OB/GYN Care Orlando
OB/GYN & MedSpa located in Oviedo, FL and serving the greater Orlando Area
It can be incredibly heartbreaking when you’re trying to conceive, and it just isn’t happening. The team at OB/GYN Care Orlando in Winter Park, Florida wants to help you get to the root of your infertility issue. From laboratory testing, all the way up through an advanced laparoscopic procedure, the caring team will diagnose and treat any clear obstacles that are keeping you from getting pregnant.
Infertility Q & A
What is infertility?
- Infertility is the inability of a couple to become pregnant after 1 year of unprotected intercourse
- 10-15% of reproductive-aged couples will experience infertility
- Infertility is age-related in women and occurs with 11% of 34-year-old women, 33% of 40-year-old women and 87% of 45-year-old women.
- Therefore, an infertility workup can be initiated after 6 months of unprotected intercourse for women over 35 years of age as opposed to 12 months for women under 35 years of age.
What causes infertility?
- For spontaneous conception to occur, eggs, sperm, fallopian tubes and a uterus are necessary. Damage to any of these components can cause infertility
- Problems with ovulation, the process by which an egg is released from the ovaries, make up 27% of infertility cases
- Ovulation can be affected by the polycystic ovarian syndrome, ovarian cysts, primary ovarian insufficiency, thyroid disease, hormone imbalance or pituitary disorders.
- Scarring or damage to the fallopian tubes causes 22% of infertility cases
- This can occur in patients with a history of endometriosis, pelvic inflammatory disease, chlamydia infections, abdominal surgery, ruptured appendicitis, or diverticulitis
- Problems with sperm make up 25% of infertility cases
- Sperm development takes 90 days so high temperatures such as a hot tub or fever in the last 3 months can cause damage
- Sperm can also be damaged by testicular trauma, a varicocele, infections such as mumps or STDs, and certain medications
- 9% of infertility cases are due to other cases including uterine factors such as fibroids or scarring from prior surgeries.
- 17% of infertility cases remain unexplained
What can be done by the patient to increase fertility?
- Optimizing health is the first step
- Cigarettes, from smoking or secondhand smoke, contain toxins that cause ovaries to lose eggs more quickly than is natural
- These toxins also cause mutations in the genes within the eggs which increases the risk of miscarriage
- Just 5-8 drinks per week decrease the chance of pregnancy
- Marijuana suppresses the pathway between the brain and ovaries
- Early studies also indicate it may decrease male fertility as well
- Maintain a healthy weight
- Quit smoking
- Decrease alcohol use
- Avoid marijuana
- Keep a menstrual calendar
- Ovulation occurs 2 weeks before menses begins
- The best time to have intercourse is the 5 days leading up to ovulation and the day of ovulation
Use ovulation predictor kits to help time intercourse.
What would an infertility work up mean for you?
- Complete history including:
- Medical history to ensure there are no medical conditions that should be optimized prior to attempting pregnancy including. Also screening for a history of infections that could be the cause for infertility
- Surgical history to determine if there is a possibility of scar tissue in the abdomen or uterus
- Family history to screen for genetic disorders that could be passed on to children
- Social history to screen for behaviors that could be decreasing fertility
- Lab work can be done to ensure hormones are appropriate for the patient’s age
- If history indicates a potential problem with the sperm, a semen analysis can evaluate the number, quality, and motility of sperm
- An ultrasound is often used to evaluate the overall shape of the uterus and count the number of follicles, eggs waiting to develop, on the ovaries
- A procedure known as a hysterosalpingogram, or HSG, can be used to assess the shape and size of the uterus and to ensure that the fallopian tubes are open allowing ovulated eggs to reach the uterus.
- If necessary laparoscopic surgery can be done to look inside the patient’s abdomen to assess for and remove scar tissue
How is infertility treated?
- Ovulation dysfunction
- First eggs are removed from the ovaries.
- The eggs are then combined with sperm in a lab
- The resulting embryo is placed into the uterus where it will hopefully implant and develop into a successful pregnancy
- If the ovaries contain eggs that are just not being released properly there are medications and a surgical procedure that can help stimulate the ovaries to ovulate properly
- If following this the ovaries are still not ovulating properly, in vitro fertilization (IVF) can be done
- Tubal factor infertility
- If the tubes are closed and eggs are not making it to the uterus, sometimes a procedure can be completed to reopen the tubes.
- If there is scar tissue within the abdomen involving the tubes, this scar tissue can be removed surgically
- If the tubes are severely damaged sometimes the best treatment is to remove the tubes and proceed with IVF
- Uterine factor infertility
- If there is scar tissue or a fibroid within the uterus a surgical procedure can be done to look inside the uterus with a camera and remove the scar tissue or fibroid
- Male factor infertility
- Placing the sperm in closer proximity to the eggs can help if motility is a problem
- There are some medications available that can boost sperm count
- Intrauterine insemination (IUI) involves taking a semen sample, concentrating the sperm and gently injecting the sperm into the uterus
- If the number of sperm is very low or motility is severely restricted, IVF can be done to directly combine the sperm with the egg
Most Major Insurances Accepted
At OB/GYN Care Orlando, we accept most major insurance plans for women’s health appointments. Here is a short list of just some of the most popular plans we accept. Please contact our office if you do not see your insurance provider listed here. Anti-aging and aesthetics services are not covered by insurance plans, but may be HSA card eligible.
Words from our patients
"Everything about this Doctor and the Staff is Exceptionally Great !!! It Definitely Doesn't feel like you're going to a Gynecologist Appointment!!"
"It was my first time and I was happy with my visit to Dr. Krishingners office . All of the staff was wonderful!"
"Dr. Krishingner and his staff are very friendly! I’ve been going to Dr. Krishingner for 12 years and have followed him throughout his office locations! "
"My first visit and I am impressed as well as satisfied!!! Everyone was friendly and professional."
"I had to switch doctors due to mine retiring. This office was amazing. They don't overbook, went right back. Staff was super friendly."