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Robert J. Rubino,
Audrey A. Romero, M.D., F.A.C.O.G.
Jacqueline Saitta, M.D., F.A.C.O.G.
Allan D. Kessel,
Priya R. Patel,
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"I didn't know that!"
Infertility is not only a female issue. It surprises most people to learn that infertility is a female issue in 35% of the cases, a male issue in 35% of the cases, a combined problem of the couple in 20% of cases, and unexplained in 10% of cases. It is essential that both the man and the woman be evaluated during an infertility work-up.
As always, we will continue to provide topics that are current, informative and important to your good health.
We are deep into the middle of winter. It's only a matter of time before the first flowers start to bloom.
In this issue of our newsletter, we have a guest article from Dr. Serena Chin on fertility. We also discuss the recent outbreak of the measles and share an excerpt from the CDC on the benefits of circumcision . In our Healthy Living section, we present new findings on diet soda. And, you'll find a new interesting "Medical Fact".
We need your input for our next newsletter!
If you are experiencing menopause, please share with us your common and uncommon menopause symptoms. We will compile the information we receive and author an article on "Real Menopause Symptoms From Real Women." Please send your feedback to the email address below:
|Freezing Your Eggs And Other Fertility Guidance
Serena H. Chen, MD, FACOG
Fertility preservation is a hot topic these days. With recent dramatic improvements in birth rates using previously frozen eggs, egg freezing for fertility preservation is rapidly becoming more main stream and is an important option for women who, for whatever reason, medical or social, cannot have a baby right now. In addition to this exciting, cutting-edge technology there are other, very simple things, you can do to preserve your fertility and maintain reproductive health.
Current Environment Of Freezing Eggs
One of the biggest barriers to freezing eggs is that it is expensive (thousands of dollars to freeze each "batch" of eggs) and is not covered by insurance (elective egg freezing is almost universally not covered).This is why new programs make egg freezing more affordable and accessible. Pregnancy rates from frozen eggs are improving each year. At the very least, it may be very worth your while to sit down for a consult with a reproductive endocrinologist experienced with egg freezing to get an evaluation of your current fertility, your risks and a detailed discussion of the process.
For women who may have been diagnosed with cancer, the American Society for Reproductive Medicine (ASRM) recently declared that freezing your eggs prior to cancer treatment is no longer experimental. In July of 2013, the American Society for Clinical Oncology stated that all women of reproductive age with cancer should have counseling about egg freezing before they undergo cancer treatment.
How to preserve your fertility besides freezing your eggs:
Number one - get healthy. A healthy body and mind support fertility and may even protect against infertility.
Smoking will cause you to go through menopause 1 to 2 years earlier, and even more importantly, before menopause there is a significant association between smoking and diminished ovarian reserve. Bottom line - smoking prematurely ages your ovaries and your skin and dramatically increases your risks for cancer, heart attack and stroke. Nicotine patches, gum, Zyban (Wellbutrin) and even Chantix may be healthier alternatives to smoking.
Smoking is such a powerful ovarian (and testicular) toxin that, in one large study, even when neither partner smoked, if only one partner was regularly exposed to second hand smoke, these couples had higher rates of infertility, miscarriages and children with birth defects. Talk with your doctor if you feel you need help to quit.
Maintain A Healthy Weight
Being overweight or obese is associated with many medical problems including higher rates of cancer, cardiovascular disease, diabetes, kidney, liver and joint problems. It is also associated with significantly higher rates of infertility, miscarriages and birth defects. We also know, from a very large study by Drs. Chavarro and Willet at Harvard, that a low glycemic index diet is associated with higher rates of fertility. A low glycemic index diet is essentially a healthy diet - one that avoids sugars and processed carbohydrates and has lots of vegetables, is low in fat and high in nutrients. Even people with a normal weight can improve their fertility by improving their diet. Exercise, in addition to a healthy diet, can help with getting to or maintaining a healthy weight.
