University of Pennsylvania Health System

Penn Health for Women Newsletter

Wednesday, March 25, 2015

Women: Avoid Sports Injuries

Courtesy of CGI Racing
Last year, despite buckets of rain falling down on the city, more than 10,000 runners ventured out to take part in the first-ever Love Run Philadelphia. Called “The Race That Loves You Back”, this 13.1-mile race is scheduled for Sunday, March 29 and expected to surpass last year’s number of runners. It is also expected to have a great deal of women running.

Of those 10,000 runners last year, 73 percent were women, mostly between the ages of 18 and 49. If you’re one of the female runners planning on taking part in the 2015 Love Run – or if you’re simply looking to get more in shape – we want to make sure you understand how your body functions when you run and the ways to best reduce the risk of injury.

Are Women at an Increased Risk for Injury?

In a perfect world, every run would be completely pain-free. No soreness, no aches and no lingering effects from the previous workout. Unfortunately, many runners constantly deal with a slight disturbance.

Regardless of how careful you are, injuries do occur. And, for women, the rate of injury is slightly higher. Runner’s knee, stress fractures, shin splints and plantar fasciitis are all injuries that are more common with female runners.

“One anatomical difference between men and women leading to greater predisposition to lower extremity injuries is the wider female pelvis, which results in a larger Q-angle,” says Erik Thorell, DO. “This results in increased stress across the knee in particular.”

Simply put, men and women are built differently. Women tend to have smaller, weaker muscles supporting their knees, as well as more lax ligaments. They typically have a larger hip width to femoral length ratio, which leads to greater hip adduction (muscles located towards the lateral portion of the thigh contract and pull the thigh away from the midline of the body). Females are also more at risk of certain injuries because there is added motion in their hips and pelvis.

When it comes to bone injuries, females are, again, more susceptible than their male counterparts. Women have smaller bone dimensions and are predisposed to lower bone density. Also, estrogen, a hormone in women that protects bones, decreases sharply as women age. All of these factors increase the risk of broken bones.

“Though gender differences do predispose women more to certain musculoskeletal injuries, attention to bone health, nutrition, core strengthening and a well-structured exercise routine can mitigate some of these problems,” explains Dr. Thorell.

Tips to Reduce the Risk of Injury

Because women suffer sports injuries more often than men, it is important they take extra care prior to completing a race like Love Run Philly. There are exercises and precautions that can be done by women to reduce the risk of injury.
  • Leg lifts, back bridges and standing hip flexors help to improve motion and flexibility in the hip and glutes area.
  • Weight-bearing exercises help to build and maintain bone density. Attend dance classes, go for hikes, pick up aerobics or simply get into fast walking.
  • Balance exercises, such as Tai-Chi, can help strengthen legs.
  • Wear proper footwear and work out on appropriate (not very hard) surfaces.
  • Don’t suddenly intensify or lengthen your workouts.
We wish everyone participating in the Love Run this weekend the very best of luck.


Thursday, March 19, 2015

Ignoring Nature’s Call

Lori M. Noble, MD, a primary care physician at Spruce Internal Medicine, located at Penn Medicine Washington Square, discusses the health risks of ignoring nature’s call.

Dr. Noble
The long, grueling days of medical school and residency impart many lessons, far beyond those related to patient care. For instance, the mantra of my residency experience was "eat, sleep and pee when you can."

While I always made eating and sleeping a priority, urinating had a tendency to fall off my to-do list during a busy day.

I imagine this is not something unique to a career in medicine; I'm sure any woman who works in a demanding field can recall a time (or several) when she "held it in" a little longer than would have otherwise been comfortable. It's a pretty common sacrifice we make to get that one last thing done, typically without giving much thought to any potential consequence.

I recently came across an interesting article in a popular women's magazine that addressed the potential impact of holding it in and thought I'd share what I read and add my medical opinion.

Bladders are unique like fingerprints.

There is no real agreed upon amount of time that is considered okay to hold in urine. This is because every woman is different in terms of how hydrated she stays, how large her bladder is and how sensitive her bladder is to the stretch that happens as it fills with urine.

Bottom Line: The average woman will feel comfortable holding her urine for between three and six hours, but there's a lot of variability.

So Why Not Hold It In?

