Dr. Tina Koopersmith, fertility physician and founder of the West Coast Women’s Reproductive Center in Southern California, is a renowned fertility specialist and reproductive endocrinologistwith more than two decades of helping thousands of women facing a variety of fertility challenges realize their dreams of conceiving children. Dr. Koopersmith is a Board-certified fertility doctor in both Obstetrics and Gynecology, as well as and Reproductive Endocrinology and Infertility. In 2019 Dr Koopersmith became board certified in Integrative Medicine and she is also pursuing training and certification in Functional Medicine.
Dr. Koopersmith’s clinical areas of expertise include fertility, recurrent loss, premature ovarian failure and polycystic ovaries. In addition to providing fertility services, she also specializes in gynecologic disorders, especially hormonal disturbances in young girls with difficulty during puberty and reproductive age women with irregular cycles.
Latest Advancements in Treatment Options
While leading-edge fertility practices and treatments are the hallmark of the West Coast Women’s Reproductive Center, you’ll find that Dr. Koopersmith’s approach is unique in the level of caring and compassion she brings to all of her patients.
About Dr. Tina Koopersmith
Raised by a surgeon (her dad) and a teacher (her mom), Dr. Koopersmith followed in her parents’ footsteps, fueled by a strong desire from a young age to not only fix things and make life better for others, but also by a passion for teaching and explaining complicated information in a way that is both accessible and easily understandable.
Together We’ll Find A Way
When you are treated by Dr. Koopersmith and her hand picked staff of outstanding fertility doctors and administrative staff, you’ll find that any question you have will be answered, any concern addressed, and you will be educated and empowered to be healthy, inside and out, and to be all that you want and can be.
We look forward to meeting you, learning about you, and helping you to be healthy and happy. To schedule an appointment you can call the West Coast Women’s Reproductive Center at (818) 616-9277 or make an appointment online.
Check Out Some Videos!
Dr. Tina Koopersmith consults reality star Tami Roman on fertilityReality stars, Tami Roman & Reggie Youngblood discuss their fertility options with The Doctors and fertility specialist Dr. Tina Koopersmith.
About The West Coast Women's Reproductive Center
Uterine Surgery related to Infertility • WCWRCUterine issues are quite common but frequently can be corrected surgically.
Common uterine problems include polyps or fibroids. Adenomyosis is a condition where the glands from the inside of the uterus( endometrium) grow down into the uterine muscle.
Birth defects such as a duplicated uterine cavity also affect reproduction. Sometimes there are 2 uterine cavities separated by muscle, (a bicornuate or a didelphic uterus). This may affect pregnancy outcome but is not surgically corrected and is less likely to be associated with infertility or miscarriage. IF the division in the uterine cavity is avascular (fibrous tissue only), it is called a septum and seems to markedly increase the percentage of miscarriages. This septum can easily be cut during an outpatient surgery.
For many uterine issues, physicians often use hysteroscopy to see inside the uterus. In order to remove polyps or fibroids, trained physicians can perform a laparoscopy or laparotomy where we remove the growth through incisions. For more information on potential surgical procedures, please see our other videos.
Infertility Hormonal Treatments • WCWRCHormonal treatments are used to help women ovulate or to help them “super-ovulate”, ovulate more than one egg.
Women who do not ovulate spontaneously and have normal estradiol levels are traditionally prescribed Clomiphene Citrate, or Clomid. This medicine is a partial estrogen and partial anti-estrogen. Since 2003, stronger anti-estrogens, the aromatase inhibitors such as Letrozole, have become increasingly popular for ovulation induction. For women who don’t ovulate spontaneously, 80% will ovulate with clomiphene and 50% will conceive. Clomiphene Citrate is associated with multiple follicle growth, so twins and triplets may occur, 20% of pregnancies may be multiples. This medicine can have side effects such as hot flashes, sensitivity to light, headaches and mood swings.
Also sometimes the cervical mucus is drier and thicker and sometimes the inside of the uterus doesn’t grow as thick as it should. Letrozole seems to have less side effects, is more likely to make more than one follicle, and the cervix and endometrium are less affected. In comparison studies, letrozole is as good as and maybe more effective than clomid for inducing ovulation. Letrozole has less birth defects compared with clomid in one comparison study. Both medicines are pills taken for 5 days after the start of a period. The pills are started between day 2 and 5. Dosage starts at one pill and can be increased in subsequent cycles to 2 pills or 3 pills as needed. Ovulation typically occurs one week after the last pill but may be later than that. For heavier women a higher dose or longer dose for up to 7 days may be the initial dose. For those with associated high testosterone levels, sometimes a low dose steroid, dexamethasone, can be added to the regimen to increase fertility. Insulin sensitizers such as metformin can also be added.