Annual visits to your gynecologist and primary care doctor are important. The practice of medicine is becoming more proactive today and we are starting to learn much more about wellness. While doctor's visits in the past were all about diagnosing and treating disease, good doctors today can help advise on how to lower your risks for disease tomorrow.
Your doctor can address specific risk factors to help you be healthier. Do you have a family history of diabetes? Does anyone in your family have endometriosis? Endometriosis is strongly associated with infertility and women on birth control pills tend to have much slower progression of their endometriosis. A family history of health risks can increase your risk significantly. Other risk factors can include: premature ovarian failure, genetic diseases and fibroids. Talk with your doctor about your personal and family medical history to assess your personal risks.
Birth Control Pills
Birth control pills may be a good fertility preservation plan for women with irregular cycles. Many women with irregular periods or no periods have a condition known as PCOS or PolyCystic Ovarian Syndrome. Birth control pills can normalize the hormonal environment in these women's bodies and lower their increased risks for ovarian cancer and endometrial cancer (cancer of the lining of the uterus). Other risk factors can include: premature ovarian failure, genetic diseases and fibroids.
For women with no periods due to a condition called hypothalamic amenorrhea, birth control pills can also help them to stay healthy by maintaining hormonal support of their reproductive organs and protecting their bones from osteoporosis.
The Biological Clock Is Real
You cannot have a baby before you are ready, but at the same time, you do not want to delay becoming pregnant for too long. Infertility treatments today are quite successful but do not guarantee success. Age related female infertility is still one of the most difficult forms of infertility to treat successfully. Be informed about your decisions and options.
Preserve Your Fertility
Preserving your fertility is more than freezing your eggs. Even if egg freezing is not for you, you can help to preserve your fertility by creating healthy habits, breaking unhealthy habits and becoming informed and proactive about your own, personal risk factors for infertility.
Dr. Serena Chen is a reproductive endocrinologist in Livingston, NJ. She helps patients dealing with infertility and other issues relating to reproduction:
|The Measles Vaccine - It Works
The news has been flooded lately with the recent outbreak of the measles, which, according to the CDC yesterday, seems to continue to spread across America. There is a growing concern about the possibility of a large measles outbreak in the U.S. due to the large number of people who have not been vaccinated for the disease.
The dilemma is whether to vaccinate or not to vaccinate
If you have received the measles vaccination, you will not get measles. Vaccinations for diseases like measles, diphtheria, tetanus, pertussis and HPV have been developed to prevent disease because they work.
There is a risk of catching the disease without a vaccination.
The measles vaccine controversy stems from a fraudulent research article published in a British medical journal by Andrew Wakefield, an English medical researcher. Vaccines today have been well documented in double blinded, prospective research trials to be safe and effective. Based on the scientific evidence of the impact of vaccines reducing the incidence of the diseases they target, we highly recommended getting vaccinated.
According to the CDC, "there is a 92 percent vaccination rate in the United States, but the number of unvaccinated children is higher in certain states. In California, where an outbreak of the disease has been linked to Disney theme parks in the southern part of the state, 8 percent of kindergarteners fail to get the required immunizations against measles, mumps and rubella. In Pennsylvania, that number rises to 15 percent of kindergarteners."
The CDC also points out that parents might not realize diseases like measles are still with us and not getting your child vaccinated is not only a risk for your own child, but puts other kids in your community at risk.
Ultimately, the choice is still within the home and remains a personal choice for parents to make on behalf of their children. Parents that may have some fears about vaccines are encouraged to have a thoughtful discussion with their pediatrician about the protection vaccines offer toward diseases. It is encouraged to ensure your children receive the recommended vaccinations for their age.
|Real Menopause Symptoms From Real Women
In our last issue of our newsletter, we asked for your feedback on common and uncommon menopause symptoms from real women.
We are still compiling feedback! Please send in your experience to email@example.com
|CDC Says Circumcision Benefits Outweigh Risks|
A recent article published by the Associated Press announced the release of the first federal guidelines to show benefits to circumcision - even as rates of newborn male circumcision drop.
