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M D N E W S .C O M /// M D N E W S L O W E R H U D S O N / B R O N X ■ 2 017 0 9 " There's an art to caring for pregnant women — it's definitely not just a science. Our physicians and nursing team have the resources and education necessary to deliver safe, up-to-date care, which helps ensure good outcomes." • PEARL LIM, MD, A COLUMBIADOCTORS OB/GYN PRACTICING WITH NEWYORKƒPRESBYTERIAN MEDICAL GROUP WESTCHESTER Judy McArdle, Lactation Counselor at NewYork-Presbyterian Lawrence Hospital, helps a new mother with proper technique. She is available for all patients on the post-partum unit to answer questions, demonstrate best practices and offer support. "In terms of fertility, women are in their prime in their mid-20s," Dr. McConnell says. "As women age, so do their oocytes. In women age 35 and older, we see a decrease in the quantity and quality of eggs." Male factor infertility, which may result from an anatomical irregularity such as a varicocele, plays a role in 33 percent of infertility cases. The remainder of cases are idiopathic. Dr. McConnel l eva luates patients who are experiencing infertility at the ColumbiaDoctors' Center for Women's Reproductive Care in Scarsdale. At this location, couples can receive education about infertility, as well as a wide range of treatments. If women need a hysterosal- pingogram (HSG) — an X-ray evaluation used to diagnose tubal factor infertil- ity — or other diagnostic testing, that can be performed at NewYork-Presbyterian Lawrence Hospital. RESOLVING INFERTILITY Couples who wish to delay pregnancy but worry about advanced maternal age have multiple options, including oocyte, sperm and embryo cryopreservation. Oocyte and sperm cryopreservation may also be options for women and men facing che- motherapy or radiation therapy for cancer treatment that may impact fertility. "Prior to 2012, egg freezing was con- sidered experimental," Dr. McConnell says. " With older freezing techniques, it was difficult for eggs to survive the f reezi ng process. Usi ng t he newest freezing technique, vitrification, eggs as well as embryos are able to be frozen and thawed with a high rate of success, so egg freezing is becoming a standard treatment option for many women." T he prepa r at ion pro c e s s for e g g retrieva l prior to oocy te a nd embr yo cryopreservation or in vitro fertilization (IVF) is similar and takes 10 to 14 days. During this time, women self-administer daily injections of hormone solutions, which may contain follicle-stimulating and/or luteinizing hormones. Physicians also perform daily blood tests and vaginal ultrasounds to determine when the eggs a re ready for collection. Women ca n receive all of the preparation services in Scarsdale. Egg retrieval takes place at the Center for Women's Reproductive Care main o£ce in Manhattan. Other infertility procedures performed at the Scarsdale location include intra- uterine insemination, a technique in which physicians introduce sperm into the woman's uterus during ovulation. This therapy may be used to treat male or female factor infertility. Reasons physicians may utilize intrauterine insemination include erectile dysfunction, low sperm production or cervical scarring. "Our goal is to accommodate women by keepi ng t hem close to home a nd making care as convenient as possible," Dr. McConnell says. "We've made it easy for women to access academic-level fertil- ity services in their local community." THE BASICS OF PRENATAL CARE If women have not established a rela- tionship with an OB/GYN prior to their first prenatal appointment, physicians take a detailed medical history. During the initial appointment, physicians also confirm the pregnancy via ultrasound and determine a woman's due date. While the timing and frequency of ultrasounds can var y between practices, the f irst ultrasound is usually performed before the 10th week of preg na ncy to ma ke sure there is a heartbeat, according to