Age and Infertility

Clinicians have the ability to eliminate cervical cancer thanks to improved screening and the HPV vaccine. At the same time, mortality rates in our mostly-rural state are roughly the same as they were in 1999. Isabel Scarinci, vice chair of global and rural health, introduces Operation Wipeout, a UAB-led plan that mobilizes civil society groups to encourage screening and vaccination across Alabama. Dr. Huh and Scarinci also discuss the hope that self-sampling for HPV screening could offer for women in rural areas who may not be able to travel to a clinic.

Girls and young women (0-18) may have unique gynecological issues, yet there are few pediatric and adolescent gynecologists. Blair Lacy, M.D., one of just four such subspecialists in Alabama, explains her training and the complex considerations of working with young women. She also conveys the importance of her clinic being a safe place for parents to seek specialty care and advice about sensitive issues facing their children.

The pelvic floor is an important muscle structure at the base of the pelvis, and when it is not functioning properly it can cause issues such as painful intercourse, incontinence, and prolapse. Jennifer Fagen, a physical therapist who specializes in pelvic floor physical therapy, discusses how she helps patients address pelvic floor dysfunction through internal exams, education and feedback, and specific tailored exercises. Most of her patients improve their pelvic floor function over time, whether their muscles had been chronically tense or lax.

As many as 85% of gynecologic cancer survivors face sexual health challenges. Learn from Christina Wilson, CNP, Ph.D., about the dimensions of sexual health and how UAB providers approach each case uniquely with an expanding array of treatment options for survivors. She emphasizes that this common and sensitive aspect of survivorship is important to address with your doctor. Wilson encourages patients to think about whether or when to include their partner in planning for the sexual health effects of cancer.

Obstetrical injuries, or those that occur during labor and delivery are more common than patients may realize. Six to seven percent of women undergoing vaginal deliveries will have damage to the anal sphincter muscles, or obstetric anal sphincter injuries (OASIS). Holly Richter, M.D., and Clark Powell, M.D. discuss the complex care required for these injuries and describe their research-backed OASIS care bundle that offers a comprehensive approach bridging obstetrics and gynecology. Learn more about the importance of talking about and addressing OASIS, preferably at an institution that actively assesses quality of care.

More women are choosing to delay childbirth until their late 30s and early 40s. Diedre Gunn, M.D., joins Dr. Huh to discuss the relationship between age and infertility. She describes both the challenges and opportunities for women seeking to conceive beyond the optimal age range. Learn about the circumstances under which you and your OBGYN might consider options such as IVF, use of donor eggs, or freezing eggs and embryos.

First trimester pregnancy losses, more commonly referred to as miscarriages, occur in around 10% of all pregnancies. Dr. Huh is joined by Shweta Patel, M.D., an obstetrician, to share little-known facts about early pregnancy loss that can help patients understand this emotional experience: Why does it happen? What are the risk factors you can and can’t control? How can a pregnancy loss be managed according to your wishes? The doctors also discuss how they help patients through feelings of grief and loss amid further family planning.

Women’s health providers often deliver unexpected or difficult news to patients who may face an emotional rollercoaster. Dr. Huh discusses this important interpersonal aspect of care with Brian Brocato, M.D., a lead physician of the UAB Comprehensive Addiction in Pregnancy Program (CAPP). The doctors discuss the art of listening and connecting patients with counseling when appropriate; encouraging open communication; helping patients look toward their future realistically; and including other loved ones and family in conversations about grief or family planning after a difficulty. Learn more about the special connection effective women’s health providers share with their patients through ups and downs.

Modern obstetrics depends on information gathered by way of ultrasound imaging (also called sonography). Most women will have 2-3 ultrasounds at specific points in their pregnancies as part of normal care. Sheri Jenkins, MD, and Niki Marsh, a sonographer, join Dr. Huh to discuss the ultrasound process and how the scans are used to provide individualized care throughout a pregnancy. Learn more about the rigorous national ultrasound accreditation held by UAB Maternal-Fetal Medicine.