Infertility

There are many factors that go into the decision to choose a birth control method. This article is intended to be an overview to help you to think about these choices, and make a decision about what method is best for you.

In general decline in fertility is associated with increasing age, most notably for women. Women are born with a fixed number of oocytes which diminish with age leaving few if any capable of fertilization in the peri menopause.

Questions on Contraception answered by Marta Mendez, MD,

Questions on Contraception answered by Marta Mendez, MD

Questions on Contraception

Questions on Pregnancy

If you’re having sex, pay close attention. Sexually transmitted diseases (STDs) are on the rise in this country and it seems that people aren’t protecting themselves properly.

This is the title of an excellent book by Toni Weschler, MPH, and is the perfect resource for the subject of this column. I feel every teen and young woman should receive this book once she starts having menstrual periods.

For young people sex is a thrilling subject. They romanticise it, seeing it as a source of joy, but at the same time they can be very afraid of it. By the age of 16 half of the young folk in the world have had sexual intercourse.

One of the great joys of life can be having a baby-when we are ready and are able to provide all the love and care a child needs. One of the great setbacks in life can be an unintended pregnancy-especially for a young woman.

The types of birth control that are most reliable for preventing pregnancy are birth control pills, injections, implants, IUDs, and sterilization. Of every 100 women who use one of these types of birth control for a year, about 1 to 5 women will become pregnant.

Neutrophils infiltrate the endometrium pre-menstrually and after long-term progestin only-contraceptive (LTPOC) treatment. Trafficking of neutrophils involves endothelial cell-expressed intercellular adhesion molecule (ICAM-1).

It has been proposed that the autonomy of women is one of the mechanisms of how education influences contraceptive use in developing countries. We tested this hypothesis in a national sample of women in Pakistan.

A number of perimenopausal women and their health care providers choose to either decline or prematurely discontinue use of oral contraceptives (OCs), despite the availability of formulations that can prevent pregnancy and address perimenopausal symptoms. This lack of use is due to several factors.

Uterine fibroids are one of the most common medical conditions affecting women. Despite the fact that at least 1 out of every 4 women has fibroids, there is a considerable amount of misinformation regarding the effects of fibroids and their treatment. In order to fully understand these common uterine tumors, one needs to understand their cause, possible symptoms, diagnosis, and treatment options.

Uterine fibroids, also called myomas, are the most common tumors of the female reproductive organs. Although the exact cause of these tumors is unknown, current medical opinion is that they arise from a single microscopic smooth muscle cell. Smooth muscle cells are the type of cell that forms the uterus.

Many of the fibroid and endometriosis patients I see in my medical practice complain of major stress along with their physical symptoms. My personal impression as a physician who has worked with women patients for close to 20 years is that stress is a significant component of many recurrent and chronic health problems, including fibroids and endometriosis.

In 1984, Lesli Hicks complained to her gynecologist that her lower back hurt. She was told that she'd probably lifted something incorrectly. She sought a second opinion and an ultrasound examination.

Fibroids and Hysterectomies used to go together like Rogers and Hammerstein. Not anymore. If your physician recommends removing your uterus as the most effective treatment for severe fibroids without first considering less invasive therapies, start singing another tune and get a second opinion!

Have you ever noticed how easily misinformation develops and how eagerly it is spread by the ill informed? Of late I have heard and read all manner of seemingly authoritative pronouncements on uterine artery embolization (UAE) for the management of uterine myomas. I even saw an "authority" recently on OPRAH stating that UAE was experimental and not useful for tumors larger 4 cms.

More than 99 percent of fibroid tumors of the uterus are benign, and most require no treatment. However, if these growths get very large, they can become uncomfortable, enlarge the abdomen and bring on loner, heavier menstrual periods. Even some tiny fibroids can cause abnormal bleeding. Until recently, a woman with troublesome fibroids almost always ended up with a hysterectomy.

One hundred and six pregnant women diagnosed with Leiomyoma during pregnancy were evaluated clinically and by ultrasound. Leiomyoma size changes were analyzed on the basis of trimesters. The common echotexture pattern and the different echotextures as well as any changes in the echogenicity were noticed during the follow up. The number and location of the myomata were observed with their impact on pregnancy outcome.

Mrs. Blumenthal*, a 40-year-old G1P1, had young twins at home and was also a full-time student. She delivered her twins in 1992 by C-section after conceiving through IVF. The patient had long-standing endometriosis, treated previously by three abdominal procedures (one laparotomy and two laparoscopies).

In late 1996 Mrs. Martin contacted our office and reported concern over the fact that her periods were occurring every 2 weeks. During the office visit, she stated that she was experiencing heavy bleeding with the passage of clots that lasted approximately 7 days, requiring the use of 10 or more pads per day. The problem was very upsetting to her and was interfering with daily life at home and at work.

Fibroids are non-cancerous (benign) growths of the muscle wall of the uterus. They are probably responsible for more unnecessary gynecologic surgery than any other condition. Every year a staggering 600,000 American women have a hysterectomy. And about 30 percent of those hysterectomies, 180,000 in all, are performed because of fibroids.

Hysterectomy is no longer the only treatment for uterine fibroids. Now, GnRH agonists and laparoscopic coagulation with lasers and bipolar needles are treatment options.

Reproductive endocrinology, a relatively new subspecialty of obstetrics and Gynecology, came of age during the 1980s. The discipline has benefited greatly from substantial recent advances in reproductive biology and allied fields and technologic improvements in computers, ultrasonography, and surgical instrumentation. All of these developments have been applied to clinical practice at an unprecedented rate.

Uterine myomas irrespective of whether they are small and asymptomatic (as in the postmenopausal women) or large and symptomatic (as in premenopausal women) considerably affect uterine artery blood flow velocity. Benign uterine leiomyomas are usually easily recognized with gray-scale ultrasonography, but may sometimes be difficult to differentiate from solid ovarian tumours.

Instillation of sterile saline, air, or other contrast medium through a catheter into the uterus under real-time vaginal transducer observation for enhancement and assessment of endometrial cavity. This procedure is done on day 3 - day 7, near end of menstrual bleeding, when endometrium is thin (Day 6 is generally the "ideal day.")