Women2Women - Summer 2017 - 30

Health2Wellness

Mental, Spiritual, Physical Health & Wellness

Insight On Treatment
Options for Infertility
NEVODKA/123RF STOCK PHOTO
RIDO/123RF STOCK PHOTO

An Interview with
Shahab Minassian, MD

How long have you been practicing reproductive medicine?

When should I see a fertility specialist?

I have been practicing reproductive medicine for 30 years. I completed my fellowship in reproductive endocrinology and infertility
at Jefferson University Hospital in Philadelphia, and my OB/GYN
residency at Abington Memorial Hospital outside of Philadelphia.
I received my medical degree from Jefferson Medical College of
Thomas Jefferson University.

Women under age 35 should seek help if they don't get pregnant
within 12 months. Women older than age 35 should seek help if they
don't get pregnant within six months. However, if there are specific
medical issues in the history of one or both partners, they may need
to seek immediate help. For example, a couple should seek help if
the female partner lacks periods or has irregular periods.

Can you describe infertility and why it may occur?

Are there "warning signs" that I should be aware of?

Infertility means that you have difficulty getting pregnant. Women
also may be infertile if they can get pregnant but are unable to
stay pregnant.

Concern should be heightened when experiencing irregular or abnormal
bleeding or very painful periods, chronic pelvic pain, or previous pelvic
infection such as chlamydia or gonorrhea. You may have compromised
fertility if you have a history of pelvic surgery such as ovarian surgery,
endometriosis surgery or surgery for ectopic pregnancy.

There are steps that must occur for a pregnancy to take place.
these steps are:

* Ovulation - a woman's body releases an egg from one of her ovaries
* Egg Transport - the egg is picked up and moves through the
fallopian tube toward the uterus

* Sperm Transport - after a man's sperm is deposited, it moves
through the vagina, cervix and uterus into the woman's fallopian tube

* Fertilization - the man's sperm and the woman's egg unite in
the fallopian tube

* Implantation - when the fertilized egg attaches to the inside
of the uterus

Infertility can occur if there is an issue at any step in this process.

Can either the man or the woman have
issues that cause infertility?
Yes, both women and men can have issues that cause infertility.
Statistically, women's issues account for about one-third and men's
issues account for another one-third of infertility cases. The remaining cases are prompted by unknown issues or combined issues of
both partners.
30 Women2Women Summer 2017

What can I expect at my first appointment?
You can expect that a detailed medical history will be taken for you
and your partner, and a physical and pelvic examination are likely. A
plan for diagnostic testing would be developed, and any questions you
have will be answered. Your physician's office also will seek to confirm
your health plan's coverage for infertility diagnosis and treatment.

What tests will my partner and I need to complete?
The tests a couple needs to complete depend on the results of the
individual couple's initial evaluation. A basic infertility evaluation
could include a semen analysis for a male partner. An x-ray dye test
(hysterosalpingogram) to check if the fallopian tubes are open and
normal and blood hormonal testing in the female partner are common
tests. Women over 35 or other younger patients at risk for loss of egg
numbers are offered blood testing for their ovarian (egg) reserve. More
advanced testing may be needed, depending on the initial test results.

How long does the process take?
The initial evaluation would typically take around six weeks.



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