The authors downplay any consequence of holding in urine for a prolonged period of time, noting that the "worst case scenario" is a "bit more of a likelihood" of developing a urinary tract infection (UTI). As a physician and a woman, I take issue with this for a couple reasons:

1. UTIs can be dangerous. In some people, the infection can spread from the bladder up to the kidneys and even into the bloodstream if not treated quickly. Pregnant women and those with certain medical conditions that can affect bladder function (i.e., Multiple Sclerosis, Diabetes, etc.) are already at increased risk for UTIs, so they should be extra vigilant about emptying their bladders regularly to prevent infection.

2. Many women struggle as they get older with urinary incontinence (the loss of bladder control). Stress urinary incontinence is leakage when there is increased pressure applied to the bladder, like with coughing, laughing or jogging. Urge urinary incontinence is leakage because of an intense, involuntary contraction of the bladder, often described as the "I gotta go, I gotta go, I gotta go" feeling. Both can be made worse if the bladder fills up beyond a comfortable capacity.

Bottom Line: There are potential consequences of holding in urine for a prolonged period of time. Listen to your body and take time to go when you feel the urge.

Are There Benefits to Holding It In?

There is some evidence that holding urine can "train" the bladder to be less sensitive to the urge to go, and thus allow a woman to wait a bit longer between bathroom trips. In my opinion, the risks of holding it as outlined above, outweigh this potential benefit.

Bottom Line: When it comes to holding in urine, the risks of infection, leakage and pain outweigh the potential benefit of a modest increase in bladder capacity.

So next time you feel the urge to go, try to fight the instinct to just cross your legs and hold it in for a bit longer – your bladder will thank you for it later!

Concerns about bladder and pelvic floor health? Speak to a Penn urogynocologist.

Friday, March 13, 2015

Penn Fertility Care Celebrates 50 Years: Pioneers in IVF, Reproductive Services and Preservation

This year, Penn Fertility Care celebrates its 50th anniversary. Penn Fertility Care was the first fertility practice in the Greater Philadelphia area and established the fourth in vitro fertilization (IVF) program in the country. Propelled by expert visionaries and compassionate care, it has helped couples create and grow their families for decades.

Dr. Coutifaris
“When the Penn Fertility Care practice was first created, Penn had a vision to develop a practice that included three cornerstones that are still relevant today. They include: innovation and research of technologies to help couples conceive, education and training of the next generation of fertility specialists, and excellence in providing patient care,” says Christos Coutifaris, MD, PhD, chief of Reproductive Endocrinology and Infertility.

To commemorate the anniversary, we thought we'd give you a look at our past breakthroughs in reproductive medicine and patient care, our current focuses in the field of fertility, and our vision for the future.

The Beginning

Dr. Mastroianni
In 1964, Luigi Mastroianni Jr., MD, joined Penn Medicine as the chair of the department of Obstetrics and Gynecology. He, together with his long-time colleague, Celso Ramon Garcia, MD, were committed to establishing a world-class academic program that would develop and provide state-of-the-art care for infertile couples.

They recognized that it was critical to have a robust research program focused on reproductive biology and a clinical program focusing on human reproduction. To accomplish this, they established the division of reproductive biology, which eventually evolved into the Center for Research on Reproduction and Women's Health, one of the best research programs in women’s health.

“The tools were very limited in the 60s,” says Clarisa Gracia, MD, MSCE, director of Fertility Preservation at Penn. “There were a few medications to induce ovulation, but treatments didn't address male factor infertility or blocked Fallopian tubes, then treated solely with surgical procedures pioneered here at Penn.”

“Patient care has evolved over the past five decades. In the 1950s and 1960s, IVF had not been applied to clinical practice. Today, it's the preferred and most common infertility treatment used when the Fallopian tubes are severely damaged or absent and for unexplained or male factor infertility. In fact, due to its high success rate, IVF is being used more frequently in recent years as a first line of therapy for practically all causes of infertility,” says Dr. Coutifaris.

Dr. Mastroianni’s vision and leadership are acknowledged by many to have shaped obstetrics and gynecology into an academic and clinical specialty. Beyond his scientific expertise and his skill in training physician-scientists, Dr. Mastroianni was an eloquent advocate for reproductive biology and women’s reproductive rights.

Penn Fertility Care Today

Dr. Gracia
To this day, Penn Fertility Care continues to be among the top National Institutes of Health (NIH)-funded programs in the nation, providing a range of comprehensive reproductive and infertility services for both men and women.

“In the past, because IVF was still so new, we were very focused on its success,” says Dr. Gracia. “Now that IVF success rates have improved, our expectations have grown. We continually strive for excellence and try to make patients happier and feel good about the process.”

