Pure Heart Medi-Care Foundation

21/11/2021

21/10/2021

21/10/2021

THE HUMAN BODY

1: Number of bones: 206
2: Number of muscles:639
3: Number of kidneys: 2
4: Number of milk teeth: 20
5: Number of ribs: 24 (12 pair)
6: Heart chamber number:4
7: Largest artery: Aorta
8: Normal blood pressure: 120/80 Mmhg
9: Blood Ph: 7.4
10: Number of vertebrae in spinal column: 33
11: Number of vertebrae in the neck: 7
12: Number of bones in middle ear: 6
13: Number of bones in face: 14
14: Number of bones in skull: 22
15: Number of bones in chest: 25
16: Number of bones in arms: 6
17: Number of muscles in the human arm: 72
18: Number of pumps in the heart: 2
19: Largest organ: Skin
20: Largest gland: Liver
21: Largest cell: Female o**m
22: Smallest cell: S***m
23: Smallest bone: Stapes middle ear
24: First transplanted organ: Kidney
25: Average length of small intestine: 7m
26: Average length of large intestine: 1.5m
27: Average weight of newborn baby: 3Kg
28: Pulse rate in one minute: 72 times
29: Normal body temperature: 37C° (98.4f°)
30: Average blood volume: 4 to 5 LITERS
31: LIFETIME Red blood cells: 120 days
32: LIFETIME White blood cells: 10 to 15 days
33: Pregnancy Period: 280 days (40 weeks)
34: Number of bones in human foot: 33
35: Number of bones in each wrist: 8
36: Number of bones in hand: 27
37: Largest endocrine gland: Thyroid
38: Largest lymphatic organ: Spleen
40: Largest and Strongest bone: Femur
41: Smallest muscle: Stapedius (Middle ear)
41: Chromosome Number: 46 (23 pair)
42: Number of newborn baby bones: 306
43: Blood viscosity: 4.5 to 5.5
44: Universal donor blood group: O
45: Universal recipient blood group: AB
46: Largest white blood cell: Monocyte
47: Smallest white blood cell: Lymphocyte
48: The increased red blood cell count is called: Polycythemia
49: Blood bank in the body is: Spleen
50: River of life is called: Blood
51: Normal blood cholesterol Level: 100Mg/Dl
52: Fluid part of blood is: Plasma.

A perfectly designed machine that allows you to enjoy this adventure called life. Take care Doc Isibor Henry

19/09/2021

28/08/2021

*AT 60+ SENIOR CITIZENS USUALLY EXPERIENCE THE FOLLOWING:*

Since birth we celebrate and as we grow old, the state of our health keeps changing as well.
At various stages and age in life we celebrate specially:

1. At 40, we celebrate Ruby Jubilee

2. At 45, we celebrate Sapphire Jubilee

3. At 50, we celebrate Golden Jubilee

4. At 60, we celebrate Diamond Jubilee

5. At 70, we celebrate Platinum Jubilee

6. At 75, we celebrate Milestone

However, once we attained the age of 60 and above, all Senior Citizens usually experience various health issues as itemised below. These are usually health issues experienced by most senior citizens;

*1. Food choking*

*2. Neck pain*

*3. Leg cramps.*

*4. Tingling feet.*

The self-help tips given below may help especially senior citizens, before they can get to the doctor.

FOR:

*1. FOOD CHOKING*
You only need to "raise your hands”. By raising your hands above your head, the food stuck in your throat will go down by itself.

*2. NECK PAIN*
Sometimes you wake up in the mornings with pain in the neck. One reason could be the use of wrong pillow. In such a situation, you only need to lift your feet, then pull your toes and move your feet in a clockwise or counterclockwise direction.

*3. CRAMPS*
When you have cramps on your left leg, raise your right hand high, when having cramp in your right leg, raise your left hand high. You will immediately feel better.

*4. TINGLING SENSATION*
When the left foot is tingling, swing your right arm with all your strength, when the right foot is tingling, swing your left arm with all your strength.

*Don't just save this information, Please share with other Senior Citizens.*

----------------------------------

*NOTE: IF YOU ARE ABOVE 55 YEARS OF AGE. (Check #3)*

In USA, immediately you turned 55 years of age, you are a senior citizen.

