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Family Planning

Fertility Care  Preconception Planning  Essure Tubal Ligation  

Fertility Care

How is “infertility” defined?

Infertility is the inability to achieve pregnancy while having frequent unprotected sex for at least one year. For couples who meet certain age and health criteria, the minimum time may be as low as six or three months of frequent sex without the use of contraception. It’s often the case that couples who are trying to get pregnant may not have success in the first few months, as conception is only possible for a few days surrounding ovulation – which happens about midway through your cycle.

The providers of Steward Medical Group Women’s Health Associates are experienced in helping women with a variety of fertility problems, from hormonal imbalance to blocked tubes and damaged internal structures. Learn more about the options that may be available to you below.

We’re having problems conceiving. When should we see a doctor?

Any time you are concerned about your health is a legitimate time to schedule an appointment with your gynecologist or PCP. Generally, most physicians and fertility groups agree that a minimum of 12 months of unprotected sex without becoming pregnant is grounds for seeking fertility care for women under the age of 35. If you are between the ages of 35-40, then wait to seek care until after at least 6 months of sex. If you are a woman over the age of 40, then you may seek care after 3 months of unprotected sex. Other reasons to seek fertility care around the six- or three-month mark include:

  • Irregular (or no) menstruation
  • You have had one (or more) miscarriages
  • You’ve undergone cancer treatment
  • You’ve had fertility problems in the past
  • You’ve been diagnosed with endometriosis or another pelvic-area disease

The root of an infertility issue can be in either the male or the female. If the cause of your conception difficulties is unknown, your partner should also be a part of the fertility care process.

What are the causes of infertility?

There are many possible causes of infertility, only some of which are understood by physicians. Possible causes include:

  • Problems with ovulation, such as PCOS or hormonal imbalance
  • Blocked/scarred fallopian tubes
  • Endometriosis
  • Male fertility issues (such as low sperm count or motility problems)

Cause is indeterminable in approximately 10-15 percent of all couples challenged with infertility.

What fertility tests are available?

Providers may use one or more tests to look for the cause of your fertility issues. These may include a hysterosalpingogram (HSG), which is an x-ray of the uterus and fallopian tubes done with special radiographic dye for enhanced viewing. A sonohystogram is another advanced imaging procedure for viewing the uterine cavity. During this in-office procedure, special fluid is injected into the uterine cavity (via the cervix). The provider then uses ultrasound technology to view the structure of the uterine cavity. Your physician may also order tests to evaluate your hormone levels. Your partner may be advised to have a semen analysis. 

What fertility treatment options are available?

Fertility issues may be addressed medically, through surgery, by intrauterine insemination, or via assisted-reproduction technologies like in vitro fertilization.

  • Medical therapies may include oral drugs that regulate ovulatory function. Women may use these drugs for up to six ovulation cycles before attempting other therapies. Gonadotropin treatment is another medical therapy that may be available to you. These injections can help stimulate ovulation.
  • Surgery to remove fibroids or cysts or treat endometriosis may make pregnancy possible. At Steward Medical Group Women’s Health Associates, providers use the da Vinci Surgical System to perform these minimally invasive outpatient procedures.
  • Intrauterine insemination is another option that can be performed at our locations. This therapy may be used in conjunction with fertility drugs.

Schedule An Appointment for Fertility Care in Gilbert, Mesa or Tempe, AZ

Call 480-257-2700 or schedule online to schedule your appointment with our fertility specialist. Why wait any longer to take the first steps in growing your family?

Preconception Planning

What is preconception counseling?

A preconception counseling appointment is an opportunity for you to meet with your gynecologist (or primary care provider) and prepare for a healthy pregnancy. As a part the preparation process, your gynecologist may ask you some basic questions about your gynecologic, obstetric, and greater medical history. He or she may also advise you to take certain supplements, avoid certain substances, and test you for various diseases and health problems.

The point of a preconception counseling appointment is to ensure that you (and your partner) are in the best possible health and fully aware of potential problems and risks. Of course, it’s common for a woman to have one or more health issues when becoming pregnant. Your preconception counseling appointment is an opportunity to learn how you can best manage these health conditions as you attempt to become pregnant.

To schedule a preconception counseling appointment with a board-certified OB/GYN or certified nurse midwife in Gilbert, Mesa or Tempe, AZ, call Steward Medical Group Women’s Health Associates at 480.632.2004. 

Gynecologic History

“Gynecologic history” is a term healthcare practitioners use for all things related to menstruation, birth control, gynecologic infections, and sexually transmitted diseases. Expect to cover a lot of ground in this part of the appointment. Your gynecologist will want to know about what kind of birth control you have used, as the use of some contraceptives may require you to wait a little while before conceiving. Also, your health care provider will likely ask you about your menstrual cycle (when you started menstruating, how long your periods last, when did you have your last period, etc.).

