Downtown Spokane: 201 W. North River Dr. Suite 100 Spokane, Wa 99201

To schedule an appointment, call us at (509)-462-7070 or click here.

To schedule an appointment, call us or click here.

Far too often, cancer patients are unaware of the future fertility problems they may encounter after their treatments and surgeries. Encouraging these difficult conversations in advance can educate and help them understand how their body, specifically their egg and sperm count, may react to such treatments. It might be painful now to ask such questions, but they will be grateful, in the future, as their minds are set at ease when building their families and having children.

Our Cancer Care Teams in the Spokane area are very good at advocating for their patients and patient’s fertility.  As a cancer patient, the only thing on your mind is the cancer and treatment of the cancer. The last thing you are thinking about is the future family you are hoping for. Advocate for yourself. Ask about your future fertility. We know these conversations are not easy to talk about but if you can prevent a window from closing, it was then worth asking about. Ask about any possible fertility problems that might take place as early as possible, either before surgery or before treatment starts. You might also want to get a second opinion, or a referral to a fertility or reproductive specialist.

Please know that the Center for Reproductive Health can get patients in for a fertility consult or second opinion, almost next day, after talking with your oncologist. Oncology referrals are first priority with Dr. Robins. He and our office understand that time is precious for our cancer patients. If Dr. Robins recommends egg preservation, typically we can have the patient’s treatment complete in 6 weeks or sooner.

Egg and Sperm Preservation allows patients going through cancer treatments to vitrify their oocytes (freeze their eggs) or sperm prior to cancer treatment – Giving the patient hope for a family in the future.

During the month of March, we are coming together to spread Endometriosis awareness. Our hope is to build recognition, educate others, and honor the 176 million women worldwide suffering from this disease.

WHAT IS ENDOMETRIOSIS?


Coming from the word endometrium (the tissue that lines the uterus), endometriosis is when a similar tissue grows on the outside of the uterus. Endometrium growth is common on the ovaries, bowels, bladder, and fallopian tubes. Symptoms can differ from woman to woman and unfortunately, the severity of the pain does not indicate how much tissue has grown on the outside of the uterine cavity.

SYMPTOMS


  • Painful menstrual cramps, specifically in the lower abdomen (before or during periods)
  • Pain during and after intercourse
  • Painful urination/bowel movements during periods
  • INFERTILITY (affecting about 30-40% of women)
  • Heavy bleeding
  • Chronic pain in the low back and pelvis area
  • Fatigue
  • Gastrointestinal upsets including constipation, nausea, and diarrhea.
  • TREATMENT


  • Pain Medication
  • Hormone Therapy
  • Conservative Surgery
  • FERTILITY TREATMENT
  • Hysterectomy with removal of the ovaries
  • Endometriosis is commonly hard to diagnose. In fact, it is often misdiagnosed leaving women to suffer with their symptoms, receiving very few answers. Infertility is often a symptom of Endometriosis. Researchers believe it may be affecting as many as one in every two women with fertility struggles.

    It is important to remember, you are NOT alone. ONE in TEN women have endometriosis (more than 6.5 million women in the United States). Please, don’t hesitate to reach out to your doctor if you are experiencing symptoms. Normal periods do not cause excruciating pain, but endometriosis does!

    Medical terminology can be confusing. There are several different acronyms you will hear when you enter the fertility world. Our friends over at Resolve have put together the ultimate list of commonly used fertility acronyms and abbreviations, I will link this list HERE. A few common ones you have probably already heard, specifically dealing with fertility treatments, are IUI and IVF. Today we are talking about those two acronyms, what they stand for, their differences, cost, and what’s involved in each procedure.

     

    Let’s start with the less invasive option, IUI. IUI stands for INTRAUTERINE INSEMINATION. This is an outpatient procedure. The physician inserts sperm from a male donor/partner into the female patient’s uterus. This allows the sperm to get a head start (as it is being inserted during the time of ovulation). This procedure is less invasive than IVF, therefore is a common option for new patients. Unfortunately, not all patients/couples are eligible for this procedure. It all depends on the Doctor’s recommendation after reviewing your health history, ovarian reserve, diagnosis, age, etc.