At Penn Fertility Care, we provide consultation and evaluations, diagnostic imaging and testing, medical and surgical treatment options, and IVF. We also offer the following specialty programs:
  • Penn Polycystic Ovary Syndrome (PCOS) Center: Under the leadership of Anuja Dokras, this program takes a multi-disciplinary approach to treating women with PCOS. It provides treatment options to address their menstrual problems, fertility concerns, weight management, emotional and psychological issues and cardiovascular health.
  • Fertility Preservation Program: Directed by Dr. Gracia, Penn Fertility Care pioneered approaches for the care of patients facing fertility threatening cancer therapies. The Fertility Prevention Program offers a variety of options for both females and males to preserve embryos, eggs, sperm or ovarian tissue. 
  • Male Fertility Program: Puneet Masson, MD, director of Male Fertility at Penn, established a program that provides evaluation, testing, consultations and specialized treatment options for men with fertility concerns. Penn Fertility Care is the only clinic with a full-time reproductive urologist on site to care for couples with male factor infertility. 
“Penn Fertility Care brings together a well-rounded, diverse group of experienced fertility specialists, nurses and dedicated staff into one practice” says Dr. Coutifaris. “Our physicians are all leaders in their field with national and international reputations, and are dedicated to our specialty programs for both women and men trying to conceive.”
The Penn Fertility Care Team

The Future of Fertility Care at Penn

Our clinicians and researchers are constantly working towards improving success rates for IVF and using more sophisticated approaches to achieve better outcomes.

As the only program in the country that has received continuous funding from the NIH for clinical research, we believe we'll remain on the forefront of reproductive medicine. We're able to offer clinical trials to fertility patients and give patients access to the latest treatment options before they are widely available elsewhere in the region. 

Working with the Abramson Cancer Center and Children’s Hospital of Philadelphia, it's become routine for us to bank eggs or ovarian tissue for women who are undergoing cancer therapy. 

“There have been so many advances in cryopreservation for women’s eggs,” says Dr. Gracia. “Because we can offer this service with confidence to women, they can focus on their cancer care.”

Genetic testing of embryos is also getting more sophisticated.

“We can biopsy embryos prior to transferring the embryo after IVF and test the embryo for a number of genetic conditions,” says Dr. Dokras, director of the Preimplantation Genetic Diagnosis Program. “This level of care and diagnosis can help improve success rates, decrease the chance of pregnancy loss or avoid other genetic problems."

Looking at how much has been accomplished in the past 50 years, we're excited to see what's next for us. One thing we know for sure: We'll continue coming up with new options for people to build the family that they dream of.

“Penn continues to propel innovation, education and patient care to new levels,” says Dr. Coutifaris. “We are proud of the accomplishments that Penn Fertility Care has made over the years, but also look forward to what is ahead for the program in the years to come.”


Monday, May 12, 2014

PCOS and Sleep Apnea: When Snoring Shouldn't (or Can't) Be Ignored

Polycystic ovary syndrome (PCOS) is a complex condition, or group of physical symptoms, in which women experience infrequent menstruation, weight gain, acne, abnormal hair growth and fertility problems.

“Women with PCOS are at risk for other, related life-long conditions and symptoms including diabetes, high cholesterol, hypertension,” says Anuja Dokras, MD, PhD, director of the Penn Polycystic Ovary Syndrome Center. “They are also at risk for sleep apnea.”

Sleep apnea is a respiratory disorder in which a person experiences pauses in breathing. Pauses can last from a few seconds to a minute, and can occur multiple times throughout the night. “Sleep apnea presents itself as snoring, pauses in breathing followed by a gasp for breath and frequent, disturbed sleep,” says Dr. Dokras. “A partner or spouse may tell the person with sleep apnea this is occurring, or in some cases, the person with sleep apnea wakes themselves up during the night.” Snoring itself isn’t serious, but if a person is experiencing snoring with sleep apnea, the situation can have serious complications.

“For women with PCOS, sleep apnea can exacerbate other PCOS symptoms such as tiredness, difficulty losing weight, hypertension and insulin resistance,” says Dr. Dokras. “Of course, many women report feeling tired, but some also say they feel depressed and experience unexplained moodiness.”

Diagnosing Sleep Apnea

Allan Pack, MD, PhD, chief of the division of sleep medicine and director of the Center for Sleep and Respiratory Neurobiology at Penn says sleep apnea often goes undiagnosed.

