An ectopic pregnancy, or tubal pregnancy, is one that occurs outside of the womb. The most common location for an ectopic pregnancy is inside one of the fallopian tubes. This can occur when an egg is fertilized and does not implant into the uterus. The fertilized egg can attach to the inside of the fallopian tube, the ovary, the outside of the uterus or to the intestine. Fertilized eggs that implant outside of the uterus can not grow to become fetuses due to the lack of nutrients and non-accommodating organs.
Ectopic pregnancies are very dangerous. As the attached fertilized egg grows, it can damage organs and cause severe internal bleeding. For example, your fallopian tube isn’t designed to expand and accommodate a growing fetus. Therefore, if a fertilized egg implants there, it can rupture the tube. Arteries are located nearby and they can rupture as well.
The most common symptoms of an ectopic pregnancy are vaginal bleeding and abdominal or pelvic pain. Symptoms can become much more severe if the ectopic pregnancy ruptures. You may become dizzy or even pass out. You may experience a fast heart rate of over one hundred beats per minute. You may become pale, clammy and sweaty. Pain will become so severe that you are unable to stand or walk. Many women go into shock when an ectopic pregnancy ruptures.
If you suspect that you have an ectopic pregnancy or ectopic rupture, then you should immediately seek medical attention as you could have an immediate life-threatening condition. First, pregnancy will be confirmed. Second, an ultrasound will be performed to confirm that the pregnancy is ectopic. This will also help locate the developing embryo (fertilized egg). If the embryo or the gestational sac is too small to be detected by ultrasound, and you are in stable condition, then your doctor may monitor you closely by performing blood tests every two to three days to follow hormone levels. When the pregnancy (gestational sac, embryo or fertilized egg) has grown large enough, the ultrasound will be repeated to locate it. If it is confirmed that the pregnancy is ectopic, then immediate treatment will be ordered.
Depending on how long the fertilized egg has been growing, your doctor may be able to treat your ectopic pregnancy with a methotrexate injection. Make sure that you discuss with your doctor what you should expect after the injection, the risks involved and how to take care of yourself after the drug has been administered. If the drug is not effective or if the pregnancy (fertilized egg) has grown too large, then surgery will be necessary to remove the growing gestational sac and embryo (fertilized egg). Remember that this is not a viable egg capable of growing into a live born fetus, and it is a definite life-threatening situation.
The surgery depends on the size and location of the implanted egg. Whether or not you want to be able to conceive again is also a consideration. Laparoscopy can sometimes be used to remove the pregnancy. Keep in mind that if it is an emergency situation or if there is extensive internal injury, then a more a more extensive surgery called a laparotomy often must be performed.
If you believe that you may be experiencing any of the symptoms discussed here, seek immediate medical care. Time is of the essence when dealing with a possible ectopic pregnancy.
About the Author: Dr. Eric Daiter (Daiter, Eric), the medical director of The NJ Center for Fertility and Reproductive Medicine, LLC, a leading NEW JERSEY INFERTILITY CENTER that offers a complete range of MALE INFERTILITY AND FEMALE INFERTILITY TREATMENT. For more information on The NJ Center for Fertility and Reproductive Medicine and Daiter, Eric please visit www.drericdaitermd.com.
Monday, January 28, 2008
Sunday, January 20, 2008
Infertility and DES Exposure
Women who were pregnant between 1938 and 1971 were commonly given diethylstilbestrol (DES) by their doctors. DES is a synthetic estrogen. Doctors used to believe that DES helped to reduce the number of miscarriages and premature births that women were experiencing. If your mother was given DES, then you may experience some infertility problems or other health complications as a result.
First, try to determine if your mother was given DES during her pregnancy with you. This may be hard to determine because it may have happened so long ago. Also, many doctors just told their patients that they were taking vitamins. The really sad part about this is that DES exposure can cause cancer and infertility in the women that took it, as well as their children. If you determine that you were exposed to DES, then you should inform your doctor or infertility specialist so that special care can be taken, especially during infertility treatment.
Being exposed to DES in utero puts women at a higher risk for pregnancy complications such as ectopic pregnancies, miscarriage or premature deliveries. This does not mean that you are incapable of becoming pregnant and carrying to term if you have been exposed to DES. Many women do become pregnant and carry to term despite their exposure. The reasons that DES has negative effects on women are not entirely clear. It is widely believed that the DES exposure affects the formation of the cervix. If this is true, then it can explain why exposed women have a higher number of miscarriages than non-exposed women.
