Couples Having Difficulty Conceiving Should Undergo Thorough Counseling and Testing Before Losing Hope

Knowing where to turn, when to seek treatment and what to expect from preconception [fertility counseling and testing in advance can help couples relax during what can be a difficult time in their lives. Couples need to know that if they seek treatment early they have approximately an eighty percent chance of achieving their dream.

Norwalk and Danbury, CT September 22, 2005 -- For couples trying to achieve pregnancy, it can be discouraging -- even devastating -- to learn that they may be experiencing fertility problems. Knowing where to turn, when to seek treatment and what to expect from preconception [fertility counseling and testing in advance can help couples relax during what can be a difficult time in their lives. Couples need to know that if they seek treatment early they have approximately an eighty percent chance of achieving their dream.

Mark Leondires, MD, a board-certified Reproductive Endocrinologist and medical director at Reproductive Medicine Associates of Connecticut (RMA of CT) explains, ?Before their first visit, many patients are frustrated and unsure of what to expect from fertility counseling. We begin by advising couples on steps that will help them optimize chances for conception ? things like fertile times of the month, ovulation detection and lifestyle changes that can affect fertility.?

In cases where lifestyle factors and the simple timing of intercourse do not seem to be the problem, Dr. Leondires explains that certain tests might be recommended. Different types of fertility testing evaluate whether a woman is ovulating (or producing eggs) and whether her partner is producing enough healthy, mobile sperm. Other tests seek to determine whether the sperm can access and fertilize the egg and if implantation can occur. Evaluation of a woman's reproductive anatomy may also be necessary. Test results guide doctors in the type of treatments to recommend, if any.

?Not all women or men will undergo the same tests when being evaluated for fertility,? explains Dr. Leondires. ?Through counseling and testing an individual treatment plan needs to be developed in order to give each couple their best chance for conception.?

Common tests to check for infertility:
Doctors recommend that couples under 35 who have been trying to conceive on their own for one year seek help from a physician, while those over 35 seek counsel after six months. The American Society of Reproductive Medicine recommends that couples seek counseling from a reproductive endocrinologist, a fertility specialist, who may recommend the following tests or others.

A Man's Fertility Workup:
Male infertility plays a part in half of all infertility cases. Because evaluating fertility in a man is by nature less invasive than in a woman, many doctors choose to test men before their partners. The most essential test is a semen analysis. This test evaluates the number of sperm released, their motility, and the shape of sperm. This can identify whether functional sperm are being produced in a sufficient quantity of sperm to result in conception. This test is essential and should be completed early in the work up. Sometimes simply artificial insemination is needed to overcome mild male factor.

A Woman's Fertility Workup:
During an initial visit with a fertility specialist, a woman will be questioned about her medical history, previous fertility tests will be reviewed and a standard pelvic exam will be performed. This test will first rule out any obvious physical problems of the uterus, ovaries or cervix. Other tests that may be performed include:

Hormone Tests: Blood and sometimes urine are checked for a variety of hormone levels. These tests can determine whether levels of thyroid stimulating hormones, follicle stimulating hormones, luteinizing hormones, estrogen and progesterone are sufficient for conception.

Pelvic Ultrasound: An image of a woman's reproductive tract allows a detailed evaluation of the uterus, and ovaries for abnormalities.

Endometrial biopsy: A sample taken from a woman's uterine lining late in the menstrual cycle determines if it is sufficiently developed to be able to sustain the implantation of a fertilized egg.

Diagnostic hysteroscopy: During this minor surgery, a small camera is inserted into the uterus through the vagina to checks for polyps, fibroids or other abnormalities in the uterine cavity and womb.

Laparoscopy: During this outpatient surgery done under general anesthesia, a small-lighted camera is inserted into the abdominal cavity through a small incision in or near the naval. This allows a physician to evaluate the condition of the uterus, fallopian tubes and ovaries and detect problems such as fallopian tube obstructions, endometriosis, scarring or damage, uterine fibroids or ovarian cysts. This surgery can often lead to correction of problems that may allow a woman to achieve pregnancy.

According to the American Society of Reproductive Medicine, infertility affects more than six million Americans of reproductive age and men and women in equal numbers. More than half the couples that seek fertility treatment will become pregnant. Individual success rates are continually improving through the use new medication and technologies.

Bio:
Dr. Mark P. Leondires, M.D., FACOG, is a leading authority on reproductive medicine. Dr. Leondires is board certified in Reproductive Endocrinology and Infertility. He is a member of the Society of Reproductive Endocrinologists, the American College of Obstetrics and Gynecology, and the American Society for Reproductive Medicine. Dr. Leondires earned his medical degree from the University of Vermont College of Medicine and completed his residency in Obstetrics and Gynecology at Maine Medical Center in Portland, Maine. Dr. Leondires completed a fellowship in Reproductive Endocrinology and Infertility at the National Institutes of Health in Bethesda, Maryland.

After completion of his training, he fulfilled his military obligation by serving as the ART Director for the largest and most successful program in the military health care system at Walter Reed Army Medical Center. During this time he was an Assistant Professor at the Uniformed Services University of Health Sciences and clinical faculty for the Combined Fellowship in Reproductive Endocrinology. Dr. Leondires is currently Medical Director and lead physician with Reproductive Medicine Associates of Connecticut (RMA-CT) in Norwalk. Along with numerous teaching and research activities, Dr. Leondires has published articles in professional medical journals, national consumer magazines and newspapers, as well as abstracts and book chapters. More information about Reproductive Medicine Associates of Connecticut is available at www.rmact.com.

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