Although, you would not be collecting your social security benefits until you are 62 years of age.

The fact remains you are a senior citizen at 55

Listen to the advice below:

*CANDID ADVICE TO SENIOR CITIZENS*

Every aged person must agree there is need for extra personal well-being.

1. Avoid sleeping alone at night in the room if possible.

2. Don't ever lock yourself up alone in your room at night.

3. Where your spouse is not available, get somebody to stay with you, especially at night.

4. Don't be too busy/tired to take your drug(s), especially before retiring to bed.

5. Take to your Doctor's directive/advice, especially on what to eat or not what to eat or do.

6. Ageing is not a sickness, it's a natural process.

7. Avoid loneliness at all cost.

8 Make yourself happy, no matter the circumstances, because life goes on with or without you.

9. Reach out to people or places of interest, for as long as your strength could carry/allow you.

10. Be less rigid/ conservative about issues and circumstances.

11. Make people around you happy, but not at the expense of your joy.

12. Chase wealth less, rather, love to enjoy that much you have stored up over time.

13. Be prayerful and less materialistic.

14. Be grateful to God at all times.

15. Make the effort to take walks early in the morning to renew your ageing body

16. Avoid eating after 6:30 pm and where you feel very hungry in the night, eat fruits only and drink a lot of water.

God bless you Nature is not kind to men *who* did not *cater* for their *old* ages when they were *young* .

*Build* your own *house* where you will *live* in your *old* *age* .

*Build* businesses that will *feed* you in *your* *old* *age* .
*Create* *conveniences* that will *engage* you in your *old* *age* .
*Build* *friendship* and *goodwill* that will *serve* you in your *old* *age* .
*Right* *now* , *start* to be *relevant* in club & society or *Church* and *community* so you could be *reckoned* with in your old age.

*Old* age could be very *lonely* and *agonising* for *men* who did not *plan* for it.
*May* you not *become* a *liability* on your *children* in your *old* *age* .
*May* your *children* not *wish* you an *early* *death* when they *can't* *manage* you again in your *old* *age* .
An *old* *age* without *penny* in your *pocket* is a slow, *agonising* *death* *sentence* !

Be *warned* now...!
There are *three* categories of *people* you cannot do *without* as we are *growing* *older* , your *family* , *people* in your place of *worship* and *childhood* *friends* , who include your *Old* *School* *mates* .

*Friends* , *take* it or leave it, at *60* and *above* , *loneliness* kills because the *children* you are *working* *hard* for now will *go* their *ways* to *raise* their *own* immediate *families* and *pursue* their own *destinies* , *just* as *we* did *now* . At that time it's *these* *people* in these *3* - *categories* that *take* away *loneliness* and *keep* your *company* .

Pls, out of your *busy* *schedule* , *set* time out to *say* *HI* ! to your *real* - *old* - *age* - *cure* - *against* - *loneliness* . In the 3- *categories* , the only *one* that *knows* you *better* and can *relate* with you *down* to *heart* are your *childhood* *friends* .
So *why* are you *feeling* too *big* or *inferior* to come *along* ? It's not *possible* we'll all be at the *same* *level* . *Some* will be *very* *rich* , *moderate* and some *poor* - that is the *beauty* and *misery* of life. *Some* will be so *educated* , while *some* will *still* be *Secondary* *school* *certificate* *holders* .

*If* you are *up* , *bring* others that are *willing* *up* , and *if* you are *down* , never *bring* those that are *up* *down* with your *mouth* or *attitude* .
At close to *50* years and *above* , you have *10* to *15* years of *active* *working* life.

*Stop* saying *I* *am* this, I *am* *that* . *Flow* into other *people's* *lives* and *let* then *flow* into *yours* .

*Respect* *friendship* and *value* *relationship* .

Let us *pass* this to all *friends* on our *contacts* , *Rich* or *Poor* .

*You* *can't* *exhibit* *pride.* *Live* *simple.*

27/01/2021

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Staphylococcuss

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Staphylococcuss

What are Staphylococcuss?

