Servy Institute for Reproductive Endocrinology ( S.I.R.E )

• In order to achieve pregnancy, egg fertilization must occur, which depends on the sperm being properly shaped, possessing good health, and having the ability to rapidly move toward the egg.

• While infertility has been traditionally perceived as a problem with the female, it is now known that male infertility is involved in approximately 40 percent of infertility cases, according to the National Institutes of Health.

• About one-half of infertile men have treatable causes, but the other half experience irreversible infertility and cannot father children.

Tubal ligation reversal is a procedure that reconnects the fallopian tubes in women who have previously undergone tubal ligation (tied tubes).

It is estimated that 700,000 women undergo tubal ligation as a means of permanent contraception in the United States annually. In some cases, women may regret their tubal sterilization and desire the ability to conceive. Tubal ligation reversal and in vitro fertilization (IVF) have the potential to restore fertility for these women.

Reconnecting the fallopian tubes restores their natural function, allowing sperm to reach and fertilize an egg.

The procedure restores fertility in approximately 80 percent of women who have had tubal ligation surgery.

• Myomectomy is a surgical procedure used to remove uterine fibroids (noncancerous tumors that develop in the uterus and may cause infertility) without harming a woman’s ability to have children in the future.

• Depending on the size, quantity and position of the fibroids (also called myomas), myomectomy can be performed via laparotomy or via the more minimally invasive options of laparoscopy and hysteroscopy.

• Myomectomy can improve the chances of pregnancy in women with fibroids that may be hindering their fertility.

• In-vitro fertilization (IVF) is on of the more popular and most recommended infertility treatments because of its high success rates.

• IVF combines a man’s sperm with a woman’s egg in a laboratory dish, and the resulting embryo (fertilized egg) is implanted in the woman’s uterus.

• IVF is an effective way to overcome multiple infertility issues to achieve pregnancy.

• Hormone replacement therapy for menopause is a means of treating the symptoms of menopause by replacing the female hormones a woman’s body stops producing after menopause.

• The treatment primarily administers estrogen, or estrogen with progesterone, to replace those hormones that regulate the menstrual cycle and enable a woman to carry a pregnancy, functions that cease at menopause.

• This form of menopause treatment manages troublesome menopause symptoms of hot flashes, night sweats, vaginal discomfort and thinning of the bones.

• Hormone replacement therapy is not for every woman who suffers excessively from menopause symptoms, and each woman should discuss this option with her physician.

• Exercise and lift weights.

• Have a well-balanced natural nutrition with a good amount of protein with low fat and carbohydrates.

• Take proper vitamin and mineral supplements.

In my practice of Reproductive Endocrinology, I’ve had to evaluate and treat patients with excess of hormone and hormone deficiencies. The most common type of deficiency is found in menopausal women. If we consider that menopause occurs after the age of 40 and the average life expectancy for a woman in America is about 83, we can say that approximatively half of the American women are affected with hormone deficiency. Since women are representing about half of the US population, at least one fourth of the US citizens will eventually be hormonally deficient. In the current census, the population of the United States of America is about 330 million. Therefore, if we divide that number by four, it results in a lot of citizens with a naturally occurring hormone deficiency. It is estimated that only 30% are adequately treated, but only one third of them are compliant or follow their treatment conscientiously. This chapter is not going to be a boring scientific paper like the few I have written during my medical career regarding this particular subject. It’s only a story about my experience with this issue and a call for common sense.

Every individual, male or female, has been submitted or exposed during his (or her) life to ladies’ mood fluctuations. I remember reading a medical article about the feared pre-menstrual syndrome (PMS). The authors had interviewed thousands of incarcerated young women and found out that most crimes had been committed during the few days preceding menses. There is also an old joke with the following question: “What is the difference between a Pitbull and a woman with PMS?” And the answer is: “Lipstick!” PMS can occur at any time during the reproductive period of a woman’s life; but after menopause, when the ovaries stop functioning, the dire situation can tum into a permanent state. The affected woman feels bad and she can make everybody around her, at work or in the fan-lily, feel miserable. In my practice, we treat a lot of women who experience PMS or who are menopausal. Before talking to them we ask them fill out a questionnaire that we call “the Misery List.” Most of the time, they check the boxes facing symptoms of mood swings, anxiety, depression, lack of energy and libido, insomnia and they can add some poignant and heart touching stories.