Baby's on roller skates

Just another gynecological obstetric site

Leave a comment

Pap smear vs. HPV test, which one is more important?

Two days ago I was reading about the benefits if HPV test and how we should not even consider the taking the PAP test. women talked that  it is nothing that scratching the surface of the cervix in order to get more cells and it is the same thing with HPV test except for the fact that the HPV test is much better. it was written that all women who are against the replacement of PAP test are sheaps. I would consider the fact that anyone who is against changes for better tomorrow is a sheap and afraid of the current changes, but I would call a person with such name if the person do not know what is PAP test and why is taken? Such reaction isn’t correct! Your OBGYN should explain why is taken.

Why we take PAP test, why HPV is important and what are the differences?

both procedures are the same, a sample is taken from the cervix and sent to lab for analysis. We use the PAP test in order to detect if there is an egzistance of HPV virus or any other abnormal cell changes. Positive PAP test will give the right direction, it means that if the presence of HPV is confirmed, than you will have to do HPV test and find out if you are carrier of a high risk HPV virus.

Why wouldn’t I take just the HPV test?

Leave a comment

Does IVF raise the cancer risks?

There has been a study about how does IVF raise the cancer risks? According to:

This article was about that babies who are born through fertility treatment they suffer from a rare combination of birth defects and by that the risk of cancer is six times more increased. This study has raised serious questions about the safety of the fertility treatment that most couples have been doing in the past years. They claimed that the “researchers found that the IVF-initiated conception was six times more common than in the general population”. In this article was also found that the “children born with BWS are predisposed to a type of kidney cancer called Wilms”. However there were many questions about these studies and many mothers were upset thinking day and night about their newborns and how this is going to reflect on their future. The most interesting situation was that right after this study it was clear that none of this is true and the couples can rest a little bit.

According to:

They said that all those questions about IVF increasing the chances of cancer increasing in all the babies that are born via IVF. They claimed that “Women getting fertility treatments can be reassured that in vitro fertilization (IVF) does not increase their risk of breast and gynecological cancer”. They also said in their statement that babies born through IVF process are safe and their increased chances of cancer and kidney failure are nothing but just another false alarm. When people read this statement about IVF not increasing the cancer risks they became people full of questions.


Which one of these statementsis really true?

On one side we have the one statement that IVF is increasing the babies cancer risk and kidney failure, women are more likely that they have cervical and breast cancer risk, and on the other side we have that none of all those theses are actually true.  You have to be very careful about telling people and going straight with some kind of studies about increasing cancer, every patient that is going through the IVF process is watched very closely and it is more likely that if there is anything suspicious, than it is more than sure that doctors will notice it. That is why we have to know what we are reading and when we read something like this, instead of thinking about it at home we have go straight and ask someone that has more information about the case and inform us. However taking an opinion for granted from some source that is not classified and thinking about that instead of consulting with someone can be very dangerous. Spreading a word such as cancer can upset many people and it is not something like for example talking for today’s weather. Today we are fighting with all our strength for these kinds of false alarms, and we are hoping that we are not going to hear any more bad news about this subject.

Leave a comment

How can IVF be performed?

History of how can be IVF performed?
IVF as a technique was developed in the 1970s. This technique may differ slightly from clinic to clinic but the base of this technique is always the same everywhere.
Step by step how can be IVF performed for women
Step 1: suppress the monthly cycle
The doctor will give you a drug that will suppress your natural monthly menstrual cycle. This drug may be a daily injection that the caregivers will teach you how to give yourself, or the drug may be a nasal spray. This therapy may last about two weeks.
Step 2: boost the egg supply
You have already suppressed your natural monthly cycle, now it is time to take a fertility hormone called FSH (follicle stimulating hormone). It is a gonadotropin, which is another daily injection that you are going to give yourself for the next 12 days. It may also vary depending from the response; the FSH increases the number of eggs your ovaries produce. Increased production means that more eggs can be collected and fertilized. More eggs, more embryos to choose and use in your treatment.
Step 3: the progress
During the process the clinic will keep an eye of every progress that you make, this may include vaginal ultrasound scans to monitor your ovaries and blood tests if needed. Your final hormone injection will be 34-36 hours before your eggs due to be collected; this final injection will help your eggs to mature.
Step 4: Collecting the eggs
You will be sedated during this procedure. Your eggs will be collected under ultrasound guidance; the doctor will insert a needle through the vagina and into each ovary. Through this needle the eggs are then collected.
Step 5: Fertilization
The eggs are now collected and they have to be mixed with your partner’s or your donor’s sperm in the laboratory. 16-20 hours have to pass after they are mixed so they can check if any have been fertilized. In cases where the sperm are few or weak, each egg has to be injected individually with a single sperm. This procedure is called intra-cytoplasmic sperm injection (ICSI).
The cells are now fertilized and they need to continue to grow in the laboratory for one to five days before being transferred into the womb. The doctor will pick the best one or two embryos for transfer.
Step 6: Embryo transfer
Before the treatment you should discuss with your doctor about the number of embryo to be replaced. For women under the age of 37, in their first IVF usually have a single embryo transfer. If there are no-top quality embryos available and it is your second IVF, doctors should consider using only two embryos. Having a multiple embryo transfers may result into a multiple pregnancy and birth.
How can be IVF performed- for men
After your partner’s eggs have been collected, you’ll be asked to produce a fresh sample of sperm. The doctors are going to take the sample of sperm, wash it and spun at a high speed. This is done in order the healthier and most active sperm to be selected.