Staphylococcuss
What is Staphylococcuss
Staphylococcus is a group of bacteria that can cause a number of diseases as a result of infection of various tissues of the body. Staphylococcus is more familiarly known as staph (pronounced "staff"). Staph-related illness can range from mild and requiring no treatment to severe and potentially fatal.
Staphylococcus aureus is a type of bacteria. It stains Gram positive and is non-moving small round shaped or non-motile cocci. It is found in grape-like (staphylo-) clusters. This is why it is called Staphylococcus.
Causes of Staphylococcuss
Staph infections may cause disease due to direct infection or due to the production of toxins by the bacteria. Boils, impetigo, food poisoning, cellulitis, and toxic shock syndrome are all examples of diseases that can be caused by Staphylococcus.

Preventing staph infections
You can reduce your chances of developing staph infections by:

Ensuring that food is both properly cooked and properly chilled – read more about preventing food poisoning
Keeping your skin clean by having a bath or shower every day
Keeping any cuts clean and covered
Not sharing towels, washcloths, bed linen, toothbrushes and razors
Washing your hands with soap and warm water regularly – particularly if you come into contact with someone who has a staph skin infection
If you experience repeated staph infections and you're found to carry the bacteria on your skin, your doctor may recommend using antibacterial shampoo and nasal cream to kill the bacteria and reduce the risk of further infections.
Symptoms/Signs of Staphylococcuss
Staph infections can range from minor skin problems to endocarditis, a life-threatening infection of the inner lining of your heart (endocardium). As a result, signs and symptoms of staph infections vary widely, depending on the location and severity of the infection.
Symptoms of Staph Infection
There are many different forms of staph infections, and each has different symptoms. The most common are:
Skin Infections: These staph-related conditions include boils, cellulitis, and impetigo.
Boils are hair follicles or oil glands that have become infected and are often filled with pus. The boil may be raised, swollen, red, and painful to the touch.
Boils most often occur in areas with a lot of friction, including under the arms, in the groin, and on the buttocks.
Cellulitis is an infection of the deeper layers of skin that causes your skin to swell, turn red, and become warm and tender.
Oozing sores (ulcers) may also develop. Cellulitis most often occurs in the lower legs and feet.
Impetigo is a highly contagious skin rash most commonly seen in children. An infected person will have blisters that ooze and crust over after a few days.
Food poisoning: Eating food that has been contaminated by staph bacteria is one of the most common causes of food poisoning.
Toxic shock syndrome: Also known as TSS, this potentially deadly condition results from toxins that are produced by some strains of staph bacteria.
TSS has been associated with the use of certain types of tampons, skin wounds, and surgery.
Septic Arthritis: Staph infection is a common cause of septic arthritis. The knees are most often affected, but the bacteria can target other joints including your ankle, hip, wrist, elbow, shoulder, or spine.
Bacteremia: Also known as blood poisoning, bacteremia is a more serious result of staph infection.
As the name suggests, it occurs when staph bacteria enter a person's bloodstream. Bacteremia can affect:

Bones
Brain
Heart
Kidneys
Lungs
Muscles
Surgically implanted devices, such as artificial joints or cardiac pacemakers
Types of staph infections
Staphylococcus aureus infections range from mild to life threatening. The bacteria tend to infect the skin (see Overview of Bacterial Skin Infections), often causing abscesses. However, the bacteria can travel through the bloodstream (called bacteremia) and infect almost any site in the body, particularly heart valves ( endocarditis) and bones ( osteomyelitis). The bacteria also tend to accumulate on medical devices in the body, such as artificial heart valves or joints, heart pacemakers, and catheters inserted through the skin into blood vessels.
Certain staphylococcal infections are more likely in certain situations:
Endocarditis: When people inject illegal drugs, have an infected blood vessel catheter, or have an artificial heart valve
Osteomyelitis: If Staphylococcus aureus spreads to the bone from infection in the bloodstream or from infection in adjacent soft tissue, as may occur in people with deep pressure sores or foot sores due to diabetes
Lung infection (pneumonia): When people have had influenza (particularly) or a bloodstream infection, when people are taking corticosteroids or drugs that suppress the immune system (immunosuppressants), or when they are hospitalized because they need tracheal intubation and mechanical ventilation (see Hospital-Acquired and Health Care–Associated Pneumonia)
There are many strains of Staphylococcus aureus. Some strains produce toxins that can cause the symptoms of staphylococcal food poisoning, toxic shock syndrome, and scalded skin syndrome.