When oral pills do not directly induce follicular growth, the next step has been ovulation induction with injectable pituitary hormones including FSH or a FSH/LH combination. The oral medications work by “tricking” the pituitary to produce more FSH to stimulate the ovary to make follicles. When this stimulus isn’t strong enough, the injectables provide the FSH directly to the ovary. These are usually successful but may produce multiple follicles. If there are too many follicles and the risk of multiple gestations is too high, then the cycle needs to be cancelled or converted into an IVF cycle where all the eggs can be removed and then we control how many embryos get transferred back in.
Depending on the individual, doctors may use a combination of pills and shots that ultimately has a cost advantage and may work better than pills alone.
Factors that may directly impact the success of these treatments are weight, diet and exercise. Weight is the biggest impediment to successful OI, especially with pills. A low calorie diet along with weight loss may help improve the odds of success. . A diet which included whole fat dairy is beneficial to fertility as is a plant based diet heavy in fruits and vegetables. Vigorous exercise may also improve a woman who was sedentary to ovulate. Of course some women don’t ovulate because they exercise too much. For some, weight loss is needed, however, for others weight gain, especially in body fat, is needed to ovulate.
It is ultimately extremely important to discuss your individual situation with your doctor to create the best treatment option for you to produce your ideal results.
Fertility Semen Analysis • WCWRCWhen evaluating a man’s fertility, a semen analysis is vital to determine basic male fertility factors.
A semen analysis is done by collecting semen in a cup and evaluating the semen for:
• How much semen is produced?
• What is the PH level of the semen?
• How thick is the composition of the semen?
• What color is the semen?
• How long does the semen take to liquefy?
After analyzing the semen itself, it is important to then analyze the sperm’s characteristics. 50 million/mL sperm in each ejaculation is considered average. Anything below 20 million is considered low. Once the number of sperm is determined, the sperm’s mobility is then analyzed along with its physical characteristics. These characteristics ultimately determine abnormal sperm count.
Based on Strict Kruger Morphology, 96% of abnormal sperm is considered acceptable; as long as 4% is normal it should be able to properly fertilize an egg. It is important to analyze these factors in order to determine a man’s fertility and discuss different options with a doctor to choose the best fertility option for you and your partner.
One Baby Is Better • West Coast Women’s Reproductive Centerhttp://womensreproduction.com/ivf-one-baby-is-better.php
At West Coast Women’s Reproductive Center, we encourage our patients to have one baby at a time due to the health benefits to both the child and mother, as well as the emotional benefits to the entire family.
To improve a woman’s chance of having one baby through IVF, ideally one embryo is placed into the uterus. In women under the age of 35 the odds are higher that one embryo will implant in the uterus through IVF.
In older women, the statistical chance of an embryo implanting is lower, so physicians will often implant more than one embryo in hopes that one will attach to the uterine wall and begin to grow.
Singleton pregnancies typically last longer, average is 39 weeks, making it a healthier pregnancy for both the mother and child. One baby at a time also makes it easier to raise the child. The divorce rate rises with multiples due to the difficulties of managing more than one child at a given age.
Twin pregnancies are associated with earlier delivery dates, more time in the ICU and a higher chance of learning disabilities. At the West Coast Women’s Reproductive Center we ensure that our fertility patients are aware of all of these factors when we are working together to develop a successful conception plan.
Embryo Freezing • West Coast Women’s Reproductive Centerhttp://womensreproduction.com/embryo-freezing.php
As couples begin to age (or potentially have medical issues), some couples begin to prefer embryo freezing to ensure that embryos are stored (rather than just eggs or sperm) for a higher success rate of having a child.
Egg freezing is not always very successful; therefore, embryo freezing is one of the better alternatives to ensure having a child in the future and embryo freezing with genetic testing will most likely provide the highest chance for success.
At West Coast Women’s Reproductive Center (WCWRC) we recommend embryo freezing only if you and your partner are sure that you want to start a family together, otherwise we recommend egg or sperm freezing to eliminate ethical dilemmas later.
No matter what your situation is, it is important to express your needs and concerns to your doctor to evaluate the best option for you and your partner.
