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Category Archives: Infertility Treatment

Test required for IVF Treatment

Test required for IVF Treatment

Fertility Blood Tests

Our clinical team requests blood tests, which help us to understand how your ovaries are performing. The results allow our doctors to make the best decision as to what medication you may need.

Anti-Müllerian Hormone (AMH)

Knowledge of how you will respond to the hormone injections of an IVF treatment cycle is a very important part of fertility treatment. Depending on your own individual characteristics, you may fall into the extremes of response – an excessive response or an inadequate response.

It has been established that the AMH hormone, which is made by the ovarian follicle containing the egg, can accurately predict how your ovaries respond to fertility drugs.

This is sometimes called the ovarian reserve.

The AMH test is a simple blood test. It takes five minutes.

If the AMH concentration is high, it indicates a risk of OHSS (ovarian hyper stimulation syndrome) and we can modify our treatment to mitigate and manage this risk.

If the AMH concentration is low, it indicates that the response to traditional fertility treatment methods will be below average and your consultant will make adjustments to your treatment protocol.

Ultrasound Scan

Hospital should have state of the art ultrasound scan machines that give us clear images of the uterus and ovaries. Ultrasonography is painless and doesn’t involve an anesthetic.

The clarity of these images, allows our clinical team to easily look for any uterine problems that might exist. We continue using ultrasound technology throughout your treatment cycle to monitor your progress.

Laparoscopy

Laparoscopy is a minimally invasive surgical technique performed using an endoscope (a small device with a light on it) to view your ovaries, fallopian tubes and the outside of your uterus.

It is very helpful in diagnosing fertility issues and treating ailments such as endometriosis or ovarian cysts.

Laparoscopy and Dye

Often during the laparoscopy, the doctor will inject some dye into the cervix to observe if the dye is able to pass through both fallopian tubes or whether there is a blockage.

Saline Sonography (SIS)

The majority of our patients are required to have an SIS before fertility treatment commences. It is a routine procedure, designed to provide your doctor with as much information as possible.

SIS is an ultrasound procedure using contrast fluid – usually a salty water solution known as saline – to assess the pelvis. SIS measures the direction and length of the entrance to the womb and it also confirms that the inside of the womb (also called the endometrial cavity) has no abnormalities within it – such as polyps or sub-mucous fibroids. which could hinder the embryos from implanting in the womb. SIS may be used to confirm whether x-foam can pass through the Fallopian tubes into the pelvis and to ensure that one or more are not blocked.

 

 

For IVF Treatment,

Contact us now for,

  1. Appointment with Best IVF Specialist
  2. Second Opinion from leading IVF Specialist
  3. Cost Estimate for your IVF treatment
  4. All required details like number of days stay, procedure, etc.

You can Email to ContactLapSurgeon@gmail.com

Or Send us your details with Second Opinion Link

Or Click on WhatsApp Icon below

 

 

What couple should know before planning for children

Should know before planning for children

 

Fertility can be age related

We deferred having a baby for so long. If we had known how age impacts fertility, we could have started sooner.

Fertility gradually declines with age, in both men and women.

In women, this begins from around the age of 30. By the age of 44, the average woman has very few eggs left.

From a purely biological perspective, we recommend that couples try to start a family before the age of 35 as from then on wards fertility issues become more commonplace.

Once women approach 45, the chances of conceiving are extremely low, and associated risks are higher. There is also a higher chance of miscarriage – over 50% for those over the age of 43.

While the media will occasionally report instances of older women having children, the vast majority of these babies will be as a result of a donated egg from a younger woman.

For men, the story is somewhat similar in that fertility also declines with age. However many men remain fertile into their 50’s and beyond. However, there is a concern that children conceived by older men may have health issues.

If you are concerned about age related fertility, you should discuss the matter with your clinician. Perhaps we can blame the number of ageing rock stars producing offspring – many couples don’t realize that the age of the man can also have an impact on your chance of conceiving as a couple.

