When do you need a reproductive endocrinologist?

29
Apr
Posted by Sara

preconception healthWe get a lot of questions from women wondering how long it will take them to get pregnant. If you have been trying to conceive for a few months, you may just need more time. Most couples who try to get pregnant do so within one year. It may not happen immediately, but the odds are it will happen soon.

However, if you have been trying to get pregnant for more than a year (or six months if you are 35 or over) and have not conceived, talk to your health care provider. She may suggest you consult a reproductive endocrinologist. A reproductive endocrinologist is an obstetrician/gynecologist who specializes in diagnosing and treating infertility. They complete 4 years of medical school and a 4-year residency in Obstetrics and Gynecology. They then receive an additional 3 years of specialized training in Reproductive Endocrinology.

At your first visit, your reproductive endocrinologist will review your:

  • Medical history, including menstrual cycle, pregnancy/loss history, birth control use, & any other medical conditions
  • Family health history
  • Lifestyle and work environment

After a complete physical exam, your doctor will discuss with you any additional tests that may be ordered. These may include ovulation testing, looking at the anatomy of the uterus and fallopian tubes, determining the quality and quantity of eggs, testing hormone levels, and a pelvic ultrasound. Your partner may be referred for additional testing as well.

There are several kinds of fertility treatment. You, your partner, and your reproductive endocrinologist can decide which treatment gives you the best chance of getting pregnant and having a healthy pregnancy. Treatments include:

  • Surgery to repair parts of your or your partner’s reproductive system. For example, you may need surgery on your fallopian tubes to help your eggs travel from your ovaries to your uterus.
  • Controlled ovarian stimulation (also called COS). COS uses certain medicines to help your body ovulate and make healthier eggs.
  • In vitro fertilization (also called IVF). IVF is the most common kind of assisted reproductive technology (ART). In IVF, an egg and sperm are combined in a lab to create an embryo which is then transferred to the uterus.

Some couples may be concerned that consulting a reproductive endocrinologist means they will need IVF.  But this is typically not the case. In fact, 85-90% of infertility cases are treated with conventional therapies.

If you have been struggling to conceive, talk to your health care provider and see if consulting a reproductive endocrinologist is the right choice for you.

Have questions? Email us at AskUs@marchofdimes.org.

Zika in a nutshell

28
Apr
Posted by Barbara

This engaging short video, courtesy of CNN, tells you what you need to know about the Zika virus. Check it out!

 

 

And see our article for more detailed information on Zika and pregnancy.

Got Zika questions? Send them to AskUs@marchofdimes.org.

 

Painful memories of mumps and chickenpox

27
Apr
Posted by Barbara

Doctor talking with momIt’s World Immunization Week, a time to remember why pregnant women need certain vaccines, and why we vaccinate our kids.

I remember having mumps when I was four years old. My jaw swelled up and was so painful that I could not eat – even drinking was difficult. I remember crying from the pain and not having anything to relieve it.

Shortly after getting mumps, I remember having a bad case of chickenpox. The itchy rash drove me crazy. I scratched the fluid filled blisters on my skin until they bled (despite my parents telling me not to do so), and had scars on my skin for years.

When my kids were very young, they both had chickenpox – it was a month before the vaccine became available. They were miserable. Several years later, my daughter also had shingles. (After you have chicken pox, the virus remains “dormant” in your body. Shingles develops when the chickenpox virus “awakens.” It is a very painful condition which can linger for weeks.)

Complications can be serious

Nowadays, mumps and chickenpox are seen less and less in the United States due to vaccines. In fact, most parents who are vaccinating their children have never been sick with these diseases, making it easy to forget how serious they can be. They cause pain, discomfort, and in severe cases disability and even death.

In some cases, mumps may lead to inflammation of the testes, ovaries, brain (encephalitis), tissue covering the brain and spinal cord (meningitis), and even deafness.

Chickenpox can be especially serious for babies, pregnant women, adolescents, adults, and people with weakened immune systems. It can be harmful to your unborn baby or newborn if you get it during pregnancy (also called congenital varicella).

Pre vs post vaccine stats

According to the CDC, “Before the U.S. mumps vaccination program started in 1967, about 186,000 cases were reported each year. Since the pre-vaccine era, there has been a more than 99% decrease in mumps cases.” In 2015, there were only 1,057 cases of mumps in the U.S.