Staphylococcuss

Risk factors for staph infections
Certain conditions increase the risk of getting a staphylococcal infection:

Chronic lung disorders (such as cystic fibrosis emphysema)
Influenza
Leukemia
Tumors
A transplanted organ, an implanted medical device, or a catheter inserted into a blood vessel for a long time

Burns
Chronic skin disorders
Diabetes mellitus
Drugs, such as corticosteroids, drugs that suppress the immune system (immunosuppressants), cancer chemotherapy, or injected illegal drugs
Radiation therapy
Surgery
How to diagnose Staphylococcuss
Steps in diagnosis of S. aureus infections include:
Collection of specimens
This depends on the area of the body affected. For example, those with a skin infections or throat, nostrils and wound infections need to swabbed for pus and other discharge with the bacteria. Swabs consist of a sterile absorbent cotton tipped sticks. Those with a urinary tract infection need to provide a urine samples in sterile containers and those with a generalized blood infection need to provide blood samples. Blood samples are then transferred to blood culture bottle.
Identification of the bacteria
A small portion of the sample is swabbed onto a glass slide. This is then stained with Gram stain or dyes like crystal violet and basic fuschin and viewed under the microscope. S. aureus is Gram positive and stains blue or purple and appears as small round cocci or short chains and most commonly as grape-like clusters. Since S. aureus may be normally present on skin and mucous membranes, this test is not always confirmatory.
Confirmation of diagnosis
To confirm a diagnosis, the sample from the patient is placed onto a culture media. This could be a liquid or gel that provides sources of nutrition, carbon, energy and nitrogen for the bacteria to grow. For S. aureus, the medium used is suffused with blood and lactose. Also commonly used is the mannitol salt agar, which is a selective medium with 7–9% salt or sodium chloride that allows S. aureus to grow selectively. These media are placed on petri dishes and swabbed with the sample. The dishes are then incubated overnight at 37 degrees Celsius. After a set period of time the typical golden colonies of S. aureus are seen. These are then stained with Gram stain for confirmation and also undergo specific characteristic tests like the catalase test or the coagulase test for diagnosis.
Rapid diagnostic tests
These help in detection of the bacteria in real-time. These techniques include Real-time PCR and Quantitative PCR and are increasingly being employed in clinical laboratories.

Identification of toxins
This is important for more severe cases like toxic shock syndrome and food poisoning. Toxins produced by S. aureus, such as enterotoxins A to D and TSST-1 may be identified using agglutination tests. The tests are determined by clumping of the latex particles by the toxins present in the samples.
Antimicrobial assay studies
Many of the S. aureus strains are resistant to antibiotics. These assay studies help determine the specific susceptibility to antibiotics of the infected strain. Antibiotics like penicillin, amoxicillin, methicillin, first-generation cephalosporins, bactrim and vancomycin are commonly tested.

