Our high pregnancy rates result from applying advanced fertility treatments in a caring and empathetic environment.



Infertility, Pregnancy and Your Teeth

Posted by admin | Filed under Uncategorized

Believe it or not, taking care of your teeth is really important while you’re trying to conceive; this is true for both men and women. Healthy teeth and gums are also crucial for a successful pregnancy and childbirth.

A healthy mouth is considered free of cavities, gingivitis and periodontal disease. Cavities are caused when acid, created by consuming sugary drinks and food, reacts with bacteria present in plaque and erodes tooth enamel. Gingivitis, or inflammation of the gums, occurs when plaque buildup causes irritation, redness and swelling. Periodontal disease, also known as periodontitis, is gum disease that has progressed and spread to underlying tissue and can lead to bone and tooth loss.

These three dental conditions all have something in common: bacterial inflammation. As you prepare for conception and pregnancy, it’s important to understand why it may be time to step up your dental care routine.

It can be easy to forget to go to the dentist
Infertility treatment is intense and time-consuming. With all the frequent appointments, it can seem like you are constantly at a doctor’s office. So, it can be easy to neglect the other parts of your body, including your teeth.

Many Americans “forget” to visit their dentist annually or semi-annually. In fact, a Gallup survey conducted in 2014 found that one-third did not visit a dentist at all that year. Many avoid the experience because of the fear that treatment will be painful. But neglecting dental care has its own risks.

Poor oral health can affect overall health
Frequent brushing, flossing and regular checkups will reduce the bacteria in your mouth. These germs can find their way into your bloodstream, causing infections. Severe complications can include cardiovascular disease, diabetes, respiratory infections and dementia, in addition to pregnancy complications, erectile dysfunction and taking longer to conceive.

Dental infections and trying to conceive
The Smile Study was a pregnancy intervention study for women with periodontal disease who were in the second trimester of their pregnancy. The study found it took non-Caucasian women an additional two months to conceive, a negative conception influence similar to obesity.

The researchers advised women to have a dental check-up prior to attempting to conceive. They hypothesized that the low-grade systemic inflammation resulting from periodontal disease could affect the endometrium and the subsequent delayed ability to get pregnant.

Dental disease can also impact sperm
The quantity of healthy sperm can also be compromised by dental health. Research has shown men with poor semen parameters may have bacteriospermia, or bacteria present in the semen, that can kill healthy sperm. A small 2010 Israeli study assessed the semen analyses of 56 men, finding that 80 percent had some form of periodontal disease and 68 percent had a poor or zero sperm count.

Poor dental hygiene can affect your pregnancy
Since the goal of infertility treatment is pregnancy, pre-conception dental care is an essential step. It’s important to make sure your teeth and gums are in top shape before you conceive. This will reduce your chances of contracting gingivitis or worse since increased hormone levels during pregnancy will exacerbate existing periodontal issues. Women with periodontitis are more likely to experience pre-term labor and birth, and deliver low birth weight babies.

We think the message is clear. Don’t neglect your dental health while you’re trying to conceive, during pregnancy or throughout your life. You’ll want your mouth to be picture-perfect when your dream of parenthood comes true!




Dr. Mickey Coffler and the Importance of PCOS Advocacy

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September is PCOS Awareness Month, a wonderful opportunity to educate the public about polycystic ovary syndrome (PCOS), the most common hormonal disorder impacting women.

According to the PCOS Awareness Association, PCOS affects seven million women in the U.S., more than the number of people diagnosed with breast cancer, rheumatoid arthritis, multiple sclerosis and lupis combined. Though millions of women have this syndrome, public awareness about it is not high and support organizations receive very little funding. As a result, close to 50 percent of women are not diagnosed properly or may not learn they have PCOS until they try to get get pregnant.

This year, one of the leading PCOS advocacy organizations, PCOS Challenge, is taking awareness a step further. PCOS Challenge wants Congress to pass legislation (H. Res. 495) to officially designate September as PCOS Awareness Month. This law recognizes the seriousness of PCOS and the need for further research and treatment options and, potentially, a cure. This is a historic, bipartisan effort.