Nutrition is Important

If I had realized how important nutrition is, I’d have started eating healthily much earlier on.

A healthy diet is crucial to a successful pregnancy and a healthy baby. We recommend that couples enjoy a balanced diet and take regular exercise. The healthiest Body Mass Index for fertility is the same

as what is considered “normal weight”– a BMI between 19 and 25. Doctor recommends that females have a BMI of 30 or less before commencing treatment.

How to calculate your BMI – Log in here and enter your details

Alcohol

Drinking alcohol reduces your chances of conceiving – we never knew.

There is one simple rule with alcohol; the more you drink, the less likely you are to conceive. We recommend reducing alcohol intake for three months prior to treatment for both men and women.

For men, aside from lessened libido and possible impotence, excess alcohol consumption can lower testosterone and cause a decrease in sperm quality. If possible, alcohol should be completely removed in this period, but certainly not more than 1-2 units, weekly.

 

Smoking

I smoked for years never realizing that I was doing damage to my ovaries as well as my lungs.

The link between reduced fertility and smoking has been well established and documented. In women, smoking can damage the ovaries and it can lead to miscarriage. Smoking increases the risk of cervical cancer.

Leading research indicates that women who smoke reduce their probability of conception by 40% month after month. It also showed that smoking also causes impotency and impairment of sperm in men.

Simply put, both partners should stop smoking to maximize their chances of successful treatment.

 

 Less stress, more action

We lived with infertility, day after day, and we found it hard to take action. If we had realized how easy it is to just tackle the problem, we’d have taken action sooner and saved ourselves a lot of grief.

Be reassured that studies carried out in 2011 showed that emotional distress caused by fertility challenges or other life events during treatment will not compromise the chance of becoming pregnant.

With that said, we would recommend that couples investigate ways to relieve stress, independently and together. We can recommend some simple steps that can be very effective.

You need to understand your body

When you’re on the pill for a long time, your body has a very predictable cycle. Come off it, and things may be far from what you expect.

It can be very difficult to be told at the age of 39 that having been on the pill for a number of years, that your hormones are out of sync. It sometimes takes a number of months for the hormones and menstrual cycle to regulate. It also takes time to monitor and track your cycles so that you become attuned to your ovulation dates.

It’s not always so easy the second time around

We had one child and anticipated that the second would arrive just as easily for us.

Secondary infertility is more common than you may think. Couples may be lulled into a false sense of security and assume that ‘it’s only a matter of time, because our first child was conceived and carried to term so easily’. The key is to not postpone treatment, but to treat secondary infertility as you would primary infertility. If you are trying for more than one year, then go to see a specialist.

Wasting those precious years could lead to you compromising your ability to have a second or third baby.

One woman confessed.

“I wish we hadn’t wasted a few good years postponing treatment for the second time around”.

Although proven fertility can be reassuring, things can change after a previously successful pregnancy.

 

It can be a long road to conception

For some couples, the decision to start a family is quick – but the outcome is anything but.

Most couples really don’t think they will ever have difficulties in conceiving and so when the time is right, they begin trying. We recommend that you and your partner get a fertility check-up to make sure that there are no inhibiting factors, before you try for a baby.

It simply means that if there are fertility challenges, you allow enough time to deal with those, so that you can conceive the family that you dream of.  Unfortunately for many, the discovery of either a male or female problem may lead to a longer time delay in starting a family.

 

Sometimes you need to take a break

Fertility challenges can understandably lead to emotional stress.

Some people find taking a break from something that’s causing stress, whether that’s work, or fertility treatment, can help. While stress does not cause infertility, studies show higher levels of stress are associated with taking longer to conceive.

When you’re already on the emotionally challenging fertility roller coaster it can be hard to imagine getting into a relaxed head space, but it can make all the difference.

 

Everyone’s journey is different

Every single person has a unique set of circumstances, and their path to parenthood will take many different forms. It helps to talk about it with others – you may find it comforting to know you’re not alone, or you may get some insights that help you through to conception.