How to Prevent Staphylococcuss

Avoid shared athletic equipment: Athletes are at a high risk for developing a staph infection because of the amount of bacteria that can be transferred through a piece of equipment. Avoid any loaner equipment like helmets, gloves, shoes or pads. If loaner equipment must be used, make sure it is sprayed and wiped down with disinfectant spray and wipes.
Drink plenty of water: Try to drink anywhere between eight to ten glasses of water each day to help flush out bacteria from your body. Consuming more water each day also has many other health benefits.
Hand sanitizer: Always carry hand sanitizer whenever possible. Keep it in your purse, your school bag, briefcase or in your car. Hand sanitizer is very useful when soap and water aren't available. You'll often see hand sanitizer dispensers in public areas like the gym or the mall; don't be afraid to use them!
Do not share personal items: Soap, razors, ointments and towels being shared with others puts you at a greater risk of developing a staph infection. If you loan a towel to a friend who has a staph infection, and some of the fluids or pus from the wound wipe onto your towel, it becomes contaminated. If you use the towel again before washing it, and it touches a wound of your own, it's highly likely that you'll develop a staph infection as well.
Disinfect areas that can easily be contaminated: Lockers, gym and athletic equipment, and bathrooms are areas that are filled with germs. Use disinfectant cleaners, sprays and wipes as often as possible and be mindful of the bacteria in such areas. If you plan on using a public shower, like in a gym locker room, make sure you wear slippers or some other type of cover for your feet.
Keep away from other people's wounds: Avoid cuts and wounds on other individuals, especially if they are infected by Staph. The infection can be very contagious and can easily spread if you come in contact with the wound, or any liquid or pus from the wound.
Properly treat your own wounds: Make sure any cuts or wounds on your body are kept clean and bandaged properly until they are fully healed. Walking around with an open wound is an invitation for Staph bacteria to enter the wound and infect it. This can either occur from contact with someone with staph infection, or a contaminated object or surface.
Visit the doctor: Don't be afraid of paying a visit to the doctor if you feel there is a possibility you have a staph infection. Do not try to drain the liquid from a sore or boil yourself. If you notice that staph infections are being spread from one family member to another, notify your physician immediately.
Wash your hands: Staph infections are one of the main reasons why it is so important to frequently wash your hands. Use hot water and soap, and make sure you do a thorough job. A quick splash of water does not equate to clean hands.
Wash anything that has a higher possibility of carrying Staph bacteria immediately: Gym clothes, athletic apparel and clothing used in a hospital setting should be washed with hot water as soon as possible. This reduces the risk of developing a staph infection due to contaminated clothing.

Staphylococcuss
Treatment for Staphylococcuss
Antibiotics commonly prescribed to treat staph infections include certain cephalosporins, nafcillin or related antibiotics, sulfa drugs or vancomycin. Vancomycin increasingly is required to treat serious staph infections because so many strains of staph bacteria have become resistant to other traditional medicines.

Antibiotic resistance of S. aureus

S. aureus strains may become resistant to penicillin by producing enzymes like penicillinase that destroys the antibiotic. This is a form of β-lactamase which breaks down the β-lactam ring of the penicillin molecule. To overcome this molecules resistant to penicillinase have been developed. These include:

Cloxacillin
Dicloxacillin
Flucloxacillin
Methicillin
Nafcillin
Oxacillin
Staphylococcuss Home Remedies/Home Cure
• Apple Cider Vinegar
A mixture can be prepared by adding apple cider vinegar (1/4th cup) and honey (4 – 5 teaspoons) in water (2 cups) and consumed 2 to 3 times in a day to treat staph infection.An individual can create a solution by mixing apple cider vinegar with baking soda and apply this solution with the help of a cotton swab on the affected area to deal with the problem of staph infection.
• Basil
An individual can apply a juice extracted from fresh basil leaves on the affected area to treat various symptoms associated with staph infection. Basil oil can also be directly applied on the affected area to obtain the desired results. Regular intake of tea prepared by boiling basil leaves in water is also recommended.

Eucalyptus Oil : You can apply eucalyptus oil in combination with tea tree oil, lavender oil, rosemary oil, or oregano oil, in small quantities. This will provide a soothing relief to the boils, caused by a MRSA infection.

Echinacea : Apply a cream, containing 15% of Echinacea, on the MRSA infection in order to get rid of it quickly. Echinacea is a useful herb that rapidly heals the infection while cleaning out the harmful bacteria from the area.

Lapachol : Make lapachol tea by boiling it in a cup of water for about 10-15 minutes. Drink it at least 2-8 times a day. Lapachol is an effective herb, which helps in healing a MRSA infection.

Thyme : Thyme oil can also be used as a natural treatment for MRSA. It should be taken internally as it is quite irritating to the skin.

• Goldenseal
Goldenseal has antibacterial properties. A solution can be created by mixing goldenseal powder in water and used for washing the affected area several times in a day to treat various symptoms associated with staph infection.
• Garlic
An individual can apply crushed garlic cloves on the affected area to deal with staph infection. Garlic oil can also be directly applied on the affected area to obtain effective results.
• Ginger
An individual can apply a paste created by mixing the ginger powder and salt in manuka honey on the affected area to reduce the staph infection.
• Oregano Oil
You can use oregano oil for treating staph infection due to its antibiotic properties. Several chemical components in oregano oil help in reducing infection as effectively as traditional antibiotics.

