engagement initiatives, sponsorship of professional organizations and trade shows of $5.4 million and increased in employee-related expenses and others of $1.6 million. Advertising and marketing expenses were $53.0 million for the six months ended June 30, 2019 compared to $39.9 million for the six months ended June 30, 2018, an increase of $13.1 million, or 33%. Including the impact from Advance Medical, this increase primarily consisted of increased digital advertising, member engagement initiatives, sponsorship of professional organizations and trade shows of $10.0 million and increased in employee-related expenses of $3.1 million.
Sales Expenses. Sales expenses were $15.8 million for the quarter ended June 30, 2019 compared to $14.6 million for the quarter ended June 30, 2018, an increase of $1.2 million, or 9%. Including the impact from Advance Medical, this increase primarily consisted of increased staffing and sales commissions of $1.1 million and an increase to other sales expenses of $0.1 million. Sales expenses were $32.0 million for the six months ended June 30, 2019 compared to $28.3 million for the six months ended June 30, 2018, an increase of $3.7 million, or 13%. Including the impact from Advance Medical, this increase primarily consisted of increased staffing and sales commissions of $3.0 million and an increase to other sales expenses of $0.7 million.
Technology and Development Expenses. Technology and development expenses were $16.7 million for the quarter ended June 30, 2019 compared to $14.3 million for the quarter ended June 30, 2018, an increase of $2.3 million, or 16%. This increase resulted primarily from hiring additional personnel totaling $1.9 million and other expenses of $0.4 million. Technology and development expenses were $32.7 million for the six months ended June 30, 2019 compared to $27.3 million for the six months ended June 30, 2018, an increase of $5.4 million, or 20%. This increase resulted primarily from hiring additional personnel totaling $4.3 million and other expenses of $1.1 million.
Legal and Regulatory Expenses. Legal and regulatory expenses were $2.0 million for the quarter ended June 30, 2019 compared to $0.6 million for the quarter ended June 30, 2018, an increase of $1.4 million, or 216%. Legal and regulatory expenses were $3.6 million for the six months ended June 30, 2019 compared to $1.7 million for the six months ended June 30, 2018, an increase of $1.9 million, or 114%. The increase in 2019 in both periods resulted primarily from increased expenses to support litigation activities.
Acquisition and Integration Related Costs. Acquisition and integration related costs, incurred primarily in connection with the Advance Medical and Best Doctors integrations, were $1.1 million for the quarter ended June 30, 2019 compared to $5.8 million for the quarter ended June 30, 2018, a decrease of $4.7 million, which primarily represents the costs associated with the acquisition of Advance Medical. Acquisition and integration related costs, incurred primarily in connection with the Advance Medical and Best Doctors integrations, were $2.1 million for the six months ended June 30, 2019 compared to $7.4 million for the six months ended June 30, 2018, a decrease of $5.2 million, which primarily represents the costs associated with the abandonment of the corporate office lease of Best Doctors and costs associated with the acquisition of Advance Medical.
General and Administrative Expenses. General and administrative expenses were $38.5 million for the quarter ended June 30, 2019 compared to $26.1 million for the quarter ended June 30, 2018, an increase of $12.4 million, or 47%. This increase was driven primarily by an increase in employee-related expenses of approximately $13.2 million resulting from growth in total employee headcount to 2,256 at June 30, 2019 as compared to 1,201 employees at June 30, 2018 primarily from the impact of the Advance Medical acquisitions. Other expenses, which include office-related charges, professional fees and bank charges, increased by $0.8 million for the quarter ended June 30, 2019 as compared to June 30, 2018. General and administrative expenses were $74.5 million for the six months ended June 30, 2019 compared to $50.1 million for the quarter ended June 30, 2018, an increase of $24.4 million, or 49%. This increase was driven primarily by an increase in employee-related expenses of approximately $17.5 million resulting from growth in total employee headcount to 2,256 at June 30, 2019 as compared to 1,201 employees at June 30, 2018 primarily from the impact of the Advance Medical acquisitions. Other expenses, which include office-related charges, professional fees and bank charges, increased by $6.9 million for the six months ended June 30, 2019 as compared to June 30, 2018, to support the growth of our business.
Depreciation and Amortization. Depreciation and amortization was $9.8 million for the quarter ended June 30, 2019 compared to $8.1 million for the quarter ended June 30, 2018, an increase of $1.8 million, or 22%. Depreciation and amortization was $19.4 million for the six months ended June 30, 2019 compared to $16.3 million for the six months ended June 30, 2018, an increase of $3.1 million, or 19%. The increase in both periods was primarily due to the impact from acquisitions. Additional amortization expenses primarily related to an increase in acquisition-related intangible assets that increased from $305.7 million at June 30, 2018 to $315.4 million at June 30, 2019 and an increase