     

    There is no recovery time needed after an IUI and less costly compared to IVF. The IUI itself takes about 10 minutes in office. Some women may experience spotting or slight cramping after the procedure. We recommend patients think as if they are pregnant. Therefore, they should continue to take their prenatal vitamin with Folic Acid 800mcg daily. They also need to avoid alcohol, smoking, recreational drugs, and limit caffeine intake to 200mg daily (1-2 cups of coffee per day max). Tylenol 325mg or 500mg is ok to take during this time and during pregnancy.

     

    The more invasive, costly, time consuming, but affective option is IVF. IVF stands for IN VITRO FERTILIZATION. IVF treatment starts with the stimulation and monitoring phase. This consists of self-administered injectable medication for 10-14 days. The patient will also be monitored frequently with blood work and ultrasounds during morning clinic. The stimulation and monitoring phase of IVF can be a very stressful time. There are a lot of things to remember, several early mornings and many injections. We encourage you to keep your schedules as light as possible so as not to add any additional stress during this time. Try not to plan trips, schedule extra projects, or commit to additional responsibilities. Your number one responsibility is to take care of yourself, try to relax, and follow your nurse’s instructions. All of this helps to ensure a smooth stimulation cycle.

     

    Once the doctor determines your follicles are ready for egg retrieval, the procedure will take place. This involves a female patient’s eggs being surgically removed from the ovaries. We require patients to have a driver to and from the procedure. We also recommend getting plenty of rest (no working, driving, exercise), applying a heating pad, taking Tylenol or Ibuprofen for cramping, and hydrate post retrieval. Most women complain of cramping, bloating, and spotting post retrieval, but usually feel better by the next day. Most patients feel their very best with their period following retrieval which is expected about two weeks after egg retrieval.

     

    The eggs are then transferred to a laboratory where they are fertilized by the male’s sperm, creating embryos! “In vitro” is Latin for “in glass,” and refers to the process of fertilizing an egg in a laboratory dish. The process involves hormonally controlling the ovulatory process, removing ova (eggs) from the woman’s ovaries and letting sperm fertilize them in a fluid medium. The fertilized egg (zygote) is then transferred to the patient’s uterus with the intent to establish a successful pregnancy.

     

    Success rates for either treatment can be different for each individual patient/couple. As always, with all fertility treatments, we recommend staying in touch with your nurse coordinator throughout the process. They are there to answer your questions and help you every step of the way!

     

    An estimated one in every eight American couples struggles to conceive. If you are one of these couples, you know that it can be an emotional and sometimes isolated journey. At Center for Reproductive Health, we encourage patients to find people (friends, family, other couples, counselors) to talk to and share their feelings with. Our team wants to help you start the conversation about infertility with your selected community. We’ve seen celebrities and bloggers speak out their TTC struggles, but there is still a stigma surrounding the topic of infertility, making it difficult to have a productive, two-way conversation.

    Ideally, you will feel loved and supported before, during and after any conversation about struggling with infertility. Unfortunately, many people – even your closest friends and family – may not know what to say or may worry about saying the wrong thing. We want to encourage you to keep the conversation going. So much positive growth can come from sharing your story! We’re sharing some known strategies to start the conversation about infertility on your terms:

    Respect your boundaries. Have an idea of what you’re willing to share and what will remain between you and your partner. You may feel comfortable expressing your worries and thoughts, but not as willing to reveal the results of your partner’s semen analysis. Agree on what to keep close and when to reach out.

    Educate those who may not know what fertility treatment entails. Your friend’s lack of knowledge is not intended to come across as disinterest or insensitivity. Be patient and willing to teach the people that walk alongside you in this journey. We often find that the more people learn about infertility and fertility treatments, the more open the conversation can become.

    Know your audience. Different people in your community are likely to respond with different levels of comfort and support. You can tailor your approach and the amount of detail you share with each person.

    Ask for support. Your community may not know how to help you. They love you and it can be difficult for them to see you suffering. You may need to teach them how to deal with the emotional side of fertility treatment. Explain that you’re going through a lot and need someone to listen and help you process. A counselor with experience with fertility issues can be an additional, invaluable resource. Dr. Robins, Center for Reproductive Health’s Medical Director, can refer you to someone in the Inland Northwest.