• According to a 2007 study published in the Journal of Medical Microbiology, researchers found there was a positive effect of oregano essential oil on staphylococcus aureus and staphylococcus epidermidis strains.

Dilute 8 to 10 drops of oregano oil in 2 tablespoons of olive oil or any other carrier oil. Apply it on the affected area and leave it on for a few hours before washing it off. Reapply several times a day.
Mix 5 drops of oregano oil in a glass of water or fruit juice. Drink it twice daily for a week.

Note: Pregnant women should avoid intake of oregano oil.Applying oregano oil on the affected area multiple times in a day can help in curing the inflammation and pain resulting from staph infection
Turmeric
An individual can create a tonic by boiling turmeric powder (4 teaspoons), black pepper powder (1 teaspoon), coconut oil (1 teaspoon) and lemon juice (1 teaspoon) in water and consume this tonic several times in a day to cure staph infection. Turmeric powder can also be applied on the affected area to reduce the staph infection.

Complications of Staphylococcuss
If staph bacteria invade your bloodstream, you may develop a type of infection that affects your entire body. Called sepsis, this infection can lead to septic shock — a life-threatening episode with extremely low blood pressure


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Celebrating Nigeria, telling our story

13/11/2020

WHO IS AT RISK FOR HIGH BLOOD PRESSURE?
Everyone is at risk of developing high blood pressure, but there are certain factors that can increase your risk:
• AGE- Blood pressure tends to rise with age
•RACE/EHNICITY- High blood pressure is more common in African men.
•WEIGHT- People who are overweight or have obesity are more likely to develop high blood pressure.
•SEX- Before age 55 men are more likely than women to develop high blood pressure. After age 55, women are more likely than men to develop it.
• LIFESTYLE- Certain lifestyle can raise your risk for high blood pressure, such as eating too much sodium (salt) or not enough potassium, lack of exercise, drinking too much alcohol, and smoking.
• FAMILY HISTORY- A family history of high blood pressure raises your risk of developing high blood pressure.

HOW CAN I PREVENT HIGH BLOOD PRESSURE?
You can help prevent high blood pressure by having a healthy lifestyle. This means
√ Eating a healthy diet
√ Getting regular exercise
√ Being at a healthy weight
√ Limiting alcohol
√ Not smoking
√ Managing stress
cares
tested today ......... pure heart Medicare foundation page

07/11/2020

WHAT IS CHOLESTEROL?
Cholesterol is a type of lipid. It's a waxy, fat- like substances that your liver produces naturally. It is vital for the formation of cell membranes, certain hormones and vitamin D.
Cholesterol doesn't dissolve in water, so it can't travel through your blood on its own. To help transport cholesterol your liver produces lipoproteins. They carry cholesterol and triglyceride (another type of lipid) through your blood stream.
The two major forms of lipoprotein are low-density lipoprotein (LDL) and high-density lipoprotein (HDL).
If your blood contains too much low-density lipoprotein cholesterol, it is known as "high cholesterol" and when left untreated can lead to many health problems, including heart attack or stroke.
GET TESTED contact US pure heart Medicare foundation page
CARE

06/11/2020

WHAT IS FILARIASIS?
FILARIASIS: Filariasis is an infections tropical disease caused by one of the several thread-like parasitic round worms. The larval form of the parasite transmits the disease to humans by the bite of a mosquito.

WHAT IS THE CAUSE OF FILARIASIS
When a most bites a person who has lymphatic filariasis, microscope worms circulating in the person's blood enter and infect the mosquito. When the infected mosquito bites another person, the microscopy worms pass from the mosquito through the skin, and travel to the lymph vessels.
TESTED contact US on pure heart Medicare foundation page #

24/09/2020

What is Normal Fertility and When Does it Become Infertility?
What is Infertility?

