The Reproductive Medicine and Surgery Center of Virginia, PLC, a fertility clinic located in Charlottesville, Virginia functions as a group practice. This is intended to better serve
your needs. Many outpatient appointment dates are dependent
on the menstrual cycle. Therefore you will be seen by both doctors
Bateman and Williams depending on who is covering the fertility clinic office on any given day.
As your infertility
testing and treatment progresses from one menstrual cycle to
the next it is important for us to know if you are pregnant.
If your menstrual period is not normal, in any way, a blood
pregnancy test should be performed by your local doctor or in
our Charlottesville, VA fertility clinic office. Rarely, what seems to be a normal menstrual period
is actually bleeding in early pregnancy-sometimes it could be
a sign of tubal pregnancy.
To avoid exposure to any medications
or procedures (like intrauterine insemination or hysterosalpingograms),
it is our policy for you to do a home pregnancy test at the
end of each cycle. This should be done during your menstrual
period. If your home pregnancy test is positive, blood test
confirmation should be performed.
There is
medical evidence that supplemental folic acid may help prevent
neural tube birth defects (spina bifida). To be effective this
treatment should begin prior to conception. We recommend that
you take a multivitamin containing 0.4 mg (400 micrograms) of
folic acid daily. This is available over the counter. The supplemental
folic acid treatment will continue during pregnancy.
There is
recent information that supplemental Vitamin A taken in amounts
that exceed the FDA recommended 100% requirement might cause
birth defects. We caution you about this risk.
There is
some evidence that male infertility may be helped by taking
over the counter medications-vitamins and antioxidants. The
research on this issue is inconclusive. A combination of these
over-the-counter drugs, that does no harm, and may improve male
fertility includes: a multivitamin with zinc (without iron),
Vitamin C 500 mg, Vitamin E 400 mg, and selenium 10 micrograms.
Even men with "normal" sperm counts may benefit. This
treatment is inexpensive-a few dollars a month and can easily
be purchased at nutrition stores.
Another more
complicated formulation for male infertility is called "Fertile One."
It contains the above ingredients and more-some amino acids
(the building blocks of protein) that have long been thought
to be responsible for improving sperm movement. Medical research
on this product is promising, but incomplete at this time and
it is more costly (about $91 per month) than the regimen above.
Fertile One can be purchased via the company web site or by calling 1-877-237-3748.
Another product
commercially available for men is Conception XR by Fertility
Sciences - go to www.conceptionxr.com for more information and pricing.
Many times
sonograms are performed around mid-cycle (at ovulation). The
lubricant gel we use for the scanner has been tested in our
lab regarding effects on sperm. Sperm are unaffected by our
ultrasound gel.
There is
animal and human experimental evidence that St. John's Wort,
Echinacea Purpura, and Ginkgo Bilboba have ill effects on sperm
and/or eggs. Our fertility specialists recommend that neither the husband nor the wife
take these herbal products while trying to conceive.
There is
clear medical evidence that tobacco use, by either partner,
reduces the chance for pregnancy. Tobacco use by the male reduces
IVF pregnancy rates by as much as 50%. The degree of affect
relates to the amount of tobacco use - the less you use the
better - none is best. Tobacco use in the male may increase
the risk of childhood cancer in offspring.
Caffeine
also causes a decrease in fertility - again related to amount.
The equivalent of three 6-oz. cups of coffee, taken daily, has
been shown to reduce fertility. One cup may cause a slight affect
- moderation is the key. Remember that other things contain
caffeine.
Prostaglandin
inhibitors (e.g. Motrin, Anaprox) are commonly used for menstrual
pain. We caution you against using these drugs around the time
of ovulation - this may interfere with egg release.
A recent
publication suggests that alcohol ingestion, even in small amounts,
by either partner significantly reduces in vitro fertilization pregnancy rates and increases pregnancy loss rates. It is reasonable
to infer that alcohol consumption by either partner reduces
fertility in regard to all forms of infertility treatment. We
suggest complete abstinence from alcohol-husband and wife- while
trying to conceive.
Doctors
Bateman and Williams maintain teaching appointments at the University
of Virginia. These are unpaid positions granted to physicians
outside of the full time faculty. We are honored to hold these
appointments. On some days there will be a UVA Ob/Gyn resident
seeing patients with us in the Outpatient Care Center office.
The residents' role in your care may be reviewing your medical
history at the initial visit and/or performing minor physical
examinations or sonograms. Doctors Bateman or Williams will
always be present for exams and sonograms. Residents will never
make decisions regarding your treatment. If you prefer not to
see residents let us know and we will flag your chart accordingly.
The residents understand the sensitivity of your medical problem
and appreciate your allowing them to observe our care. As an
aside - the vast majority of Ob/Gyn residents are women.
Either Doctor
Bateman or Williams is always "on call" and available
for medical emergencies related to your care at RMSCVA. If you
have an off hours emergency, you may: go directly to the MJH
emergency room - there are ER physicians on duty at all times
who can begin the evaluation of your condition and involve Doctors
Bateman or Williams if necessary; you may, if you live a long
distance from Charlottesville be seen in your local emergency
room or by your referring Ob/Gyn.
If you have a question about
whether you need to be seen or not about your care with us,
you may reach us by phone - call our office number at (434)
982-8520 after 7:00am and the answering service will contact
us to call you back. We endeavor to provide clear instructions
on mixing and administering medications, etc - making it rarely
necessary to call after hours. We understand that unexpected
things will happen and we are available to solve problems. As
much as we regret it, we are humans and need to sleep at night…
Please be thoughtful about off hour's calls.
There are
usually several infertility treatment scenarios that are possible and appropriate
for a given infertility circumstance. We will lay them out for
you and make a mutual decision about what is best for you as
a couple. If you want to be more or less aggressive - let us
know.
Unfortunately
we are unable to help everyone. Despite state of the art treatment,
some patients will not conceive. As your treatment proceeds
we will let you know what is ahead and we will let you know
when we think you should consider discontinuing treatment. This
is a difficult decision and many times treatment lacks a clear
endpoint. We encourage an open discussion with us if you are
becoming frustrated or considering discontinuing treatment.
Because most
insurance companies in the State of Virginia offer little or
no financial assistance for infertility treatment, financial
constraints are a common reason for discontinuing or postponing
treatment. It is a frustrating reality for doctors and patients.
Please let us know when you are having financial challenges.
Sometimes we will be able to alter your treatment plan to try
to minimize cost.
It is our
sincere goal to help you conceive and to meet your emotional
needs during your treatment. As your treatment proceeds we will
outline the plan and answer your questions about where we are
headed. If any facet of our care is inadequate we want to know.
This is a team effort between a couple and their fertility specialist. Please
help us meet your needs. |
