<?xml version="1.0" encoding="UTF-8"?><rss version="2.0" xmlns:content="http://purl.org/rss/1.0/modules/content/" xmlns:wfw="http://wellformedweb.org/CommentAPI/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:atom="http://www.w3.org/2005/Atom" xmlns:sy="http://purl.org/rss/1.0/modules/syndication/" xmlns:slash="http://purl.org/rss/1.0/modules/slash/" > <channel> <title>Fertility Archives - goldsteinmd</title> <atom:link href="https://www.goldsteinmd.com/category/fertility/feed/" rel="self" type="application/rss+xml" /> <link>https://www.goldsteinmd.com/category/fertility/</link> <description></description> <lastBuildDate>Wed, 22 Jan 2025 00:50:45 +0000</lastBuildDate> <language>en-US</language> <sy:updatePeriod> hourly </sy:updatePeriod> <sy:updateFrequency> 1 </sy:updateFrequency> <image> <url>https://www.goldsteinmd.com/wp-content/uploads/2017/12/cropped-header-logo-2-1-32x32.png</url> <title>Fertility Archives - goldsteinmd</title> <link>https://www.goldsteinmd.com/category/fertility/</link> <width>32</width> <height>32</height> </image> <item> <title>Information about Polycystic Ovarian Syndrome (PCOS)</title> <link>https://www.goldsteinmd.com/blog/about_pcos_polycystic_ovarian_syndrome</link> <comments>https://www.goldsteinmd.com/blog/about_pcos_polycystic_ovarian_syndrome#respond</comments> <dc:creator><![CDATA[GoldsteinMD]]></dc:creator> <pubDate>Thu, 12 Jan 2023 17:43:47 +0000</pubDate> <category><![CDATA[Fertility]]></category> <category><![CDATA[Screenings]]></category> <category><![CDATA[Ultrasounds]]></category> <guid isPermaLink="false">https://www.goldsteinmd.com/?p=5626</guid> <description><![CDATA[<p>Recently, I have had a run of several young women who have presented (accompanied by their mothers) having received a diagnosis elsewhere of polycystic ovarian syndrome (PCOS). They have looked this up online and they are relatively distraught having learned about issues of infertility, insulin resistance, and a predilection later in life for diabetes. None … <a href="https://www.goldsteinmd.com/blog/about_pcos_polycystic_ovarian_syndrome" class="more-link">Continue reading<span class="screen-reader-text"> "Information about Polycystic Ovarian Syndrome (PCOS)"</span></a></p> <p>The post <a href="https://www.goldsteinmd.com/blog/about_pcos_polycystic_ovarian_syndrome">Information about Polycystic Ovarian Syndrome (PCOS)</a> appeared first on <a href="https://www.goldsteinmd.com">goldsteinmd</a>.</p> ]]></description> <content:encoded><![CDATA[<p>Recently, I have had a run of several young women who have presented (accompanied by their mothers) having received a diagnosis elsewhere of polycystic ovarian syndrome (PCOS). They have looked this up online and they are relatively distraught having learned about issues of infertility, insulin resistance, and a predilection later in life for diabetes. None of these recent cases truly had the entity itself. What they had was not unusual for late adolescence (women in their teens and even early twenties) whose menstrual cycle is still slightly irregular because of the fact that the hypothalamic-pituitary-ovarian axis has not yet matured, and someone performed an ultrasound and they had multiple small follicles in their ovary, and thus, were told they had polycystic ovarian syndrome. </p> <p>The original description of the entity was called Stein-Leventhal syndrome and, basically, these patients looked a little like Humpty Dumpty – they were obese, they had male-pattern hair growth (chin especially), and blood work showed increased androgens (testosterone and an entity know as DHEA-S). The problem began in 2003 when an international conference in Rotterdam produced what was known as The Rotterdam Criteria for the Diagnosis of PCOS. At that time the consensus was if a women had two of the following three characteristics she could be labeled as having PCOS. They were 1) irregular menses, 2) increased androgens (either in their blood or clinical manifestations), and 3) more than twelve follicles in their ovary on ultrasound. The problem is, however, that many young women, as stated