Most people will have the strong desire to conceive a child at some point during their lifetime. Understanding what defines normal fertility is crucial to helping a person, or couple, know when it is time to seek help. Most couples (approximately 85%) will achieve pregnancy within one year of trying, with the greatest likelihood of conception occurring during the earlier months. Only an additional 7% of couples will conceive in the second year. As a result, infertility has come to be defined as the inability to conceive within 12 months. This diagnosis is therefore shared by 15% of couples attempting to conceive. We generally recommend seeking the help of a reproductive endocrinologist if conception has not occurred within 12 months. However, there are various scenarios where one may be advised to seek help earlier. These include:

Infrequent menstrual periods: When a woman has regular menstrual periods, defined as regular cycles occurring every 21 to 35 days, this almost always indicates that she ovulates regularly. Ovulation of the egg occurs approximately 2 weeks before the start of the next period. If a woman has cycles at intervals of greater than 35 days, it may indicate that she is not ovulating an egg predictably, or even at all. Ovulation of the egg is essential for pregnancy. Therefore, we recommend an evaluation if menstrual cycles are infrequent or irregular in a couple attempting pregnancy.
Female age of 35 years or older: For unclear reasons, egg numbers decrease at a rapid rate as women age. Furthermore, as aging occurs, egg quality, or the likelihood of an egg being genetically normal, decreases. Therefore we recommend a fertility evaluation if a couple has been attempting pregnancy for 6 months or more when the woman is 35 years of age or older.
A history of pelvic infections or sexually transmitted diseases: Sexually transmitted infections, such as chlamydia or gonorrhea, can cause inflammation and permanent scarring of the fallopian tubes. The presence of open tubes is essential for natural conception, as s***m must traverse the tubes in order to reach and fertilize the ovulated egg. We recommend immediate evaluation for a couple attempting pregnancy when the woman has a prior history of pelvic infection. As part of the fertility evaluation, we will perform an HSG, a test designed to evaluate if the fallopian tubes are open.
Known uterine fibroids or endometrial polyps: Uterine abnormalities, such as fibroids that indent the endometrial cavity and endometrial polyps, can impair how the endometrium (the lining of the uterus) and embryo interact to lower implantation and pregnancy rates. These abnormalities can also cause irregular bleeding between menstrual cycles. Evaluation should be pursued by 6 months of attempted pregnancy in women with a known history of these abnormalities or a history of bleeding between menstrual cycles. The main approach to correcting or removing these uterine abnormalities is by hysteroscopy, a surgical method by which a narrow scope with a camera is placed within the uterine cavity. Instruments can be introduced through the hysteroscope, allowing the surgeon to remove or correct any anatomic abnormalities.
Known male factor semen abnormalities: If a male partner has a history of infertility with a prior partner, or if there are abnormalities on his semen analysis, then we advise earlier fertility evaluation, ideally within 6 months of attempting pregnancy.
What is Involved in the Fertility Evaluation?
Infertility Tests

History and physical examination – First and foremost, your fertility physician will take a very thorough medical and fertility history. Your doctor may ask you many of the following questions: How long have you been trying to get pregnant? How often are you having in*******se? Do you have pain with menstrual periods or in*******se? Have you been pregnant before? What happened with your prior pregnancies? Have you had any sexually transmitted infections or abnormal pap smears? How often do you have menstrual cycles? Do you have any medical problems or prior surgeries? Do you have a family history of medical problems? These and many other questions will help your physician design a specific evaluation and potential treatment for you. In addition to a careful history, a physical evaluation may also be performed.

Transvaginal ultrasound – Ultrasound is an important tool in evaluating the structure of the uterus, tubes, and ovaries. Ultrasound can detect uterine abnormalities such as fibroids and polyps, distal fallopian tube occlusion, and ovarian abnormalities including ovarian cysts. Additionally, transvaginal ultrasound affords the opportunity for your physician to assess the relative number of available eggs. This measurement is called the antral follicle count and may correlate with fertility potential.

Laboratory testing – Depending on the results of the evaluation discussed above, your physician may request specific blood tests. The most common of these tests include measurements of blood levels of certain hormones such as estradiol and FSH, which are related to ovarian function and overall egg numbers; TSH, which assesses thyroid function; and prolactin, a hormone that can affect menstrual function if elevated.

Hysterosalpingogram (HSG) – This test is essential for evaluating fallopian tubal patency, uterine filling defects such as fibroids and polyps, and scarring of the uterine cavity (Asherman syndrome). Many uterine and tubal abnormalities detected by the HSG can be surgically corrected.

