Pelvic Abnormalities Treatable with In Vitro Fertilization – Edison, New Jersey
Even if both partners are able to produce healthy, fertile eggs and sperm, conception may still be hindered if the woman has pelvic abnormalities that prevent fertilization. In these cases, surgery or in vitro fertilization can treat many of our patients from Edison and surrounding New Jersey communities.
- Pelvic Infertility Causes
- Vaginal Abnormalities
- Cervical Mucus Abnormalities
- Defects in the Uterine Cavity
- Fallopian Tube Blockage
- Endometriosis
- Treatments for Pelvic Abnormalities
- Laparoscopy
- In Vitro Fertilization
Pelvic Infertility Causes
Vaginal Abnormalities
Abnormalities of the vagina and uterus can disrupt fertilization. Oftentimes, these irregularities can either be repaired with surgery or bypassed with in vitro fertilization. When you arrive at our Edison, New Jersey fertility center for a consultation with Dr. Eric Daiter, he can determine whether your infertility is caused by pelvic factors. What follow are some of the more common physical defects of the vagina that lead to reduced fertility.
- Fusion of the labia - This is caused by a hormonal imbalance during development in the womb and can cause the vaginal orifice to be smaller and more difficult for sperm to travel through.
- Imperforate hymen – Normally, there is a tiny opening in the hymen that allows menstrual fluid to exit the body. A hymen with no perforation can cause menstrual fluid to flow up and out through the fallopian tubes, increasing the risk of endometriosis.
- Transverse vaginal septum – Also created during development in the womb, a transverse septum is a sort of wall that separates the upper and lower portions of the uterus. A septum can block fertilization by preventing sperm from reaching the mature egg. A skillful vaginal surgeon, such as Dr. Daiter, can remove this septum and reconnect the two halves of the uterus.
Cervical Mucus Abnormalities
The state of mucus created by the cervix is very important to the success of fertility attempts. For most of the ovulatory cycle, cervical mucus is rather thick and too acidic for sperm to survive for long. Just before ovulation, this mucus becomes “friendly” to sperm entering the vagina, changing its pH and viscosity accordingly.
If your cervical mucus is found to be hostile to sperm, you may choose to take a round of hormones or other fertility drugs to correct the mucus. However, many couples find that the time period needed to test, treat, and retest cervical mucus is extremely lengthy; in this case, Dr. Daiter can investigate an alternate fertility treatment plan such as artificial insemination or in vitro fertilization.
Defects in the Uterine Cavity
A uterus with abnormalities can prevent any sperm from making their way to the fallopian tubes. Therefore, it is important to eliminate the possibility of uterine defects early in the infertility treatment process. A hysterosalpingogram, or HSG, is a safe and cost effective way of identifying any abnormalities.
The HSG is a test that allows the doctor to view the inner structure of the uterus and fallopian tubes using fluoroscopy, or moving x-ray pictures. First, Dr. Daiter will inject a small amount of dye into the uterine cavity, after which he will be able to watch its flow on a nearby monitor. Because the image is intensified and magnified on this screen, patients are exposed to a much smaller amount of radiation than was used in the past.
Any adhesions or other abnormalities found during the HSG can be repaired with hysteroscopy, a non-invasive surgical technique in which tools are inserted through the cervix.
After a healthy egg has been fertilized by sperm in the fallopian tube, the newly created embryo normally travels down the tube and implants in the nutrient-rich wall of the uterus. Women who have a congenitally malformed uterus have a lowered chance of successful pregnancy.
Most abnormalities of the uterus are caused when it is developing in the womb. The uterus develops from two tubes known as Mullerian ducts. As a female embryo develops, these two ducts fuse together and eventually form the uterus and fallopian tubes. If this development is disturbed, the following defects that affect fertility can occur:
- Septate uterus – In this case, the uterus is not completely formed into a cavity. The wedge-shaped piece of tissue that remains inside the uterus is not equipped to properly nourish an embryo. Embryos that implant on this piece of tissue tend to result in miscarriage.
- Unicornuate uterus – When one of the Mullerian ducts fails to form, only one fallopian tube and half a uterus are formed. Fertility is dependent on the size of the resulting uterus. There are few accepted surgical techniques to correct this situation; a gestational surrogate may be the best choice.
- Didelphic uterus – If the Mullerian ducts fail to fuse, a woman may develop two cervices and two uteri. Because each of the two uteri are smaller than normal, normal development of an embryo may not be possible.
Fallopian Tube Blockage
If the fallopian tubes are blocked, it is impossible for sperm to reach an egg to fertilize it. Blockage of the fallopian tube where they meet the uterus often comes from a small plug of mucus or tissue, and can be treated with a process similar to an HSG, in which a catheter is used to flush out the plug with dye.
If the blockage is caused by a more serious condition such as endometriosis or severe pelvic adhesions, further surgery may be necessary.