Patients often say that once they embark on the journey that they begin to feel better and more optimistic. It is important to do something about it and not to listen to the negative comment. There are many paths to having a child and once you become a parent, it doesn’t matter about the path that you took to get there.

 

For IVF Treatment,

Contact us now for,

  1. Appointment with Best IVF Specialist
  2. Second Opinion from leading IVF Specialist
  3. Cost Estimate for your IVF treatment
  4. All required details like number of days stay, procedure, etc.

You can Email to ContactLapSurgeon@gmail.com

Or Send us your details with Second Opinion Link

Or Click on WhatsApp Icon below

 

Male Fertility Issues

Male Fertility Issues

Male Fertility Testing

While millions of sperm are produced every day in the testes, its development is complex. Medications, hormone imbalances, and environmental factors can all affect production, maturation and quality of sperm.

Although usually over 40 million sperm are released at ejaculation, sperm are very small and most of the semen consists of fluid that provides nutrients and enzymes to nourish the sperm.

Just as the journey of the egg can be held up, the transportation of sperm can sometimes be a root cause for infertility.

The epididymis is responsible for the sperm’s maturation, storage and transport. Sperm gain motility and an ability to fertilise an egg, once they pass through the epididymis.

We perform an analysis of the semen to find out whether there are any obvious problems with sperm production.

This analysis measures the amount of semen produced and also determines the concentration, motility, volume and structure of sperm in the sample.

Sperm analysis helps us to identify the best form of treatment.

For the most reliable test results, and to ensure the highest sperm count for our testing purposes, we advise you to avoid any sexual activity that results in ejaculation for 3 to 5 days before the analysis.

Testing is discreet and two rooms are provided. Samples are analysed within sixty minutes. Your results are discussed during consultation with one of our clinical team or sent to your GP, depending on your preference.

DNA Integrity Testing

DNA provides the genetic instructions for all living things. It is tightly packed into the head of the sperm to avoid damage. However, in some cases the DNA becomes broken or fragmented and this can lead to reduced fertility.

Assessing DNA integrity for some people allows for better treatment selection. If the level is high, we can amend your treatment plan to reduce the impact on embryo quality.

Antisperm antibodies

Our immune systems generate antibodies to protect us, and usually sperm cells are hid- den from the immune system in the testes. However, sometimes this protective barrier can be compromised by inflammation due to mumps, testicular injury, or surgery.

As a result, the immune system sees the sperm for the first time and develops antibodies against them, affecting their quality and their ability to swim freely.

If antibodies are detected and found to impact significantly, our embryologists will use a method to separate out the good quality sperm from the poorer quality to reduce any negative impact.

In most cases, we can retrieve enough sperm to allow us to perform IVF or IUI. If the antibodies have reduced the availability of good quality sperm then ICSI will be the recommended treatment option.

 

For IVF Treatment,

Contact us now for,

  1. Appointment with Best IVF Specialist
  2. Second Opinion from leading IVF Specialist
  3. Cost Estimate for your IVF treatment
  4. All required details like number of days stay, procedure, etc.

You can Email to ContactLapSurgeon@gmail.com

Or Send us your details with Second Opinion Link

Or Click on WhatsApp Icon below

 

 

 

 

Female Reproductive Issues

Female Reproductive Issues

Endometriosis

Endometriosis is one of the most common conditions affecting women in their reproductive years. Endometriosis occurs when endometrial cells, usually found only in the womb, migrate to other areas of the pelvic cavity such as the fallopian tubes or the ovaries.

This endometrial tissue can appear as spots or patches called implants or as cysts on the ovaries and can affect surrounding tissue, causing adhesions or scar tissue.  A woman’s

 

ability to conceive might be impacted by endometriosis causing a blockage in the Fallopian tubes. It could also interfere with the ovulation function or diminish optimal conditions for the travelling egg/oocyte.

