If you are under age 35, you should seek treatment for infertility if you have been having unprotected intercourse for one year or more without having a baby. If you are over the age of 35, you should seek evaluation and treatment if you have not conceived after six months of unprotected intercourse. It does not matter if you have been “trying” to conceive all this time, only if you have been having unprotected intercourse. Fertility problems may be due to factors in the man or in the woman and commonly involve multiple factors in both partners.
At Gold Coast, we make use of the Road Map to Success. As a result, our success rates are among the highest in the nation. One of the reasons our success rates are so high is that we focus on identifying all causes of infertility in the couple and individualize treatment for each person. Dr. Palter, a board-certified reproductive endocrinologist, has advanced training in all modalities of treatment for infertility, from medication to surgery to the latest innovations in IVF.
Many couples cannot conceive because of problems affecting male fertility. A man may have male infertility and not have any symptoms whatsoever. Any man who is trying to conceive and has problems with erection or ejaculation should seek treatment. Other potential signs of male fertility are changes in sex drive or decreases in beard growth. However, most men with infertility have no symptoms at all. A sperm test in a simple and easy test that can diagnose male infertility problems. There are many effective treatments or male infertility available.
At Gold Coast, we work in conjunction with top notch urologists and male infertility center to coordinate the most effective care. We also conduct our own sperm analysis and preparation when conducting artificial insemination. We are a NYS license insemination site. Donor sperm is available for those women who require this service.
POLYCYSTIC OVARIAN SYNDROME
Polycystic ovarian syndrome is an extremely common disorder that prevents a woman from releasing an egg normall each month, due to excess oduction of male hormones. Common
signs polycystic ovarian syndrome are irregular menstrual cycles, excess fatial or body hair, acne and obesity. However, there are unusual forms of polycystic ovarian syndrome where women may not have any of these features at all. Polycystic ovarian syndrome is commonly treated with medications to restore normal hormonal function and a regular release of eggs from the ovary. Polycystic ovarian syndrome may also be a cause of miscarriage.
Enormous advances have recently been made in the treatment of PCOS. Newer medications are available with minimal to no side-effects. More exciting, these medications are able to achieve ovulation and pregnancy in women in whom older standard medications did not work. At Gold Coast, we utilize the Road Map to Success of creating an individualized treatment plan that takes each patient’s condition and goals into account.
Couples should seek treatment after they have had two miscarriages. There are many causes of recurrent miscarriage. Our evaluation will look for genetic problems, clotting problems, hormonal problems, structural problems of the uterus, among others. There are a wide array of treatments that range from simple medications to complex fertility therapies, that enable patients suffering from multiple miscarriages to conceive and carry a baby to term.
At Gold Coast, we aggressively seek the sometimes elusive causes for recurrent miscarriages, and help patients to maintain their pregnancies to term. We have patients that have had as many as 10 miscarriages before coming to Gold Coast, who have gone on to have a successful pregnancy. Our mental health specialist is available to help any patient who is dealing with the stress of recurrent miscarriage, to help manage the emotional rollercoaster of the syndrome and to give patients the strength to keep trying.
Endometriosis is a common cause of infertility. It is present in 5% of the general population, but 33% of patients with infertility. Endometriosis is defined as the abnormal presence of uterine lining tissue outside of the uterus. This tissue normally grows inside of the uterus and shed in a menstrual period each month if pregnancy does not occur. In patients with this disease, the cells grow abnormally inside of the abdomen on the outside of the uterus or on the ovaries or fallopian tubes. There is internal bleeding each month at the time of the menstrual period and this causes internal scarring and damage to the reproductive organs. Many patients with endometriosis have pelvic pain especially at the time of their menstrual period or pain with intercourse. Many patients with endometriosis have chronic pain in addition to their infertility. However, some patients with endometriosis have no symptoms at all except for infertility.
There are many treatments for endometriosis, including medications, fertility drugs and surgery. Dr. Palter is a world-famous surgeon, who has trained other doctors from around the world to effectively treat endometriosis both surgically and through medication therapy. For more information, see Dr. Palter’s bio. We specialize in all of these therapies and individualize the treatment for your specific condition.
Fibroids are present in approximately 40% of the population. Some fibroids, however, will cause infertility. Other common symptoms of fibroids are heavy menstrual periods or pelvic pressure or discomfort. Fibroids are abnormal, non-cancerous tumor growth of muscle on or inside the uterus. Not all fibroids require treatment and we have special sophisticated diagnostic tests that can determine if a fibroid should be treated. Fibroids can be removed through advanced minimally invasive telescopic surgery, which in many cases may not require any incision.