“There are two different ways we can diagnose sleep apnea,” he explains. “A sleep study in a sleep lab that resembles a hotel room requires patients be hooked up to wires throughout the night. An electroencephalogram, or EEG, monitors brain activity throughout the night to determine how well an individual is sleeping, while patients are watched using respiratory monitors to see if there are pauses in their breathing as they sleep”. Dr. Pack explains “at-home” sleep studies are also an option for some patients.

“For patients without a lot of other health conditions, an ‘at-home’ sleep study can monitor sleep, and pauses in breathing,” he says. “The only difference is that an EEG study is not done in the home.”

Treatments for Women with PCOS and Sleep Apnea

Treatment for PCOS includes medication, nutritional counseling and weight loss. “Weight loss can help improve sleep apnea, but treatment for sleep apnea itself can have a marked improvement on a woman’s life,” says Dr. Dokras.

Dr. Pack says most patients can use a continuous positive airway pressure machine, or CPAP machine, to help regulate breathing throughout the night.

“A CPAP machine uses a mask with pressurized air to force the airways in the mouth and neck to remain open while the person is lying down and asleep,” says Dr. Pack. “A CPAP machine is very effective. Patients who use it report having more energy throughout the day, and less drowsiness.”

There is also a small amount of evidence that suggests use of a CPAP machine can help other metabolic functions in women with PCOS such as insulin resistance, high blood pressure and high cholesterol. For those who cannot tolerate wearing a CPAP mask throughout the night, an oral device that pulls the jaw forward may be an option for treatment.

For those who cannot tolerate wearing a CPAP mask throughout the night, an oral device that pulls the jaw forward may be an option for treatment.

"We are learning more and more that restful, healthy sleep is important for every other body function," says Dr. Dokras. "That's why it's so important women with PCOS talk to their physician about their sleep, and if they are experiencing any symptoms of sleep apnea."

Wednesday, April 23, 2014

What Women Need to Know About Endometrial Cancer

Endometrial cancer is the most common gynecologic cancer in the United States. A statistic like this can be daunting and a bit frightening, but the good news is according to gynecologic oncologist Emily Ko, MD, MSCR, assistant professor of obstetrics and gynecology at Penn Medicine, women diagnosed at an early stage generally have good outcomes.

“Knowing the symptoms of endometrial cancer is extremely important,” says Dr. Ko. “Irregular bleeding is typically the first symptom. At that point, a woman should see a physician for an exam, and all of the appropriate tests needed to make a diagnosis.” Endometrial cancer is a cancer that develops in the lining of the uterus called the endometrium. There are two types of endometrial cancer. Type 1 endometrial cancer tends to be associated with diabetes, obesity and metabolic syndrome, a cluster of conditions that includes high blood pressure, high blood sugar levels and high cholesterol.

“Together with cancer treatment, it’s important for women with this type of endometrial cancer to work on other areas of their health such as weight management, exercise and diet in order to have better control of the associated issues like diabetes and high blood pressure that can affect their overall health,” says Dr. Ko. She adds that there are even some clinical trials examining the use of metformin, widely used in the treatment of diabetes, to treat pre-cancerous cells in the uterus.

Type 2 endometrial cancer tends to be biologically different and is less related to metabolic syndrome, says Dr. Ko. “This type of endometrial cancer has a different way of developing in the uterus,” she adds. “We tend to see this type of cancer more frequently in African-American women.”

Who is at Risk for Endometrial Cancer?

While there are currently no screening recommendations for endometrial cancer, it’s important women speak with their physicians about their personal risk. Endometrial cancer is typically diagnosed in women over the age of 45. Other risk factors for endometrial cancer may include:
  • Obesity
  • Diabetes
  • Family history of endometrial cancer
  • Early onset of menstruation
  • Polycystic ovary syndrome (PCOS)
  • Hormones – excessive estrogen through hormone replacement therapy or obesity
  • Tamoxifen after menopause

Gynecologic Oncologists at Penn – Part of Your Entire Team

Key to successful outcomes is early detection and coordination of your care. “As surgeons, we perform complex surgery, but we also provide chemotherapy and collaborate closely with radiation oncologists at Penn,” says Dr. Ko.

“For women with endometrial cancer, we perform minimally invasive surgery via robotic-assisted surgery or laparoscopy,” she says. She also explains that in some cases, medical management with hormones or medications, or radiation alone may be used in place of surgery – especially for women who want to preserve their uterus.

