Doctors Discovering More Clues to Solve the Mysteries of Infertility
There is little in the world of medicine more frustrating than the mysteries of infertility. The American Society for Reproductive Medicine reports that about 10% of childbearing couples in the U. S. struggle with the questions of infertility. The process of conceiving and carrying a healthy baby to term is complex, with many variables that have to fall into place. There are numerous factors that affect this delicate balancing act, but by breaking the process down and focusing on the minute details of each stage of conception, reproductive medicine researchers have been able to solve many issues that were a mystery to us just a few years ago.
Norwalk and Danbury, CT (PRWEB) June 14, 2006
There is little in the world of medicine more frustrating than the mysteries of infertility. The American Society for Reproductive Medicine reports that about 10% of childbearing couples in the U. S. struggle with the questions of infertility. “Why can’t we achieve pregnancy on our own?” “Why didn’t our In Vitro Fertilization attempts work?” “Do I have ‘good’ eggs?” While the process of conception still remains a mystery at many levels, the good news is that researchers are finding more and more clues to improving the process, from ovulation and egg retrieval to fertilization and implantation.
“The process of conceiving and carrying a healthy baby to term is complex, with many variables that have to fall into place,” notes Dr. Mark Leondires, M. D., a reproductive endocrinologist, Medical Director at Reproductive Medicine Associates of CT, and a leading authority on reproductive medicine. “There are numerous factors that affect this delicate balancing act, but by breaking the process down and focusing on the minute details of each stage of conception, reproductive medicine researchers have been able to solve many issues that were a mystery to us just a few years ago,” Dr. Leondires adds.
It all starts with an egg
In fertile women, each month one follicle nurtures the growth of a single egg that is released into the fallopian tube then fertilized. However, the process is not quite so simple for the roughly 6 million American women who struggle with infertility. Stimulating ovulation with medication has been standard therapy for ovulatory disorders, but Dr. Leondires explains that research and practice have led to a more targeted approach in recent years. “Today we have an arsenal of different therapy combinations, from those that work best on young, responsive patients to those that are effective with poor responders whose follicle counts are lower than usual,” he says.
Delivering the sperm
When conception occurs naturally, the sperm meets and fertilizes the egg somewhere between the ovaries and the uterus – usually in the fallopian tubes. However, a host of factors can make this process difficult, if not impossible, and that’s where In Vitro Fertilization (IVF) comes in. “Today we can help women with structural abnormalities in the reproductive organs that make it impossible to conceive naturally, as well as men whose sperm quality or quantity make it difficult to achieve fertilization, to conceive through IVF,” Dr. Leondires notes. “Although IVF facilitates fertilization by joining the sperm and egg in the laboratory it does not guarantee fertilization,” Dr. Leondires points out. “Many factors come into play. The sperm must be able to penetrate the egg, then the sperm and egg membranes must merge, and finally, the egg must ‘close’ itself off to other sperm,” he explains. Doctors can also assess any problems that are occurring during the fertilization process, and fix them with a process called Intracytoplasmic Sperm Injection (ICSI). “With ICSI, one healthy sperm is injected directly into the egg, which eliminates challenges associated with membrane penetration or additional sperm entry,” Dr. Leondires adds.
Monitoring the embryo
Once an embryo is created, doctors have new ways to monitor and evaluate its likelihood of survival in the womb. A recent trend is to allow the embryo extra time in the laboratory, enough to develop into a blastocyst. “As a more mature embryo comprising 125-530 cells, a blastocyst may allow improvement in embryo selection for transfer, which could lead to fewer embryos transferred and a lesser chance of a
Multiple gestation, which in and of itself can be a risk for loss of the pregnancy,” Dr. Leondires explains.
In fact, Dr. Leondires urges IVF patients to consider the potential for multiple births seriously when they are asked how many embryos they wish to transfer per attempt. “I encourage my own patients to weigh their diagnosis, the number of cycles they have undergone, and the risks associated with a multiple gestation. ,” he notes.
After the transfer
“Supporting the early pregnancy is another challenge that reproductive medicine experts have been researching for many years, and we have learned that there are probably hundreds of factors that converge perfectly in order to create a successful implantation,” Dr. Leondires says. The good news is that miscarriage rates are no higher for IVF pregnancies than they are for naturally conceived pregnancies. “When an infertility patient successfully conceives, she is carefully monitored, and given hormone replacements that simulate what the body does naturally to support a healthy pregnancy to term,” Dr. Leondires explains.
“Like many other ‘medical mysteries,’ infertility is becoming less and less mysterious as researchers and physicians work to uncover effective new ways to treat this challenging disease,” Dr. Leondires concludes.
Dr. Mark P. Leondires, M. D., FACOG, is a leading authority on reproductive medicine. Dr. Leondires is board certified in Reproductive Endocrinology and Infertility. He is a member of the Society of Reproductive Endocrinologists, the American College of Obstetrics and Gynecology, and the American Society for Reproductive Medicine. Dr. Leondires earned his medical degree from the University of Vermont College of Medicine and completed his residency in Obstetrics and Gynecology at Maine Medical Center in Portland, Maine. Dr. Leondires completed a fellowship in Reproductive Endocrinology and Infertility at the National Institutes of Health in Bethesda, Maryland. After completion of his training, he fulfilled his military obligation by serving as the ART Director for the largest and most successful program in the military health care system at Walter Reed Army Medical Center. During this time he was an Assistant Professor at the Uniformed Services University of Health Sciences and clinical faculty for the Combined Fellowship in Reproductive Endocrinology. Dr. Leondires is currently Medical Director and lead physician with Reproductive Medicine Associates of Connecticut (RMA-CT) in Norwalk. Along with numerous teaching and research activities, Dr. Leondires has published articles in professional medical journals, national consumer magazines and newspapers, as well as abstracts and book chapters. More information about Reproductive Medicine Associates of Connecticut is available at www. rmact. com.
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