    None of the above strategies are easy to implement, but they are important steps toward conquering the anxieties that can come along with talking about infertility. Many of our Center for Reproductive Health patients and partners have said that the willingness to talk provides the freedom and strength to thrive throughout fertility treatment.

    If you’re looking for an appointment or consultation to address your fertility concerns, callCenter for Reproductive Health in Spokane, Washington. Dr. Robins also sees new patients in Missoula, Montana and Richland, Washington on a regular basis.

    The team at Center for Reproductive Health is excited to announce that Dr. Edwin Robins is now seeing new patients in the Tri-Cities! Men and women from around the country have started their families at Center for Reproductive Health in Spokane, but we understand that traveling for an appointment can be difficult. We are partnering with local physicians in Richland, Washington to bring the fertility experts to you.

    The next date available for Richland appointments is September 10, 2018. That day, Dr. Robins will be seeing new patients inside the Columbia Shores OBGYN building: 138 Keene Rd, Richland, WA 99352

    New patient consultations are free of charge. To schedule an appointment, call (509) 462-7070.

    Edwin Robins, MD is Center for Reproductive Health’s Medical Director and a Board Certified Reproductive Endocrinologist. He has helped thousands of Inland Northwest families find their path to parenthood over the past 20 years. Prior to moving to Spokane, Dr. Robins was an Associate Director at the Institute of Reproductive Medicine and Science of St. Barnabas.

    Dr. Robins served as head of the Division of Reproductive Endocrinology at the National Navy Medical Center in Bethesda, Maryland. Dr. Robins received his M.D. degree and completed his residency at Loma Linda University School of Medicine in California. He did a fellowship at the National Institutes of Health and Federal Fellowship Program, where he later started the assisted reproductive technology program.

    The author of numerous research papers, Dr. Robins also served as assistant professor at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. Dr. Robins is committed to treating every patient with dignity and respect and takes time to understand each case of infertility, ensuring you get the most appropriate and effective approach to your care.

    You can learn more about new patient consultations and other appointments offered outside of Spokane by calling (509) 462-7070. We look forward to seeing you!

    Depending on a couple’s response to traditional fertility treatments and other health factors, In Vitro Fertilization (IVF) may be the best option for a successful pregnancy. IVF treatments are highly technological and complex. Each person’s experience and treatment will vary, but there are some common things for all couples to consider before starting IVF treatment.

    The Center for Reproductive Health team provides couples with several strategies that help couples prepare for IVF treatment:

    Spokane’s Center for Reproductive Health has helped thousands of Inland Northwest families conceive through fertility treatments like IVF. With over 20 years of experience, Dr. Robins and his team of experts are prepared to help you find your path to parenthood.

    To make an appointment, call (509) 462-7070.

    Undergoing an infertility journey can take a toll on you physically and emotionally.

    In times of stress, it can be easy to forget about your mental health, but paying attention to your emotional well-being is crucial to helping you thrive throughout fertility treatment. Many aspects of infertility are outside of your control and the doctor’s control. This can lead to self-blame, feelings of ineffectiveness, and comparing yourself to everybody else. Negative thinking can lead to more stress and magnify unfavorable circumstances.

    Anxiety is another common mental health issue experienced by those facing fertility challenges. Center for Reproductive Health patients have shared their anxieties about whether or not treatment will work, a lot of worry after procedures, and endless thoughts about being pregnant while waiting for the next appointment or pregnancy test.

    The team at Center for Reproductive Health suggests three things people can do to improve their mental well-being during times of stress.

    1. Communicate with your partner

    Stress and anxiety can create distance between you and your partner. By sharing the emotional burden and setting time aside to reflect and talk together, you can close that gap. It is important to accept that both males and females are emotionally affected by infertility, so both partners need to share, support and listen to each other.

    2. Practice mindfulness techniques

    With all the complex thoughts racing through your mind, daily mindfulness activities can help keep you in the present moment, even if you only do it for 5 minutes a day. Many Center for Reproductive Health patients have said that yoga and meditation have helped them manage stress during fertility treatment. There are several smartphone apps, such as headspace, available to download that include guided mediation.