Likewise, chickenpox used to be very common in the U.S. before the vaccine became available in 1995. The CDC notes that in the early 1990’s, an average of 4 million people got chickenpox, 10,500 to 13,000 were hospitalized and 100 to 150 died each year. Most of the severe complications and deaths from chickenpox occurred in people who were previously healthy.

The CDC estimates that each year in the U.S., more than 3.5 million cases of chickenpox, 9,000 hospitalizations, and 100 deaths are prevented by the vaccine. The vaccine may not prevent all cases of chickenpox, but it is very effective at preventing the severe ones.

What can you do?

The best way to reduce the chance of you or your baby getting sick with mumps or chickenpox is to receive these and other vaccines before pregnancy.

Then, when your child is born, follow the immunization schedule to be sure he’s protected.

Have questions about vaccinating against chickenpox? See the American Academy of Pediatrics (AAP’s) FAQs.

Not sure if/when you or your child should be vaccinated against mumps? See the AAP’s explainations.

Bottom line

There is so much we can’t control in life. But thankfully, getting mumps and chickenpox is something we can usually prevent through vaccinations.

 

One couple’s rocky road to parenthood

25
Apr
Posted by Barbara

In honor of National Infertility Awareness Week, we are grateful that one mom shared her story with us. We hope that her journey will inspire others who may be on this path.

couple w pregnancy testInfertility is a journey. And every journey looks different. Some end in happiness and some do not.

In early 2015, after 3 years of trying to get pregnant, my husband and I found out that we were expecting. After all of the roadblocks we had hit along the way, hearing, “you’re pregnant” was surreal. The pregnancy was not without challenges, and I was extremely paranoid that we would somehow lose this baby. I am happy to say that my son was born healthy at 38.5 weeks, albeit with a nearly week long NICU stay. But, this happy ending came after a journey of twists and turns and more downs than ups.

I’d wanted to be a mother for as long as I can remember. . . That sounds so cliché, doesn’t it?

We were young and had only been married for a couple of years when we decided to start a family. We were so naïve and full of hope! I went off my birth control and started actively trying to have a baby. I read everything I could about getting pregnant and started charting my cycles.

When my cycles went from the perfectly timed 28 days to 60 and 70 days, I knew something was off. I did some reading and thought I might have polycystic ovarian syndrome (PCOS). (The beauty and danger of the internet!) PCOS happens when you have hormone problems along with cysts on the ovaries. I bought a book, went on a diet and started exercising. I learned everything I could about getting pregnant with PCOS and did my best to take control of my body.

After 6 months of trying to conceive with no luck, my doctor examined me, ran some tests (blood and ultrasound) and confirmed the PCOS diagnosis. She told me that she could write a prescription for Clomid to try and stimulate ovulation. But, she said that before I could start on the Clomid, my husband needed to have a semen analysis. (A large number of infertile couples have both female and male infertility issues, and they don’t want to unnecessarily medicate someone.)

To say that my husband was less than thrilled would be an understatement. It took me a few months to convince him to go for the test. He finally went and when we got the results back we were devastated. His sperm count was very low and the chances of conceiving on our own were basically zero. The doctors told us that they might be able to treat my husband and me, so that we could conceive. Little did we realize that this was just the beginning of years of doctors’ visits, but nevertheless, we jumped in with both feet.

Dealing with infertility can be all-consuming (at least it was for us). I would wake up and go to sleep thinking about it. There was never down time for my brain. I would see a pregnant woman or a couple with a baby and I would feel jealous, angry and sad. Hearing that other couples got pregnant without even trying was overwhelming. . . And the medical bills were never ending. Our insurance didn’t really cover any of our treatments so we paid almost all of it out-of-pocket. We were saving for a down payment on a house when we started trying to have a baby. And after the fertility treatments we were back to square one.

Through all of the doctors’ visits, blood work, ultrasounds and shots, I kept up the hope that someday I would be a mother.

Fast forward…

Now that we’re 6 months into being parents, I can say that I am thankful for my son every day. The first couple of months were incredibly challenging, and the idea that “maybe I wasn’t meant to have kids” crossed my mind frequently. But, I now revel in time spent with my son.

Although at the time, it seemed that the process of trying to conceive was going on and on, with no end in sight, I can say now that it is becoming a distant memory. The intense joy my husband and I feel every time we see the smile on our son’s face or see him hit another milestone, fills me with happiness and pushes the difficult journey of how we got here into the background.

