Dallas' Advanced Women's
Infertility and Recurrent Miscarriage Treatment
at Cohen Center
Cohen Center provides compassionate care and state-of-the-art diagnosis and treatment to married couples seeking assistance in achieving viable pregnancies.
We provide patients with a complete approach to treatment of their reproductive problems. We have the ability to offer multiple treatment methods, simple and cutting edge, and a balanced approach to achieve our mission. With 35 years of experience, Dr. Cohen is able to help many couples achieve their goal without the need for complex, costly and invasive assisted reproductive technologies. Services offered include medical and surgical evaluation and treatment of infertility and recurrent miscarriage and referral for IVF and GIFT procedures. At the majority of their visits, patients are seen by the physician, this includes ultrasound appointments.
Therapeutic measures include hormonal therapy with insemination if necessary, hysteroscopic and laparoscopic surgery and immunological therapy. Donor sperm is also available when such treatment is necessary.
Each couple has a detailed and individualized assessment. Treatment alternatives designed to address specific problems are discussed with the couple. A treatment plan is intended to facilitate the most likely chance of a successful pregnancy and the couple actively participate in the decisions regarding their reproductive health care treatment plan. Often couples share four to five reasons that are causing their inability to conceive and/or maintain a pregnancy. Diagnoses of unknown causes are very rare and dependent on the detail of the couple¡¯s investigation.
Complex Reproductive Immune Disorders
While there has been approximately fifteen years of investigative and positive evidence to support testing and treatment of immune disorders as current state of the art care, this type of testing and treatment is not yet considered the standard of care. At Cohen Center patients are given information in order for them to make an informed decision regarding their treatment path. We have seen scores of babies born as a result of treatment for immunological disorders for patients with multiple miscarriages or with failed attempts to conceive using standard techniques.
Immunological causes and treatments should be considered in patients who present with a history of endometriosis, multiple surgeries, repeated pelvic infections, recurrent general infections, Chron¡¯s disease, ulcerative colitis, previous complicated pelvic surgery, livedo reticularis, recurrent miscarriage and prior failed IVF with a normal uterus, high quality and well developed embryos and an uncomplicated embryo transfer. In addition patients with a family history of a collagen disease, such as Lupus Erythematosis, Sjorgens, Psoriasis, stroke or blood clots should also be investigated for immunological causes.
Tests for immunological disorders, when the medical and familial history indicate, include anti-phospholipid antibodies, lupus anti-coagulant, anti-nuclear antibodies, anti-thyroid antibodies, rheumatoid factor, natural killer cells, embryo toxic antibodies, factor V leiden and sticky platelets. The main treatment for most of these disorders is the use of anti-coagulants and aspirin therapy. Some disorders may also require corticosteriod therapy. These therapies act by allowing the growth and development of the placenta in its earliest phase of formation by helping new blood vessels to develop, grow and remain open. Later in pregnancy, anticoagulants allow adequate blood flow to the placenta to ensure adequate nutrition and oxygenation of the developing fetus. Repeatedly elevated natural killer cells are treated with intravenous gammaglobulin (IVIG). Use of IVIG for patients with a diagnosis of infertility or recurrent miscarriage is considered state of the art but not yet the standard of care. Dr. Cohen has used IVIG successfully since 1996 without a single significant complication.