Medical evidence supports having the procedure done and that health insurers should pay for it. "The scientific evidence is clear that the benefits outweigh the risks," added Mermin, who oversees the agency's programs on HIV and other sexually transmitted diseases.Germs can grow underneath the foreskin, and CDC officials say the procedure can lower a male's risk of sexually-transmitted diseases, penile cancer and even urinary tract infections.
The CDC started working on the guidelines about seven years ago, when a cluster of influential studies in Africa indicated circumcision might help stop spread of the AIDS virus.
The CDC feels the guidelines are important, as the rates of newborn male circumcision have been dropping. The thinking on circumcision has swung wildly over the years. It's been practiced by Jews and Muslims for thousands of years, but didn't become common in this country until the 20th century. By one estimate, only 25 percent of U.S. male newborns were circumcised in 1900. It gradually became the cultural norm, and in the 1950s and 1960s surpassed 80 percent. But then the trend reversed. Part of it had to do with changing demographics, as the U.S. population grew to include larger numbers of ethnic groups that didn't traditionally circumcise their children.
Opposition to the procedure also grew from advocates who decried the pain, bleeding and risk of infections to newborns. Their message was aided by the Internet and by the neutral stance of physicians groups - including, for a time, the American Academy of Pediatrics.
A wave of state Medicaid programs stopped paying for newborn circumcisions, which cost roughly $150 to $200. The list eventually rose to 18 states, according to CDC numbers. By 2010 the newborn circumcision rate was down to about 58 percent, according to one CDC estimate.
But even as the circumcision rate dropped, more medical evidence came in supporting it - particularly three rigorous and influential studies in Africa that looked at the spread of HIV and other sexually transmitted diseases in circumcised and uncircumcised men and their partners.
In the new guidelines, the CDC says there is now strong evidence that male circumcision can:
- Cut a man's risk of getting HIV from an infected female partner by 50 to 60 percent.
- Reduce their risk of genital herpes and certain strains of human papillomavirus by 30 percent or more.
- Lower the odds of urinary tract infections during infancy, and cancer of the penis in adulthood.
The guidelines say circumcision is safer for newborns and infants than for older males, noting the complication rate rises from 0.5 percent in newborns to 9 percent in children ages 1 to 9, according to the CDC. Minor bleeding and pain are the most common problems, experts say.
CDC officials are recommending doctors tell parents of baby boys of the benefits and risks of circumcision.
Because circumcision can be beneficial to men as well, the CDC says information about the procedure also should be given to sexually active uncircumcised men - especially men considered to be at higher risk of catching HIV, the guidelines say.
Healthy Living: New Findings On Diet Soda
Following is an excerpt from an article in a summary journal from John Hopkins:
If your idea of "going on a diet" is switching from regular soda to diet soda, you might want to reconsider. According to new research, overweight adults who drink diet soda are likely compensating (calorically speaking) by eating more food.
"Although overweight and obese adults who drink diet soda eat a comparable amount of total calories as heavier adults who drink sugary beverages, they consume significantly more calories from solid food at both meals and snacks," says Sara Bleich, an associate professor in John Hopkins' Department of Health and Policy Management and lead author of a paper published by the American Journal of Public Health. If people hope to lose weight by drinking diet soda, they will also need to eat less, she says.
"Overweight and obese adults looking to lose or maintain their weight - who have already made the switch from sugary to diet beverages - may need to look carefully at other components of their solid-food diet, particularly sweet snacks, to potentially identify areas for modification," says Bleich.
The Rubino OB/GYN Group On LinkedIn
We are happy to announce we have created a company LinkedIn page for The Rubino OB/GYN Group where we will share information on the practice, new offerings, special announcements and much more.
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Pay Your Rubino OB/GYN Bills Online
The Rubino OB/GYN Group offers vitaMedMD™ in all 4 office locations. VitaMedMD offers patients high quality physician recommended products at an affordable price. Available products include Women's Multivitamin, Prenatal Plus, Prenatal One, Menopause Relief and Iron 150.
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