    3. Don’t hesitate to seek professional help at any stage of your journey

    Mental health professionals provide many patients with support, tools and strategies to help them cope with stress and anxiety related to fertility treatment. Whether you’ve just had an initial consultation or recently completed a procedure, there’s no shame in seeking professional help. Center for Reproductive Health can refer you to local mental health counselors with experience helping people going through fertility treatment.

    Center for Reproductive Health offers personalized fertility treatments and support for couples and individuals. Founded in 1998, Center for Reproductive Health has helped more than 4,000 Inland Northwest families conceive babies and has grown to be Spokane’s largest reproductive health clinic. To learn more or to make an appointment, call (509) 462-7070.

    The team at Center for Reproductive Health answers your frequently asked questions about Intrauterine insemination (IUI).

    What is IUI?

    Intrauterine insemination (IUI) is an infertility treatment in which sperm are placed into your uterine cavity through a catheter. IUI is a type of artificial insemination in which sperm are injected directly into your uterine cavity near the time you ovulate. Your doctor may recommend IUI to treat many causes of infertility, especially when there is a problem with the sperm such as low sperm count or low motility. IUI bypasses the cervix, so it is a useful treatment if there is an incompatibility between sperm and the cervical mucus. This procedure can be performed with either your partners sperm or with sperm from a donor.

    How is Intrauterine Insemination (IUI) performed?

    The insemination takes a few minutes. The Endocrinologist will insert a small catheter through your cervix into your uterine cavity, and inject the sperm through the catheter into your uterus. You most likely will not feel discomfort during the procedure.

    How can IUI help to improve my chances for pregnancy?

    The sperm are placed very close to the site of fertilization. IUI also improves delivery of the sperm to the egg, especially when the sperm count is low or the sperm do not move well.

    I heard that we may need to go through this procedure more than once. Is that true?

    If you do not become pregnant, you may have to repeat the procedure during your next cycle. Further evaluation may be needed if you do not become pregnant. At Center for Reproductive Health, each patient has an individualized treatment plan to help achieve a healthy pregnancy. You will be provided with reliable information and support to make the best decision for your family.

    How soon will we know if this treatment was successful?

    You will most likely know in about 2 weeks – if you become pregnant, you may miss your next period. A blood test will confirm whether or not you are pregnant.

    IUI is one of the many treatments offered to Center for Reproductive Health patients. You can make an appointment with Dr. Robins at Center for Reproductive Health by calling (509) 462-7070. Free nurse consultations are also available for new patients.

    Still left with questions? Our Patient Liaisons are experts in the leading fertility treatments. You can submit questions to them online, here: http://crh.mdctlm2.wpengine.com/contact-us/.

    Dr. Robins at Spokane’s Center for Reproductive Health (CRH) has been helping Inland Northwest families grow for over 20 years. With the most advanced technology and distinguished medical experts, the CRH team works tirelessly to help you achieve a healthy pregnancy quickly and safely. Before and during fertility treatment, there are steps you, the patient, can take to improve your chances of getting pregnant.

    Keep Your Eye On The Scale

    There is a strong correlation between a woman’s BMI (body mass index) and her fertility potential. For a woman’s reproductive system to function properly, she has to have a healthy amount of fat. Women who are underweight often lack the fat needed for reproduction, causing their bodies to ovulate infrequently or not at all. Even the smallest weight gain can help restart the reproductive system. Being overweight can make conception challenging, as well. Overweight women can experience insulin resistance, which may cause the ovaries to produce an excess amount of hormones and stop releasing eggs. And don’t forget about your partner! Overweight men have shown to have abnormal semen, which may attribute to low sperm count and motility.

    Skip Happy Hour

    Studies have shown that consuming 4-5 alcoholic drinks per week can decrease fertility. Women who consume 10 alcoholic drinks per week show an even greater decrease in their chances of conceiving. Since there is no confirmed data of a safe threshold for consumption, Dr. Robins typically recommends limiting or refraining from alcohol when trying to conceive and during pregnancy.

    Put Out That Cigarette

    Smoking presents serious risks to your overall health. However, you may not realize the impact smoking has on your fertility. Studies have shown that women who smoke have a 54 percent chance of taking a year or longer to conceive, compared with non-smokers. The delay in conception is directly impacted with the quantity of cigarettes smoked. The more cigarettes smoked, the more estrogen-reducing chemicals enter the body. Male smokers often have lower sperm counts. The good news is that the damage from smoking is somewhat reversible. Sperm regenerates about every 74 days, and may be better quality after quitting.