Semen analysis – The semen analysis is the main test to evaluate the male partner. There are four parameters analyzed: 1) semen volume – should be at least 1.5 to 2 ml. A smaller amount may suggest a structural or hormonal problem leading to deficient semen production; 2) s***m concentration – normal concentration should be at least 20 million s***m per 1 ml of semen. A lower concentration may lead to a lower chance for conception without treatment; 3) s***m motility or movement – a normal motility should be at least 50%. Less than 50% motility may significantly affect the ability for s***m to fertilize the egg without therapy; and (4) morphology, or shape – there are three parts of the s***m that are analyzed for morphology: the head, midpeice, and tail. Abnormality in any of those regions may indicate abnormal s***m function and compromise the ability of s***m to fertilize the egg. Ideally, using strict morphology criteria, a minimum of 5 – 15% normal forms leads to a better ability for s***m to fertilize the egg. An abnormal semen analysis warrants a further evaluation usually by a reproductive urologist. Your physician will refer you to a reproductive urologist if appropriate.

What are the Common Causes of Infertility?
What Causes Infertility?

1) Advancing maternal age: Historically before the latter 20th century, women were conceiving in their teens and twenties, when age-related abnormalities with the egg were not evident. However, in our modern era, women are delaying child birth until their thirties and forties, which has lead to the discovery of the adverse effect of advanced maternal age on egg function. In fact, female age-related infertility is the most common cause of infertility today. For unknown reasons, as women age, egg numbers decrease at a rapid rate. And as aging occurs, egg quality, or the likelihood of an egg being genetically normal, decreases as well. Hence the ability to conceive a normal pregnancy decreases from when a woman is in her early 30s into her 40s. A woman is rarely fertile beyond the age of 45. This applies to the ability to conceive with her eggs, but not with donor eggs.

2) Ovulation disorders: Normal and regular ovulation, or release of a mature egg, is essential for women to conceive naturally. Ovulation often can be detected by keeping a menstrual calendar or using an ovulation predictor kit. There are many disorders that may impact the ability for a woman to ovulate normally. The most common disorders impacting ovulation include polycystic o***y syndrome (PCOS), hypogonadotropic hypogonadism (from signaling problems in the brain), and ovarian insufficiency (from problems of the o***y). If your cycles are infrequent or irregular, your doctor will examine you and perform the appropriate testing to discover which problem you may have and present the appropriate treatment options.

3) Tubal occlusion (blockage): As discussed previously, a history of sexually transmitted infections including chlamydia, gonorrhea, or pelvic inflammatory disease can predispose a woman to having blocked fallopian tubes. Tubal occlusion is a cause of infertility because an ovulated egg is unable to be fertilized by s***m or to reach the endometrial cavity. If both tubes are blocked, then in vitro fertilization (IVF) is required. If a tube is blocked and filled with fluid (called a hydrosalpinx), then minimally invasive surgery (laparoscopy or hysteroscopy) to either remove the tube or block/separate it from the uterus prior to any fertility treatments is recommended.

4) Uterine fibroids: Fibroids are very common (approximately 40% of women may have them) and the mere presence alone does not necessarily cause infertility. There are three types of fibroids: 1) subserosal, or fibroids that extend more than 50% outside of the uterus; 2) intramural, where the majority of the fibroid is within the muscle of the uterus without any indentation of the uterine cavity; and 3) submucosal, or fibroids the project into the uterine cavity. Submucosal fibroids are the type if fibroid that has clearly been demonstrated to reduce pregnancy rate, roughly by 50%, and removal of which will double pregnancy rate. In some cases, simply removing the submucosal fibroid solves infertility. Often, but not always, submucosal fibroids can cause heavy periods, or bleeding between periods. There is more controversy regarding intramural fibroids, where larger ones may have an impact and may necessitate removal. Subserosal fibroids do not affect pregnancy. Your physician will examine you carefully to determine if you have fibroids and if removal is necessary.

5) Endometrial polyps: Endometrial polyps are finger-like growths in the uterine cavity arising from the lining of the uterus, called the endometrium, These abnormalities are rarely associated with cancer (