The UT Voice Center
Symptoms, Your doctor has diagnosed you as having laryngopharyngeal reflux disease or LPR. This condition develops when stomach acid travels up into your throat. Although you may experience heartburn or indigestion, many of our patients do not have these complaints. Some of the more common symptoms seen in our patients include: Sensation of drainage down the back of the throat or excessive mucus Feeling of…, Diagnosis, Most often, your physician can diagnose LPR by examining your throat and vocal cords with a rigid or flexible telescope. The voice box is typically red, irritated and swollen from acid reflux damage. This swelling and inflammation will eventually resolve with medical treatment, although it may take a few months. At other times, you may have to undergo a dual-channel pH probe test to diagnose your…, Treatment, Most of the time, LPR is well controlled with medications such as proton pump inhibitors (PPIs). Occasionally, surgery is needed in severe cases or those that do not resolve with the use of medication. The recommended surgery is called a laparoscopic nissen fundoplication and is performed by a general surgeon. Positive proof of reflux disease is needed first, generally by a pH probe study. With…, Important information about your medications, If you are taking a PPI such as Nexium, Protonix, Prevacid, Aciphex, Prilosec (omeprazole) or Zegerid, it is important to take your medicines 30 minutes to one hour before meals. These medicines may be given twice a day, so that will mean taking a pill before breakfast and dinner. The medicine is absorbed better if taken this way. You should know that your insurance company/pharmacy program…
Donor Process, The first step begins with an evaluation from one of our reproductive endocrinologists who will discuss your diagnosis and goals with you and help you understand your treatment options. The most common reason why people choose egg donation is because of poor egg quality due to advanced maternal age or premature ovarian insufficiency. Another indication is for women who carry some serious genetic…, Laboratory Testing and Genetic Screening, Egg donors are generally healthy young women, usually between the ages of 21-30. Before being chosen as donors, they undergo psychological and medical screening to determine if they are likely to be a good donor candidate. The screening includes a thorough psychologic evaluation, a medical history, a physical exam and laboratory testing. Potential egg donors will have an in-depth evaluation of…, Matching Donor and Recipient, We understand that choosing to receive donated oocytes carries with it a giving up of hope for pregnancy with one's own oocytes, and this can be a feeling of great loss. There are probably many characteristics that you hope your oocyte donor will possess, and you probably hope that your oocyte donor will have many of your characteristics. We will do what we can to select a donor who meets your…, The Egg Donation Process, In general, stimulation of the oocyte donor's cycle is brought about using a similar regimen of drugs that a woman using her own oocytes for in vitro fertilization-embryo transfer is commonly given. The egg donor will receive hormone injections to produce development of multiple eggs. During the time that the donor is receiving the gonadotropin injections, she will undergo frequent vaginal…, If I’m interested in Becoming an Egg Donor, You may fill out this form or call our egg donor coordinator at 210-450-9513 . UT Health Fertility Center doctors are also faculty at The University of Texas Health Science Center San Antonio School of Medicine. This allows us to remain one of the most cost-efficient fertility practices in the area. Our staff is happy to answer questions about referrals, itemized diagnostic and treatment costs…
Does ART damage the ovaries?, There is no evidence to suggest that oocyte retrieval damages the ovaries. There have been reports which suggests that infertile women who take fertility drugs and do not get pregnant have an increased risk of ovarian cancer. However, the control (comparison) populations may not have been selected accurately. The fertility drugs used in ART have been in use over 30 years, and other studies have…, Why is the success rate with ART low?, Studies of human reproduction indicate that for a couple with proven fertility, the likelihood of conception is only 20 percent per month. In couples with infertility, they still may have a chance of conceiving spontaneously, but it may only be 2-3 percent per month. ART affords couples with infertility factors higher chances for conception than the age-related expected fertility rate for…, We’re concerned about multiple births from ART. Should we just have one embryo transferred?, For most patients undergoing ART, transfer of a single embryo is likely to be recommended to reduce the risk of a multiple pregnancy. With the transfer of just one embryo, there is still a risk of multiples as that single embryo can split to create identical twins. This happens approximately 2% of the time. Any time more than one embryo is transferred, the chance is increased further for a…, Is there an increased chance of birth defects if I become pregnant through ART?, No. The risk of congenital anomalies in children conceived through ART is the same as the risk in the general infertility population. Chromosome abnormalities, such as Down syndrome also occur at a rate similar to the general population., I had my tubes tied (tubal ligation) several years ago. Would I be a candidate for IVF?, Although surgical reversal of tubal sterilization may be an option, IVF is a good option, especially in older women or in couples with male factor infertility. The overall success rates are similar for ligation reversal and IVF, although the results of IVFT are obtained more rapidly than ligation reversal. If ligation reversal has been attempted and has failed, IVF represents the best option.…, Does insurance cover the procedure?, Unfortunately, most insurance plans do not cover ART procedures. Some programs cover portions of the therapy. Our staff would be happy to help you determine your level of coverage. We strongly recommend you do this prior to starting ART therapy., How many days does the entire procedure take?, The entire procedure takes up to six weeks. However, we only need to see you intensively at the UT Health Physicians Fertility Center over a two-week period. These details are discussed here., Can we have intercourse while attempting ART?, Yes. We recommend that the man abstain from ejaculating into the vagina for at least 72 hours preceding egg retrieval. Near the time of egg retrieval, the ovaries can be enlarged and tender, which can make intercourse uncomfortable., What if I ovulate before the retrieval?, Virtually all cases of premature ovulation are now prevented by the appropriate use of medication to suppress ovulation. In rare cases in which ovulation suppression is not used, we perform an ultrasound prior to retrieval to make sure the follicles are intact. In the uncommon case of ovulation, we will not perform retrieval because the quality of the remaining oocytes is affected adversely., Will scar tissue around my ovaries make it impossible to retrieve oocytes?, The oocytes can usually be retrieved by transvaginal aspiration even when the ovaries are covered with scar tissue. In rare cases, scarring pulls the ovaries out of the normal pelvic position. This condition can be identified before ART with ultrasound., How much activity is recommended after ET?, We recommend a fairly quiet first 24 hours after embryo transfer. Thereafter, most patients resume their normal routines. Strenuous exercises should be avoided until a pregnancy test has been performed., After embryo transfer, how long must we wait until we have intercourse without risk to the embryo?, No one knows for sure. We recommend abstinence for a minimum of 48 hours after transfer.