Blockage of fallopian tubes may also occur at the far end of the tubes, near the ovaries. Damage in this area can be serious and is usually caused by inflammation associated with infections in or near the pelvic area. Depending on the amount of damage done by such infections, a woman may not be able to conceive normally. In these cases, in vitro fertilization may provide the best chances of conception and pregnancy. If you live in Edison or elsewhere in New Jersey and would like to learn more about your fertility treatment options, contact the New Jersey Center for Fertility to schedule a consultation with Dr. Daiter.
Endometriosis
Endometriosis is a condition in which uterine tissue grows in places other than the uterus, usually in the pelvic region near the reproductive structures. Its two main symptoms, pain and infertility, depend largely upon the severity of the disease. It is thought that nearly 10 percent of all women develop endometriosis at some point; however, this incidence rises to nearly 40 percent of women with infertility problems.
The causes of endometriosis are not completely understood. Some scientists believe that endometrial tissue grows in the pelvic region when obstructions in the cervix and uterus cause menstrual fluid to flow backwards through the fallopian tubes. Others think that a woman’s lowered immune response can fail to remove endometrial tissue as it develops in unusual places.
Endometriosis has four recognized stages of development. Stages I and II, minimal and mild, do not have a direct effect on fertility, though treatment is recommended so the endometriosis does not progress into stages III or IV, moderate and severe. These more advanced stages have a marked effect on fertility and need to be treated as part of any thorough fertility treatment plan, such as one attempting in vitro fertilization.
Surgery is the only reliable method of diagnosing and treating endometriosis. Dr. Daiter prefers laparoscopy, as it is less invasive than older abdominal surgery methods. Laparoscopy involves only three or four tiny incisions, through which camera equipment and surgical tools are passed. Dr. Daiter uses these tools to find and remove excess endometrial tissue, thereby increasing the chances of fertility.
How well laparoscopy works in your situation is highly dependent on the stage of your endometriosis and whether you have any other physical factors inhibiting your fertility. Keep in mind that there is no way to permanently remove the cause of endometriosis, so your symptoms may reappear in time.
A consultation with Dr. Eric Daiter is the first step towards determining and eliminating the source of your infertility. Contact the New Jersey Center for Fertility to make an appointment.
Treatments for Pelvic Abnormalities
If your infertility results from a physical abnormality of the pelvis, Dr. Daiter can employ a variety of surgical treatments to improve your chances of conception.
Laparoscopy
Laparoscopy is popular due to its non-invasive nature and its adaptability for different pelvic defects. In the past, laparoscopy was mostly used as a diagnostic tool; a camera was inserted through a one-centimeter-long incision so the doctor could see the inside of the pelvic cavity and best gauge the level of injury or disease inside.
As surgical tools such as lasers and ultrasound have become smaller and more portable, Dr. Daiter has been able to use laparoscopy to treat conditions such as uterine adhesions and endometriosis. Quick healing allows women and their partners to concentrate on further fertility treatments such as in vitro fertilization.
In Vitro Fertilization
When faced with pelvic abnormalities such as blocked fallopian tubes or scar damage from endometriosis, in vitro fertilization may allow you to conceive by “getting around” your damaged tissue.
Although Dr. Daiter will customize your in vitro fertilization procedure based on your medical history, most of our Edison, New Jersey patients undergo similar procedures. First, Dr. Daiter may prescribe fertility drugs designed to make several eggs mature at once. Once ready, they will be removed by Dr. Daiter and fertilized in the laboratory using sperm from your partner.
After two to five days, the fertilized eggs have matured into embryos that are ready to be placed back into the womb. This final step of in vitro fertilization is a delicate one, performed by Dr. Daiter himself at the IVF New Jersey facility. He will insert two to four embryos directly into your uterine cavity; if all goes well, one or more embryos will implant and begin to develop into a baby.
If you and your partner have tried unsuccessfully for at least a year to conceive a child, pelvic abnormalities may be to blame. Surgery or in vitro fertilization, both available through our Edison, New Jersey facility, may be able to help you achieve your dream of having a healthy baby. Contact the New Jersey Center for Fertility today to schedule a one-on-one consultation with Dr. Daiter.
Additional Fertility & Reproduction Resources:
http://www.drericdaitermd.com
http://www.infertilitytutorials.com
http://www.thenewjerseyovulationcenter.com/index.php
http://www.thenewjerseypelvicpaincenter.com/clinical_evaluation.php
http://www.thenewjerseyinfertilitytreatmentcenter.com/
http://www.thenewjerseymaleinfertilitycenter.com/
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How Can I help You?
Dr Eric Daiter has 20 years of experience as an infertility expert and he has seen which treatments work best for different situations. If you have a fertility problem, Dr Eric Daiter would be happy to help you (either as a second opinion or a new patient + in the office or on the telephone). It is easy, just call us at 908 226 0250 to set up an appointment (leave a message with your name and number if we are unable to get to the phone and someone will call you back).
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"I always try to be available for my patients since I do understand the pain and frustration associated with fertility problems or endometriosis."
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"I understand that the economy is very tough and insurance companies do not cover a lot of the services that might help you. I always try to minimize your out of pocket cost while encouraging the most successful and effective treatments available."
