All posts in Reproductive health

Understanding Secondary Infertility

Young mother working with her baby“I can’t be infertile. I already have a child. So, what’s wrong with me?” These words are spoken too frequently by loving women struggling to expand their families. Infertility is a heartbreaking condition that impacts 7.5 million American women. While many associate infertility issues with couples striving to conceive their first child, more than three million women who have already had a child find themselves unable to conceive a second time, leaving them frustrated and uncertain.

If you’re looking to grow your family, but are experiencing difficulties conceiving after your first child, talk to your OBGYN about the possibility that you are experiencing secondary infertility. To prepare for your conversation, read on to learn more about this condition, and its causes.

Secondary Infertility Defined

Secondary infertility occurs when a woman is unable to get pregnant, or carry a pregnancy to full term, after she has had her first child. Your OBGYN may diagnose you as experiencing secondary infertility if:

  • You have already given birth without the use of medical support or fertility medications but are then unable to get pregnant again, or you experience recurrent miscarriages, and;
  • You are under age 35 and have been trying for one year to get pregnant, or;
  • You are age 35 or older and have been trying for six months to get pregnant.

Secondary Infertility Causes

Just like with primary (or first time) infertility, a wide variety of factors in both the male and female partner could be the cause of secondary infertility. In some cases, the underlying cause of a woman’s infertility may have worsened after her first birth. To determine the exact cause of any conception issues you face, speak with your OBGYN. What follows, however, is a list of possible causes.

  • Advanced reproductive age, which could lead to poor egg quantity or quality.
  • Endometriosis, which occurs when tissue that normally lines the uterus grows outside the uterus.
  • Pelvic adhesions, a condition that makes it difficult for an egg to be picked up by the fallopian tube, and could be caused by endometriosis or prior abdominal scarring.
  • Asherman’s syndrome (intrauterine adhesions), which may have developed after a complicated earlier pregnancy, such as one in which a uterine infection occurred that caused the development of adhesions around the fallopian tube.
  • Poor sperm quality or quantity, which could be caused by changes in a man’s health, new medications, or excessive weight gain.
  • Defective ovulation, which may or may not be caused by excessive weight gain.
  • Smoking, by either the male or female partner.
  • Pelvic or uterine scarring.
  • A blocked fallopian tube(s).
  • Irregular menstrual cycles.
  • Being underweight.
  • Excessive drinking.

Treatment Options

If you fear you may be experiencing secondary infertility, start by speaking with your OBGYN. He/she can prescribe a fertility treatment that will best address your specific complications. In most cases, treatments for secondary infertility are the same as those used to treat primary infertility. Recommended treatments may include assisted reproductive technologies (ART), medications, fertilization procedures, and egg donation.

What’s most important to remember is that you are not to blame for your inability to conceive a second (or third, or fourth) time. Talk to your OBGYN. Together, you can work to identify the cause of your struggles and determine a plan that will help you bring another beautiful life into the world.


What is Infertility and When Should You Seek Help?

Senior doctor offers medical advices to a coupleInfertility. Go ahead and say the word out loud. There is no reason to feel embarrassed or ashamed if you fear you may be experiencing infertility issues. Rather than fearing that infertility is a word that should go unspoken and unacknowledged, learn the truth about this treatable condition, and when you should seek help.

Infertility Defined

Infertility is a condition of the reproductive system. Not entirely a female-related condition, approximately 30 percent of infertility is due to a female factor, 30 percent is due to a male factor, and the remaining 40 percent is due to problems in both partners or some other unexplainable component.

Infertility-Related Definitions

What follows is a list of some common terms associated with infertility that you should familiarize yourself with if you feel you may be experiencing this condition.

ART (Assisted Reproductive Technology) – Any procedure where a woman’s eggs are surgically removed from a woman’s ovaries and combined with sperm to assist a woman in getting pregnant. IVF, GIFT, and ZIFT are all forms of ART.

Cryopreservation – The process of freezing extra embryos from a couple’s ART procedure for potential future use.