GnRH Analogs (GnRH agonists or antagonists), Gonadotropin releasing hormone (GnRH) is a hormone produced in the brain which indirectly stimulates ovarian function. Analogs of GnRH are synthetic forms of this hormone which do not directly induce follicle development or ovulation but which have become very important in ART therapy. There are several advantages to using GnRH agonists or GnRH antagonists. First, they make ovarian stimulation…, Gonadotropins, To increase the likelihood of pregnancy through ART, multiple oocytes must be produced. This is accomplished through the administration of gonadotropins-hormonal medications which stimulate the ovaries. Stimulation can be achieved with a variety of drug regimens. Gonadotropin medications come in several forms. Menopur® is a combination of FSH and LH. They replace a woman's own LH and FSH which…, Human Chorionic Gonadotropin, Human chorionic gonadotropin (hCG) is an injectable medication that is administered to complete oocyte maturation (trigger shot). It can also be used in conjunction with clomiphene citrate, or in a natural cycle. The newest recombinant formulation called Ovridel® (choriogonadotropin alpha) comes in a pre-filled syringe and in a dose of 250 micrograms and is now routinely used as the trigger shot…, Clomiphene Citrate, Clomiphene citrate (Clomid® and Serophene®) is an oral medication that is commonly administered to induce ovulation in women who do not ovulate regularly. We also use clomiphene citrate for minimal stimulation IVF-ET. Typically, each 50 mg pill costs approximately $5.00 to $8.00. Mechanism of Action Clomiphene acts within the brain to promote the production of the hormone, GnRH. As a result, the…
ART: A Step-by Step Guide, Every cycle of ART involves multiple steps, and each occurs at a specific time during an approximately six-week period. The procedure begins around the time of ovulation in the month preceding the ART cycle. We present an approximate timetable and overview below. There are different treatment regimens available for ovarian stimulation. Your physician will individualize your treatment regimen…
The following are suggested books and other resources for those interested in fertility and reproductive health., Infertility - Medical, American Society for Reproductive Medicine - Defining Infertility Potter Daniel A M.A.; Hanin Jennifer S., M.A. What to Do When You Can't Get Pregnant: The Complete Guide to All the Technologies for Couples Facing Fertility Problems. New York: Marlowe and Company, 2005. Corson, Stephen L., M.D. Conquering Infertility: A Guide for Couples . New York: Prentice Hall Press, 1990. Franklin, Robert…, Infertility - Emotional, Becker, Gay. Healing the Infertility Family. New York: Bantam Books, 1990. Hill, Susan. One Woman's Passionate Quest to Complete Her Family. New York: Viking Penguin, 1990. Mullens, Anne. Missed Conceptions: Overcoming Infertility. Toronto, Canada: McGraw-Hill Ryerson, 1990. Clapp, Diane, BSN, RN and Merle Bombardieri, LICSW. How Can I Help? A Handbook for Family and Friends of Couples Going…, Assisted Reproductive Technologies (ART), American Society for Reproductive Medicine - Fact Sheets and Infographics Centers for Disease Control and Prevention . 2013 Assisted Reproductive Technology Success Rates. U.S. Department of Health and Human Services, 2015. Wisot, Arthur L., M.D. and David R. Meldrum, M.D. A Guide to In Vitro Fertilization and Other Assisted Reproductive Methods. New York: Parohs Books, 1990. Silber, Sherman…, Organizations, RESOLVE National Headquarters 1310 Broadway Somerville, MA 02144-1731 617-623-1156 Telephone Helpline: 617-623-0744 RESOLVE of South Texas Arkansas, Louisiana, New Mexico, Oklahoma, Texas HelpLine: 1-866-668.2566 Email: info@resolve.org The Endometriosis Association P.O. Box 92187 Milwaukee, WI 53202 414-355-2200 1-800-992-3636 The American Society for Reproductive Medicine 1209…
, About Your Visit, On your first visit, please bring a list of all the medications and supplements you are currently taking. Advise us if you have any allergic reactions to any medications. Each time you meet with your provider make sure to ask them if you need refills. If you are a new patient, try to obtain your previous medical records, including recent laboratory tests, prior to your appointment. Please arrive…
The intracytoplasmic sperm injection (ICSI) technique attempts to achieve fertilization by the direct injection of a single sperm into the cytoplasm (interior) of the egg. After retrieval of the eggs, they are freed of surrounding cells by a combination of enzyme treatment and microdissection. Using special micromanipulation equipment, the mature eggs are individually injected with a single sperm…
One of the first questions that most people ask is, "what is the chance for success?". The initial hope of achieving a pregnancy by IVF is often dampened by the answer to this question. In 2019 in our program, liveborn infants occurred in approximately 48.5% of cases in women 35 and younger and in which women had embryos derived from their own eggs transferred to the uterus. The 2019 nationwide "…