‘I love the doctors!’

A patient of ours had these kind words about her treatment:

“I love the doctors! So caring and empathetic. You never feel rushed or just another number. They sit with you and explain everything in detail so you can understand it easily and will make sure you do understand it.”

We thank her so much for taking the time out to share her experience with us. You can read others like this at our web site.

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Endometriosis: Immune cell discovery could provide relief for women with ‘hidden’ pain disorder

A key cause for the pelvic pain experienced by women with endometriosis has been uncovered, potentially opening new opportunities for pain relief for the condition.

Researchers in the United Kingdom have discovered how cells in our immune system play a role in stimulating the growth and activity of nerve cells in the condition, leading to increased sensitivity to pain in the pelvic region. The discovery was published in The FASEB Journal.

Around 176 million women worldwide suffer from endometriosis, in which cells like the internal lining of the uterus (endometrium) grow outside of it in the form of lesions, typically in the pelvic (peritoneal) cavity. It can cause significant pelvic pain and is associated with infertility for some women with the condition. Currently, treatment options are limited to surgical removal of lesions or medical management to suppress ovarian hormone production.

Lead author Dr. Erin Greaves said, “Endometriosis is sometimes considered a ‘hidden disorder’ because of a reluctance to discuss what can be passed off as ‘women’s problems.’ Hormonal solutions rely on suppressing ovarian function but are not ideal as they can cause unwanted side effects, and prevent the user from becoming pregnant. We are trying to find non-hormonal solutions.

“Endometriosis can affect women throughout their lives and is a very common condition,” she continued. “This discovery will go some way towards finding ways to relieve symptoms for women who suffer from endometriosis.”

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Problems conceiving, part 1

Getting pregnant may seem simple, but the act of conceiving a child can often be very difficult. It involves many bodily functions and systems being in good condition in both the male and the female, all of which must happen in the right sequence and at the right time.

Consider that the average woman of reproductive age only has a 20 percent chance of getting pregnant in any month of trying. And if conditions are hampering male and/or female reproductive systems, the chances are much worse. Infertility – defined as not conceiving after 12 months of having sex on a regular basis with no contraception – affects as many as 1 in 8 couples.

Causes of infertility can range from not timing intercourse properly to being overweight to structural problems with the reproductive organs. Reproductive Science Center of New Jersey’s goal is to find out what factors are causing infertility in a woman or couple and develop a personalized treatment plan to help them achieve pregnancy.

The primary causes of failure to achieve pregnancy fall into three categories: medical issues, lifestyle factors and genetics. Patients can address some of these lifestyle issues themselves, and our reproductive endocrinologists can address most medical conditions.

In this series of blog posts, we will discuss those three categories in more detail, along with a fourth category: unexplained infertility. If you’d like a sneak peek at this series, visit our web site.

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CDC reports that US fertility rate is at ‘all-time low’

According to CNN, the general fertility rate in the United States continued to decline last year. A new report from the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics states, “The 2018 general fertility rate fell to another all-time low for the United States.”

The general fertility rate dropped 2% between 2017 and 2018 among girls and women age 15 to 44 nationwide, the report says. In 2017, the total fertility rate for the United States dropped below what’s needed for the population to replace itself, according to a different report by the National Center for Health Statistics in January 2018.

You can read more about the report at CNN’s web site.

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Paternal age over 51 years reduces success rate in IVF and ICSI

While female fertility comes to an end at menopause (at an average age of 51 years), men do not have similar biological senescence. Studies have shown that sperm counts may decline and DNA damage in sperm cells may increase over time, but the celebrity fatherhood of aging actors and rock stars perpetuates the myth that male fertility might last forever.

However, the published evidence does show that men are indeed regulated by a biological clock. Studies have demonstrated a decline in natural male fertility and an increase in miscarriage rate as men get older. So far it is not yet known whether paternal age affects outcomes in IVF and intracytoplasmic sperm injection (ICSI), or if there is (or should be) any age limit to treatment.

A recent analysis of almost 5,000 IVF/ICSI cycles performed at a single center in London indicates that success rates do decline significantly after a paternal age of 51 years. Miscarriage rate in this study was not affected by the age of the male partner. Nevertheless, the investigators confirm that paternal age over 51 does significantly affect the chance of success in assisted reproduction, adding that this warrants a call for “a public health message for men to not delay fatherhood,” said Dr. Guy Morris, from the Centre for Reproductive and Genetic Health in London.

“In the context of this emerging evidence for the deleterious effect of increasing paternal age, our data certainly support the importance of educating men about their fertility and the risks of delaying fatherhood,” he said. This study was observational and not designed to investigate any biological explanation for its findings. However, Dr Morris said that the data “suggest that semen quality decreases with increasing age and that this decline mirrors the decline in IVF outcome which we found.”

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Patient raves about ‘impressive bedside manner’

A recent patient of ours has this to say about her treatment:

“Just started seeing [the doctor]. So far I’m very impressed with him and his staff. He explained things perfectly and he is willing to answer any question I may have. He has an impressive bedside manner. Kim the nurse stays in contact with me and keeps me updated. So far I like everything I see and experience! Hopefully they can help us! His staff has been nothing but kind!”

Thanks to this patient for her kind words. We really appreciate everyone who takes the time to share their experience with us. Please read more such reviews at our web site.