The only real way to diagnose endometriosis is by surgery or laparoscopy. Laparoscopy allows direct visualization and ideally biopsy of areas suspected of having endometriosis.

Polycystic Ovarian Syndrome (PCOS)

Polycystic Ovary Syndrome (PCOS) causes symptoms in up to 20% of women of reproductive age. In fact, it is the single biggest inhibitor of female fertility. PCOS can interfere with hormones that regulate reproduction and the ovulation process.

PCOS is easily recognized through clinical assessment, hormonal analysis and ovarian ultrasound.

PCOS does not necessarily mean difficulty in becoming pregnant, and is often treatable with a combination of medication and lifestyle changes. At Rotunda IVF, we can give you best guidance and advice in tackling the treatment of PCOS.

Ovulation Problems

The process of Ovulation is complex. There are a number of barriers to conception that you can encounter along the way. Diagnosing an ovulation problem is straightforward. It requires blood tests and, in some cases, an ultrasound scan.

Many women respond to medication that boosts the ovulation process, meaning IVF is not always required.

Blocked Fallopian Tubes

Fallopian tubes must be free and clear for a successful pregnancy. Blockage of the Fallopian or reproductive tubes account for 20-25% of fertility problems experienced by women. The most common causes are chronic infection, endometriosis or swelling of the tubes by secretion (hydrosalpinx).

If there is a tubal blockage, you will either be referred to a Rotunda IVF consultant who specializes in tubal surgery or you will be referred for IVF treatment.

Psychosexual

Sometimes, the root cause of infertility can be psychological rather than physiological. It is not uncommon for a person to lose interest in sex due to stress or lifestyle factors. Some women even experience pain during sexual intercourse.

 

For IVF Treatment,

Contact us now for,

  1. Appointment with Best IVF Specialist
  2. Second Opinion from leading IVF Specialist
  3. Cost Estimate for your IVF treatment
  4. All required details like number of days stay, procedure, etc.

You can Email to ContactLapSurgeon@gmail.com

Or Send us your details with Second Opinion Link

Or Click on WhatsApp Icon below

 

Tips to Help Get Pregnant – Women

Tips to Help Get Pregnant – Women

 

1. Eat nutritious food

Eat a healthy, balanced diet rich in nutrients. Include leafy greens, heart healthy beans, grains, seeds and whole milk products. Reduce your consumption of sugar, highly processed foods and trans fats.

2. Stop smoking

The more you smoke, the more you risk negatively impacting your ability to get pregnant. Smoking affects your oestrogen levels and ovulation. Smokers are more likely to experience early menopause and smoking can impair the quality of a woman’s eggs.

3. Avoid illegal drug use

Illegal drugs are considered to be unsafe in pregnancy and most will pass through the placenta to your baby in the womb. Some may affect the healthy development of your baby.  If drugs are an issue for you, get help. Being informed about the risks to a pregnancy will help you to make better choices.

4. No alcohol

A 2009 study done at Harvard University of couples undergoing IVF showed that women who drank more than six units per week were 18% less likely to conceive, while men were 14% less likely.

5. Have sex

Regular intercourse 2-3 times per week ensures that you don’t miss the fertile window. Some couples confine their sexual activity specifically to the time when the woman is ovulating. Try instead, to ensure that you have sex regularly through the month. Keeping sex spontaneous, relaxing and fun is the ideal.

6. Exercise regularly

Regular moderate exercise is good for your body, your weight and your stress levels.  That means that exercise may help you to get pregnant. Avoid hard-core exercise that may, if over done, impact your menstrual cycle.

7. Take Folic Acid

Take a daily dose of 500ug folic acid three months before you plan to conceive, right up to and including the first trimester of your pregnancy. Folic acid is crucial because it helps to reduce the risk of neural tube defects.

 

8. Get blood tests

Ask your GP to check for rubella and chicken pox status, blood group Rh factor, Hepatitis B and Hepatitis C.