Contact your Member of Congress
PCOS Challenge is encouraging PCOS patients and medical professionals to contact their Congressional representatives to let them know the importance of the bill’s passage. If your Congressional representative is not already a sponsor, you can identify him or her at this link: http://bit.ly/2ePFWy0. Sponsors are listed here: http://www.pcoschallenge.org/prioritize-pcos.

PCOS advocacy organizations
In addition to advocating for positive legislation, PCOS organizations play important roles in moving the conversation forward about how to help women with PCOS control their symptoms, prevent future disease complications like heart disease and diabetes, and combat fertility if pregnancy is their goal. Two of the leading ones are PCOS Challenge and the PCOS Awareness Association.

PCOS Challenge (http://www.pcoschallenge.org), the group behind the passage of H. Res. 495, is one of the leading nonprofit support organizations advancing PCOS awareness and serves nearly 45,000 members. Its focus is education and raising public consciousness; it also provides “confidence” grants to women for laser hair removal and other treatments to deal with body hair growth.

The PCOS Awareness Association (http://www.pcosaa.org) is another not-for-profit providing resources and information to women with PCOS.




Finding the Right Answers with Dr. Michael Feinman

Posted by admin | Filed under Infertility, Uncategorized

Today Amanda is enjoying her life as a busy mother of newborn twin boys. But for more than four years she was frustrated both by her inability to get pregnant as well as by not being able to find a doctor who could provide her with a diagnosis.

Amanda recalled, “I Just wanted to know why I wasn’t conceiving. I’m the type of person who needs to have answers about my problems, but no one could tell me why I couldn’t get pregnant. It was frustrating.”

Amanda and her husband underwent one unsuccessful cycle of IUI with their OBGYN in Florida. After the couple moved to California, they decided to take a short break from fertility treatment. But Amanda was in her mid 30s and soon realized it was “do or die” time for her fertility. After researching clinics, she met with a few doctors and quickly learned how important it is to be compatible with the physician who treats you.

Amanda found her perfect match with Dr. Michael Feinman. “More than with other doctors I met, Dr. Feinman seems to push the envelope of fertility treatment and thinks out of the box,” she said. “Dr. Feinman suggested we have an Endometrial Receptivity Analysis (ERA) before the egg retrieval for our first IVF. This was a game-changer. He wanted to know why I couldn’t get pregnant almost as much as I did. Plus, I liked his dry sense of humor and how he didn’t sugarcoat my situation.”

The ERA assesses the optimal time when the endometrium will be ready for the embryo transfer. Based on the ERA results, Dr. Feinman froze Amanda’s eggs and prescribed progesterone and Estrace for a month. The two embryos Dr. Feinman transferred a month later became Amanda’s twins, Hunter and Cooper.

Amanda advises other couples to be realistic, but hopeful: “With fertility treatment, you may not always get the answers you want. But with a doctor like Dr. Feinman, you can be assured he will go the extra mile to get you answers so you can make the final decision about what is best for you.”




Two Women, One Dream to Create a Family

Posted by admin | Filed under IVF, Uncategorized

In the last several decades, lesbian would-be parents have increasingly sought reproductive assistance to have babies. It’s estimated that approximately one-third of lesbian households have children, having achieved motherhood either through non-assisted insemination, fertility treatment, adoption or through prior heterosexual relationships.

While two women trying to make a family together equals double the set of reproductive organs, they still may encounter obstacles on their way to getting pregnant and having a baby.

If you are part of a same sex female couple, here are some important issues you should consider as you embark on your family building journey.

Testing may necessitate a change in plans
Often couples come to us with a well-conceived idea of who will carry the child and who will provide the egg. However, testing may reveal that one or both women have reproductive challenges.

If that happens, we urge flexibility in moving forward. Many lesbian couples realize they need assistance with insemination, but may not anticipate infertility issues that could arise after we perform diagnostic testing on the woman who will be the genetic mother and/or carry the pregnancy.

Many assisted reproductive options are available
Most couples, especially those with no known infertility conditions, start with intrauterine insemination (IUI), where donor sperm is specially washed, processed and concentrated. Once the sperm has been prepared, it is placed in the uterus using a procedure similar to what you experience in a pap smear.

