Appendicitis and female infertility

Is there any link between a severe ruptured appendix and later infertility? Pregnancy is the end result of many complex functions in both the male and female reproductive tracts. One critical step in the process is the egg and sperm meeting and joining together before being transported to the womb to develop. Open and healthy fallopian tubes are necessary for this to occur. The fallopian tubes can be damaged by prior pelvic inflammation, including inflammation caused by appendicitis. Most women with a history of appendicitis do not become infertile, and treatment is available for women who have difficulty conceiving. If the tubes are kinked or blocked by scar tissue, surgery can restore the tubes. The surgery is often done through a laparoscope. If the tubes are severely damaged, in vitro fertilization (IVF) can be performed. In IVF, the egg and sperm are mixed outside the body and then placed in the uterus. This process bypasses the fallopian tubes. (Locked) More »

Conditions that affect fertility

There are many reasons why a couple may have difficulty in conceiving a child. Disease, drugs, heredity, lifestyle habits or even exposure to certain toxins can affect fertility. (Locked) More »

Endometriosis and infertility

I have a family history of endometriosis. I have heard this condition could lead to infertility. What treatments are available, and how do you know for sure if you have it? Endometriosis is a condition in which the endometrial tissue that normally lines the uterus is found on other organs. The organs are usually in the pelvis and include the ovaries, bladder, bowel, and peritoneum (the sheet of tissue that lines the pelvis). Most cases probably occur when the endometrial tissue sheds from the uterus during a menstrual period. But instead of exiting the body through the vagina as the menses, the tissue flows backward through the Fallopian tubes to the pelvic cavity. (Locked) More »

Female Infertility

For a man and a woman who are having frequent intercourse without using any birth control, the average amount of time that it takes to conceive is six months. Most couples are able to achieve a pregnancy within one year if they have intercourse frequently (twice per week or more often). Between 10% and 15% of couples will continue to have difficulty conceiving after one year of trying. When pregnancy is this slow to occur, the man and woman are diagnosed as infertile. Infertility can be caused by health problems in the man, the woman or both partners. In some infertile couples, no cause can be found to explain the problem. In approximately 20% of couples, more than one cause of the infertility is found. The cause of infertility occurs about as often in men as in women. Normal aging reduces a woman's ability to become pregnant. Ovulation, the process of forming and releasing an egg, becomes slower and less effective. Aging begins to reduce fertility as early as age 30, and pregnancy rates are very low after age 44, even when fertility medications are used. Even though fertility is less reliable for women of older ages, approximately 20% of women in the United States have their first child at or after age 35. (Locked) More »

Follow The Fertility Diet?

Adapted from The Fertility Diet (McGraw-Hill) by Jorge E. Chavarro, M.D., Walter C. Willett, M.D., and Patrick J. Skerrett. If you have been having trouble getting pregnant—or getting pregnant again—forget about the so-called fertility foods like oysters and champagne, garlic, ginseng, kelp, and yams. The true fertility foods are whole grains, healthy fats, excellent protein packages, and even the occasional bowl of ice cream. This isn't just wishful thinking. Instead, it comes from the first comprehensive examination of diet and fertility, an eight-year study of more than 18,000 women that uncovered ten evidence-based suggestions for improving fertility. This work, from the landmark Nurses' Health Study, fills a critical information gap on diet and fertility. The recommendations that follow are aimed at preventing and reversing ovulatory infertility, which accounts for one quarter or more of all cases of infertility. They won't work for infertility due to physical impediments like blocked fallopian tubes. And they aren't meant to replace a conversation with a clinician about whether an infertility work-up is needed. The strategies described below don't guarantee a pregnancy any more than do in vitro fertilization or other forms of assisted reproduction. But it's virtually free, available to everyone, has no side effects, sets the stage for a healthy pregnancy, and forms the foundation of a healthy eating strategy for motherhood and beyond. That's a winning combination no matter how you look at it. (Locked) More »

Male Infertility

Infertility is the inability to achieve a normal pregnancy. About one in seven couples in the United States is unable to conceive a child after trying regularly for one year. Some couples will have success in the second or third year of trying, but couples that cannot conceive after three years are very unlikely to ever succeed unless they seek medical assistance. Infertility in a couple may be caused by the male partner, the female partner or both. Studies suggest the male partner alone is infertile in about 20% of cases and that both partners have fertility problems about 30% of the time. Therefore, the male partner plays a role in about half of all couples that have difficulty conceiving a child. In about 15% of cases, infertility tests are completely normal in both partners, despite the fact that the couple cannot conceive a child. Male infertility has a wide variety of causes, which can be broken down into several major groups: (Locked) More »

References for "Advice about which antidepressant to choose first"