For women who are still interested in having children, Penn gynecologic oncologists work closely with reproductive medicine and fertility specialists at Penn Fertility Care, so women undergoing treatment for cancer have options for child-bearing.

“Aside from comprehensive cancer care at the Abramson Cancer Center, we offer women exercise interventions, nutritional counseling and we have access to related services like diabetes and cardiovascular care,” says Dr. Ko. “Because we all work together, it’s easy to follow patients, and share information so we know the whole picture of health.”

And, Dr. Ko adds, advances in endometrial cancer research continue. “Technology and research have allowed us to get more sophisticated in the way we view cancer so we can treat it with more personalized approaches,” she says. “Tumor biology, targeted therapy, genetics and prevention are all adding more information so we can continue to enhance the standard of care.”

Learn more about Penn's Gynecologic Cancer Team and find out what's right for you.

Wednesday, April 9, 2014

Increasing Cancer Risk - Is it in Your Genes?

In a New York column titled My Medical Choice published last year, Angelina Jolie announced she carried the BRCA gene mutation and had a double mastectomy to minimize her risk of developing breast cancer.

And for women with Lynch syndrome, another genetic condition, their medical choices can sometimes be just as complicated.

Lynch syndrome, also known as hereditary nonpolyposis colorectal cancer (HNPCC), is an inherited condition that increases the risk of colon cancer and other cancers such as ovarian and endometrial cancer.

“Lynch syndrome isn’t rare,” says Anil Rustgi, MD, chief of the division of gastroenterology at Penn Medicine. “It’s estimated this inherited condition accounts for about four percent of colon cancers every year.”

Dr. Rustgi says that Penn’s nationally renowned Gastrointestinal Cancer Risk Evaluation Program evaluates and treats patients with Lynch syndrome, and helps coordinate care with other disciplines such as gynecologic oncology.

“Women who are diagnosed with colon, endometrial or ovarian cancer and who have a family history of the disease may be evaluated via genetic testing and counseling,” says Dr. Rustgi. “The general recommendation for average-risk colorectal cancer screening is a colonoscopy after age 50,” says Dr. Rustgi, “but, because of their higher risk, women and men with Lynch syndrome receive more and different types of screenings starting in their 20s.”

He adds that women with Lynch syndrome who have stopped having children may also prophylactically have their ovaries or uterus removed to prevent ovarian or endometrial cancer. Until then, women should have annual endometrial biopsies and annual transvaginal ultrasounds to evaluate the ovaries, starting between ages 25 to 35 or when the diagnosis is made.

“Genetic testing is powerful in that it gives men and women a chance to take hold of their health by taking measures to minimize their risk,” says Dr. Rustgi. “These are not easy medical choices to make, but with proper genetic evaluation and counseling, they can be informed decisions.”

Evaluating Your Risk for Colorectal Cancer

The Gastrointestinal Cancer Risk Evaluation Program at Penn Medicine offers information, evaluation, and follow-up for people who are at increased risk to develop gastrointestinal cancer due to a personal or family history of colon polyps, colon cancer, or other gastrointestinal cancers (pancreatic, stomach, esophageal, liver). It is also important to note that a personal or family history of genitourinary cancers such as ovarian, bladder, kidney, and uterine cancer may contribute to an individual’s risk for colorectal cancer.

The program offers nationally recognized experts, led by Dr. Timothy Hoops and Dr. Rustgi, in the diagnosis and treatment of colon and other gastrointestinal cancers. Penn’s genetic counselors also have extensive experience in family history assessment, education and counseling for people with a family history of gastrointestinal cancer. The team also includes physicians and health care specialists from all needed specialties, including gastrointestinal medicine, hematology-oncology, medical genetics, radiation oncology, surgery, radiology and pathology.

For additional information or to make an appointment, call 800.789.PENN (7366) or visit PennMedicine.org/gastroenterology.

Friday, March 28, 2014

Women's Pelvic Health Informational Session

Join Penn Medicine for an informational session on Incontinence and prolapse. Did you know that nearly 50 percent of women suffer from bladder and pelvic floor disorders at some point in their lifetimes?

Bladder and pelvic floor disorders include urinary and fecal incontinence and pelvic organ prolapse (when the vagina, uterus, bladder or rectum “falls down”). Pelvic floor disorders affect women of all ages, but post-menopausal women and women who have given birth are most at risk.

