AboutEdward Joseph Ramirez, MD, FACOG Expertise I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.
Experience I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 15 years.
Organizations American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, Society of Assisted Reproductive Technology, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists,Resolve-National Chapter, Open Path - Northern California, Board of Directors Monterey Medical Society
Publications American Journal of Obstetrics and Gynecology
Education/Credentials Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco
Question I am 35 years old and have never achieved a pregnancy. In the past I have been diagnosed with chronic BV, trichomonas, HPV, PID, and endometriosis. I recently read that all of these conditions could be symptomatic of a unicellular microorganism called microplasma genitalium. What information do you know of this organism? I have been successfully treated for each of these infections. Is there a specific fertility treatment that I should try with these past issues? Is my infertility permanent? I have been symptom free since my divorce 3 years ago.
Answer Hello Lynn from the U.S.,
The main problem with this variety of infections, is that some of them could have led to tubal damage. That is, the bacteria ascend into the tubes leading to inflammation and scarring. Once the tubes are damaged, they do not function and so natural pregnancy cannot occur. The way that we currently check for this is using a test called the HSG (hysterosalpingogram) to see if the tubes are open. This still is not specific enough but if there is severe damage to the tubes, it will return showing the blockage. If one tube is blocked, you can assume that the other is damaged as well, although it may not be blocked. If the tubes are blocked there is no other alternative other than IVF for treatment of the infertility. IVF works by bypassing the tubes by extracting the eggs directly from the ovaries.
Endometriosis can also be a cause for infertility. Endometriosis is a pelvic disease that causes the pelvis to be inflamed. It is thought that this inflammation attacks and kills the egg at the time of ovulation. In addition, it can cause scar tissue formation in the pelvis that will prevent the egg from getting to the tube. Again, in cases of severe endometriosis, IVF is the treatment of choice.
At 35 years old, your age is now going to be a factor A woman's fertility decreases significantly after the age of 35. Therefore, if you are contemplating getting pregnant or having children, you might want to start aggressively trying with IVF. If you have never undergone an infertility evaluation, then you should start there. IVF may not be your only option.
Sincerely,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