I am sending baby dust to everyone out there struggling with infertility.

 

Please feel free to share your thoughts or personal story below.

 

Making vaccines easier for your child

21
Apr
Posted by Lauren

Mom calming crying babyIn recognition of National Infant Immunization Week (NIIW), March of Dimes is participating in a blog relay to discuss the critical role vaccines play in protecting children, families, and communities against vaccine-preventable diseases. NIIW is sponsored by the Centers for Disease Control and Prevention (CDC). You can follow the NIIW conversation on social media using hashtag #NIIW.

Let’s face it – getting a shot is not a pleasant experience for you or your baby. But making sure your child receives her vaccines to stay healthy is so important! Vaccines allow children to become immune to a disease without actually getting sick from the disease. It is always better to prevent an illness than to treat it after it occurs.

Here are some tips to make getting vaccinations easier:

  • Provide comfort. Keep your baby cuddled in your lap and sing to her. Here are ways to hold your baby or young child while she receives her shot.
  • Bring her favorite toy, book or blanket.
  • Make eye contact with her and tell her everything will be okay.
  • Be honest with your child; tell her the she may feel a pinch, but the shot will keep her healthy.
  • After the shot, hug and praise your child. For your baby, swaddling, breastfeeding or a bottle may offer relief.
  • Before leaving the office, ask your provider to advise you about a non-aspirin pain reliever in case your child is uncomfortable after the shot.

Keep your baby on track

It is important to keep up-to-date with your child’s vaccinations. It may seem like your baby needs many shots, but remember, receiving multiple vaccines at one time does not overload her immune system. Several vaccines contain only a tiny fraction of what your baby is exposed to every day in her environment. And your baby needs more than one dose of certain vaccines because each one builds up her immunity. Here is a complete schedule of your baby’s vaccines along with answers to many of your questions.

Off track? Use this handy tool to help you get back on schedule.

For the top 5 reasons why vaccines are important to your child’s health, see this post. Still got questions? Send them to AskUs@marchofdimes.org.

Remember: CDC strongly recommends giving babies the recommended immunizations by age two as the best way to protect them from 14 serious childhood diseases, like whooping cough and measles. You can learn more by visiting the CDC website. Be sure to stop by the other #NIIW relay participants’ blogs to learn about the benefits of immunization– tomorrow’s post will be hosted by What to Expect.

 

April brings showers and IEP meetings

20
Apr
Posted by Barbara

worried-womanthmApril is a time when most school systems schedule meetings with parents to review all of the services their child is receiving and to establish a plan for the next school year. If you have a child with a developmental delay, disability or birth defect, he may be eligible to receive services. But often there is so much to learn that it can seem overwhelming.

As a parent, it is important to know the programs or services that may benefit your child. It is equally important to understand the system. Our blog series can help you sort it all out.

If your child is receiving services at school, it is a good idea to learn the difference between an IEP and a 504 plan. This post breaks it out into a chart and explains the vital differences. Another great place to go for clarity is Understood, a website dedicated to helping parents with children who have special learning needs.

In addition, we suggest you contact the Parent Training and Information Centers in your state, which offer free guidance to parents. Find your center and learn more about these vital resources.

If your child is still a toddler, he may be able to receive help through the early intervention system. Children are eligible up until their third birthday.

Have questions? Send them to AskUs@marchofdimes.org. We’re here to help.

 

Breastfeeding can reduce your stress

18
Apr
Posted by Lauren

2012d032_0483It’s true, breastfeeding releases hormones that help you feel more relaxed.

Oxytocin is one of the hormones your body makes to produce breast milk. Oxytocin is responsible for your milk letdown and also helps your uterus contract to the way it was before you became pregnant. But there’s even more that oxytocin does for moms; it helps you reduce your stress.

Oxytocin is often referred to as the “anti-stress” or “love” hormone and for good reason. Oxytocin is part of a complex interaction in your body that reduces stress and helps you bond with your baby. How does oxytocin do this? The hormone is associated with a decrease in blood pressure and cortisol levels (the hormone released in response to stress).  Oxytocin also increases relaxation, sleepiness, blood flow, digestion and healing. Studies have shown that moms who breastfeed also have a lower response to stress and pain.

So go ahead and take advantage of the benefits of breastfeeding. The deep relaxation may make you feel ready for a nap, so put your feet up while you nurse and take this time to refocus. After you put your baby back in her basinet or crib, take a cat nap to feel reenergized.