DES Exposure – A possible cause of infertility, Diethylstilbestrol (DES) is a synthetic form of estrogen that was prescribed to pregnant women between 1940 and 1971 to prevent pregnancy complications. It is now known that DES may be the cause of premature birth, miscarriage, and ectopic pregnancy among daughters born to mothers who were prescribed DES before it was banned by the Food and Drug Administration (FDA).

Endometriosis – A possible cause of infertility, endometriosis is a painful chronic condition in which tissue, like that which lines the uterus, develops outside the uterus in areas such as the abdomen, on the ovaries, fallopian tubes, and ligaments that support the uterus.

Follicle-Stimulating Hormone (FSH) – A hormone produced by the pituitary gland that helps an egg mature and be released. High levels of FSH may be an indication of infertility caused by low ovarian reserves.

Gamete Intrafallopian Transfer (GIFT) – A procedure to treat infertility in which a woman’s eggs are removed, mixed with sperm, and immediately placed into her fallopian tube.

In Vitro Fertilization (IVF) – A procedure to treat infertility in which a woman is prescribed an ovulation stimulating medication to produce an excess number of eggs. The eggs are surgically removed and fertilized in a dish with sperm. If fertilization is successful, the embryo is transferred back to the woman’s uterus.

Intracytoplasmic Sperm Injection (ICSI) – A procedure used to treat infertility in which a single sperm is injected directly into an egg.

Intrauterine Insemination (IUI) – Formerly known as artificial insemination, IUI is a procedure used to treat infertility. The procedure takes the male’s sperm, washes and treats it, then injects it into the woman during ovulation to increase the chances of conception.

Luteal Phase Defect (LPD) – A possible cause of infertility, LPD occurs when the ovaries don’t release enough progesterone, or the uterine lining does not adequately respond to the hormone.

Male Factor Infertility (MFI) – A term used when a man has a lower than normal chance of fertilizing an egg without assistance.

Miscarriage – Also referred to as “spontaneous abortion,” a miscarriage is the spontaneous loss of a fetus before the twentieth week of pregnancy.

Reproductive Endocrinologist – A specialist who identifies and treats infertility in both men and women.

Tubal Disease – A possible cause of infertility, tubal disease is a disorder in which a woman’s fallopian tubes are blocked or damaged, restricting the egg and subsequent embryo from making it to the uterus.

Uterine Factor – A structural or functional disorder of the uterus that results in reduced fertility.

Zygote Intrafallopian Transfer (ZIFT) – A procedure used to treat infertility in which a woman’s eggs are surgically removed and fertilized in a dish with sperm. If fertilization is successful, the embryo is transferred back to the woman’s fallopian tube.

When Should You Seek Help?

You may be diagnosed with infertility if you are under age 35 and have had unprotected, well-time intercourse for one year without being able to get pregnant and/or carry a baby to term. You may also be diagnosed with infertility if you are age 35 or older and have had unprotected, well-timed intercourse for six months without being able to get pregnant.

If either of these scenarios describes you, and you think you may be experiencing infertility, speak with your OB-GYN. He/she can properly diagnose you and help guide you toward a treatment plan that is right for you and your family.  And if you are looking for a new practice and live in the WNY area, give our team a call today. We are accepting new patients.


Everything Women Need to Know about Ovulation and Getting Pregnant

kinderwunschIf you have decided that you are ready to get pregnant then it’s time to learn all about ovulation. Understanding your ovulation cycle, and all of the factors that impact your fertility, will help you to put yourself in the best position to become pregnant when it is most desirable. Read our ovulation overview guide and checkout the tools and resources we’ve provided to help prepare yourself for your upcoming pregnancy. Then you better get started decorating that nursery!

Understanding Ovulation

Ovulation occurs when a mature egg is released from the ovary, travels down the fallopian tube, and is in position to be fertilized. The cycle occurs approximately once per month. In preparation for possible conception, the uterine lining thickens. If fertilization does not take place, the uterine lining and unfertilized egg will eventually shed and you experience menstruation. Women who are trying to become pregnant should understand the typical timing of their ovulation cycle in order to maximize their likelihood for conception during their available monthly window of fertility.