If you suspect that you have been exposed to DES, then it is very important to work closely with your family physician or infertility specialist. Your doctor should order screenings to see if you have any of the negative health effects of DES exposure. Breast exams and mammograms should be performed regularly. Self breast exams should be performed at least monthly so that you can catch changes early. You should receive regular pelvic exams and PAP smears. Your doctor may do an extra type of PAP smear to check for clear cell adencarcinoma, believed to be caused by DES exposure.
Clear cell adencarcinoma is the type of cancer believed to be linked to DES exposure. This is a rare type of cancer that affects the vagina and cervix. Survival rates are very high for this type of cancer. The most common treatment for clear cell adencarcinoma is surgery. The surgery usually includes the removal of the uterus, fallopian tubes, and ovaries. Occasionally the vagina, or parts of the vagina, must also be removed. The surrounding lymph glands may also be removed. Radiation may also be used to treat the cancer.
Work closely with a caring physician or infertility specialist that understands what you could be facing. If it is determined that you were exposed to DES, then you will need special health care as well as special pregnancy monitoring in your quest to conquer infertility.
On occasion, patients of Dr. Daiter, Eric have offered their testimonials for other couples seeking quality infertility treatment. This testimonial may help you with your decision when you are choosing a reproductive endocrinologist for your infertility treatment.
Dr. Daiter, Eric was always discussing with us where we were and what our next options were. He explained all the various treatments from mildly aggressive to very aggressive and worked with us to come up with a plan that we all felt comfortable with. I always felt like he kept me very well informed so that I could make intelligent choices. He always personally called me when ever I had some tests done, as soon as he got the results and discussed them. This was usually within a day of the tests being done. That really stood out in my mind because, with all my other doctors, when I have lab work done, it takes a good week before I hear anything from them. Even then, many times their policy is to have the office staff call only when there is a problem. You can only hope that nothing was overlooked.
I spoke to other people who were going to other Infertility Specialists in the area and they said their doctors would only discuss the test results after a whole series of tests were done. The patients expressed that the doctors made them feel rushed and uncomfortable asking a lot of questions. They also expressed that the office staff was rude and abrupt with them when they called with questions. I was very fortunate – I never felt this way with Dr. Daiter, Eric or his office staff.
About the Author: Dr. Eric Daiter (Daiter, Eric), the medical director of The NJ Center for Fertility and Reproductive Medicine, LLC, a leading NEW JERSEY INFERTILITY CENTER that offers a complete range of MALE INFERTILITY AND FEMALE INFERTILITY TREATMENT. For more information on The NJ Center for Fertility and Reproductive Medicine and Dr. Daiter, Eric please visit www.drericdaitermd.com.
First, try to determine if your mother was given DES during her pregnancy with you. This may be hard to determine because it may have happened so long ago. Also, many doctors just told their patients that they were taking vitamins. The really sad part about this is that DES exposure can cause cancer and infertility in the women that took it, as well as their children. If you determine that you were exposed to DES, then you should inform your doctor or infertility specialist so that special care can be taken, especially during infertility treatment.
Being exposed to DES in utero puts women at a higher risk for pregnancy complications such as ectopic pregnancies, miscarriage or premature deliveries. This does not mean that you are incapable of becoming pregnant and carrying to term if you have been exposed to DES. Many women do become pregnant and carry to term despite their exposure. The reasons that DES has negative effects on women are not entirely clear. It is widely believed that the DES exposure affects the formation of the cervix. If this is true, then it can explain why exposed women have a higher number of miscarriages than non-exposed women.
If you suspect that you have been exposed to DES, then it is very important to work closely with your family physician or infertility specialist. Your doctor should order screenings to see if you have any of the negative health effects of DES exposure. Breast exams and mammograms should be performed regularly. Self breast exams should be performed at least monthly so that you can catch changes early. You should receive regular pelvic exams and PAP smears. Your doctor may do an extra type of PAP smear to check for clear cell adencarcinoma, believed to be caused by DES exposure.
Clear cell adencarcinoma is the type of cancer believed to be linked to DES exposure. This is a rare type of cancer that affects the vagina and cervix. Survival rates are very high for this type of cancer. The most common treatment for clear cell adencarcinoma is surgery. The surgery usually includes the removal of the uterus, fallopian tubes, and ovaries. Occasionally the vagina, or parts of the vagina, must also be removed. The surrounding lymph glands may also be removed. Radiation may also be used to treat the cancer.
Work closely with a caring physician or infertility specialist that understands what you could be facing. If it is determined that you were exposed to DES, then you will need special health care as well as special pregnancy monitoring in your quest to conquer infertility.