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How to get pregnant on your own: part 6

Difficulty conceiving can be a result of factors that affect both men and women. This includes lifestyle factors well within the control of both partners. Couples should consider making some lifestyle adjustments before and during their efforts to conceive. In the last part of our series on how to get pregnant on your own, we offer the following do’s and don’ts for increasing your odds.

Step 6: Lifestyle changes that can help couples get pregnant

Do eat a healthy, well-balanced diet. A healthy diet helps with weight management. Research shows that a healthy diet can help mitigate the relationship between weight and infertility, as obese, overweight or underweight women can experience a decrease in fertility. Obesity also negatively affects men’s sperm count and quality.

Do start taking prenatal vitamins. A large body of research shows that women who take folate-containing vitamins or folic acid supplements prior to conceiving and through the course of their pregnancy can reduce the risk that their offspring will be born with birth defects.

Do continue moderate exercise. Moderate exercise looks different for every individual, based on their fitness level and fitness goals. Exercise can help manage stress, which can interfere with female ovulation, and help men and women manage their weight, which can impede fertility.

Do limit caffeine consumption. Though the connection is somewhat unclear, excess caffeine consumption (more than four cups of coffee a day) appears to harm female fertility and may increase the risk of miscarriage. Reduced fertility was not seen in women who drink less than two cups a day.

Do discuss medications with a doctor. Certain prescription and over-the-counter medications can increase the risk of birth defects. Always discuss the medications you are taking with your provider to review the safety of those medications while attempting to conceive.

Don’t use tobacco products or other recreational drugs. Tobacco products, including but not limited to cigarettes, cigars, electric cigarettes or vape pens, and chewing tobacco, negatively impact fertility in women and men.

Don’t drink alcohol. Women who are trying to get pregnant are encouraged to stop using alcohol completely. Alcohol consumption can lower the number and quality of a man’s sperm and contribute to poor overall health.

Want more info on how to get pregnant? Visit our web site.

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Dr. Martinez ‘is my hero’

A happy patient writes:

“Wow—Alan Martinez is my hero. When I met Dr. Martinez I fell in love with his positivity even after I had failed IVF with a different doctor. First IVF, 2 embryos, one transfer and another frozen. Pregnancy test — PREGNANT with a healthy baby girl. Went back 18 months later and today I’m eight-weeks pregnant with my frozen embryo. Wow he is just amazing in every single way. I love him and his staff!!! Marianela is one of the greatest MAs. Thank you for completing my family and making my dreams come true.”

Congratulations! And thanks to her for her kind words. We really appreciate those patients who take the time to share their experience with us. You can read more of them here.

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How to get pregnant on your own: part 5

Before exploring fertility care and services, couples should first try everything they can to increase their chances for natural conception. In the fifth part of our series on how to get pregnant on your own, we offer this tip.

Step 5: Ovulation tracking methods

While this natural fertility window is optimal during certain days of the female menstrual cycle, ovulation is often difficult to track with precision. According to a study from ASRM and the Society for Reproductive Endocrinology and Infertility (SREI), ovulation tracking methods can accurately predict when ovulation is occurring, but there is little evidence that ovulation monitoring during the menstrual cycle increases the chances of achieving pregnancy. Women who track their cycles by using observations of several factors accurately predict their ovulation about 50 percent of the time.

Ovulation tracking is quite difficult because menstrual cycles vary in length, and irregular menstrual cycles are not uncommon in women. Though 25 percent of infertility cases involve ovulatory disorders, irregular cycles are not always an indication of infertility. A medical evaluation can determine if irregular menses are actually within the normal range or the result of an underlying condition.

When used properly, ovulation tracking methods can help predict when ovulation is occurring for many women with some accuracy. Though ovulation tracking does not significantly increase the chances of pregnancy, it can help couples better predict when the “fertile window” will occur and determine the best days to have intercourse.

Popular ovulation monitoring techniques include the following:

  • Smartphone apps. Smartphones can help users calculate when ovulation will begin. Most apps estimate approximate ovulation dates with information the user provides and average cycle length information. These are no more accurate than counting the days on the calendar manually.
  • Tracking changes in cervical mucus. During each menstrual cycle, vaginal secretions change consistency and can be used to somewhat reliably determine what stage of the menstrual cycle a woman is in. Research conducted by ASRM found that tracking changes in cervical mucus can be more effective than tracking menstruation and ovulation on a calendar. However, the practice is still quite limited.
  • Measuring basal body temperature (BBT). Basal body temperature may rise after ovulation has occurred. Measuring BBT can determine that ovulation has already occurred but it cannot predict when ovulation is going to happen.
  • Urine analysis kits. These measure the level of luteinizing hormone (LH) in the urine. LH levels in the urine surge 12-36 hours before ovulation begins. When used properly, LH tests can identify whether ovulation is occurring over 80 percent of the time. Research shows that though relatively effective in determining ovulation, LH testing can result in false positives and provide unreliable results if the user is taking ovulation induction medications, has POCS (polycystic ovary syndrome), or has unknowingly entered menopause.

Want more info on how to get pregnant? Visit our web site.

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‘Warm and caring’

A patient of ours writes:

“Dr. Mensah is very warm and caring. She makes you feel comfortable in uncomfortable situations. She’s stepped in to assist on two different procedures and it was flawless after her arrival.”

Thanks so much to this patient for the kind words. We really appreciate everyone who takes the time to share their experience with us. You can read more like this at our web site.

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