Tracking Ovulation

A woman’s monthly ovulation cycle should be measured from the first day of her menstrual period until the first day of the next period. For most women, their ovulation cycles last anywhere from 28 to 32 days, however this timing can vary significantly, which is why tracking your own personal cycle, rather than estimating a 30-day period, is essential in accurately determining fertile days. Most women ovulate between day 11 and day 21 of their monthly cycle, so to track the time period in which your body is most fertile, start with the first day of the last menstrual period, or calculate 12 to 16 days from the next expected period. It is important to understand that while it is possible to estimate your ovulation and track your fertility, ovulation may occur on a different day each month. The longer you track your ovulation the better your understanding will be of your body’s unique timing.

Tools and Calendars

Ready to start tracking? Here are some helpful digital tools that will make monitoring your menses easy.

  • Ovulation Calculator — By answering a few questions regarding key dates surrounding your menstrual cycle, this free online ovulation calculator from WebMD helps you predict your most fertile days of the month.
  • Pregnancy Test Calculator — This free online tool will tell you when you should take a pregnancy test for the most accurate results.
  • Woman Calendar App — Available for Apple iPhone, iPad, and iPod Touch, this fertility awareness app is ideal for women trying to conceive. It can be used to track menstrual periods, to monitor physical conditions, and to schedule activities accordingly. Cost: $9.99
  • WomanLog Calendar — Available for Apple and Android devices, this menstrual and fertility calendar for women offers an ovulation and fertility forecast, notifications, and tracking calendars. Cost: Free.

What Pregnant Women Need to Know about Zika Virus

MosquitoMuch has been reported recently about the outbreak of the Zika virus. This disease is seeing a surge in diagnosed cases especially in Southern and Latin American countries. Zika virus poses great risks for pregnant women, due to potential health complications and side effects to unborn babies who contract the virus from their infected mothers. Such risks include the potential for birth defects, and in the most severe cases, even infant death. If you are pregnant or looking to become pregnant, you should be aware of the causes and risks associated with Zika virus so that you are prepared to keep yourself and your baby safe during and after your pregnancy.

What is Zika virus?
The Zika virus is a usually mild disease that’s transmitted through the bite of an infected mosquito. Unfortunately, there is currently no vaccine for Zika virus, nor is there any current treatment.

What are the known side effects and symptoms?
Zika symptoms include fever, rash, headaches, red eyes, muscle and joint pain, and pain behind the eyes. Cases of death from Zika are extremely rare, but have been reported.

How does Zika virus spread?
The primary way that women can contract the Zika virus is by being bitten by an infected mosquito. Women can also contract the Zika virus from infected male sexual partners. A fetus whose mother has the Zika virus can become infected either during pregnancy or during delivery.

What health risks does the virus pose to babies?
It is believed that Zika virus can cause a condition known as microcephaly in infants who contract the disease in utero or during delivery. Microcephaly is a neurological condition in which a baby’s head develops much smaller than expected during pregnancy. Typically, a baby’s head grows as its brain grows, however in cases of microcephaly, the baby’s brain does not develop properly, or stops growing after birth, resulting in an undersized head. Other birth outcomes detected in fetuses infected with the Zika virus include: eye defects, hearing deficits, and impaired growth. In the most severe cases, microcephaly can be fatal.

What health risks does the virus pose to women who want to become pregnant in the future?  According to the Centers for Disease Control and Prevention (CDC), it is believed that women who contract the Zika virus are not at risk for birth defects in future pregnancies after the virus has cleared from their blood. Evidence indicates that once a woman has been infected with the virus, she is likely to be protected from a future Zika infection.

What parts of the world face the greatest risk?
For women living in the continental United States, the odds of contracting the Zika virus are extremely low. While cases of Zika have been reported in the continental United States, they have only been cases of individuals who recently traveled to countries with Zika transmission. The CDC recommends that women who are pregnant, or looking to become pregnant, should not travel to the following countries, unless visiting an area with an elevation above 6,500 feet where mosquitos are less prevalent:

  • American Samoa
  • Aruba
  • Barbados
  • Bolivia
  • Bonaire
  • Brazil
  • Cape Verde
  • Colombia
  • Commonwealth of Puerto Rico, U.S. territory
  • Costa Rica
  • Cuba
  • Curacao
  • Dominca
  • Dominican Republic
  • Ecuador
  • El Salvador
  • French Guiana
  • Guadeloupe
  • Guatemala
  • Guyana
  • Haiti
  • Honduras
  • Jamaica
  • Marshall Islands
  • Martinique
  • Mexico
  • New Caledonia
  • Nicaragua
  • Panama
  • Paraguay
  • Saint Martin
  • Saint Vincent and the Grenadine
  • Samoa
  • Saint Maarten
  • Suriname
  • Tonga
  • Trinidad and Tobago
  • U.S. Virgin Islands
  • Venezuela

If you are pregnant and have traveled to, or lived in, an affected country, see your OBGYN whether or not you’ve experienced any symptoms.

How can women protect themselves and their babies from Zika virus?
Women should minimize their risks of being exposed to Zika by avoiding countries with known outbreaks. Pregnant women and those trying to become pregnant who plan to travel to an impacted area should talk to their OBGYN prior to traveling. If you can not avoid traveling to a location were Zika has spread, wear long sleeves, pants, and socks, stay inside during peak mosquito hours, and apply forms of mosquito repellent safe to use during pregnancy. In addition, women can minimize their potential exposure to mosquitos by maintaining window screens and air conditioning in their homes, and eliminating places where mosquitos breed such as tires, buckets, and other areas where water pools.

What happens if you do contract Zika while pregnant?
Your doctor will consider administering an amniocentesis test to check your fetus for the virus, and you will likely receive ultrasounds every three to four weeks for the rest of your pregnancy to check for signs of microcephaly.

If you are pregnant of thinking of becoming pregnant, talk to your OBGYN today about the risks of Zika virus to make sure you and your baby are protected now and throughout your pregnancy.


Understanding the Causes and Risks of Gestational Diabetes

Mommy eating healthyGestational diabetes is a form of the metabolic disease that impacts pregnant women who do not have a previous history of diabetes, but who have high blood glucose levels during their pregnancy. The Centers for Disease Control and Prevention (CDC) estimate that in 2014 as many as 9.2 percent of pregnant women suffered from this condition. If you are pregnant or trying to become pregnant, understand the risks and treatment options available to help ensure a safe and healthy pregnancy.

The causes of gestational diabetes are not completely known, however it is believed that hormones from the placenta that help the infant during development begin to block the action of the mother’s insulin into her own body. When proper insulin levels decline, glucose cannot leave the blood to be converted into energy, instead building up in the blood in unsafe levels, a condition known as hyperglycemia.

Risk Factors
All pregnant women are at risk of developing gestational diabetes, however some women are at a higher risk. Risk factors for gestational diabetes include:

  • Age. Women age 25 or older during their pregnancy are more likely to develop gestational diabetes.
  • Weight. Women with a body mass index (BMI) of 30 or higher are more likely to develop gestational diabetes.
  • Family history. Women who have a close relation, such as a parent or sibling, that has previously been diagnosed with type 2 diabetes are at a greater risk for gestational diabetes.
  • Personal health history. Those who have suffered from prediabetes are at a greater risk of gestational diabetes. Prediabetes is a condition defined by slightly elevated blood sugar that may be a precursor to type 2 diabetes. Women are also at a greater risk if they were diagnosed with the condition during a previous pregnancy, if they delivered a stillbirth, or if they delivered a baby who weighed more than nine pounds.
  • Race. While experts are uncertain of the reason, women who are African American, Hispanic, American Indian, or Asian are more likely to develop gestational diabetes.

Potential Impact to Mother and Baby
Gestational diabetes impacts the mother in late pregnancy after the baby’s body has been formed. Untreated or poorly controlled gestational diabetes can have serious consequences on infants. Women with gestational diabetes experience an overuse of the pancreas as it works to produce insulin that is ultimately ineffective in lowering blood glucose levels. The high levels of blood glucose are eventually transferred to the baby through the placenta, causing the baby’s pancreas to overproduce insulin as well. Eventually, the extra, unneeded energy is stored by the baby as excess fat, a condition known as macrosomia.

Babies with macrosomia face several potential health risks, including damage to their shoulders during birth, low blood glucose levels at birth due to extra insulin levels, and breathing problems. Later in life, the babies are at a higher risk of suffering from obesity and type 2 diabetes.