If you have not had a recent Pap smear or been tested for HPV, then this appointment may be an opportunity for you to do so. If you are not in a monogamous relationship and you or your partner have had multiple sex partners in the past, your provider will likely recommend STI testing. Pelvic exams are also normal parts of preconception counseling.

Obstetric History

Your obstetric history includes past pregnancies (including failed pregnancies). If you saw a different obstetrician in your earlier pregnancies, then your current provider will want to know about your pregnancy and birthing experience. 

Medical History

Your medical history has to do with chronic conditions, such as cardiovascular disease and diabetes, as well as other health complications you may have had. If you have any allergies, your provider will want to know about these, as well. 

Other Topics for Preconception Counseling

Your provider may bring up these questions and topics, as well:

  • Tobacco, alcohol, and drug use
  • Diet and exercise
  • Mental, emotional, and social history
  • Are you up-to-date on vaccinations?

5 Things You Can Do Before Becoming Pregnant

The Office on Women’s Health (part of the U.S. Department of Health and Human Services) recommends that all women do the following five things before becoming pregnant:

  1. Take 400 to 800 micrograms of folic acid per day. This essential vitamin helps lower the risk of certain birth defects, including spina bifida.
  2. Quit smoking; stop drinking alcohol.
  3. Take the steps to manage any medical conditions that could affect your pregnancy, including (but not limited to) diabetes, obesity, asthma, epilepsy, and oral health.
  4. Talk to your health care provider about all medications you are taking. This includes over-the-counter drugs, prescription drugs, vitamins, and supplements. Also, make sure you are up-to-date on your vaccinations.
  5. Avoid toxic substances that could expose you to infection. This includes cleaning the cat litter box!

Schedule Your Preconception Counseling Appointment 

Are you thinking about becoming pregnant? Not planning a family now, but want to be prepared? Consider scheduling a preconception counseling appointment with at Steward Medical Group Women’s Health Associates. For appointments, call 480.632.2004 or schedule online.

Essure Tubal Ligation

What is Essure?

Essure is a permanent sterilization procedure that is performed in just a few minutes on an outpatient basis. No incisions or anesthesia is required. Essure is available in Gilbert, Mesa, and Tempe, AZ through Steward Medical Group Women’s Health Associates. The procedure has been performed on more than 500,000 women since it first became available in 2002.

How effective is Essure tubal ligation?

According to five-year clinical data studies, Essure has an effectiveness rate of 99.83 percent. This makes Essure the most effective birth control on the market. Your gynecologist can tell you more at Steward Medical Group Women’s Health Associates.

How is the Essure procedure performed?

The Essure procedure relies on two small nickel-titanium alloy coils with stainless steel inner coils. These two coils are inserted into the fallopian tubes – through the vagina, cervix, and uterus – via hysteroscope. During the procedure, the uterus is filled with fluid so that your health care provider can view the fallopian tubes. Using a tiny catheter, in conjunction with the hysteroscope, the provider inserts the coils into the fallopian tubes.

Over the next three months, the body naturally responds to the nickel coils by creating scar tissue around them (a painless process). During this time, you will need to use another form of contraception, as the fallopian tubes are not fully blocked. After about three months, scar tissue blocks the fallopian tubes entirely, preventing sperm from reaching the ovaries and fertilizing an egg.

At the three-month point, you will return to your OB/GYN at Steward Medical Group Women’s Health Associates for an x-ray or ultrasound to confirm that the fallopian tubes are entirely blocked. If the coils remained in place and scar tissue developed, then the procedure was effective. The Essure procedure is non-reversible.

What are the benefits of Essure (compared to other birth control methods)?

Essure offers a number of benefits when compared to other birth control methods:

  • Unlike other permanent sterilization procedures, no incisions or general anesthesia is necessary. (Many health care providers offer local anesthesia; however, even local anesthesia is not necessary with Essure.)
  • No hormones. Essure does not interfere with your body’s natural hormone production and regulation. No hormones are involved.
  • Virtually no recovery process. The procedure takes just a few minutes to complete. Patients can return home about 45 minutes after the procedure and can return to their normal activities in one to two days or less.
  • Clinically proven to be the most effective form of birth control. Essure is 99.83 percent effective.
  • Covered by insurance. Many health insurance plans cover the Essure procedure.

Schedule An Appointment for Essure in Gilbert, Mesa or Tempe, AZ

To learn more about Essure non-surgical sterilization, contact Steward Medical Group Women’s Health Associates at 480.632.2004 or schedule online.



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