Leave a comment

Unexplained fertility, do you even consider about IVF? Where the border stands?

Nearly 80% of the couples that are trying to have a baby suffer from unexplained infertility. This is a message that has been sent from the Queen’s University Belfast and it has been published in the journal Reproductive Biomedicine Online.
According to this report there are 1 million couples worldwide that undergo fertility treatments every year. We may have heard about that on the daily news, but we didn’t know that one third of them are told about the unexplained infertility problem that they have. This actually means that doctors cannot explain what is wrong and why they cannot have a baby. It is a huge problem among all young couples that are desperately seeking ways to have a baby.
If you have an unexplained infertility, do you even consider about IVF? Where the border stands? Simple explanation about those borders
This so called border stand right into the women age, how long have they been trying to have a baby, and if the woman have been pregnant before and had her first child. This is a border that explains everything. From personal experience I have seen many couples that have been trying to have a baby. Yes most of them were diagnosed with unexplained infertility which is quite often these days. There is something that I and my colleagues cannot understand. It is about why people and I are talking about young couples about 22-24 years all are disappointed. Usually they are disappointed after trying in the first month. They should not be disappointed because they are too young and they haven ben trying too long. That is why the doctors say that you have to be married for three years and then try all the methods for getting pregnant. Starting with IVF too early is not such a great solution unless you are 35 years old and have been trying in the past three or four years. It is understandable that doctors recommend the less invasive and cheaper methods before starting the in vitro fertilization process, which is $12,000 per cycle, but with those methods the doctors are making a huge disservice. When we talk about those women that are under 35 could be better off trying to get pregnant on their own. This is only at least for the next few months. As for women that are older than 35, it is better to avoid wasting their precious time and straight ahead to IVF or consider about the adoption options.
Just trust yourself
Having always irregular periods, which means twice a year the chances of ever getting pregnant are too small. Doctors in these cases often prescribe Clomid in order to induce ovulation. Most doctors do not recommend, but Provera has done miracles in some infertility cases. Women that are 40 years old have a chance for getting pregnant despite their age. Unexplained infertility, do you even consider IVF? Where the border stands? Having a good doctor that believes in you can help in these situations. It is actually the most important thing. No matter how far that doctor is you have to find him and take your chances.

Leave a comment

Artificial insemination & IVF benefits, risks

What is an Artificial insemination & IVF benefit, risks? -Artificial insemination is a technique used to help in certain kinds of infertility in both men and women. It is a procedure where the male’s sperm is inserted into a women’s cervix, fallopian tubes or uterus. By entering the sperm directly it makes the trip shorter from the sperm and bypasses any possible obstructions. Intrauterine insemination is a procedure where the sperm is placed in the uterus and it is the most common form of artificial insemination. This is a technique that has a key advantage which is the simplicity of this procedure with few side effects. Because of this your doctor may recommend it as an initial form of treatment for infertility.
For what type of infertility can artificial insemination be recommended?
The artificial insemination is very popular and it can be recommended for various fertility problems. It is more popular to those men that have very low sperm counts or sperm that isn’t strong enough to swim through the cervix and up into the fallopian tubes. It is also recommended for women who have endometriosis or other abnormalities of their reproductive organs. It is considered that women with unreceptive cervical mucus are also good candidates for artificial insemination. The mucus that surrounds the cervix can prevent the sperm from getting into the uterus and fallopian tubes. With the artificial insemination you can allow the sperm to skip the cervical mucus entirely. There are cases when doctors can’t determine the reason of why the couple is infertile and in that cases they recommend the artificial insemination to be their first step for getting pregnant.
Before the artificial insemination starts in order to make sure if you are ovulating your doctor will use ovulation kits, ultrasound or blood test. If the test is confirmed your partner will be asked to produce a sample of semen (he will have to abstain from sex two to five days, it is to ensure a higher sperm count). For those that live in the clinic’s neighborhood, they can collect the sample home by masturbating. If you are not, you will be provided a private room for this purpose. The provided sperm is “washed” within one hour of ejaculation. After they have washed the sperm in a laboratory, the sperm can be placed in a thin tube called catheter and this tube has to be placed through the vagina and cervix into the uterus. This procedure is painless and takes only few minutes. After the procedure the woman has to lie down 15-45 minutes to give the sperm a chance to work.
The success rate, benefits, and risks from the artificial insemination can vary. However there are factors that can decrease your chance of success such as:
• The ager of the women- older age woman, lees chances of success
• Poor egg quality
• Poor sperm quality
• Endometriosis
• Damaged fallopian tubes (it is usually from a chronic infection)
• Blocked fallopian tubes