Your OBGYN will likely evaluate your risk factors for gestational diabetes early in your pregnancy. Based on those factors, he or she will help determine a screening frequency to identify any risk factors early. For example, women at high risk may be tested at their very first prenatal visit, while women at average risk will likely be screened during the second trimester.

Women diagnosed with gestational diabetes will require frequent checkups, especially during the final trimester. During these exams, and possibly even in between visits through self-testing, their blood sugar will be monitored. Your OBGYN may also prescribe insulin to help control your blood sugar.

Directly after the birth, your OBGYN will likely check your blood sugar and will want to test it again in six to 12 weeks to determine if levels have returned to normal. Even with an eventual normal reading, women who have been diagnosed with gestational diabetes should receive a diabetes screening at least every three years.

In addition to constant monitoring of blood sugar levels, there are treatment options available for women to manage gestational diabetes, including:

  • Following a healthy diet high in fruits, vegetables, and whole grains.
  • Receiving regular exercise, which helps lower blood sugar by stimulating the body to move glucose into cells and use it as energy.
  • The use of insulin, which is prescribed for 10 – 20 percent of women suffering from gestational diabetes.

Every woman strives for a healthy pregnancy. Talk to the doctors at Chouchani, Sayegh and Bagnarello about the factors that may impact your risk for developing gestational diabetes. Our doctors will work with you to help identify any threats early to keep you and your new loved one safe and healthy.


Breaking Down Misperceptions about Miscarriage

Screen Shot 2015-12-04 at 8.33.02 AMMiscarriages are saddening medical occurrences that happen more often than is realized, yet the couples who suffer them rarely speak of their losses. Whether their silence is born out of a fear that the sympathies of others may make the loss more emotionally distressing, or out of a greater fear that a pregnancy may never be possible, miscarriages are often an emotional burden that too many couples bear alone. Such isolation is unnecessary, however, as approximately 10 to 20 percent of known pregnancies end in miscarriage, and as many as 50 percent of pregnancies are miscarried so early that the pregnancy is not even known. Though the early termination of any pregnancy can be heart breaking, couples looking to conceive should take comfort in knowing that they are not to blame or at fault for the loss of their fetus. Understanding the truths and overcoming the misperceptions of miscarriages can give comfort to those recovering from such a loss.

The majority of miscarriages occur during the first 13 weeks after conception. Since many women wait to share news of their pregnancy with family and friends until after the first trimester, many of the miscarriages that occur during the first thirteen weeks are often unknown by anyone other than the mother and father.

Truth: A great number of miscarriages occur so early that even the couple is unaware that an embryo had formed.

Though it is commonly believed that lifting heavy objects, participating in dangerous activities, and long-term stress can cause miscarriages, none of these factors have been proven to be valid risk factors. It is believed that the majority of miscarriages are caused by genetic abnormalities within the embryo that would prevent a baby from fully developing healthily and surviving after birth. About 60 percent of the time, miscarriages occur when the embryo or fetus has an abnormal number of chromosomes. In addition, some illnesses may place a woman at a greater risk for miscarriage, including some viral infections, thyroid disease, and diabetes.

Truth: Fatal genetic errors are not usually caused by the mother’s genetics.

Risk Factors
Some of the risk factors that may lead to a miscarriage include:

  • An older maternal age
  • Extremely low or high maternal weight
  • Moderate to high alcohol consumption during pregnancy
  • Smoking or illicit drug use during pregnancy
  • Use of nonsteroidal anti-inflammatory drugs (NSAID) around the time of conception
  • Uterine trauma
  • Previous miscarriage(s)

About 5 percent of women have recurrent miscarriages, a condition defined by three or more losses. In most of these cases, however, the recurrent miscarriages are caused by underlying health issues such as a structural problem with the uterus, thyroid problems, hormonal imbalances, or clotting disorders.

Truth: Most women who miscarry go on to have a successful pregnancy and give birth to a healthy baby.