9. Prescription medications

If you are on any medications, review their implications for pregnancy and indeed fertility with your GP.

10. Track your Menstrual Cycle

Make sure that you understand your menstrual cycle – the most fertile time is between days 8-14 of a regular monthly cycle. However, many women have irregular periods and it is important to track and monitor those cycles so that you can work with your fertility doctor to know when ovulation is likely.

11. Manage your BMI

You can work out your appropriate weight, for your height using the Body Mass Index (BMI). Evidence suggests that fertility improves dramatically if people with a high BMI can achieve a 5% reduction in weight. In fact, the ideal weight is a BMI below 30.

12. Check your Ovarian Reserve

A blood test to measure a woman’s level of Anti-Müllerian Hormone (AMH) – a hormone secreted by cells in developing egg sacs – is a good indicator of her ovarian reserve.

 

For IVF Treatment,

Contact us now for,

  1. Appointment with Best IVF Specialist
  2. Second Opinion from leading IVF Specialist
  3. Cost Estimate for your IVF treatment
  4. All required details like number of days stay, procedure, etc.

You can Email to ContactLapSurgeon@gmail.com

Or Send us your details with Second Opinion Link

Or Click on WhatsApp Icon below

 

 

 

 

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In vitro fertilization (IVF) Treatment

In vitro fertilization (IVF) Treatment

In vitro fertilization (IVF) helps with fertilization, embryo development, and implantation, so you can get pregnant.

IVF stands for in vitro fertilization. It’s one of the more widely known types of assisted reproductive technology (ART).  IVF works by using a combination of medicines and surgical procedures to help sperm fertilize an egg, and help the fertilized egg implant in your uterus.

First, you take medication that makes several of your eggs mature and ready for fertilization. Then the doctor takes the eggs out of your body and mixes them with sperm in a lab, to help the sperm fertilize the eggs. Then they put 1 or more fertilized eggs (embryos) directly into your uterus. Pregnancy happens if any of the embryos implant in the lining of your uterus.

During IVF, mature eggs are collected (retrieved) from your ovaries and fertilized by sperm in a lab. Then the fertilized egg (embryo) or eggs are implanted in your uterus. One cycle of IVF takes about two weeks.

IVF is the most effective form of assisted reproductive technology. The procedure can be done using your own eggs and your partner’s sperm. Or IVF may involve eggs, sperm or embryos from a known or anonymous donor. In some cases, a gestational carrier — a woman who has an embryo implanted in her uterus — might be used.

 

Why Should I Start IVF Treatment?

In Vitro Fertilization is typically used when couples have continuously failed in attempts to conceive and after other types of fertility treatments were not successful. IVF can be used to treat infertility caused by a number of reasons, including female ovulation disorders, premature ovarian failure, uterine fibroids, genetic disorders, blocked, damaged or removed fallopian tubes, and male infertility, such as decreased sperm count.

Women who have damaged or removed fallopian tubes can get pregnant through IVF treatment because the eggs are retrieved from the ovaries, and the embryos are transferred through the cervix — no direct need for open fallopian tubes.

For couples who hope to use an egg donor or surrogate, IVF treatment is a viable option.

 

Common IVF Terms You May Have Heard

Starting IVF treatment isn’t just about what happens at the doctor’s office — you’ve probably already realized that there’s a lot of research involved in the process. To help, here are a few common IVF terms that you may have heard, explained.

