Fibroids are smooth muscle tumors of the uterus. They grow from the muscle cells of the uterus. They are benign ( non-cancerous), and are the commonest tumours found in a young woman. Since they are so common ( about 25% of women in the childbearing group will have fibroids) , many infertile women will also be found to have fibroids. However, most fibroids do not affect fertility and can safely be left alone or made to shrink.
Unfortunately, many doctors are very anxious to surgically remove these, and this unnecessary
surgery can actually cause infertility !
Fibroids are classified according to their location and are of 3 types. The uterus has 3 layers - the inner lining which lines the cavity, called the endometrium; the wall of the uterus which consists of smooth muscle, called the myometrium; and the outer lining , called the
serosa.
A fibroid which grows in the muscular
wall of the uterus is called an intramural
( "within the wall" ) fibroid.
A fibroid which grows
mainly on the outer surface of the uterus, under the serosa, is called subserosal.
A fibroid
which grows just under the uterine lining, inside the uterine cavity, is called a submucous or intracavitary fibroid.
Although the exact cause is unknown, the growth of fibroids, like all tumours, seems to be related to a gene that controls cell growth.
Fibroid growth is also affected by the
reproductive hormones estrogen and progesterone.

Hi doc,
Kindly educate me on this. I had previously done a semen analysis which showed 96million and 74 million / ml. The analyses showed more than 80% normal forms and more than 50% actively motile. 18months after the last test, my count showed 3.2million/ml with heavy growth of staph and fungal growth. This was in feb,2011. Now, after completing antibiotic and anti fungal treatment, analysis still show numerous pus cells (but no growth on culture, on four occassions one month apart), but count has been 5.5, 8.3,18.6 and 9.6 million /ml respectively with normal forms b/n 50-60% and motility b/n 30-40%. I also noticed that my ejaculate is not as thick (or viscous) as it used to be. I have been on maca herbs, vit c, zinc and lately, clomid (based on low testo) over 3weeks, but the doc says I'll take it for 6months, 5omg daily.

I want to know if infection induced low sperm count is difficult to treat like low sperm count without any known cause and if I can still make my wife pregnant naturally, or must I use IVF?

Then, what's your opinion on IUI, seems different docs share different opinions on it.

Thank for your reply.

Its just this month and the result was positive but the lab guy said something about traces mabe it means the use of gynacosid didnt finish the work but i havnt seen any blood so far its like 4 days gone since i was supposed to have seen the stuff

Doc how do i get intouch privately then secondly the result was positive but after taking gynacosid, and taking the test the lab guy said something about there still be some traces but am yes to bleed.

obidia:

Doc how do i get intouch privately then secondly the result was positive but after taking gynacosid, and taking the test the lab guy said something about there still be some traces but am yes to bleed.

You can chat with me Kenny_haastrup@yahoo.com.
I'm not getting you please.

ok thanks

glory1220:

Hi doc,
Kindly educate me on this. I had previously done a Fluid analysis which showed 96million and 74 million / ml. The analyses showed more than 80% normal forms and more than 50% actively motile. 18months after the last test, my count showed 3.2million/ml with heavy growth of staph and fungal growth. This was in feb,2011. Now, after completing antibiotic and anti fungal treatment, analysis still show numerous pus cells (but no growth on culture, on four occassions one month apart), but count has been 5.5, 8.3,18.6 and 9.6 million /ml respectively with normal forms b/n 50-60% and motility b/n 30-40%. I also noticed that my expel is not as thick (or viscous) as it used to be. I have been on maca herbs, vit c, zinc and lately, clomid (based on low testo) over 3weeks, but the doc says I'll take it for 6months, 5omg daily.

I want to know if infection induced low Fluid count is difficult to treat like low Fluid count without any known cause and if I can still make my wife pregnant naturally, or must I use IVF?

Then, what's your opinion on IUI,  seems different docs share different opinions on it.

Thank for your reply.