For even more benefits of breastfeeding, read our post.

Have questions? Email or text us at AskUS@marchofdimes.org.

FDA approves folic acid fortification of corn masa–a great day for babies!

14
Apr
Posted by Sara

Hispanic mom and babyToday the U.S. Food & Drug Administration (FDA) announced that it will allow corn masa flour to be fortified with folic acid. This announcement is a victory for America’s mothers and babies, and caps more than 20 years of work by the March of Dimes to prevent serious birth defects of the brain and spine known as neural tube defects (NTDs).

Scientists have long recognized that folic acid can prevent NTDs.  After wheat flour and related products were required to be fortified with folic acid in 1996, the incidence of neural tube defects dropped by about one-third.  The Centers for Disease Control and Prevention (CDC) estimates folic acid fortification in the U.S. has saved about 1,300 babies each year from these fatal or devastating birth defects – a total of 26,000 babies born healthy since folic acid fortification began in 1998.

But corn masa flour wasn’t part of that rule, and that may be part of the reason that neural tube defect rates have remained higher among Hispanic babies. Foods like tortillas, tamales, pupusas, chips and taco shells can now be fortified. Adding folic acid to corn masa will help to prevent neural tube defects.

The March of Dimes looks forward to the prevention of even more NTDs in the U.S. — giving more babies a chance for a full, happy life, and giving their families the joy of a healthy child.

Please join us in thanking the FDA by tweeting to @US_FDA or posting on their Facebook wall with messages like these:

Join our Advocacy Action Center for updates about how you can make a difference for healthy pregnancies and healthy babies.

Can a mosquito cause birth defects? Listen to this interview on Zika virus and pregnancy

12
Apr
Posted by Barbara

Get the latest update on the Zika virus – what it is, how it spreads, signs and symptoms, how it can affect a pregnancy, and what you can do to stay safe.

March of Dimes Senior Vice President & Chief Medical Officer, Edward R.B. McCabe MD PhD, was interviewed by The Coffee Klatch on Blog Talk Radio. Listen to the entire interview to get answers to your Zika questions.

You can text or email your questions to AskUs@marchofdimes.org.
 

 

Stress can affect your pregnancy

11
Apr
Posted by Sara

Research demonstrates that stress during pregnancy is associated with an increased risk for some pregnancy complications. Feeling stressed is common during pregnancy. Your body and your family are going through many changes. While a little stress is fine, serious stress may cause problems.

Causes of stress

The causes of stress are different for every woman. Some common causes of stress during pregnancy include:

  • Managing the typical discomforts of pregnancy, such as nausea, constipation, and exhaustion.
  • Mood swings. Your changing hormones can causes changes in your mood.
  • Worries about childbirth and being a good mom.
  • Work deadlines and managing job-related responsibilities before you give birth.

A little stress can help you take on new challenges and regular stress during pregnancy probably doesn’t add to pregnancy problems. But serious types of stress during pregnancy may increase your chances of certain complications.

Serious stress during pregnancy

While most women who experience significant stress during pregnancy have healthy babies, high levels of stress do increase your chances of certain pregnancy problems.

  • Acute stress in early pregnancy has been linked with an increased risk for premature birth. Acute stress results from a reaction to a traumatic event, such as natural disasters, death of a loved one, or terrorist attacks.
  • Chronic stress can cause complications such as preterm birth, low birthweight, hypertension and developmental delays in babies. Examples of events that can cause chronic stress include financial problems, divorce, serious health problems, or depression.
  • Post-traumatic stress disorder (PTSD) disorder coupled with a major depressive disorder has been associated with an increased risk for preterm birth. PTSD is a disorder that develops in some people who have seen or lived through a shocking, scary, or dangerous event.

How does stress cause problems in pregnancy?

We don’t completely understand the effects of stress on pregnancy. But certain stress-related hormones, such as cortisol and norepinepherine, may play a role. Also, serious or long-lasting stress may affect your immune system, which protects you from infection. Infections can be a cause of premature birth.

Stress also may affect how you respond to certain situations. Some women deal with stress by smoking cigarettes, drinking alcohol or taking street drugs. These behaviors can lead to pregnancy problems, including preterm birth and low birthweight.

How can you reduce stress during pregnancy?

There are many ways that you can manage your stress during pregnancy. Watch our video to learn more.

 

Have questions? Email us at AskUs@marchofdimes.org.