    Identify Your Stress-Busters

    Trying to conceive can be stressful, even before treatment. Once you begin fertility treatment, it’s important to manage your stress and anxiety appropriately Some patients have reported that participating in support groups, getting massages or journaling to be helpful. We suggest scheduling time for stress-busting activities, just like your treatment appointments. Your health should be a top priority during treatment.

    What will you do to improve your fertility? Even modest lifestyle adjustments can make a big difference in improving your fertility and help you get pregnant faster. You can make an appointment at Center for Reproductive Health today by calling (509) 462-7070.

    Related Posts: 6 Signs You Should See a Fertility SpecialistWhy Am I Not Getting Pregnant?

    An estimated 1 in every 8 couples struggle to conceive. While infertility is defined as the inability to conceive after having regular, unprotected intercourse for 1 year, it is considered “normal” for an average fertile couple under 35 years of age to try for 1 year before conception occurs. But for those individuals who are older than 35, that time frame for conception becomes smaller. If you have not conceived during this time frame, you may be asking, “Why?” Our fertility experts at Spokane’s Center for Reproductive Health explain six reasons why you might not be getting pregnant.

    1. Maternal Age

    Age is one of the initial indicators used to assess a woman’s fertility health. From ages 30 to 35, there is a gradual decline in a woman’s ability to become pregnant; after age 40, there is a sharp decline in conception. Women are less likely to ovulate regularly as they age, which could be a reason for a decline in one’s fertility. Women also produce fewer healthy eggs as they age, creating resistance to fertilization and lower pregnancy rates.

    2. Excess Body Weight

    While not every woman who is overweight will struggle to conceive, there are many that do struggle. Weight can be concerning for women when it contributes to reproductive health concerns, such as irregular menstrual cycles and ovulatory dysfunction. Excess weight can cause an increase in insulin levels, which may lead to the ovaries producing male hormones and limited egg release.

    3. Not Enough Body Weight

    While being overweight has implications on fertility, an appropriate amount of fat is necessary for a healthy reproductive system. The appropriate amount may vary based on the person. Too little body fat can cause absence of periods and ovulation, making conception very difficult.

    4. Smoking Habit

    Smoking can have negative effects on your reproductive health. Compared to non-smokers, smokers commonly experience a higher chance that conception will take 1 year or longer. Smoking can also reduce the levels of estrogen in the body.

    5. Existing Medical Conditions

    Nearly one-third of all infertility diagnoses in women are related to Polycystic Ovary Syndrome, commonly referred to as PCOS. PCOS is the most common ovulatory disorder in women of reproductive age and is caused by hormonal imbalances that hinder ovulation. Endometriosis is also a common cause of infertility, in which tissue lining the inside of the uterus grows outside of the uterus. These conditions can often go undiagnosed, as many people don’t have noticeable symptoms.

    6. Your Partner

    While infertility is generally perceived as a female issue, the reality is 40 percent of infertility is connected to male reproductive health issues. Erectile dysfunction, ejaculatory issues, spinal cord injuries, tumors, and undescended testes are all fairly common culprits of male infertility. Because basic testing for these problems is relatively simple and inexpensive, a semen analysis is performed as part of every couple’s routine testing at Center for Reproductive Health.

    Month after month of negative pregnancy tests can be disappointing and frustrating for men and women alike. If this list didn’t provide you with any clear indications of potential fertility concerns, please note that these six reasons are not the only possibilities. Even after testing, some couples find that their infertility is ‘unexplained.’ This can be a baffling or discouraging diagnosis when there is not a real “reason” for the infertility. Individualized tests, analysis and consultations with Dr. Robins will help determine your best way forward.

    If you have been trying to conceive and are not getting pregnant, it might be time to see a fertility specialist at Center for Reproductive Health. When it comes to fertility, time is of the essence. Advanced technologies and treatments are available to help you find your path to parenthood.

    If you would like to learn more, please call (509) 462-7070 to schedule an appointment.