In order to be best positioned to deliver a baby to full term, women should maintain a healthy weight through proper nutrition and exercise, should not consume drugs or alcohol, and should be screened and treated if necessary for any sexually transmitted diseases (STD). In addition, pregnant women should take a folic acid supplement, avoid possible radiation exposure, and avoid contact sports.

Truth: In most cases, fully preventing a miscarriage is outside of a woman’s control.

The loss of any child at any time is devastating, however women must understand that as long as they lead a healthy lifestyle and avoid drugs and alcohol and other risky behaviors, they are giving their fetus the best possible chance for a healthy birth. For the many women who experience a miscarriage caused by genetic factors outside of their control, they should not take on the burden of guilt, or the feeling that the loss was their fault. Rather, they should emotionally and physically prepare themselves to try again to carry a baby full term, since for the great majority of women who miscarry, a healthy and happy baby is still on the horizon.

Whether you are pregnant or planning on becoming pregnant, it’s important to see your OB-Gyn. Our office is currently accepting new patients. Call for an appointment today.


I Skipped My Period. Could I be Pregnant?

calendar marked important yearFor many women, their periods are a routine certainty, the timing of which can be dependably calculated. For other women, their menstrual cycle may vary naturally. Abnormal delays, or entirely missed periods however, can be a cause of concern for women who are not trying to get pregnant. If your period is late, or has skipped entirely, and you are sexually active, you should consider the possibility that you may be pregnant; however there are several other factors that can cause a late or missed period that women should be aware of when considering possible reasons for the delay.

  1. Stress: Possibly one of the most significant factors that can impact various aspects of a woman’s normal body functioning is stress. When stress levels rise, a woman’s body can develop a condition called “hypothalamic amenorrhea.” The hypothalamus region of the brain regulates many of a woman’s hormones, however it is easily impacted by stress. If you are experiencing an extreme life event that has raised your stress levels, your hypothalamus may not properly regulate the hormones necessary for your menstrual cycle to occur as usual.
  2. Extreme Weight Loss: For women whose body mass indexes (BMI) drop rapidly below 18 or 19, they may begin to experience missed periods. Of greater concern, is the potential that such rapid weight loss is associated with anorexia or bulimia. A woman’s body will attempt to protect her from getting pregnant if her body is not healthy enough to support a fetus. When a woman’s BMI is extremely low, her body will prevent ovulation, resulting in low productions of estrogen, which halts the build-up of a woman’s uterine lining, and ultimately results in a missed period.
  3. Extreme Weight Gain: Similar to the menstrual impact of severe weight loss, women who experience a rapid increase in their weight can negatively impact their body’s ability to continue its normal menstrual cycle, and also may realize delayed or missed periods.
  4. Extreme Fitness Training: Women who are training for extreme, physically challenging events, such as running a marathon, or any other athletic competition that requires diligent hours of athletic training, may experience a skipped period. Extreme levels of fitness that put strain and stress on a woman’s body increase the likelihood that her body will halt her menstrual cycle due to her already taxed physical state.
  5. Issues with Your Birth Control Method: Women who take any form of oral, implantable, or injectable contraceptive should speak with their doctor to ensure they understand all of the risk factors and potential side effects of the medication. Some low-dose oral contraceptives can cause a lack of menses. Though not dangerous, it can be an unexpected and alarming side effect.
  6. Breast Feeding: Some women who have just given birth and are actively breastfeeding find that they do not return to a regular menstrual cycle until they have completed breast-feeding.
  7. Premature Menopause: In the United States, the average age of natural menopause is 51, however some women under 40 can experience what is known as premature ovarian failure, or premature menopause. For these women, their hormones are significantly imbalanced which can result in missed periods, among other physical side effects.
  8. Thyroid Irregularity: The thyroid gland regulates metabolism and assists in maintaining other normal body functions. Any type of thyroid imbalance may cause a woman’s period to be delayed or skipped entirely.
  9. Polycystic Ovary Symptom (PCOS): This condition results in a hormone imbalance that can halt ovulation, which can alter a woman’s normal level of estrogen, progesterone, and testosterone. Symptoms vary, with some women only experiencing menstrual irregularity, while others may miss their period entirely and repeatedly.
  10. Celiac Disease: This disease, which is characterized by an intolerance to gluten, if left untreated or undiagnosed, could add physical stress to a woman’s body and ultimately result in missed periods.
  11. Illegal Drug use: Aside from the highly addictive and dangerous nature of illegal drugs such as heroin, cocaine, LSD, mescaline, PCP, methamphetamine, and marijuana to name a few, use of these unnatural substances can also cause irregularities in a woman’s menstrual cycle.