The 'thickness' or 'thinness' of your Fluid ia not a measure of your fertility so relax.
Your motility poor and I don't know the exact level of testosterone but trust me uf I'm going to treat low testosterone I won't use Clomid.
If motility is poor, this suggests that
the testis is producing poor quality sperm and is not functioning properly - and this may mean
that even the apparently normal motile sperm
may not be able to fertilise the egg.
And yes I will always do IUI before I go all the way to IVF unless there's a clear cut reason not to,
The presence of pus cells suggest seminal infection and it need to be cleared and. Rom the look if it the cause of your poor motility is mixed.
If you have any clarification talk to me and feel free to ask any questions that's seems unclear to you.

Doc can you kindly reply me i just sent a mail to your box

obidia:

Doc can you kindly reply me i just sent a mail to your box

I just replied you.

Fibroids are smooth muscle tumors of the
uterus. They grow from the muscle cells of the
uterus. They are benign ( non-cancerous), and
are the commonest tumours found in a young
woman. Since they are so common ( about 25%
of women in the childbearing group will have
fibroids) , many infertile women will also be found to have fibroids. However, most fibroids do not affect fertility and can safely be left alone or made to shrink,
Unfortunately, many doctors are very anxious
to surgically remove these, and this unnecessary surgery can actually cause infertility !
Fibroids are classified according to their location
and are of 3 types. The uterus has 3 layers -
the inner lining which lines the cavity, called the
endometrium; the wall of the uterus which
consists of smooth muscle, called the
myometrium; and the outer lining , called the
serosa. A fibroid which grows in the muscular
wall of the uterus is called an intramural
( "within the wall" ) fibroid. A fibroid which grows mainly on the outer surface of the uterus, under the serosa, is called subserosal. A fibroid which grows just under the uterine lining, inside the uterine cavity, is called a submucous or intracavitary fibroid.
Although the exact cause is unknown, the
growth of fibroids, like all tumours, seems to be related to a gene that controls cell growth.
Fibroid growth is also affected by the
reproductive hormones estrogen and
progesterone.ll" ) fibroid. A fibroid which grows mainly on the outer surface of the uterus, under the serosa, is called subserosal. A fibroid which grows just under the uterine lining, inside the uterine cavity, is called a submucous or intracavitary fibroid.
Although the exact cause is unknown, the
growth of fibroids, like all tumours, seems to be related to a gene that controls cell growth.
Fibroid growth is also affected by the
reproductive hormones estrogen and
progesterone.

HI Dr.

Please can you recommend a good donor egg IVF program in Lagos?

STATS

Me - 29 yrs never being pregnant.
DH - 32yrs
TTC - 3 years
Diagnosis - Endo (caused permanent scarring to tubes) and high FSH (possibly ovarian failure)
2 failed fresh IVFs 6 eggs retrieved both cycles with only two fertilized.
DH sperm count/morphology optimal.

P.S. I have also done a lap to take out the endo and some fibroids in 2007 (I think the endo is back cos I am cramping again)

I would be grateful for any suggestions thanks.

oops! sorry 2009! I had the lap in 2009.

Tacoma:

HI Dr.

Please can you recommend a good donor egg IVF program in Lagos?

STATS

Me - 29 yrs never being pregnant.
DH - 32yrs
TTC - 3 years
Diagnosis - Endo (caused permanent scarring to tubes) and high FSH (possibly ovarian failure)
2 failed fresh IVFs 6 eggs retrieved both cycles with only two fertilized.
DH Fluid count/morphology optimal.

P.S. I have also done a lap to take out the endo and some fibroids in 2007 (I think the endo is back cos I am cramping again)

I would be grateful for any suggestions thanks.

Yea there very good Donor egg IVF centre in Lagos.
You dint mention the ones you've been to so we can eliminate them but I have a very particular one in mind. I've worked with them for a couple of years and still do. So talk to me online.
Endometriosis ( "endo" is a common disorder that affects women of reproductive age. It occurs when normal endometrial tissue (the lining of the uterus) grows outside the uterus. This misplaced tissue may implant itself and grow anywhere within the abdominal cavity.
Many specialists feel that severe endometriosis
is more likely to be found in infertile women who have delayed pregnancy and for this reason, the condition is sometimes labeled a "career woman's disease".
The symptoms are usually progressively severe menstrual cramp, pain during intercourse. While some people does not have any of the above symptoms.
Treatment can be surgical or medical.
Though very expensive but easy to manage.
There's a new medical treatment of Endo.
You did not tell me if your Doctor checked your AMH ( a measure of your ovarian reserve) and FSH level.
Talk to me online kenny_haastrup@yahoo.com