  • Blastocyst: Going through the IVF process can seem clinical, especially when it comes to what reproductive tissues and matter are called. After an egg is fertilized by sperm, it develops into blastocyst. Within five to seven days, these cells then turn into an embryo, which can be transferred to the uterus during IVF.
  • Clomid: Clomid is a commonly used fertility medication that a doctor may recommend during IVF. It encourages the body to ovulate and release an egg.
  • HCG levels: Human Chorionic Gonadotropin (HCG) is a hormone created by the body after conception has occurred. HCG can be tested for from blood or urine, and is the hormone that pregnancy tests identify to determine if conception has occurred. After an IVF cycle, your HCG levels will be checked to determine if you are pregnant.
  • IVF with PGS: Some couples choose to undergo IVF after determining they have a family or genetic history of particular diseases, syndromes or other traits. Preimplantation Genetic Screening (PGS) can be used to study each embryo and determine if it has genetic or chromosomal abnormalities before being transferred to the uterus.
  • PCOS: Polycystic Ovarian Syndrome (PCOS) is an ovarian issue that can cause irregular menstrual cycles and make it difficult for women to ovulate — a crucial part to the conception and pregnancy process. Women with PCOS do not release eggs regularly, and their ovaries often have many small cysts within. IVF is a strong option for women with PCOS, since it can help their bodies ovulate to achieve pregnancy.

 

Steps involved in IVF treatment

There are five basic steps in the IVF and embryo transfer process:

Step 1: Fertility medications are prescribed to stimulate egg production. Multiple eggs are desired because some eggs will not develop or fertilize after retrieval. A trans-vaginal ultrasound is used to examine the ovaries, and blood test samples are taken to check hormone levels.

You may need several different medications, such as:

  • Medications for ovarian stimulation. To stimulate your ovaries, you might receive an injectable medication containing a follicle-stimulating hormone (FSH), a luteinizing hormone (LH) or a combination of both. These medications stimulate more than one egg to develop at a time.
  • Medications for oocyte maturation. When the follicles are ready for egg retrieval — generally after eight to 14 days — you will take human chorionic gonadotropin (HCG) or other medications to help the eggs mature.
  • Medications to prevent premature ovulation.These medications prevent your body from releasing the developing eggs too soon.
  • Medications to prepare the lining of your uterus. On the day of egg retrieval or at the time of embryo transfer, your doctor might recommend that you begin taking progesterone supplements to make the lining of your uterus more receptive to implantation.

Step 2: Eggs are retrieved through a minor surgical procedure that uses ultrasound imaging to guide a hollow needle through the pelvic cavity to remove the eggs. Medication is provided to reduce and remove potential discomfort.

Typically, you’ll need one to two weeks of ovarian stimulation before your eggs are ready for retrieval. To determine when the eggs are ready for collection, your doctor will likely perform:

  • Vaginal ultrasound, an imaging exam of your ovaries to monitor the development of follicles — fluid-filled ovarian sacs where eggs mature
  • Blood tests, to measure your response to ovarian stimulation medications — estrogen levels typically increase as follicles develop and progesterone levels remain low until after ovulation

Sometimes IVF cycles need to be canceled before egg retrieval for one of these reasons:

  • Inadequate number of follicles developing
  • Premature ovulation
  • Too many follicles developing, creating a risk of ovarian hyperstimulation syndrome
  • Other medical issues

Egg retrieval can be done in your doctor’s office or a clinic 34 to 36 hours after the final injection and before ovulation.

  • During egg retrieval, you’ll be sedated and given pain medication.
  • Transvaginal ultrasound aspiration is the usual retrieval method. An ultrasound probe is inserted into your vagina to identify follicles. Then a thin needle is inserted into an ultrasound guide to go through the vagina and into the follicles to retrieve the eggs.
  • If your ovaries aren’t accessible through transvaginal ultrasound, an abdominal surgery or laparoscopy — a procedure in which a tiny incision is made near your navel and a slender viewing instrument (laparoscope) is inserted — may be used to guide the needle.
  • The eggs are removed from the follicles through a needle connected to a suction device. Multiple eggs can be removed in about 20 minutes.
  • After egg retrieval, you may experience cramping and feelings of fullness or pressure.
  • Mature eggs are placed in a nutritive liquid (culture medium) and incubated. Eggs that appear healthy and mature will be mixed with sperm to attempt to create embryos. However, not all eggs may be successfully fertilized.

