Sponsored by:
For too many women, endometriosis is overlooked, and the repercussions can be physically taxing. Pain is a symptom that goes hand in hand with endometriosis – when tissue that lines the uterus grows outside where it should be – and can include pain with periods, sex and bowel movements, among other symptoms. A diagnosis isn’t easy to come by – but on a daily basis, Dr. Jason Kofinas and the Kofinas Fertility Group focus on identifying endometriosis, and helping the many women who struggle with it.
“I have seen patients that have gone through 12 IVF cycles, but no one has even mentioned endometriosis – they just keep doing it over and over,” he explains. “We take a step back and think of all the angles, and try to figure out what the problem is.”
Founded in 1987 by Jason’s father, Dr. George Kofinas, the group has achieved a number of fertility firsts, including the first in vitro fertilization procedure and birth in Brooklyn. Today, it offers a dedicated team of specialists who develop comprehensive, individualized treatments for each new patient.
Dr. Jason Kofinas has seen many endometriosis patients come to him without a diagnosis. The vast majority are surprised when he mentions endometriosis, and a significant number have never even heard of it. Fortunately, the Kofinas Fertility Group prides itself on getting to the root of the issue and ultimately finding a solution.
How is endometriosis diagnosed?
The biggest problem that Dr. Kofinas has encountered with endometriosis is how difficult it can be to diagnose. Doctors can try to diagnose their patients through an ultrasound or MRI that would potentially show endometriosis lesions or cysts on the ovaries, but there still isn’t a good test that will tell a patient with absolute certainty, short of moving onto laparoscopic surgery.
“Laparoscopy is the gold standard of diagnosing endometriosis,” says Dr. Kofinas, “but if they have had an ultrasound or MRI that definitely shows endometriosis lesions or cyst on the ovary, then they have a presumed highly likely diagnosis, which requires treatment.”
Kofinas Fertility Group uses a first-of-its-kind reproductive surgery center that tackles 12 to 18 endometriosis surgeries a week, with four out of the five surgeons alone specializing in endometriosis. Dr. Kofinas has a team-first approach that has allowed for safer, more efficient delivery of care, and better outcomes.
“The surgical aspect of fertility training has gone away, and a lot of fertility doctors are unable to sufficiently treat endometriosis surgically,” he explains. “So what ends up happening is they either attempt IVF as a way to bypass the problem, or they have a referral surgeon who they send a patient to, not a fertility surgeon.”
How does endometriosis affect fertility?
Many doctors believe that IVF will overcome every case of endometriosis, and also that endometriosis always affects a patient’s egg quality. Dr. Kofinas wants to dispel these myths – he’s had patients who have had both endometriosis and good embryos, and there isn’t a clear-cut thesis on how endometriosis affects a woman’s egg quality.
“Endometriosis can affect implantation of an embryo, it can increase risk of miscarriage, and it can also increase the risk of third-trimester complications if not treated before initiating pregnancy.”
Dr. Jason Kofinas
What happens after the surgery for women trying to get pregnant?
The chance of pregnancy can increase naturally if there are no other issues, and the chance of pregnancy loss decreases, depending on the patient’s age and health of ovaries. Yet every woman is different, and there is a spectrum of options for each patient to consider after the surgery. An IUI (intrauterine insemination) is a more mild approach to fertility, and patients have also seen success after surgery. A patient might try three to four months of IUI before moving on to IVF. As Dr. Kofinas puts it, “You cannot generalize and apply to every single patient. You have to go with the risk and benefits every time you make a decision.”
Helping women who have experienced multiple failed transfers and pregnancy loss is something that Dr. Kofinas and his team are passionate about – getting to the root of the specific problem, and identifying why it keeps happening. “If there is a recurring issue and outcome, you can’t just not address an obvious problem,” Dr. Kofinas says. Even though genetic testing of the embryo before the transfer is now available during IVF, there are still a lot of variables: “Far too often, these anatomic lesions are ignored.”
In an area of health care that deserves a brighter spotlight, the Kofinas Fertility Group can help women with endometriosis identify their specific issues, problem-solve and increase their chances of growing their family. For more information, visit Kofinasfertility.com.