess testosterone can prevent the ovaries from releasing an egg, resulting in irregular menstrual cycle. Irregular and missed cycles reduce the chances of conception. Once pregnancy is achieved, it can cause complications during pregnancy which may lead to miscarriage or premature delivery. Incidence of miscarriage may be as high as 50%, or 35% higher than the national average. The theory is that high insulin levels result in an irregular blood clotting around the uterine lining which compromises the flow of nutrients and release of wastes between the placenta and the fetus.

Unfortunately there is no cure of the disease; however the symptoms are largely treatable by adjustments in lifestyle and medications. Some medications used during infertility treatment, such as metformin, can help normalize insulin levels and reduce the symptoms experienced. Losing weight may also help reduce symptoms. Oral contraceptive pills, such as can be taken to help regulate periods and cut down on the unwanted hair growth. Treatment plans must be customized, as each woman will experience varying levels of the symptoms.

Researchers are seeking women ages 12 and up to join in studies related to Polycystic Ovary Syndrome all across America. More information about these studies, ranging from genetics, to diabetes, to reproduction, can be found online at www.clinicaltrials.gov.


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 chronic pelvic pain. For more information, please visit www.infertilitytutorials.com



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