This article is sponsored by The Center for Innovative GYN Care
Planning to have a child can be an exciting and emotionally overwhelming moment. It is an important lifetime commitment. However, for many women and men, soon after trying to start a family, the path becomes murky. Those who struggle with infertility can feel shame, anxiety and depression. This is where a roadmap to parenthood is needed. Women who have had trouble conceiving naturally, or with IUI or IVF treatments should consider getting a fertility evaluation with a GYN specialist.
The investment in fertility treatments can be very expensive. The average cost of an in vitro fertilization treatment is $12,000, and with additional tests or medicine needed, the costs can climb up to $25,000. As families consider expanding, it is wise to make sure that the uterus is a healthy place for a baby to grow. When a GYN condition is resolved prior to beginning treatments, IVF success rates are higher, and often fewer are needed. In many cases, after GYN surgery, couples are able to conceive naturally.
Conditions like fibroids, endometriosis, pelvic adhesions, uterine polyps, uterine septum, and inflammation of the fallopian tubes (hydrosalpinx) can affect the healthy trajectory of a pregnancy. Many women who feel they are ready to start a family have difficulty conceiving, suffer through multiple miscarriages, or deliver early putting the mother and baby at risk. And many of those discover that they have a GYN condition that could have been treated. The emotional toll on a woman or couple trying to conceive can be painful.
If these conditions are identified and treated early there is a greater chance of conceiving and carrying a child to term. If surgery is necessary, minimally invasive GYN techniques make it possible for many women to begin starting their family sooner than with open, more invasive procedures.
INFERTILITY IN THE UNITED STATES
There are many causes of impaired fecundity (this term includes both the inability to get pregnant and/or the inability to carry a child to term), or pre-term birth that can put both mother and child at risk.
Need To Know Infertility Facts from the American Society for Reproductive Medicine:
- Infertility is NOT an inconvenience; it is a disease of the reproductive system that impairs the body’s ability to perform the basic function of reproduction.
- Infertility affects 6.7 million women in the U.S. — about 11% of the reproductive-age population (Source: National Survey of Family Growth, Centers for Disease Control and Prevention [CDC] 2006-2010).
- Men and women have infertility rates that are equal.
- One quarter of infertile couples have more than one factor that contributes to their infertility.
- Most infertility cases — 85% to 90% — are treated with conventional medical therapies such as medication or surgery.
Note: United States statistics on infertility only include married/co-habitating women, and does not reflect the general population. Impaired fecundity stats include all women.
In June 2014, the Centers for Disease Control released National Public Health Action Plan for the Detection, Prevention, and Management of Infertility, a white paper outlining their recommendations for addressing and treating infertility. From the Executive Summary:
“Specifically, this plan focuses on:
- Promoting healthy behaviors that can help maintain and preserve fertility.
- Promoting prevention, early detection, and treatment of medical conditions that can threaten fertility.
- Reducing exposures to environmental, occupational, infectious, and iatrogenic agents that can threaten fertility.
Because of its public health focus, these strategies also call for promoting healthy pregnancy outcomes associated with treating and managing infertility and improving the safety and efficacy of infertility treatments.”
It is no secret that as women and men age, the question of fertility becomes more sensitive. For women who have never had a child, the percentage who experience infertility increases dramatically with age:
- Between ages 15-34, infertility rates range between 7%–9%.
- After 35, infertility affects women proportionately higher.
- One quarter of women (25%) among those aged 35–39 years
- Thirty (30) percent among those aged 40–44 years
EVEN IF YOU WANT TO WAIT TO CONCEIVE, TREAT GYN CONDITIONS EARLY
Infertility rates in women over 35 rise due to diminished egg quality, changes to ovulation, and because of an increased risk of damage to the reproductive organs from untreated gynecological conditions including endometriosis, fibroids, and tubal disease. These conditions are often overlooked by patients and doctors due to societal normalization of pelvic pain or abnormal bleeding associated with women’s menstrual cycle.
ENDOMETRIOSIS: EARLY DIAGNOSIS AND TREATMENT IS ESSENTIAL
It can take up to a decade for a woman to be diagnosed with endometriosis. It is often misdiagnosed or ignored until the pain is extreme. Endometriosis can affect fertility in multiple ways. The body responds to endometriosis by releasing excess inflammatory cells. This can cause pain, or create pelvic adhesions which can prevent conception. In addition, the inflammatory cells can potentially affect sperm function or impair the function of the fallopian tubes, endometriomas, fluid filled cysts on the ovaries that result from endometriosis can alter ovarian function.
FIBROIDS: WATCHING AND WAITING IS DANGEROUS
Fibroids can indeed affect fertility, despite common misperceptions by many women and medical practitioners. Fibroids are often treated as though they are the equivalent to a headache. “Watch and wait; If they aren’t bothering you, you don’t need to do anything about them.” This common phrase uttered in exam rooms dismisses the fact that they can, and very often grow to sizes that can disrupt plans for having a family.
Fibroids can block fallopian tubes, making it difficult for a fertilized egg to make it into the uterus. This can potentially cause an ectopic pregnancy within the tube, a life threatening condition for the mother. Fibroids can make it difficult for an embryo to attach to the uterine wall, or if they are very large, can impede the growth of a fetus. In addition, many women with fibroids end up delivering prematurely, putting the infant at risk.
TREATING GYN CONDITIONS THAT AFFECT FERTILITY AT THE CENTER FOR INNOVATIVE GYN CARE
The advanced trained minimally invasive GYN surgeons Dr. Paul MacKoul, MD, and Dr. Natalya Danilyants, MD at The Center for Innovative GYN Care have developed techniques to treat many of the causes of infertility, with faster recovery times.
Fibroids large or small, no matter the location can be removed safely with the LAAM-BUAO technique. This groundbreaking technique uses just 2 small incisions. Using one 5MM incision at the belly button and an inch and a half incision at the bikini line, the CIGC specialists are able to remove all fibroids and repair the uterus by hand. This ensures the womb is strong enough to hold a growing baby.
Endometriosis, hydrosalpinx, or pelvic/intrauterine adhesions are conditions that can all be treated with DualPortGYN. DualPortGYN uses 2 tiny 5MM incisions, one each at the belly button and the bikini line. Retroperitoneal dissection and temporary occlusion of the uterine artery make CIGC procedures for fertility possible. These are techniques used by CIGC surgeons that allow them to clearly see the entire pelvic cavity. All of the vital structures can be protected so that each GYN procedure can be performed safely, efficiently and thoroughly in an outpatient setting. Resection of endometrial implants, resection of pelvic adhesions, and other procedures are performed with a clear path, so that all of the vital structures can be avoided.
Hysteroscopy is used for two additional conditions, uterine polyps (excess growth of the lining of the womb) and uterine septum (a wedge-like wall at the top of the womb). Hysteroscopy procedures use a thin camera that is inserted into the vagina, and are also performed in an outpatient setting.
If a GYN condition is diagnosed and treated early, there is a higher likelihood of a woman’s chances of conceiving naturally or with fertility treatments, and carrying a child to term. If ignored, damage can be irreversible.