above, will be having slight irregularity to their menses as the cycle “matures,” and as the resolution of transvaginal ultrasound has increased, as many as 50% of women will have more than twelve follicles in their ovary. These recent patients that I saw were 1) not obese, 2) had no evidence of increased androgens, either clinically or in their blood, and 3) were extremely healthy. They have what I have now referred to as “multicystic ovaries,” which are common and not abnormal in younger women. It has been my experience that the overwhelming majority of such patients, as they get into their mid- and later twenties, ultimately have very normal menstrual cycles, normal fertility, and no increased risk of insulin resistance or diabetes. </p> <p>Too many healthcare providers are still functioning under these misconceptions. However, some papers have called for using a threshold of more than twenty-five follicles per ovary. Other groups have recommended a threshold of greater than twenty follicles per ovary. It is also, in my opinion, important as to how the follicles are arranged in the ovary. In the original description of polycystic ovarian syndrome, the follicles were all very peripheral and often were referred to as a “string of pearls,” as opposed to just an increased randomly distributed number of follicles. </p> <p>Furthermore, there is a group known as the Androgen Excess and PCOS Society that has gone on record as saying that women who have irregular menses and multiple follicles, but no evidence of increased androgens should not be labeled as PCOS. Finally, an NIH workshop in 2012 recommended that the name “PCOS” be changed to “metabolic reproductive syndrome” because PCOS focuses on the polycystic ovarian appearance, which, as described in detail above, is the least sensitive factor for making such a diagnosis. However, it is highly unlikely that this “name change” will take hold. </p> <p>If you or a daughter or a niece or someone you know has received the diagnosis of polycystic ovarian syndrome, hopefully this information will be helpful. As always, I am available for consultation. </p> <p>Dr Steven R. Goldstein is a leading <a href="https://www.goldsteinmd.com/" target="_blank" rel="noopener">gynecologist in NYC</a>, a <a href="https://www.goldsteinmd.com/services/menopause-and-perimenopause/" target="_blank" rel="noopener">menopause specialist in NYC</a>, <a href="https://www.goldsteinmd.com/services/best-obgyn-manhattan/" target="_blank" rel="noopener">obgyn Manhattan</a> and <a href="https://www.goldsteinmd.com/" target="_blank" rel="noopener">NYC Gyn</a></p> <p>The post <a href="https://www.goldsteinmd.com/blog/about_pcos_polycystic_ovarian_syndrome">Information about Polycystic Ovarian Syndrome (PCOS)</a> appeared first on <a href="https://www.goldsteinmd.com">goldsteinmd</a>.</p> ]]></content:encoded> <wfw:commentRss>https://www.goldsteinmd.com/blog/about_pcos_polycystic_ovarian_syndrome/feed/</wfw:commentRss> <slash:comments>0</slash:comments> </item> <item> <title>Fertility decline, freezing eggs: myths and realities</title> <link>https://www.goldsteinmd.com/blog/fertility-decline-freezing-eggs-myths-and-realities</link> <comments>https://www.goldsteinmd.com/blog/fertility-decline-freezing-eggs-myths-and-realities#respond</comments> <dc:creator><![CDATA[GoldsteinMD]]></dc:creator> <pubDate>Wed, 05 Sep 2018 13:53:50 +0000</pubDate> <category><![CDATA[Fertility]]></category> <category><![CDATA[Pregnancy]]></category> <guid isPermaLink="false">https://www.goldsteinmd.com/?p=2522</guid> <description><![CDATA[<p>Fertility decline, freezing eggs: myths and realities In last week’s New York Times, just before the holiday weekend, there was an article about a 22-year-old single woman who decided to freeze her eggs. In that article it said that fertility was declining by age 20. This is extremely inaccurate and unfair. According the American College … <a href="https://www.goldsteinmd.com/blog/fertility-decline-freezing-eggs-myths-and-realities" class="more-link">Continue reading<span class="screen-reader-text"> "Fertility decline, freezing eggs: myths and realities"</span></a></p> <p>The post <a href="https://www.goldsteinmd.com/blog/fertility-decline-freezing-eggs-myths-and-realities">Fertility decline, freezing eggs: myths and realities</a> appeared first on <a href="https://www.goldsteinmd.com">goldsteinmd</a>.