Dr. Drew Tortoriello

Adenomyosis

Adenomyosis is a prevalent gynecological disease in which endometrial (uterine lining) cells invade into the uterine muscle layer (myometrium). This ectopically located endometrial tissue is functional, proliferating and “menstruating” during every menstrual cycle. The ensuing inflammation will permeate into the uterine muscle, causing it to undergo hyperplastic changes leading to a bulkier, heavier, and occasionally tender uterus. The prevalence of adenomyosis may be as high as 35% of reproductive-age women and typically presents with painful and heavy menses.

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Intraovarian PRP – a promising technique that requires more investigation

 
Platelet-rich-plasma, or PRP, is a fraction of blood obtained upon
centrifugation that is enriched for cells called platelets. Other
cells, including white blood cells and red blood cells are ideally
excluded.  Platelets have been shown to secrete chemicals that
facilitate clot formation and are vital in preventing excessive
bleeding in humans, but they are also capable of secreting other
factors that facilitate cell growth and tissue repair. It is for this
restorative capacity…

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Starting Your Journey With SFS

 
Infertility treatment encompasses a wide range of possibilities, of
which IVF is only one option.  It is not the treatment of choice for
everyone.  However, while in the past, IVF was often considered the
last common pathway, today, due to a myriad of factors, IVF is
regarded as one of the mainstays for helping couples achieve the goal
of a healthy family.   In the final analysis, it is our
individualized approach to treatment and our emphasis on putting
patients at the fore…

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Egg Freezing for Future Fertility

 

Many patients come to me in their late 30s and 40s to either assess
their relative fertility or to start fertility treatments, and they
are often unpleasantly surprised to find out that their ovarian
reserve is low. It might be age-appropriate or even lower than age
might predicate, but both scenarios are frequently met with
consternation.
We know that there are several things that can hasten ovarian
follicular demise and lower the egg count prematurely.  Among these
fact…

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Endometriosis Mechanism of Infertility

 

Endometriosis is known to have a profoundly significant negative
effect on fertility.  Normal natural pregnancy rates are in the range
of 0.15 to 0.20 per month and decrease with age, but women with
endometriosis tend to have a lower monthly rate of about 0.02–0.1
per month.  Conversely, infertile women are 6 to 8 times more likely
to have endometriosis than fertile women. 
Why does endometriosis cause infertility?   The inflammation
associated with endometriosis ca…

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“Silent” Endometriosis

 
Endometriosis is a pelvic inflammatory disease attributable to ectopic
implants of uterine lining (endometrium) establishing a foothold in
inappropriate locations in the pelvis, especially the ovaries, the
peritoneal lining, and the bladder.  It is believed that retrograde
menstrual flow through the fallopian tubes allows some still viable
endometrial cells to enter the pelvis and implant where it lands.  In
unusual circumstances, endometrial cells can travel and establish
the…

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Raised Blood Prolactin

Prolactin (PRL) is a protein hormone (closely related to human growth
hormone
[https://drgeoffreysherivf.com/human-growth-hormone-administration-in-ivf-does-it-enhance-eggembryo-quality-and-outcome/])
that is secreted by specialized cells in the anterior part of the
pituitary gland. In addition, the hormone is also produced and
secreted by a broad range of other cells in the body, most prominently
various immune cells, the brain, and the endometrium (lining of the
uterus). …

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Diminished Ovarian Reserve: The Sher Philosophy

 

It appears from my vantage point that the proportion of patients
suffering from diminished ovarian reserve is on the increase.

This increase is likely due to several reasons:

* Social/lifestyle: Many women are deliberately delaying their
childbearing to focus on other aspects of their life, including the
furtherance of their education and their career objectives.

* Environmental issues: As technology advances, we are constantly
being exposed to new food addi…

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A Thin Uterine Lining: Vaginal Viagra may help

 
In 1989, Dr. Sher first published a study that examined the
correlation between the thickness of a woman’s uterine lining (the
endometrium), and the odds of embryo implantation in IVF patients.
This study revealed that when the uterine lining measured at least 9mm
in thickness by the day of the “hCG trigger” (in fresh IVF
cycles), or at the time of initiating progesterone therapy (in embryo
recipient cycles, e.g. frozen embryo transfers-FET, egg donation-IVF
etc.) , pregna…

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Diagnosing and Treating Immunologic Implantation Dysfunction (IID)

 
Central to making a diagnosis of an immunologic implantation
dysfunction (IID) is a need for the appropriate interpretation of
Natural Killer Cell Activity (NKa). In this regard, one of the
commonest and most serious errors, is interpret the blood
concentration of natural killer cells as being relevant. Rather it is
the activity (toxicity) of NK cells that matters as mentioned. This
activity can best be measured using the blood, K-562 target cell test
(the gold standard). and/ o…

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