On occasion, patients of Dr. Daiter, Eric have offered their testimonials for other couples seeking quality infertility treatment. This testimonial may help you with your decision when you are choosing a reproductive endocrinologist for your infertility treatment.
Dr. Daiter, Eric was always discussing with us where we were and what our next options were. He explained all the various treatments from mildly aggressive to very aggressive and worked with us to come up with a plan that we all felt comfortable with. I always felt like he kept me very well informed so that I could make intelligent choices. He always personally called me when ever I had some tests done, as soon as he got the results and discussed them. This was usually within a day of the tests being done. That really stood out in my mind because, with all my other doctors, when I have lab work done, it takes a good week before I hear anything from them. Even then, many times their policy is to have the office staff call only when there is a problem. You can only hope that nothing was overlooked.
I spoke to other people who were going to other Infertility Specialists in the area and they said their doctors would only discuss the test results after a whole series of tests were done. The patients expressed that the doctors made them feel rushed and uncomfortable asking a lot of questions. They also expressed that the office staff was rude and abrupt with them when they called with questions. I was very fortunate – I never felt this way with Dr. Daiter, Eric or his office staff.
About the Author: Dr. Eric Daiter (Daiter, Eric), the medical director of The NJ Center for Fertility and Reproductive Medicine, LLC, a leading NEW JERSEY INFERTILITY CENTER that offers a complete range of MALE INFERTILITY AND FEMALE INFERTILITY TREATMENT. For more information on The NJ Center for Fertility and Reproductive Medicine and Dr. Daiter, Eric please visit www.drericdaitermd.com.
Thursday, January 3, 2008
Hysteroscopy
Couples looking to get pregnant may find themselves seeking help from an infertility specialist. After an infertility evaluation and diagnosis, your doctor can give you all of your options weighing cost, benefits and risks. If you are a woman combating infertility and you have irregular or uncommonly heavy periods, then your reproductive endocrinologist may wish to perform a hysteroscopy.
This procedure is performed with a hysteroscope, or a tiny telescope that allows your doctor to look around inside of your uterus. It is inserted through the vagina and cervix and is considered a minimally invasive surgery. The shape and structure of the uterus will be inspected for any abnormalities. Your doctor will look for polyps and fibroids that could be causing you problems. From here, your doctor can take biopsies of your uterine lining for closer inspection. Fibroids can be removed as well. The openings of your fallopian tubes can be inspected with the hysteroscope. For removal of fibroids, polyps or uterine lining, special surgical instruments can be inserted through the hysteroscope once it is in place.
Your doctor may suggest that you have a hysteroscopy in the office under a local anesthetic for diagnosis of uterine problems causing irregular periods, heavy bleeding or failed attempts at becoming pregnant or sustaining a pregnancy. If it is determined that a surgical procedure is necessary, then you will most likely be placed under general anesthesia for the hysteroscopy. Many surgeries inside of the uterine cavity can be performed with the help of a hysteroscope.
Recovery time is generally very low when a hysteroscope is used. This is because there are no actual incisions made during the procedure. Hysteroscopic procedures are very common when determining the causes of infertility. When used for diagnostic purposes, the complication rate is extremely low. When used operatively, you should discuss the risks associated with the specific procedure that you’re having with your doctor.
Depending on your condition, your doctor may recommend a sonohysterography before a hysteroscopic procedure. This is basically a fluid injected through the cervix into the uterine cavity. A sonogram is then performed to get an idea of what may be going on inside the uterus. The fluid gives a contrasting view of the uterine cavity and can be very effective at determining the presence of uterine abnormalities.
Talk to your doctor about all of your options when determining the causes of your infertility. Choose your reproductive endocrinologist well. Consider experience, success rates and patient testimonials when making your decision. This information about hysteroscopic procedures has been provided by Dr. Daiter, Eric. Here is a sample patient testimonial about Dr. Daiter, Eric that may give you an idea of what type of person you are looking for when choosing your infertility specialist:
I was referred to Dr Eric Daiter by my OB-GYN in early 2002. Dr Daiter offers extended office hours for the convenience of his patients. As a result, my husband and I were able to get an appointment within a few days. Before even meeting Dr Daiter, I was happy with the way he accommodated us. After meeting with him, I was very pleased to have been referred to him. He was extremely professional, taking the time to thoroughly explain to us all of the available procedures, their ramifications, and their potential outcomes. I felt very comfortable to continue the pursuit to identify and understand the cause of our infertility under the care of Dr Eric Daiter.