At Gold Coast, we provide advanced surgical therapy for endometriosis. This includes laparoscopic surgery, which is performed through a tiny keyhole incision. Dr. Palter is world famous for developing advanced miniaturized instrumentation and specialized techniques for the treatment of fibroids and endometriosis. For more information, see Dr. Palter’s bio.
Ovulation problems occur when a woman does not release an egg normally each month. In the most extreme form, no egg is released and menstrual periods may be very delayed or absent. In milder forms, there may be a lengthening of the menstrual cycle. If the cycle is under 25 days or more than 35 days in length or irregular from month to month, ovulation problems are likely. Ovulation problems will lead to infertility and may also be a cause of miscarriage. They are commonly treated with medications.
At Gold Coast, we use the Road Map to Success to create an individualized treatment plan for every patient. We perform specialized urinary and ultrasound monitoring to determine if an ovulation problem occurs, and then take aggressive and personalized action to treat the problem through medication if necessary.
ADHESIONS (SCAR TISSUE)
Adhesions are present when scar tissue exists in the internal reproductive organs. The most common problem that results from this is blockage of the fallopian tube, which is the passage that the egg takes from the ovary to the uterus. When this tube is blocked, the egg and sperm cannot meet and infertility exists. Adhesions are common causes of pelvic pain as well. Adhesions are also commonly present when ectopic or tubal pregnancies occur. Adhesions may also occur inside the uterus, scarring it partially or completely closed causing infertility or miscarriage. This is a frequently missed problem.
At Gold Coast IVF, we have specialized 3D ultrasound equipment and miniaturized surgical telescopes that can diagnose adhesions within the uterus without any incision. Dr. Palter is world famous for his techniques in repairing adhesions within the uterus. Dr. Palter has been a leading researcher in studies and in developing new methods of preventing adhesions. For more information, see Dr. Palter’s bio.
The fallopian tube is the passageway that the egg takes from the ovary to the uterus. It is a vital structure in human reproduction. Far from a simple passageway, it is the site where sperm and egg meet. The fallopian tube is lined by specialized cells that both propel the egg and sperm as well as secrete nutritive substances that enable fertilization and early embryo growth to occur.
Fallopian tube disease is one of the most common forms of infertility in the United States. Patients may have partially or completely blocked fallopian tubes without any symptoms whatsoever. Dr. Steven Palter is an internationally regarded expert in the diagnosis and repair of fallopian tube disease. He is one of the only physicians in the world to use pinhead sized telescopes to look inside the fallopian tube to assist in diagnosing its health and helped develop the equipment. He has performed research in the laboratory that identified what the normal cellular functions of the lining cells are. An evaluation of the fallopian tube can be done with a simple x-ray test. Since the interpretation of this test is so vital, Dr. Palter personally performs x-ray tests himself. If you have had these tests done elsewhere, he will review the original x-ray films to ensure that no disease has been missed. Should there be suggestions of tubal disease, pregnancy can still occur. The two options are to either correct the disease through laparoscopic “key hole” surgery or to go around the tubes using in vitro fertilization. While a professor at Yale Dr. Palter conducted research that discovered several aspects of basic tubal function and identified abnormalities in diseased tubes. It has recently been shown that certain blocked tubes may even dramatically reduce the chances of success with IVF (if untreated) so this evaluation is crucial for all patients with infertility, regardless of the mode of treatment chosen
Common causes of obstructive fallopian tubes are scarring from endometriosis, prior pelvic infections “which may never have had symptoms”, inflammation in the pelvis, or abnormalities from birth.
Asherman’s syndrome refers to scarring within the uterus. While previously felt to be a rare disorder, it has been recognized to be increasingly more common. Some patients with Asherman’s syndrome may have no symptoms whatsoever. Others may have lighter menstrual flow or even completely absent menstrual flow. The most common cause of Asherman’s syndrome is scarring inside the uterus that forms after a D&C procedure is performed for a miscarriage or placental tissue that does not pass after childbirth. Any woman with infertility or altered menstrual cycles who has had a miscarriage or previous birth, even if it is via C-section, should be checked to see if she has Asherman’s syndrome. The treatment of Asherman’s syndrome is surgical. A small telescope is placed through the vagina into the uterus and using tiny scissors the scarring is removed and the uterine cavity reconstructed.
Dr. Palter is an internationally recognized expert in both the diagnosis and treatment of Asherman’s syndrome and regularly treats patients who travel from around the world for treatment – as one of our patients recently told us, “Traveling 100 miles for you to treat me was a no-brainer.” He has developed a comprehensive preoperative evaluation and operative treatment regime that results in excellent results. He frequently lectures to other physicians on how to make the diagnosis and his treatment algorithm, which results in high success rates is frequently sought by others. He is proud to have been awarded a Prize from the American Association of Gynecologic Laparoscopists (AAGL) for his work on Asherman’s Syndrome.