Sharp Mary Birch now has offerings in North County! The Sharp Mary Birch Education Center in Carlsbad includes physician offices and an education space where the hospital will host classes such as Childbirth Preparation, Baby Care Basics, and Breastfeeding.
Childbirth Preparation One-Day Class
This class is designed for busy couples who want the basic facts about childbirth preparation in one day.
Saturday, May 12, 2018
9:30 AM to 4:00 PM Offered by: Sharp Mary Birch Hospital Where:Sharp Mary Birch Education Center 6125 Paseo Del Norte, Suite 130 Carlsbad, CA 92011 More info
Saturday, June 9, 2018
9:30 AM to 4:00 PM Offered by: Sharp Mary Birch Hospital Where:Sharp Mary Birch Education Center 6125 Paseo Del Norte, Suite 130 Carlsbad, CA 92011 More info
Childbirth Preparation Four-Week Class
Our popular childbirth preparation classes prepares expecting parents for everything from labor and delivery to breastfeeding and newborn care.
Begins Tuesday, May 15, 2018
6:30 PM to 9 PM Offered by: Sharp Mary Birch Hospital Where:Sharp Mary Birch Education Center 6125 Paseo Del Norte, Suite 130 Carlsbad, CA 92011 More info
Begins Tuesday, June 26, 2018
6:30 PM to 9 PM Offered by: Sharp Mary Birch Hospital Where:Sharp Mary Birch Education Center 6125 Paseo Del Norte, Suite 130 Carlsbad, CA 92011 More info
Baby Care Basics Class
In this hands-on class, parents learn all the basic baby care they need to know
before heading home with their newborn, including diapering, dressing,
swaddling and more.
Saturday, May 26, 2018 9:30 AM to 12 PM Offered by: Sharp Mary Birch Hospital Where:Sharp Mary Birch Education Center 6125 Paseo Del Norte Carlsbad, CA 92011 More info
Tuesday, June 12, 2018
6:30 PM to 9:00 PM Offered by: Sharp Mary Birch Hospital Where: Sharp Mary Birch Education Center 6125 Paseo Del Norte Carlsbad, CA 92011 More info
Friday, June 15, 2018
9:30 AM to 12:00 PM Offered by: Sharp Mary Birch Hospital Where: Sharp Mary Birch Education Center 6125 Paseo Del Norte Carlsbad, CA 92011 More info
Breastfeeding Class
This class teaches the basic skills for successful breastfeeding so parents can feel more comfortable and confident once their baby arrives. Topics include positioning, proper latch, breast pumps, and more.
Saturday, May 26, 2018
12:30 to 3:30 pm Offered by: Sharp Mary Birch Hospital Where:Sharp Mary Birch Education Center 6125 Paseo Del Norte Carlsbad, CA 92011 More info
Friday, June 15, 2018
12:30 to 3:30 pm Offered by: Sharp Mary Birch Hospital Where: Sharp Mary Birch Education Center 6125 Paseo Del Norte, Suite 130 Carlsbad, CA 92011 More info
Tuesday, July 24, 2018
6:30 PM to 9:30 PM Offered by: Sharp Mary Birch Hospital Where:Sharp Mary Birch Education Center 6125 Paseo Del Norte, Suite 130 Carlsbad, CA 92011 More info
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Many transgender individuals are of reproductive age at the time of transition, so it is imperative that family-building goals are part of the conversation. Though not exhaustive, this post is designed to help transgender individuals understand their fertility options and barriers they may encounter at different points in transition. Regardless, transgender individuals should speak to a fertility specialist (called a Reproductive Endocrinologist) to discuss the impact of hormonal and/or surgical treatment on their fertility, as well as options for fertility preservation. They should also speak with an experienced counselor to help address the potential impact of fertility treatments on any gender dysphoria, the impact of temporary discontinuation of hormonal therapy and the need for emotional support.
*For the purposes of this article, to avoid confusion, transitioning males will be referred to as FTM and transitioning females will be referred to as MTF.
Prior to Hormone Therapy and/or Surgery
For FTM individuals, improvements in cryopreservation (freezing) technology have made freezing eggs a realistic option for many. To do so, a series of injections of ovarian stimulating hormones are given for ~10-12 days, with frequent monitoring with ultrasound and estrogen levels. When the eggs are ready for retrieval, a transvaginal egg retrieval is performed under light anesthesia, using a small needle that punctures through the vaginal wall and into each ovary. Risks related to the medications and the egg retrieval procedure are minimal. Recovery is quick, with most people able to return to work or school the next day. Eggs are frozen on the day of retrieval and remain in cryopreservation until ready for use. Long-term viability and utility of eggs is still unknown as the freezing technology is still relatively new. The number and quality of eggs available for retrieval is best in younger individuals, optimally ≤ 30 years old. Prior to treatment, an assessment of quantity can be made to tailor expectations for egg retrieval. Though still experimental, cryopreservation of ovarian tissue at the time of hysterectomy can also be considered. This is currently only performed at specifically designated research sites under institutional review board (IRB) approval.