If you feel that you are experiencing irregularities in your menstrual cycle that may be caused by any of the factors listed above, or if you think you may be pregnant, speak with your doctor so that he or she can help you understand the cause of your irregularity.


Which Birth Control Method Do Most Doctors Use? The Answer Might Surprise You.

Birth Control symbole- IUD and contraceptive Pills and CondomPills. Injectables. Implantables. Condoms. Diaphragms. Even the rhythm method. With so many contraceptive choices available to today, how can a woman know which choice is right for her and her body? What most women want to know when making this decision is what method do most health care professionals choose for themselves? The answer: An implantable device known as an IUD.

A recent study published in the journal Contraception found that 40 percent of surveyed family planning providers between the ages of 25 and 44 who currently utilize protection use an intrauterine device, or IUD. In comparison, 16 percent reported using oral contraception, while only nine percent reported using condoms as their primary birth control method.

What is an IUD? An IUD is a small contraceptive device, often t-shaped, which is inserted into a woman’s uterus by her doctor. It is considered a long-acting, reversible contraceptive method. In addition to the study published by Contraception, IUDs have been endorsed by the American Academy of Pediatrics as an excellent method to prevent teenage pregnancy. What makes the IUD such a population choice among experts?

  • It’s highly effective – Studies have shown the IUD to be 99 percent effective. Compare that to oral contraceptives that are only 91 percent effective, and condoms that are only 82 percent effective.
  • Set it and forget it – Oral contraceptives require a woman to remember to take a specific pill at the same time every day. With life’s uncertainties, even the most disciplined woman can accidentally skip a dose. Once inserted, a woman does not need to do anything to maintain her IUD, and some can even be effective for as many as ten years.
  • It’s reversible – Once an IUD is removed, a woman’s regular hormonal cycle will take over, and a woman can begin to attempt to conceive.
  • There are options – There are multiple IUD products available for women to choose from. There are hormone-free options that can be effective for up to ten years, or versions that release low-doses of progesterone that can be safely used for five years, depending on a woman’s needs.
  • It’s safe – Women considering IUDs are screened by their doctor to ensure that they are good candidates for the device, which decreases the risk of pelvic infections which have been associated with the devices in the past

With so many contraceptive options available to women, the IUD can be a convenient, safe, and effective solution for women of all ages and lifestyles. For more information on IUDs and options that may be available to you, speak to your doctor or make an appointment at WNY Ob-Gyn during your next visit.


The Tick Tock of Your Biological Clock

Biological ClockHow Much Time Do You Really Have to Get Pregnant?

When asked “where do you see yourself after you graduate college?” many young women confidently reply by reciting a heavily considered, regimented life plan:

“I’m going to land my dream job by 22, get engaged to the man of my dreams by 25, we’ll move in together at 26, we’ll get engaged by 27, and get married by 29. By 30 I’ll have become a senior executive in my company, and my husband and I will have three kids before I’m 35, a boy, and two girls, in that order.”

While it may sound like a quintessential and highly responsible plan, the reality is that life sometimes takes us by surprise, leaving us making modifications to our “final” plan along the way. For women whose unexpected life events result in a delay in childbearing, many report that they begin to feel the metaphorical ticking of their biological clock – an internal feeling of foreboding that they need to have a baby soon “before it’s too late.” What is this feeling that we associate with a ticking clock? At what age do women really begin to lose fertility, and what steps should women who want to have a baby take to ensure the highest likelihood for conception?

The term “biological clock” often refers to a woman’s increased maternal instincts as they age and worry that they will soon be too old to successfully naturally conceive. There is debate as to whether the ticking clock is a true physical and psychological response, or a socialized experience.