Leave a comment

I can’t afford IVF

If you tried for some time and can’t afford IVF (in-vitro fertilization), because it has become a financial burden, but you still want to try, we can raise your hope and suggest a list of financial help for couples that can’t afford IVF. Since IVF costs vary based on location and degree of health insurance, check with your doctor to see what financial options are best and recommended for you, based on your specific situation. This is what we suggest for making your fertility treatments affordable:

Refund programs

The general concept of IVF refund programs or shared risk program is that you pay fee for a number of IVF attempts, and if at the end of the cycle you have not taken a baby home, you get your money back (usually from 80% to 100%). The direct information for each program can be taken from IVF centers of your interest. The centers that provide these programs do not guarantee a successful outcome, but they guarantee that your money is refunded if the outcome is unsuccessful. The drawback of these programs is that if you do get pregnant during your first or second IVF cycle, you will not get a refund.


Patients that can’t afford IVF can obtain unsecure loans that cover the expenses. There are several companies that work with loans specifically for IVF, for example ( or (

Low cost programs

This includes looking for programs on fertility clinics specifically offering low cost procedures or visiting overseas clinics that can provide IVF treatment with lower costs. ( ). Before you make a decision to leave the country and go abroad, you should learn more about the clinic and their success rate. You will also have to determine how much you will need for travel expenses, and the amount of time that you will need to take off from work to travel abroad. Also you can apply for a grant for a scholarship program through some organizations like ( )

Health insurance

Some health insurance cover a portion of the costs associated with IVF. You can contact your health insurance company or your employer’s human resources department to learn if some of the IVF costs are a covered expense. Contact the insurance commission in the state where you reside because the state laws vary in some states the law is requiring insurers to cover the treatments.

Egg shearing

Some fertility clinic programs offer discount or free IVF cycles to women who are willing to donate any remaining eggs that are not being used during their IVF. Usually you will have to meet certain egg donor requirements and criteria to be eligible.

Lower technology treatments

Before trying IVF consider lower cost treatments like IUI. IUI program may be good option for couples with fertility issues like low sperm count, endometriosis, or unexpected infertility.  You should discuss your options with your doctor, and find out witch treatment make most sense for your fertility issues, though IUI does not have the same success rate as IVF.



Leave a comment

Simple explanation about the IVF process

Simple explanation about the IVF process in few steps that you might be interest about reading it!

You and your husband are trying to have a baby, but something is not right and you are tired trying at all. There’s got be a solution for your problem. You have considered about all options about conceiving and you have probably heard already about the IVF procedure. You have talked already, and you want to find out what this procedure includes. Yes this procedure that most couples are considering today if they cannot conceive on the natural way. Before you start this procedure you have to be prepared.

Not only you have to be prepared physically, emotionally but you have to be prepared for all IVF costs that you need to cover. IVF is the longest procedures of all. You have to know that you must be extremely patient and you have to learn how to manage not to be disappointed if this procedure doesn’t give you the result that you have expected even after the first time you try.

Have you start with the IVF process?

When you start with the IVF process you have to prepare yourself on what to expect when you’ll first start with this procedure. You have to answer all the questions that are related on you medical history and social history. By answering these questions you can allow the clinic to assess the impact of a potential birth on the baby and on any other children you may have.

You are now accepted for treatment, blood tests will be taken from you and your partner. Your hormone profile will be done via blood sample that if going to be taken in the menstrual cycle in order to see if there is likely to be any difficulty in obtaining eggs and if there is a hormonal imbalance. Your clinician will be with you in every step of this procedure to discuss about your treatment plan. If you have any questions you have to know that counseling is always available and it can be helpful while you go through this process.