I had the following procedures performed by Dr Eric Daiter: uterine biopsy, hysterosalpingogram, hysteroscopy and laparoscopy. In general, each procedure was completed safely, successfully and without complications. Before each procedure, Dr Daiter explained, in detail, what I could expect during each procedure and what the possible outcomes would be. Dr Daiter never progressed to the next step until he was certain that all of my questions had been addressed and I felt comfortable with the upcoming procedure. I trusted Dr Daiter because I felt he was committed to me and my husband and our quest to find the root of our infertility. I value Dr Daiter as a professional, but more importantly as a caring and compassionate human being. The attention he displays through his commitment toward his profession and patients made us feel as if he was truly an interested party and not just a detached professional.
About the Author: Dr. Eric Daiter (Daiter, Eric) is the medical director of The NJ Center for Fertility and Reproductive Medicine, LLC, a leading NEW JERSEY INFERTILITY CENTER that offers a complete range of MALE INFERTILITY AND FEMALE INFERTILITY TREATMENT. For more information on The NJ Center for Fertility and Reproductive Medicine and Daiter, Eric please visit www.drericdaitermd.com.
This procedure is performed with a hysteroscope, or a tiny telescope that allows your doctor to look around inside of your uterus. It is inserted through the vagina and cervix and is considered a minimally invasive surgery. The shape and structure of the uterus will be inspected for any abnormalities. Your doctor will look for polyps and fibroids that could be causing you problems. From here, your doctor can take biopsies of your uterine lining for closer inspection. Fibroids can be removed as well. The openings of your fallopian tubes can be inspected with the hysteroscope. For removal of fibroids, polyps or uterine lining, special surgical instruments can be inserted through the hysteroscope once it is in place.
Your doctor may suggest that you have a hysteroscopy in the office under a local anesthetic for diagnosis of uterine problems causing irregular periods, heavy bleeding or failed attempts at becoming pregnant or sustaining a pregnancy. If it is determined that a surgical procedure is necessary, then you will most likely be placed under general anesthesia for the hysteroscopy. Many surgeries inside of the uterine cavity can be performed with the help of a hysteroscope.
Recovery time is generally very low when a hysteroscope is used. This is because there are no actual incisions made during the procedure. Hysteroscopic procedures are very common when determining the causes of infertility. When used for diagnostic purposes, the complication rate is extremely low. When used operatively, you should discuss the risks associated with the specific procedure that you’re having with your doctor.
Depending on your condition, your doctor may recommend a sonohysterography before a hysteroscopic procedure. This is basically a fluid injected through the cervix into the uterine cavity. A sonogram is then performed to get an idea of what may be going on inside the uterus. The fluid gives a contrasting view of the uterine cavity and can be very effective at determining the presence of uterine abnormalities.
Talk to your doctor about all of your options when determining the causes of your infertility. Choose your reproductive endocrinologist well. Consider experience, success rates and patient testimonials when making your decision. This information about hysteroscopic procedures has been provided by Dr. Daiter, Eric. Here is a sample patient testimonial about Dr. Daiter, Eric that may give you an idea of what type of person you are looking for when choosing your infertility specialist:
I was referred to Dr Eric Daiter by my OB-GYN in early 2002. Dr Daiter offers extended office hours for the convenience of his patients. As a result, my husband and I were able to get an appointment within a few days. Before even meeting Dr Daiter, I was happy with the way he accommodated us. After meeting with him, I was very pleased to have been referred to him. He was extremely professional, taking the time to thoroughly explain to us all of the available procedures, their ramifications, and their potential outcomes. I felt very comfortable to continue the pursuit to identify and understand the cause of our infertility under the care of Dr Eric Daiter.
I had the following procedures performed by Dr Eric Daiter: uterine biopsy, hysterosalpingogram, hysteroscopy and laparoscopy. In general, each procedure was completed safely, successfully and without complications. Before each procedure, Dr Daiter explained, in detail, what I could expect during each procedure and what the possible outcomes would be. Dr Daiter never progressed to the next step until he was certain that all of my questions had been addressed and I felt comfortable with the upcoming procedure. I trusted Dr Daiter because I felt he was committed to me and my husband and our quest to find the root of our infertility. I value Dr Daiter as a professional, but more importantly as a caring and compassionate human being. The attention he displays through his commitment toward his profession and patients made us feel as if he was truly an interested party and not just a detached professional.
About the Author: Dr. Eric Daiter (Daiter, Eric) is the medical director of The NJ Center for Fertility and Reproductive Medicine, LLC, a leading NEW JERSEY INFERTILITY CENTER that offers a complete range of MALE INFERTILITY AND FEMALE INFERTILITY TREATMENT. For more information on The NJ Center for Fertility and Reproductive Medicine and Daiter, Eric please visit www.drericdaitermd.com.
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