For MTF individuals, sperm tend to be very robust and survive freezing for extended periods of time. For this reason, sperm cryopreservation is an excellent option for potential use in the future, either for inseminations (IUI) or with more advanced technology like in-vitro fertilization (IVF). A number of collections (usually 4-6) is recommended to increase options for use.
After Hormone Therapy
Reproduction for transgender individuals who have initiated transition with hormones will typically involve temporary discontinuation. This can cause difficult physical and emotional changes that are best addressed actively with a qualified mental health professional as part of the treatment process.
The impact of long-term hormone exposure on eggs, sperm and offspring is essential unknown. It is imperative that individuals who choose to pursue treatment understand the limitations of our current knowledge.
For FTM, several options exist. For individuals wishing to carry a child, case reports[1] have shown spontaneous resumption of menses after discontinuation of testosterone therapy, even in situations of use for many years. In another study[2], 57% of individuals had been on hormone therapy for an average of 3.7 years. However, 23% required the assistance of a fertility specialist to conceive, suggesting that the previous testosterone exposure may have affected the function of the ovary. For individuals wishing to preserve eggs, case reports[3] also exist showing successful egg retrieval. Protocols were even used to minimize negative impact of estrogen exposure, improving patient compliance.
For MTF, most data regarding resumption of sperm production after sex steroid suppression comes from short-term male contraception studies; this means the data is not necessarily applicable to the transgender population who are using estrogen, particularly for long periods of time.[4] The data we do have would suggest that return of sperm production is slow (many months), and sometimes not at all. Therapies are available to promote resumption of sperm production; these can be discussed with a Urologist who specializes in fertility or a Reproductive Endocrinologist.
Non-Biological Options
For transgender individuals who have had surgery or do not wish to disrupt their hormone therapy, many options still exist for family building. Egg and sperm donors (from known or anonymous sources) as well as gestational carriers can be part of a family building plan.
For transgender individuals interested in family planning, it is critical that they are informed of their options. Because there are currently no formal practice guidelines for physicians providing fertility guidance and care to transgender individuals, it is important to make sure you seek advice from experts in the field of Reproductive Endocrinology and/or Urology. These specialists can help guide you through options, risks, and outcomes to optimize your care.
Best Wishes in Reproductive Health!
Wendy B. Shelly, MD
Board Certified, Obstetrics/Gynecology and Reproductive Endocrinology
[1] Gidoni YS, Raziel A, Strassburger D, Kasterstein E, Ben-Ami I, Ron-El R. Can we preserve fertility in a female to male transgender after a long term testosterone treatment – case report. Fertil Steril 2013;100:P-77.
[2] Light AD, Sevelius J, Obedin-Maliver J, Kerns J. Pregnancy after transitioning: the male-gendered experience with fertility, pregnancy, and birth outcomes. Fertil Steril 2013;100:P-895.
[3] Rodriquez-Wallberg KA, Dhejne C, Stefenson M, Degerblad M, Olofsson JI. Preserving eggs for men’s fertility. A pilot experience with fertility preservation for female-to-male transsexuals in Sweden. Fertil Steril 2014;102:P-65.
[4] Stahl P. Recovery of spermatogenesis after hormone therapy: what to expect and when to expect it. Fertil Steril 2017;107:338-339.
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San Diego Orthobiologics Medical Group is pleased to have been the first medical center in San Diego to offer the revolutionary LIPOGEMS® Regenerative Medicine therapy.
LIPOGEMS® is an FDA approved medical device used to process regenerative cells derived from your own fat tissue. It’s used for the treatment of joint pain and tendon injuries.
Why is the LIPOGEMS® treatment so unique? Lipogems is a game changer in Regenerative Medicine due to its cutting edge technology that uses your body’s own fat tissue to cushion and support injured areas as your body heals itself. Lipogems is an FDA-cleared medical device that is used to harvest, concentrate, and transfer autologous (your own cells) adipose tissue. The adipose tissue that is being processed by Lipogems is ‘minimally manipulated’ in accordance with FDA’s criteria for human cell and tissue products. The fat tissue can be removed from the abdomen or thigh areas. This tissue is then precisely injected into the patient’s injured areas with the use of ultrasound or x-ray guidance.
Unlike steroid or gel injections, the tissue will stay in the treated area for years allowing your body to maximize the benefits for an extended period of time. The Lipogems procedure can be performed in less than one hour in an outpatient clinical setting.
Lipogems was awarded Best New Technology in Sports Medicine in 2016 by Leading Sports Medicine Physicians.