After three unsuccessful IUIs, or the identification of an infertility diagnosis through testing, our doctors will recommend in vitro fertilization. One woman can be the genetic mother and also carry the child, or each woman can play a role through reciprocal IVF. Occasionally, neither female partner has viable eggs, and then we will recommend donor eggs or donor embryos. If both women have problems with their uterus, they may need to consider surrogacy.

Both partners can be involved in creating their baby
Reciprocal IVF, also know as co-maternity, is a way for two women to be involved in the creation and gestation of their baby. One woman participates in the egg retrieval to use her eggs. The eggs are combined with donor sperm to form embryos. The resulting embryos are transferred to her partner’s uterus.

If both women want to experience childbirth, they each can undergo IVF simultaneously, or at another time when they want to expand their family.

Outside legal counsel might be needed
Since there are LGBT legal and contractual issues regarding same sex parenting, HRC offers legal resources for its patients. This is especially important when you are using a known sperm donor to ensure that donor has no legal parental claim or obligations.

HRC Fertility is dedicated to helping lesbian women achieve their dreams of parenthood. Having a baby is the beginning of an exciting journey that starts with finding a knowledgeable, committed fertility team to guide you and your partner.




The Quest for Eggs and the Risk of OHSS

Posted by Dr Jane L Frederick | Filed under Uncategorized

During IVF, infertility doctors prescribe injectable medications called gonadotropins to help women produce as many robust looking eggs as possible for their upcoming IVF cycle. This is called controlled ovulation induction.

We are on a quest for the optimal number of eggs to combine with sperm to create as many viable embryos as possible. All of these efforts increase our patients’ chances to have a successful IVF cycle now and in the future with frozen cycles.

But there can be side effects from taking these medications. One of the most serious is ovarian hyperstimulation syndrome (OHSS). At HRC Fertility, we are committed to educating our patients to recognize the symptoms of OHSS as well as knowing what to do if they start experiencing any of them. Our first duty to you is to “do no harm.”

Who is most at risk?
Women with polycystic ovary syndrome (PCOS) and those who are underweight are more prone to OHSS. Other indicators are being under 30, having a large number of follicles, an increasing level of estrdiol before an HCG shot and a history of OHSS episodes. Some research has indicated anti-mullerian hormone and antral follicle count levels may be predictive of OHSS, but more studies are needed.

When does OHSS start?
OHSS starts approximately seven to 10 days after your egg retrieval. So be on the alert because it can start with mild symptoms that progress to more serious, and even life-threatening ones.

What is OHSS?
Fertility drugs used for stimulation cause the ovaries to enlarge. In some cases, the ovaries are so sensitive to these medications that they enlarge four to five times their normal size, producing very high levels of estradiol, a form of estrogen.

Having hCG (human chorionic gonadotropin) in your system, which is given in a “trigger” shot to release eggs from mature follicles, also plays a role in OHSS. OHSS may worsen if you become pregnant and create your own hCG.

Occasionally, additional substances may be produced in excess and fluid can collect in the abdomen, which causes swelling and discomfort.

What are the symptoms of OHSS?
It is important to recognize when your symptoms are not normal. Many women will experience a mild amount of bloating or abdominal pain, but when combined with other symptoms or a rapid worsening, it is best to err on the site of caution and let your health care provider know you are feeling discomfort.

Mild to moderate symptoms
Mild to moderate abdominal pain, bloating, nausea, vomiting, diarrhea, ovarian tenderness and a sudden weight increase of two more pounds on any two consecutive days

Severe symptoms
Symptoms can quickly escalate into the severe form and can include excessive bloating; unusual abdominal tenderness or pain; sudden, rapid weight gain as high as 40 to 40 pounds in five to 10 days; noticeable increase in urination; nausea and the inability to eat routine meals or to take fluids; and shortness of breath.

What should you do if you suspect OHSS?
Immediately call your doctor or nurse coordinator. We would rather you be safe than sorry.

Can we prevent OHSS?
Researchers are looking for ways to better predict which patients may be most at risk as well as fine tune medication protocols.

Our physicians closely monitor patients with serial ultrasounds, laboratory testing and by educating you about signs and symptoms of OHSS. Severe OHSS is rare, with one to two percent of women experiencing it, but our goal is to prevent any of our patients from experiencing it. Education, monitoring and communication are key to prevention.