Loans & doctors

There are couples that are going through the same procedure. Your clinician can point you at the right direction so you can have a talk about their experience and share some thoughts. Be careful about the loans and the health insurance, you might find yourself in a very difficult situation during this process. Check out your health insurance policy and see what they can or can’t cover. There are lot of options that your doctor or your clinic can offer you, you might get lucky and not pay for the fees that most couples pay. First of all choose the clinic that has most successful rates. It may be more expensive, but if there are good results it may be cheaper than paying twice for the same procedure in some other clinic. Do not let the cheaper prices full you against the successful rates, most couples do that.



Leave a comment

Before IVF- More about the fertility drugs

Generally, fertility drugs are used to treat problems with ovulation or recurrent miscarriage. However, this is not always the case, so even if you’re using assisted reproductive techniques such as IVF (in vitro fertilization), fertility drugs are still an important part of treatment. In this case, fertility drugs may increase the number of eggs the women produces. Some are taken orally, and some are injected. What do these wonder pills and injections do? In general, these medications work by causing the release of hormones that either trigger or regulate ovulation. Fertility drugs can also be used in men to treat male factor infertility, but this is less common.

Commonly Prescribed Fertility Drugs

Since the number and names of all of the infertility medications may seem dizzying, here are the basic facts on the drugs most commonly prescribed.

  • Clomiphene
    Clomiphene is usually the first choice for treating infertility, because it is effective. Clomiphene works by stimulating hormones in your brain (hypothalamus and pituitary gland) to release hormones like GnRH (gonadotropin releasing hormone), FSH (follicle stimulating hormone), and LH (luteinizing hormone) – that will stimulate the ovaries to produce egg (or several) each month, while gonadotropins stimulate your ovaries directly to produce an egg (or several). That’s all some women need to get pregnant.
  • Gonadotropins
    Brand names: Pergonal, Repronex, Fertinex, Follistim, Gonal F, Novarel, Ovidrel, Pregnyl, Profasi, and Menogon and Puregon (available only in Europe). These drugs are meant to mimic the LH hormone in the body, LH triggers ovulation. And sometimes they are combined with FSH treatment, also known as human menopausal gonadotropins (hMG), but this may be used in some special cases, not that requently. They are injectables.

But like many other fertility solutions, such as in vitro fertilization, fertility drugs can increase your chance of multiple births — and the more babies you carry, the greater your risk for complications such as miscarriage and premature labor. About 10 percent of women who take Clomid have multiples (mostly twins), as do 10 to 40 percent of women who take gonadotropins.

Risks of Fertility Drugs

As with the use of any drug, risks come with fertility drugs. One risk you’re no doubt familiar with is the risk of a multiple pregnancy. Multiples, either twins, triplets, or higher-order, can occur when using fertility drugs.  The side effects of clomiphene are generally mild. They include hot flashes, blurred vision, nausea, bloating, and headache. Clomid can also cause changes in the cervical mucus, which may make it harder to tell when you’re fertile and may inhibit the sperm from entering the uterus.

Another potential side effect of fertility drug use is ovarian hyperstimulation syndrome, or OHSS. OHSS happens when the ovaries are overly stimulated, becoming dangerously large and filled with too much fluid. This fluid, which is released with ovulation, can lead to serious complications. OHSS is rarely life threatening, but it should be taken seriously.


Before IVF- What is intrauterine insemination?

What is IUI?

Intrauterine insemination (IUI) involves a laboratory procedure to separate fast moving sperm from more sluggish or non-moving sperm.The fast moving sperm are then placed into the woman’s womb close to the time of ovulation when the egg is released from the ovary in the middle of the monthly cycle.

Is IUI for me?

Your doctor may recommend IUI if:

  • there is unexplained infertility
  • there are ovulation problems
  • the male partner experiences impotence or low sperm count or decreased sperm mobility
  • you do not have any known fertility problems but may not have a male partner and are trying for a baby using donated sperm.
  • Ejaculation dysfunction


In sum, IUI is a reasonable therapy for some infertility patients, but should be abandoned for IVF by the end of the third IUI cycle.

It is essential that your fallopian tubes are known to be open and healthy before the IUI process begins, because one of the most common causes of infertility is blockage of the fallopian tubes. A tubal patency test is usually carried out as part of your assessment by the fertility clinic. When the pelvis and tubes are healthy, dye passes freely through both tubes. There should be no adhesions present that might prevent an egg from having access to either tube from the ovaries.