What is a known fact, however, is that as women age, their fertility levels decrease. In general, the best age for women to get pregnant and carry a healthy baby to term is between the ages of 20 and 35. Once women enter their 40s, as many as 40 percent of pregnancies end in miscarriage, and by the time they reach 45, only ten percent of women are able to conceive naturally. This statistic is a concern to many women today, as the number of older mothers is rising as women prioritize education and career before having children. In 1999, only 16 percent of new mothers were over age 35. By 2008, that number had increased to 23 percent.

Women who want to conceive may be able to look to their family history to determine the longevity of their fertility. If a woman’s mother or grandmother was able to conceive naturally into her late thirties and forties, she may be able to as well. Women should also avoid smoking, excess alcohol and recreational drug use, as all of these can negatively impact egg quality. Women who want to conceive should also maintain a healthy diet, and should lead an active lifestyle to ensure a healthy weight, to minimize the chances of miscarriage.

For women with questions or concerns regarding their fertility, their best bet, is to speak to their physician. Simple tests can determine a woman’s fertility, and a doctor can provide options for increasing the likelihood of conception as well as maintaining a healthy pregnancy. If you are looking for a top Ob-gyn practice in Western New York, please give Chouchani, Sayegh and Bagnarello MD a call today. We are accepting new patients.


Bringing On Baby: How Best to Prepare Your Body for Pregnancy

Baby standing in cot

You’ve read the baby books, you’ve talked to your friends, and you’ve started picking out names. The only thing that you need to do now is to conceive. Preparing for pregnancy is an emotional, mental, and physical responsibility. Follow these 8 tips to best position your body to bring a healthy and happy baby into the world:

  1. Begin taking folic acid supplements. Taking 400 micrograms of folic acid a day for at least one month prior to conception and during your first trimester can decrease the chances of your baby being born with a neural-tube defect by 50 to 70 percent.
  2. Eliminate alcohol, tobacco, and drug use. Smoking and drug use can increase the risk of having a miscarriage, a premature birth, or a baby with low birth weight. Tobacco use can also affect your fertility, and may impact your ability to conceive. Read these tips to help quit smoking.
  3. Increase your consumption of healthy foods. Even before you conceive, make sure that your body has the nutrients needed for a healthy pregnancy. Increase your daily intake of fruits, vegetables, and whole grains, as well as foods that are high in calcium. Be sure to eat a variety of sources of protein, such as beans, nuts, poultry and meats. In addition to increasing your consumption of healthy foods, eliminate foods that may increase your risk of acquiring a food-borne illness. Reduce your intake of unpasteurized soft cheese, unpasteurized juices, cold deli meats, and raw and undercooked fish and poultry. These foods can have high rates of bacteria that can cause illness, and in the most serious cases lead to a miscarriage or stillbirth.
  4. Maintain a healthy weight. Women with a health body mass index (BMI) may be more readily able to conceive. A pregnant woman whose body weight is too high may experience delivery complications, while a woman whose weight is too low may give birth to an underweight infant.
  5. Begin, or stick to, an exercise routine. A healthy exercise program includes 30 minutes of moderate exercise at least three times per week. If you are not currently exercising on a regular basis, slowly increase the length and intensity of your workout routines. Once you become pregnant, continue your fitness routine, unless you experience complications or are advised to stop by your doctor. A consistent exercise routine can help you to maintain a healthy weight, improve your cardiovascular and pulmonary health, and can increase your flexibility, all of which will benefit you during your pregnancy.
  6. Reduce your caffeine intake. Women who are pregnant or are trying to conceive should not consume a large amount of caffeine. An overconsumption of caffeine has been linked to an increased risk of miscarriage.
  7. Be aware of your mental health. Women who suffer from depression are twice as likely to have problems with fertility. Women who are looking to get pregnant should obtain a mental health screening, especially if they have a family history of depression.
  8. Make an appointment with your OB-GYN. Last but certainly not least, you should make an appointment to see your doctor. He/she can assess your overall health and make sure everything is normal in order to give you and your baby the best start.

Preparing your body to carry a baby is an important aspect of pregnancy that should not be overlooked. A healthy body will be best able to carry a baby to full-term, enabling you to deliver a healthy baby without complications. Chouchani, Sayegh and Bagnarello MD is accepting new patients. Give us a call today.