LIPOGEMS® is a comprehensive Regenerative Medicine treatment that uses your own stem cells and their cellular ‘niche’ to maximize results. Mesenchymal stem cells require support from other cells and proteins to exert their healing benefits. Unlike other so-called ‘stem cell’ treatments, the unique advantage of LIPOGEMS® is that the complete healing environment of the fat tissue is maintained to improve cell viability and regenerative capacity.
Dissolving the fat with enzymes as occurs with stromal vascular fraction (SVF), eliminates or destroys some of stem cells and tissues required for healing. This activity is prohibited by the US Food and Drug Administration (FDA) without special permission or research licenses.
What are the Practical and Scientific Benefits of Adipose Tissue?
Research has shown that regardless of a person’s age, their fat maintains certain reparative properties unlike other tissues such as bone marrow, which may lose healing capacity with age.
Minimally invasive and pain-less procedure
Abundant number of cells unlike bone marrow or amniotic tissue
Contains high concentration of micro-vessels which harbor specialized healing cells such as perivascular cells, also called pericytes
What is the Lipogems® device? The Lipogems® device is a class II A sterile medical device intended for the closed-loop processing of your own fat tissue in medical procedures involving the harvesting, concentrating and transferring of a patient’s own adipose tissue. It gently washes inflammatory impurities from the adipose tissue using saline and resizes the adipose tissue to create an optimal size to inject the Lipogems precisely into desired tissue locations by the physician.
Am I a candidate for Lipogems therapy?
Lipogems has now been successfully performed in more than 8,000 clinical cases globally.
You are a candidate if you:
Suffer from an injury or condition that limits your normal daily functioning due to a soft tissue defect in the tendon, ligament, muscle or joint cartilage.
Treatment options, such as physical therapy, medications or steroid injections have not provided permanent relief.
You would like to consider alternatives to a total hip, shoulder or knee joint replacement surgery.
You do not suffer from a severe medical illness (cancer, infection, bleeding disorder), are pregnant or breastfeeding, or unable to temporarily discontinue blood thinner medications.
Lipogems® Testimonials
Patients undergoing the Lipogems procedure at our clinic undergo a strict screening procedure to assure that they are ideal candidates for the treatment.
Within the last 23 months of tracking our outcomes, more than 90% of our patients experienced significant relief with the treatment and were reported to resume normal, pain- free physical activity. Most of our patients have been able to improve their fitness, lose weight and improve the quality of their lives in a meaningful way.
San Diego Orthobiologics Medical Group is very excited to offer this Regenerative Medicine to our patients, while conducting ongoing clinical research in improving patient care and comfort.
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Dear Fertility Specialists Medical Group in San Diego, How can I check how many eggs I have left? Thanks!
Sarah
Hi Sarah,
Thank you for your important question. At Fertility Specialists Medical Group in San Diego we get this question all of the time. Our current understanding is that women are born with every egg they will ever have. This means that, over time, your supply decreases and, therefore, age is a major predictor of fertility .
One of the best determinants of egg supply is an ultrasound that looks at the ovaries. During the ultrasound there are black circles or follicles that are seen on the ovaries. These follicles have zero or one developing egg within them. Your doctor will count the total number of follicles on each ovary and add them to get your Antral Follicle Count. This number is the first estimate of your egg supply. An ultrasound is included in your initial consult at Fertility Specialists Medical Group in San Diego. This number is not your total egg supply, but a representation of that supply. The majority of your eggs are actually in a quiet resting state and are too small to be seen on an ultrasound. Each month a percentage of them wake up and become responsive to signals from the brain and start to grow. These growing follicles are what we see on ultrasound. We use this number, in conjunction with blood tests, to estimate your egg supply. You won’t get an exact number of eggs you have, but a category such as good, medium, or low. The blood tests we use are: Anti-Mullerian Hormone (AMH), an Ovarian Assessment Report (OAR), and/or Follicle Stimulating Hormone (FSH) in conjunction with Estradiol (E2).
At Fertility Specialists Medical Group in San Diego we will review your history and discuss which of these tests are appropriate for you. In general, the higher your levels of AMH the higher your egg supply is. This is because AMH is released from the follicles that are seen on your ultrasound. So, the more follicles you have, the more AMH you have. Conversely, the higher your FSH, the lower your egg supply. That is because FSH is your brain’s volume nob for talking to the ovary and asking it to produce an egg. The lower your egg supply is the louder your brain has to talk to your ovaries (higher FSH) to produce an egg. The OAR is a computational algorithm that takes in to account your AMH, FSH, and E2 along with the other hormones: Inhibin (InhB) and Luteinizing Hormone (LH) as well as your age. The advantage of this test is that it can roughly predict how many eggs you would have with an IVF or egg freeze cycle.
I know this is a lot of information, Sarah, but the basics are that you have an ultrasound and blood tests to determine your ovarian reserve.
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Dr. Maas