In the past, infertility was blamed wholly and
solely on the woman. This may have been to
protect the fragile male ego, was because the
male psyche equates fertility with virility, and
views failure to father a child with shame.
Studies today however show that 40% of
infertility is because of a medical problem with
the man.
The vast majority of men have simply no way of
judging their fertility before getting married
(unless, of course, they have had a premarital
affair and fathered a pregnancy - the ultimate
proof of male fertility ! Rarely, however, some
men may know they have a fertility problem -
for example, a sexual problem of impotence,
which prevents consummation of the marriage;
or one of hypospadias (in which the urethra is
located at the base of the penis and the semen cannot be put in the vagina); or undescended testes (in which both the testes are not in the scrotum).
When testing a couple for infertility, the man
must always be tested first. Tests for the
woman are far more complicated, invasive and
expensive - it is much simpler to find out if the
man has a problem.

Thank you very much for your quick response. I did the 2 IVF cycles in the US. When my RE told me I had a high FSH (which funny enough was normal before I started the 2 IVF cycles) added with the poor quality of eggs retrieved during the 2 failed cycles, I know not to do further tests because honestly I am tired. So, DH and I discussed with my RE that we would like to move up to DE IVF.

We have decided to do the procedure in Nigeria because there are more "black donors' like me in Nigeria and also it is way cheaper . I would like a reputable clinic that screens the egg donors VERY well!.

Thank you very much for your time

Prolactin is a hormone that is secreted by your
pituitary gland, a pea-sized gland found below
the brain. Prolactin is found in both men and
women and is released at various times
throughout the day and night. As the name
suggests, the role of prolactin is to stimulate
milk production in pregnant women. It also
enlarges a woman's mammary glands in order to
allow her to prepare for breastfeeding .
Prolactin and Infertility
Prolactin doesn't just cause your body to
increase milk production - it also affects your
ovulation and menstrual cycles. ( This is why
women who are breastfeeding rarely get
pregnant). Prolactin inhibit two hormones
necessary for ovulation: follicle stimulating
hormone (FSH) and gonadotropin releasing
hormone (GnRH). When you have high levels of
prolactin in your blood ( a condition called
hyperprolactinemia) , you will not ovulate and this will result in infertility. This anovulation can also cause you to have irregular cycles.

Tacoma:

Thank you very much for your quick response. I did the 2 IVF cycles in the US. When my RE told me I had a high FSH (which funny enough was normal before I started the 2 IVF cycles) added with the poor quality of eggs retrieved during the 2 failed cycles, I know not to do further tests because honestly I am tired. So, DH and I discussed with my RE that we would like to move up to DE IVF.

We have decided to do the procedure in Nigeria because there are more "black donors' like me in Nigeria and also it is way cheaper . I would like a reputable clinic that screens the egg donors VERY well!.

Thank you very much for your time

Nordica Fertility centre has a dry good egg donor centre.
Let me know when you are ready and I will call Dr Ajayi to review you and book you for donor egg IVF and screening.

Irregular periods are common in infertile women.
However, many women are very confused about the relation between irregular periods and their infertility. They naively assume that once their periods become regular, they will conceive.
While it's easy to make the periods regular by
putting a woman on birth control pills, this will
obviously not help her to get pregnant.
You need to remember that just like infertility is only a symptom, and not a diagnosis, irregular
periods are also just a symptom of an underlying problem called anovulation, or not ovulating. It is the underlying anovulation which causes both the irregular periods and the infertility, and this is what needs to be treated.
Infertile women with irregular periods need the
following medical tests: blood test for measuring the level of the reproductive hormones, FSH,LH,PRL and TSH on Day 3 of their cycle, so we can find out what the reason for the anovulation is.
Once we know what the problem is, then we
can treat it by inducing ovulation !need the
following medical tests: blood test for measuring the level of the reproductive hormones, FSH,LH,PRL and TSH on Day 3 of their cycle, so we can find out what the reason for the anovulation is.
Once we know what the problem is, then we
can treat it by inducing ovulation !

