Patient Education : Conditions

Premier OBGYN Specialists strives to maintain a comfortable and individual relationship with you while staying up-to-date on the latest treatments and procedures. Below is a list of conditions which affect women of all ages and how our doctors can address your personal needs.

Infertility

If you have been attempting pregnancy for 6 months and have been unsuccessful, you may want to talk to your doctor about possible causes of infertility. Several tests can be done for couples who are trying to conceive.

For women, your doctor will do the following:

Obtain your menstrual history
Perform ovulation tests, either blood (LH) or basal body temperatures (BBT)
Perform STD (Chlamydia) screening
Order a transvaginal ultrasound
Perform a hysterosalpinogram (HSG) – Hysterosalpinogram (HSG) is an x-ray done right after your menstrual period to evaluate the inside of the uterus and any fallopian tube blockage. A small amount of dye is placed in the uterus through the cervix then x-rays are taken.
Perform a postcoital test – This test is performed around ovulation, within 2 to 6 hours after intercourse. The cervical mucus is examined to see if sperm are present and moving normally.

If any tests are abnormal, further evaluation with hysteroscopy is done. A thin telescope device is placed through the cervix into the uterus. The uterus is then filled with fluid to see inside.

Your doctor can also perform a laparoscopy. During this procedure, a small telescope device is inserted through the lower edge of the navel and the abdomen is filled with gas so that the doctor can evaluate your ovaries and tubes for endometriosis and scar tissue.

For men, a semen analysis is performed. Usually after evaluation by a urologist, a sample specimen is obtained and evaluated.

Treatment:

Infertility is usually treated with clomiphene citrate, human chorionic gonadotropin, and/or intrauterine insemination. Less than 5% of all infertility cases are treated with in vitro fertilization or other so-called assisted reproductive technologies.

Clomiphene citrate (CC)

CC is a drug that induces ovulation and is used as a front line fertility treatment for both anovulatory and ovulatory women. It can be damaging to the cervical mucus, however, and should be combined with intrauterine insemination (IUI) so as to maximize chances for conception.

The typical initial dose is 50 mg per day for 5 days at the beginning of the woman’s menstrual cycle. Patients should use an LH kit (a kit that predicts when ovulation will occur based on the level of LH in the woman’s urine) and time their intercourse to maximize the chances of conception.

If ovulation doesn’t occur, the dose can be increased by 50 mg increments. A transvaginal ultrasound may be performed to allow the physician to get a close-up view of the development of the follicle (a cluster of cells in the ovary that change in color and shape during the different phases of the menstrual cycle).

Transvaginal ultrasound (US)

A transvaginal ultrasound involves inserting an ultrasound probe into the woman’s vagina. Ultrasound waves emitted from the probe pass through the vaginal wall and bounce off the ovaries, producing an image or photograph of the ovaries. If follicular development appears normal, the next step usually involves an injection of the hormone HCG (human chorionic gonadotropin) to trigger ovulation, and is often followed by intrauterine insemination.

Intrauterine Insemination (IUI)

Intrauterine insemination is used for couples with low sperm count, cervical mucus problems or unexplained infertility. During ovulation, a woman’s cervical mucus should be abundant, clear and slippery to facilitate the sperm’s passage up through the cervical canal. If it’s not, which may be the case for women on CC infertility therapy, IUI is an effective medical alternative. IUI involves separating the sperm from the seminal fluid and re-suspending it in a small amount of fluid that is then placed directly inside the uterus through a small catheter.

Human chorionic gonadotropin (HCG)

Human chorionic gonadotropin (HCG) is a hormone that stimulates the ovaries and triggers ovulation. It is often used in women for whom CC medication doesn’t work but in whom follicular development appears normal. HCG is a very potent fertility drug that should only be used under the guidance of a fertility specialist.

Some tests to evaluate a couple’s fertility and many treatments for infertility are not covered by insurance. We work with our patients’ insurance companies to verify benefits and will assist with either insurance claims or private pay options.

Human Papillomavirus

Helping Prevent Cancer and HPV Spread

Human Papillomavirus (HPV) - The Human Papillomavirus (HPV) is one of the most common sexually transmitted diseases. Most people that have genital HPV infection do not even know they are infected. The virus lives in the skin or mucus membranes and usually causes no symptoms. Some people may have visible warts or have pre-cancerous changes in the cervix, vulva, anus, or penis. Most women are diagnosed with HPV on the basis of an abnormal pap smear.

Human Papillomavirus and Gardasil Vaccine

HPV is a common virus. In 2005, the Centers for Disease Control and Prevention (CDC) estimated that 20 million people in the United State had this virus. There are different types of HPV. Some cause no harm. Others can cause disease of the genital area. For most people, the virus goes away on its own. When the virus does not go away, it can develop into cervical cancer, pre-cancerous lesions, or genital warts, depending on the HPV type.

Gardasil is a vaccine that helps protect against the following diseases caused by HPV types 6, 11, 16 and 18: Cervical Cancer, abnormal or pre-cancerous cervical, vaginal, and /or vulvar lesions and genital warts. Gardasil helps prevent these diseases, but it will not treat them.

Gardasil is for girls and women 9 through 26 years of age. It is given as an injection. You or your child will receive 3 doses of the vaccine. Ideally the doses are given as: First dose - at a date you and your health care professional choose, second dose - 2 months after the first dose, and third dose - 6 months after the first dose.

Make an appointment to talk to your physician about whether or not Gardasil is right for you or your child.

Incontinence

What Is It?

Incontinence - Incontinence is when you experience the incontrollable loss of urine. Whether you leak when you cough, laugh, sneeze or have sudden urges to go to the bathroom and they are intense enough that you fear you will not get there in time. It is treatable and often times, curable. Over 13 million Americans, 82% of them being women, experience the problem. Incontinence can occur among ages 15-64 and is estimated 10-30% have urine control problems and about 1 an 4 women ages 39-59 have had episodes of incontinence. Treatments may include medication and sometimes surgery.

Menopause

What Is It?

Menopause - Menopause is said to have occurred when a women has not had a periods for 12 months. Menopause is when the ovaries no longer release eggs and decrease production of the sex hormones estrogen, progesterone and androgen. It is a natural occurrence that marks the end of fertility and childbearing years.

Premenstrual Syndrome

What Is It?

Premenstrual Syndrome - Premenstrual Syndrome (PMS) is a term commonly used to describe a wide range of severe recurrent symptoms that occur from several days to two weeks before your period. Up to 40% of women have symptoms that may require treatment. Symptoms may occur anytime between puberty and menopause. The most common age is late 20's to early 30's. Symptoms may become worse with age and stress. The underlying causes are not really understood.