The second essential requirement is that there is no significant problem with sperm numbers or sperm quality. If your partner is unable to provide sperm, or if you do not have a male partner, you may want to consider donated sperm.


How does IUI work?

For women:

  • If you are not using fertility drugs IUI is done between day 12 and day 16 of your monthly cycle – with day one being the first day of your period. You are given blood or urine tests to identify when you are about to ovulate. Many clinics will provide you with an ovulation predictor kit to detect the hormone surge that signals imminent ovulation.

– or –

If you use fertility drugs to stimulate ovulation, vaginal ultrasound scans are used to track the development of your eggs. As soon as an egg is mature, you are given a hormone injection to stimulate its release.

You should consider the best option for you with your doctor.


  •  The sperm are inserted 36 to 40 hours later. To do this, the doctor first  inserts a speculum (a special instrument that keeps your vaginal walls apart) into your vagina.

A small catheter (a soft, flexible tube) is then threaded into your womb via your cervix. The best quality sperm are selected and inserted through the catheter.

The whole process takes just a few minutes and is usually a painless procedure but some women may experience a temporary, menstrual-like cramping.

  • You may want to rest for a short time before leaving the clinic – ask your clinic what they recommend.


For men:

  • You will be asked to produce a sperm sample on the day the treatment takes place.
  • The sperm are washed to remove the fluid surrounding them and the rapidly moving sperm separated out.
  • The rapidly moving sperm are placed in a small catheter (tube) to be inserted into the womb.

Leave a comment

Getting ready for IVF- what is reproductive immunology?

“In the 1980s, it became clear to me that products of an activated immune system could damage the placenta and cause miscarriage, as well damage the embryo and cause implantation failure. Natural killer cells, which help to keep the body from developing cancer, can over-populate the uterus or exist at too high levels within the blood stream. These cells than go overboard, killing the embryo or interfering with the endocrine system that produces the hormones that are essential for pregnancy. This response can often be associated with complications for both the mother and her baby if the pregnancy occurs without treatment to suppress the activity of the immune system“.  – Dr. Alan E. Beer (“Is Your Body Baby Friendly?”)

Dr. Alan E. Beer is widely considered as the pioneer in the field of reproductive immunology, he believes that it is not simply due to back luck that some women fail to conceive or have repeated pregnancy failure.

If you have a complex medical and fertility history, and failed fertility treatments, you might want to consider making further tests in advice with your doctor for your immune system. If you have repeated miscarriages, some doctors think that your immune system may be rejecting your pregnancy. So in normal pregnancy, it is thought that your body does something to stop the fetus being rejected. However, there is no convincing evidence that immune rejections of the fetus does actually ever happen in women with fertility problems.

summary of the most relevant testing:

  • Antiphospholipid Antibodies (APA). These are the glue molecules for implantation and placentation.
  • Antinuclear Antibodies (ANA). Some women develop antibodies to the baby’s DNA or DNA breakdown products and this problem is reflected by a positive Anti-nuclear antibody test (ANA). This is often with a speckled pattern. We also advise that women have testing to double-stranded DNA, single-stranded DNA, polynucleotides and histones.
  • Elevated CD 56+ Natural Killer Cells. This test determines the killing power of a woman’s Natural Killer Cells in the test tube. Elevated NK numbers and/or NK activity can be associated with increased risk for infertility and loss.
  • Th1/Th2 Cytokines (chemical messengers in the blood). The immune system is balanced between a TH1 (autoimmune) and TH2 (pregnancy or suppressive response). TH1 predominance can also be associated with reproductive failure. The Th1 Th2 Assay can help to determine a patient’s risk for this problem.
  • T regulatory cells (Treg). Higher numbers of Tregs in the blood have been associated with better pregnancy outcome.
  • Thrombophilias . Thrombophilia is increased tendency to clot.Throughout an entire normal pregnancy, the mother’s ability to produce blood clots in the uterus and the placenta is suppressed. However, in some mothers, this clotting tendency is not suppressed sufficiently. This can contribute to many pregnancy complications.
  • CD57 cells in the endometrium. High levels of CD57+ cells may be associated with increased risk of infertility and loss.

From your circumstances, and medical history, your consultants aim to advice you on the most appropriate tests and treatments for you. Depending on the tests results you will get appropriate immune treatments and medications.

What should I ask my doctor?

If you are recommended immunological treatments as part of your fertility treatment, we advise you to make sure you feel properly informed about the potential benefits and risks of the tests and treatment.

Your clinic should explain:

  • why they think the tests and treatment may help you
  • what the risks and side effects may be
  • the costs you will incur.