Stress, Sex and Infertility
We are now seeing many couples who are
having difficulty conceiving because they are
too stressed or too busy to have sex ! This is
the price couples often pay for living in a huge
metropolis !
Having a sexual problem is bad enough - and the
added stress of the involunatary " infertility "
makes it even worse. This often becomes a
negative vicious cycle, which is hard to break.
The demand to have intercourse at the proper
times can provoke frustration when one
partner has a business trip, is working late, or
just cannot get in the mood for sex. Couples
who go through cycles of sex on demand often find that lovemaking loses its spontaneity and playfulness.
Sex becomes a chore to be performed at mid-cycle only. Sometimes the pressure to perform at mid-cycle is so great that a man has trouble with erection or is unable to ejaculate.
Both men and women with fertility problems
also suffer from anxiety and stress over their
sex life, and this often become a chicken-and-
egg problem. In a study of men and women
about to undergo infertility treatment,
researchers found that both anxiety and
stress over sex were fairly common problems.
This means that these men sometimes have
problems producing a semen sample on demand
( either when timing baby making sex at home
or when producing a sample in the clinic) .

IUI
Sometimes nature needs help to start a
pregnancy - and the doctor can do this by giving the sperm a piggy back ride through a fine tube into the body. This procedure is called
intrauterine insemination ( IUI) or artificial
insemination with husband’s sperm (AIH) - and
effectively, the doctor is giving nature a helping hand by increasing the chances of the egg and sperm meeting.
IUI is useful when:
The woman has a cervical mucus problem - for
example, it maybe scanty or maybe hostile to the sperm. With an intrauterine insemination (IUI) the sperm bypass her cervix and enter the uterine cavity directly.
The man has antibodies to his own sperm. The "
good" sperm which have not been affected by
the antibodies are separated in the laboratory
and used for IUI.
If the man cannot ejaculate into his partner's
vagina. This is usually because of psychologic
problems such as impotence (inability to get and
maintain an erection) and vaginismus ( an
involuntary spasm of the vaginal muscles so that vaginal penetration is not possible); or anatomic problems of the penis, such as uncorrected hypospadias; or if he is paraplegic.
The man suffers from retrograde ejaculation in
which the semen goes backward into the
bladder instead of coming out of the penis.
For unexplained infertility, since the technique of IUI increases the chances of the eggs and sperm meeting.
If the husband is away from the wife for long
stretches of time (for example, husbands who
work on ships or work abroad), his sperm can befrozen and stored in a sperm bank and used to inseminate his wife even in his absence.

Obesity and Fertility,

Obesity results in an increased production of
estrogen; this hormonal imbalance in turn
interferes with ovulation, which of course, is
the basis of successful conception.
Ovulatory disorders are the leading cause of
female infertility, resulting in the disruption of
hormones, menstrual cycles, and conception.
Approximately 15% of such disorders are linked
to weight disorders, mainly being overweight and obese.
High estrogen levels associated with obesity can also result in pre-cancerous transformations (usually reversible) in the uterus.
According to several studies, women whose
obesity could be traced back to their childhood
(childhood obesity) had a greater risk of
amenorrhea, a condition in which menstrual
cycles are absent.
Women who are overweight or obese are less
likely to respond to fertility drugs, because
excess weight interferes with the proper
absorption of a variety of drugs used in
infertility treatment.
So ladies please watch it.
infertility treatment.
So ladies please watch it.

Did you guys hear that there's a new Law in Lagos that any guy who impregnates a woman and refuse to take responsibility risk been jailed?
God help us, why would anyone want to start what he can't finish.
If we dey cry we dey see road now.

Thank you DR for your assistance, lecture and analysis. I'll keep u posted as soon as i get HORMONAL test result. Just a question for you; what is the success rate of IUI in Nigeria

Dear Dr. Haastrup,

Dear Dr. Haastrup,

From my user name, am sure you know who I am.  

Been TTC for 11 months, my BMI is 29. I know am overweight, but there are far more obese people who take in easily.

Would my being overweight affect my chances of conception?

ITSURS:

Thank you DR for your assistance, lecture and analysis. I'll keep u posted as soon as i get HORMONAL test result. Just a question for you; what is the success rate of IUI in Nigeria

Basically the chances of IUI is 50% anywhere but these criteria depends on a lot of factors eg like what the patient is presenting with and the method used. But anywhere its not less than 50%.

mogbomoya:

Dear Dr. Haastrup,

From my user name, am sure you know who I am.  