Join Heidi Harvie, MD for a discussion about the signs, symptoms and latest treatment options available for pelvic and bladder floor disorders.


TUESDAY, MARCH 11, 2014 | 6:00 –7:00 PM
Penn Medicine Washington Square
19th floor | Philadelphia, PA 19104
Free parking available for attendees


Tuesday, March 25, 2014

Paternity After A Vasectomy?

That tattoo you thought was a great idea in college? Maybe not so much now. And that perm you shelled out big bucks for in 1985...probably wouldn't be a discussion with your hairstylist today.

It’s a fact of life – situations change, minds change, decisions change.
For men and couples who make a decision not to have any (or any more) children, they might decide to have a vasectomy. But what if their minds change? Or, in many cases, a relationship ends, a new one begins and all of the sudden you do want to have children?

“A vasectomy is one of the most common urologic procedures and should be considered a permanent form of contraception,” says Puneet Masson, MD, assistant professor of urology in surgery and director of Male Fertility at Penn Medicine. “That being said, approximately five percent of vasectomized men express the desire for future children and one to two percent may seek consultation regarding options for future fatherhood.”

Dr. Masson sees men who are interested in having a vasectomy. However, he advises that they should only have the procedure if they are 100 percent sure they do not want any more children. A man can also cryopreserve sperm if there is any concern that someday he may desire more children.

“Of course, we understand that life is dynamic and unpredictable and that some vasectomized men are highly interested in achieving a genetic pregnancy,” says Dr. Masson. “There are two options for these patients: vasectomy reversal, and sperm extraction. Both pathways are equally effective at achieving future children and the decision depends on the preferences of the patient/couple.”
Puneet Masson, MD, director of Male Fertility at Penn Medicine.

Reversing a Vasectomy

First, it’s important to understand how sperm is made. Sperm are made in the testicle in extremely small tubules called seminiferous tubules. This process takes approximately 60 days. Afterwards, they are slowly transported to the epididymis and continue to mature over a period of two weeks. Following this, they are ready to be ejaculated and are stored in the section of the vas deferens immediately next to the epididymis and part of the epididymis itself.

During a vasectomy, the vas deferens is cut and each end of the vas is tied, clipped, and/or burned. Thus, the semen of a vasectomized man should not contain any sperm. During a vasectomy reversal, the vas deferens is reconnected so that the man’s ejaculate contains sperm.

A vasectomy reversal typically takes four to six hours and is done under general anesthesia. Afterwards, the patient is able to go home the same day. Following a healing period, the man is “allowed” to resume unprotected sexual relations. Due to swelling in the vas deferens, which occurs as a natural part of healing, it may take up to a year before sperm are visible in the ejaculate. If the more complicated connection is done (vas to epididymis), it may take up to 18 months.

“What all patients should understand is that there is no guarantee that a pregnancy will be conceived through natural means following a vasectomy reversal,” says Dr. Masson. “Though most studies report a ‘natural’ pregnancy rate between 50 and 70 percent, some couples may still choose to participate in assisted reproductive therapy following a vasectomy reversal and do in utero insemination (IUI) and/or in vitro fertilization (IVF).”

Retrieving Sperm

“A sperm extraction procedure is also an excellent option for vasectomized men who desire future children,” says Dr. Masson. A percutaneous epididymal sperm aspiration (PESA), testicular sperm aspiration (TESA), microsurgical epididymal sperm aspiration (MESA), and microsurgical testicular sperm extraction (microTESE) are procedures that directly extract sperm from either the epididymis or testicle. This can be done under local anesthesia, conscious sedation (aka “twilight anesthesia”), or general anesthesia, and can be completed in about an hour.

“What is important to understand is that all sperm extracted must be used in conjunction with IVF, where a woman undergoes an egg retrieval procedure and the sperm must be injected directly inside the egg,” Dr. Masson says. “After a few days, the developing embryo is placed into the woman’s uterus. Excess sperm that was not used for fertilization is usually cryopreserved and stored for future IVF cycles.”

All vasectomized men who are interested in future genetic children should be counseled on both options. A full female evaluation is also recommended, as this may aid couples in making an informed decision. Penn Fertility Care is committed to understanding a couple’s reproductive goals and preferences. Our team includes physicians, nurses, and financial counselors who can discuss all aspects of fatherhood after a vasectomy and individualize a plan for future family planning.
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