Egg Donor • West Coast Women’s Reproductive Centerhttp://womensreproduction.com/ivf-egg-donor.php
Once IVF became a successful technique, the concept of egg donation followed shortly after.
Egg donor IVF requires three people: the egg donor, the intended mother and the intended father. Unlike sperm, it is more involved to collect eggs. Oocyte retrieval is first required from the egg donor.
To improve chances of success, ovarian stimulation with fertility drugs is started so that more than one egg is grown in the egg donor. The recipient is then given estrogen while the donor takes the fertility medications. After the eggs are harvested and joined with the intended father’s sperm, the recipient adds progesterone to the estrogen regimen. The embryo is then placed in the recipient’s uterus 5 days post retrieval. Any extra embryos can be frozen as insurance.
With improvements in egg freezing, egg banks are now starting to store frozen eggs and this is another option for finding an egg donor. The egg donor still takes the fertility drugs and undergoes the oocyte retrieval. The eggs will be flash frozen on the day of retrieval. If eggs are stored, then there won’t be a need to synchronize the 2 women’s cycles. Eggs will be purchased, the recipient’s uterus will be prepared for transfer and on a set date, the eggs will be thawed and fertilized. 5 days later, the embryos will be transferred.
Should the couple decide to use Preimplantation Genetic Diagnosis (PGS), the embryos will be genetically screened and refrozen for transfer later.
WCWRC is here to evaluate your options with you and determine the best option for you and your partner in relation to egg donation.
Fibroids and how they affect fertility • WCWRCA fibroid is a non-cancerous tumor of smooth muscle, usually found in the uterus. Fibroids are extremely common in women.
Fibroids can be inside the cavity. If this is the case, the fibroid is removed using a hysteroscopy to see inside the cavity.
Some fibroids are partially in the cavity and partially in the uterine muscle wall. We also try to remove these using a hysteroscope. Sometimes only part of the entire fibroid can be removed with this method.
When analyzing a fibroid, we examine several factors to determine the potential impact on the patient’s fertility, including amount, size and location, and if the cavity is distorted. Also what is the history of the fibroid.
Much like real estate, location and size are extremely important. Depending on the situation, larger fibroids that are completely in the muscle layer of the uterus are not always removed. Large fibroids that distort the cavity are more likely to have a detrimental effect on fertility and may need to be removed. However, serosal fibroids that are located outside the uterus do not need to be removed for fertility.
The West Coast Women’s Reproductive team is happy to answer any questions you may have about your fibroids. If you are suffering from infertility, we can work with you to develop your treatment plan to ensure your greatest chance of conception.
Fallopian Tube factors related to Infertility • WCWRCIn order for us to see a picture of your uterus and your fallopian tubes, we use a Hysterosalpingogram (HSG).
Typically, the HSG is performed in a Radiology Center where X-ray dye is used to see inside the uterus. The uterus and tubes are imaged with fluoroscopy. With the ultrasound, we can get a better view of the inside of the uterus (see saline infusion sonogram) compared with the traditional HSG. And by adding a mixture of saline and air we can check for tubal patency. We can also visualize the space behind the uterus utilizing this technique. In this manner, we can perform the HSG without X-ray dye and without a trip to the radiology center. For more information on this type of procedure, please see our other videos or contact our office.
Infertility Diagnosis & Treatment • West Coast Women’s Reproductive Center
AMH Testing • West Coast Women’s Reproductive CenterAMH levels are one of the first things a doctor should be testing when a woman is inquiring about her fertility because it tells the doctor and her patient how many eggs she has in her ovaries.
AMH levels are determined through a blood test that can be done on any day during your menstrual cycle. AMH is made by primordial follicles, or eggs that are not yet ready to respond to hormones, grow, and ovulate. The higher your AMH level, the more eggs in reserve you have that will grow into mature eggs some day.
Extremely high AMH levels suggest there are many small eggs in those ovaries, The high level of AMH may inhibit ovulation. Women with high AMH levels respond exuberantly to fertility medications, they are “hyper-responder”. Low AMH indicates that few eggs in the ovaries, these women often don’t respond well to fertility medications, meaning only a few eggs grow even with strong fertility medications. Doctors utilize your AMH levels to determine dosing and protocols of fertility stimulation medications to try to maximize your response during treatment. AMH levels DO NOT correlate directly with PREGNANCY LEVELS. We know how important getting pregnant is and we want to be here for you on your journey towards successfully starting a family.