</p> ]]></description> <content:encoded><![CDATA[<p><strong>Fertility decline, freezing eggs: myths and realities</strong></p> <p>In last week’s New York Times, just before the holiday weekend, there was an article about a 22-year-old single woman who decided to freeze her eggs. In that article it said that fertility was declining by age 20. This is extremely inaccurate and unfair. According the American College of Obstetricians and Gynecologists, fertility remains <u>relatively</u> constant until about age 30 then begins to decline and there is a <u>sharper</u> falling off after age 35 and especially after age 40. I have dealt with this issue of the “biological clock” with my patients for more than 25 years.</p> <p>The ability to freeze eggs rather than embryos is now an option if one has not identified a <u>partner</u> with whom one wants to have their children. When first introduced into this country (it was developed in Italy) NYU was one the pioneers in the United States. I was, however, somewhat in an awkward position serving on the Gynecologic Practice Committee of the American College of Obstetrician and Gynecologists when, initially, this was meant to be offered on an experimental basis to patients who had cancer and were about to undergo chemotherapy. There was an opinion by the American College of Obstetricians and Gynecologists as well as the American Society of Reproductive Medicine that this should be done on an experimental basis without charge. In those early days, NYU was offering this as a clinical service and charging patients and, as all of you are probably aware, it is not covered by insurance.</p> <p>Those times have changed, however. This is no longer experimental. It has been around long enough to have proven that it is virtually as successful as frozen embryos can be. I have begun to discuss with my single patients who are not engaged or married and/or have no intention of being pregnant in the next several years to consider consultation with fertility experts and to <u>consider</u> freezing eggs. I do so not because I am so concerned that they will not be able to have a baby. I have seen so many women in my career who have had successful pregnancies at 37, 38, even 39. But so many of them have come back at 42 or 43 and say, “you never told me how great this was,” and now they are trying to have a <u>second</u> baby and that does not come so easily.</p> <p>It is very interesting that virtually no one have ever come to me worrying about their fertility and said, “can I have <u>two</u> babies.” Thus, when I speak to patients now at 32, 33, 34 about the possibility of freezing eggs, it is often with the idea that that may be for the <u>second</u> child, obviously depending on their individual circumstances. I do feel, however, that 22, as talked about in the New York Times article, is much too young to be subjecting one’s self to the treatment involved in terms of medication, procedures, and cost to freeze eggs simply because of a fear of declining fertility.</p> <p>If this is not something that applies to you, perhaps you can pass this along to some friend or family member.</p> <p>Dr Steven R. Goldstein is an <a href="https://www.goldsteinmd.com/services/best-obgyn-manhattan/" target="_blank" rel="noopener">Obgyn in Manhattan</a> who may be able to assist couples with information on pregnancy.</p> <p>The post <a href="https://www.goldsteinmd.com/blog/fertility-decline-freezing-eggs-myths-and-realities">Fertility decline, freezing eggs: myths and realities</a> appeared first on <a href="https://www.goldsteinmd.com">goldsteinmd</a>.</p> ]]></content:encoded> <wfw:commentRss>https://www.goldsteinmd.com/blog/fertility-decline-freezing-eggs-myths-and-realities/feed/</wfw:commentRss> <slash:comments>0</slash:comments> </item> </channel> </rss>