Been TTC for 11 months, my BMI is 29. I know am overweight, but there are far more obese people who take in easily.

Would my being overweight affect my chances of conception?  

Numerous studies have demonstrated that women who are obese (body mass index
over 30) are more likely to have ovulation problems that result in irregular or
infrequent menstrual cycles and infertility.
Women who are obese are also at increased riskfor miscarriage though the reasons for this are as yet unclear. I
n the treatment of infertility, they are less successful. For example, in vitro fertilization (IVF) pregnancy rates are lower in
obese women compared to those of normal
weight. This may be due in part to the fact
that obese women do not respond to fertility
medications as well and have a higher percentage of immature eggs.
Fertility surgery is also riskier in obese women compared to normal weight women.
And I note that just as our genetic composition are different so also will our body's response or otherwise to what's 'normal',
And the above inferences are made barring that the women presents with any other issue.e of immature eggs.
Fertility surgery is also riskier in obese women compared to normal weight women.
And I note that just as our genetic composition are different so also will our body's response or otherwise to what's 'normal',
And the above inferences are made barring that the women presents with any other issue.

drhaastrup:

Basically the chances of IUI is 50% anywhere but these criteria depends on a lot of factors eg like what the patient is presenting with and the method used. But anywhere its not less than 50%.

Thank you DR, enjoy the rest of the evening

Polycystic Ovarian Disease,
We don't really understand what causes PCOD.
However, we do know that the characteristic
polycystic ovary emerges when a state of
anovulation persists for a length of time.
Patients with PCO have persistently elevated
levels of androgens and estrogens, which set up a vicious cycle.
Obesity can aggravate PCOD
because fatty tissues are hormonally active and they produce estrogen which disrupts ovulation.
Overactive adrenal glands can also produce
excess androgens, and these may also
contribute to PCOD.
Treatment of PCOD for the infertile patient will usually focus on inducing ovulation to help them conceive.

Diagnosis ,
PCOD can be easy to diagnose in some patients.
The typical medical history is that of irregular
menstrual cycles, which are unpredictable and
can be very heavy, and the need to take
hormonal tablets (progestins) to induce a period.
Patients suffering from PCOD are often obese
and may have hirsutism, (excessive facial and
body hair) as a result of the high androgen levels.
However, remember the "sin of diagnostic greed " ! Not all patients with PCOD will have all or any of these symptoms. I see many patients who have what I call "occult PCOD". They have regular cycles, but when they are superovulated, they grow lots of eggs, which is typical of patients who have PCOD.
Most gynecologists ( and even infertility specialists !) often overlook this
diagnosis, because they do not think of it.

Hi Dr H,

I'm not sure but I think I have occult PCOD

First ICSI, i produced 13 eggs, second ICSI 15 eggs, third 14 eggs and the last one 27 eggs.

Does Metformin help in treating PCO?

Many thanks in advance.

We have now learned that many patients with
PCOD also have insulin resistance - a condition
similar to that found in diabetics, in that they
have raised levels of insulin in their blood
( hyperinsulinemia) , and their response to insulin is blunted. This is why some patients with PCOD
who do not respond to clomiphene are treated
with antidiabetic drugs, such as metformin.
Studies have shown that these drugs can help
to improve their fertility by reversing their
endocrine abnormality and thus improving their
ovulatory response

In Vitro Fertilization:
If 3 cycles of IUI have failed, then In Vitro
Fertilization is the best treatment option for
patients with PCOD. However, many IVF clinics
have little experience in superovulating these
women, and they often mess up their
superovulation. Because these women grow so
many eggs in response to the HMG injections
used for superovulation, and because doctors
are very worried about the risk of ovarian
hyperstimulation, they often end up triggering
egg collection with HCG when the eggs are
immature. They consequently get lots of eggs,
but since most of these are immature,
fertilization rates and pregnancy rates are very poor.
But from extensive experience in dealing with women with PCOD( which is much commoner any ways), one can do  a much better job at getting these women to grow many mature eggs.
Also, if your FS carefully and meticulously flush each and every follicle at the time of egg collection, the risk of PCOD patients developing ovarian hyperstimulation Will reduce,