What are fibroids and what is a specialist who treats this condition?
Meet with Ulas Bozdogan, MD, FACOG
Endometriosis & Fibroids Specialist located in Hackensack, NJ and New York City, NYBook Online
Infertility:This is considered the inability to become pregnant. It is usually further defined by a period of time in which pregnancy isn’t accomplished after a legitimate trial of intercourse (assuming a frequency understood to make conception likely). Infertility is also attributable to circumstances in which there is conception, but failure to implant occurs or there are recurrent miscarriages. Infertility can also result from a compromise in the male factor, i.e., low sperm count or hormonal dysfunction (low testosterone).
There are some exotic causes as well. There could be immune system problems that prevent fertilization and even allergic reactions to sperm.
Infertility Specialist: Dr. Ulas Bozdogan is a specialist in who diagnoses and manages pelvic problems such as infertility. First, he is a gynecologist, board-certified by the American Congress of Obstetricians and Gynecologists. This is the highest achievement an OBGYN doctor can attain in the specialty and it means he has been trained and certified in many aspects of infertility, including endocrinology and hormonal imbalances, ovulation difficulties, mechanical obstruction of the fertility routes of sperm and eggs, and endometriosis and infections and the scarring they cause that create infertility.
Second, Dr. Bozdogan uses the latest state-of-the-art technology and diagnostic—and if necessary, surgical—techniques, which sets him apart from others treating infertility. His vast experience (thousands) in performing vaginal ultrasound, hysteroscopy, laparoscopy, and other procedures using minimally invasive robotic procedures increases the safety, decreases the blood loss, and makes complications of any diagnostic or therapeutic procedure less, should they be necessary. His techniques also significantly decrease recovery time and postoperative pain, which is an important consideration in wanting to resume attempting pregnancy. In fact, he even teaches robotic procedures to other doctors who want to begin using the robot in their own practices.
FREQUENTLY ASKED QUESTIONS
What causes infertility?
There are many causes that result in the failure of conception—that is, failure of sperm fertilizing an egg from your ovary or failure of a fertilized egg to end up implanting successfully in your uterus:
- Your partner could have a low sperm count or abnormal sperm, e.g., sperm which isn’t motile enough to reach the egg.
- You could have ovulation problems due to hormonal or endocrine problems, e.g., polycystic ovarian syndrome, ovarian cysts, or pituitary, hypothalamus, or thyroid (glandular) problems, or due to medication which impair their normal function.
- You could have a subclinical sexually transmitted infection, such as chlamydia.
- You could have scarring in your tube(s) which mechanically block sperm from meeting egg, since fertilization occurs normally in the tube; alternatively, such scarring, while allowing fertilization, may block the fertilized egg from making it back down to your uterus for implantation, which is the cause of the devastating complication known as an ectopic (tubal) pregnancy. Also, scarring at the end of your tube(s) can make it impossible for an egg to even get into your tube. Such scarring can be from infections or endometriosis.
- You can have fibroids in your uterus which interfere with implantation, compete for the blood supply for your pregnancy, cause recurrent miscarriages, or even block where the tube empties into your uterus from which a fertilized egg normally enters for implantation.
How can infections or endometriosis cause scarring in your tubes and elsewhere in your pelvis?
While female endocrine dysfunction and male infertility are players in preventing pregnancy, the biggest challenges come from the mechanical causes of infertility: infections, endometriosis, and fibroids.
Infections: The most notorious infections are from sexually transmitted infections (“STIs”), such as chlamydia and gonorrhea. Unfortunately, chlamydia can be silent and you may not even know you ever had it unless a culture is done, making such cultures a good idea for anyone not in a monogamous sexual relationship. Other causes besides STIs can cause the tube to scar, such as E.coli and even tuberculosis. Typically such scarring is inside the tube and its patency is blocked.
Acute infection can be treated with antibiotics, but if the process has been on-going, these drugs won’t help the scarring already there. Some infections involve the ovary, making it a serious pelvic infection; ovarian abscesses can result in rupture and peritonitis.
Endometriosis: This is the gland-like tissue of the innermost lining of your uterus migrating or growing elsewhere; thus it is hormonally stimulated to cycle, just like your period. Unfortunately, this bloody debris isn’t discarded on a napkin or tampon, but can remain to cycle within your body, provoking a cyclic inflammation that interferes with conception.
Endometriosis, while very different from an infection, can be just as ruthless in causing scarring and infertility. Besides causing mechanical blockage, the large inflammatory response it provokes interferes with ovulation and conception at the biochemical level.
Of the causes of infertility, tubal infections, endometriosis, the scarring from them, and fibroids are the conditions in which you can benefit the most from an infertility specialist such as Dr. Ulas Bozdogan is. He also makes prudent use of a team approach, involving endocrinologists, urologists, and general surgeons to be available when he is addressing infertility due to many causes at the same time.
Fibroids: Uterine fibroids can contribute to infertility by merely their presence, as described above.
How is one infertility specialist better qualified than another gynecologist?
For surgical correction of infertility, expertise can only come from experience and the use of state-of-the-art technology to get the best results. A doctor like Dr. Bozdogan uses the cosmetically advantageous minimally invasive surgery such as the da Vinci robot when treating scarring and endometriosis or removing fibroids
Overall, for preservation of fertility, you’re going to want to leave surgery with as much reproductive tissue as you went in with—that is, with only the problem dealt with. Your best chance for this is a doctor like Dr. Bozdogan using the da Vinci robot.
How is a surgery done with the robotic technique?
Using the advantages of the robotic approach minimizes the complications drastically compared to more invasive surgeries other doctors do, such as simple laparoscopy, open, and vaginal procedures. This is because the robot’s advantages over the others is stereoscopic visibility, 2-hand dexterity that electronically couples with advanced instrumentation for meticulous dissection, and visibility from any angle within your pelvis. The precise technique allows for meticulous handling of tissue, which also means reduced inflammation, decreasing postoperative pain and speeding up recovery tremendously.
Infertility is a broad concept involving many different causes. For surgical correction, Dr. Ulas Bozdogan of NYCEndometriosis, using the most current approaches, gives you your best chance at a successful correction of the cause of your infertility. Using robotic surgery, he is intensely committed to restoring your normal anatomy while clearing the mechanical obstructions of scarring from infection, the functional disturbances that fibroids cause, or the multiple infertility effects of endometriosis. For the non-surgical components of infertility, Dr. Bozdogan makes prudent use of subspecialists and works in tandem with them for a team (global, all-encompassing) approach to getting you to be fertile once more and successfully become pregnant.