Cipriani A, et al. "Comparative Efficacy and Acceptability of 12 New-Generation Antidepressants: A Multiple-Treatments Meta-Analysis," Lancet (Jan. 28, 2009): Electronic publication ahead of print. Cipriani A, et al. "Metareview on Short-Term Effectiveness and Safety of Antidepressants for Depression: An Evidence-Based Approach to Inform Clinical Practice," Canadian Journal of Psychiatry (Sept. 2007): Vol. 52, No. 9, pp. 553–62. Fergusson D, et al. "Association Between Suicide Attempts and Selective Serotonin Reuptake Inhibitors: Systematic Review of Randomised Controlled Trials," BMJ (Feb. 19, 2005): Vol. 330, No. 7488, p. 396. (Locked) More »

References for "Commentary: Providing rewards for smokers who want to quit"

Salize HJ, et al. "Cost-Effective Primary Care Based Strategies to Improve Smoking Cessation: More Value for Money," Archives of Internal Medicine (Feb. 9, 2009): Vol. 169, No. 3, pp. 230-35. Volpp KG, et al. "A Randomized, Controlled Trial of Financial Incentives for Smoking Cessation," New England Journal of Medicine (Feb. 12, 2009): Vol. 360, No. 7, pp. 699-709. (Locked) More »

References for "The glutamate hypothesis for schizophrenia"

Buchanan RW, et al. "The Cognitive and Negative Symptoms in Schizophrenia Trial (CONSIST): The Efficacy of Glutamatergic Agents for Negative Symptoms and Cognitive Impairments," American Journal of Psychiatry (Oct. 2007): Vol. 164, No. 10, pp. 1593–602. Buchanan RW, et al. "Recent Advances in the Development of Novel Pharmacological Agents for the Treatment of Cognitive Impairments in Schizophrenia," Schizophrenia Bulletin (Sept. 2007): Vol. 33, No. 5, pp. 1120–30. Coyle JT. "The Glutamatergic Dysfunction Hypothesis for Schizophrenia," Harvard Review of Psychiatry (Jan.–Feb. 1996): Vol. 3, No. 5, pp. 241–53. (Locked) More »

References for "The psychological impact of infertility and its treatment"

Berg BJ, et al. "Psychological Sequelae of Infertility Treatment: The Role of Gender and Sex-Role Identification," Social Science & Medicine (1991): Vol. 33, No. 9, pp. 1071–80. Boivin J, et al. "Giving Bad News: 'It's Time to Stop.'" In: Macklon N, ed. IVF in the Medically Complicated Patient: A Guide to Management (Taylor & Francis, 2005). Burns LH. "Psychiatric Aspects of Infertility and Infertility Treatments," Psychiatric Clinics of North America (Dec. 2007): Vol. 30, No. 4, pp. 689–716. (Locked) More »

Take a deep breath

Adapted from Stress Management: Approaches for preventing and reducing stress. Proper breathing goes by many names. You may have heard it called diaphragmatic breathing, abdominal breathing, or belly breathing. When you breathe deeply, the air coming in through your nose fully fills your lungs, and you will notice that your lower belly rises. The ability to breathe so deeply and powerfully is not limited to a select few. This skill is inborn but often lies dormant. Reawakening it allows you to tap one of your body's strongest self-healing mechanisms. Why does breathing deeply seem unnatural to many of us? One reason may be that our culture often rewards us for stifling strong emotions. Girls and women are expected to rein in anger. Boys and men are exhorted not to cry. What happens when you hold back tears, stifle anger during a charged confrontation, tiptoe through a fearful situation, or try to keep pain at bay? Unconsciously, you hold your breath or breathe irregularly. (Locked) More »

Testing for male and female infertility

What tests are done to check a man and woman's fertility? Infertility is defined as the inability of a couple to conceive after one year of unprotected intercourse. This reflects how complicated even normal conception is. Many factors can affect fertility, including the presence of sperm and egg at the right time in a receptive environment. Tests can evaluate these different aspects of fertility. (Locked) More »

Treating blocked fallopian tubes

I am 39 years old, and was just diagnosed with blocked fallopian tubes. Is my only option to have children through IVF due to my age? Can I have the tubes unblocked and then have artificial insemination since that's cheaper? A blockage of the fallopian tubes is one of the most common causes of infertility. It accounts for about one third of cases in women. However, determining the best way to treat it is a complex problem without a single, clear answer. The blockage may have come from scar tissue caused by a pelvic infection, endometriosis, or pelvic surgery. (Locked) More »

Using Clomid to treat infertility

What is the success rate of using Clomid for infertility? Is there a risk of multiple births? Clomid is the brand name of the drug clomiphene, which is used to stimulate the ovary to release an egg. It is used to treat women who are infertile because they have no ovulation or infrequent ovulation. Clomiphene stimulates molecules inside of cells that are normally stimulated by the hormone estrogen. One important function of these molecules is controlling the steps that lead to ovulation. Infertility has many causes. Failure of ovulation is one of the most common. It is also one of the most successfully treated. If failure to ovulate is the only problem a couple faces, the use of clomiphene has about a 40% success rate for achieving pregnancy. (Locked) More »

In Brief: Updates about mental health parity

The State Children's Health Insurance Program (SCHIP) now includes a mental health parity provision. A study suggests that a low copayment for mental health services may increase the likelihood that patients will receive the care they need. (Locked) More »