Step 3: The male is asked to produce a sample of sperm, which is prepared for combining with the eggs. Other methods, such as testicular aspiration — the use of a needle or surgical procedure to extract sperm directly from the testicle — are sometimes required. Donor sperm also can be used. Sperm are separated from the semen fluid in the lab.

Step 4: In a process called insemination, the sperm and eggs are mixed together and stored in a laboratory dish to encourage fertilization. In some cases where there is a lower probability of fertilization, intracytoplasmic sperm injection (ICSI) may be used. Through this procedure, a single sperm is injected directly into the egg in an attempt to achieve fertilization. The eggs are monitored to confirm that fertilization and cell division are taking place. Once this occurs, the fertilized eggs are considered embryos.

Fertilization can be attempted using two common methods:

  • Insemination. During insemination, healthy sperm and mature eggs are mixed and incubated overnight.
  • Intracytoplasmic sperm injection (ICSI). In ICSI, a single healthy sperm is injected directly into each mature egg. ICSI is often used when semen quality or number is a problem or if fertilization attempts during prior IVF cycles failed.

In certain situations, your doctor may recommend other procedures before embryo transfer.

  • Assisted hatching. About five to six days after fertilization, an embryo “hatches” from its surrounding membrane (zona pellucida), allowing it to implant into the lining of the uterus. If you’re an older woman, or if you have had multiple failed IVF attempts, your doctor might recommend assisted hatching — a technique in which a hole is made in the zona pellucida just before transfer to help the embryo hatch and implant.
  • Preimplantation genetic testing. Embryos are allowed to develop in the incubator until they reach a stage where a small sample can be removed and tested for specific genetic diseases or the correct number of chromosomes, typically after five to six days of development. Embryos that don’t contain affected genes or chromosomes can be transferred to your uterus. While preimplantation genetic testing can reduce the likelihood that a parent will pass on a genetic problem, it can’t eliminate the risk. Prenatal testing may still be recommended.

Step 5: The embryos are usually transferred into the woman’s uterus three to five days following egg retrieval and fertilization. A catheter or small tube is inserted into the uterus to transfer the embryos. This procedure is painless for most women, although some may experience mild cramping. If the procedure is successful, implantation typically occurs around six to ten days following egg retrieval.

Embryo transfer is done at your doctor’s office or a clinic and usually takes place two to six days after egg retrieval.

  • You might be given a mild sedative. The procedure is usually painless, although you might experience mild cramping.
  • The doctor or nurse will insert a long, thin, flexible tube called a catheter into your vagina, through your cervix and into your uterus.
  • A syringe containing one or more embryos suspended in a small amount of fluid is attached to the end of the catheter.
  • Using the syringe, the doctor or nurse places the embryo or embryos into your uterus.

If successful, an embryo will implant in the lining of your uterus about six to 10 days after egg retrieval.

 

IVF Success Rate

The chances of giving birth to a healthy baby after using IVF depend on various factors, including:

  • Maternal age. The younger you are, the more likely you are to get pregnant and give birth to a healthy baby using your own eggs during IVF. Women age 41 and older are often counseled to consider using donor eggs during IVF to increase the chances of success.
  • Embryo status. Transfer of embryos that are more developed is associated with higher pregnancy rates compared with less developed embryos (day two or three). However, not all embryos survive the development process. Talk with your doctor or other care provider about your specific situation.
  • Reproductive history. Women who’ve previously given birth are more likely to be able to get pregnant using IVF than are women who’ve never given birth. Success rates are lower for women who’ve previously used IVF multiple times but didn’t get pregnant.
  • Cause of infertility. Having a normal supply of eggs increases your chances of being able to get pregnant using IVF. Women who have severe endometriosis are less likely to be able to get pregnant using IVF than are women who have unexplained infertility.
  • Lifestyle factors. Women who smoke typically have fewer eggs retrieved during IVF and may miscarry more often. Smoking can lower a woman’s chance of success using IVF by 50 percent. Obesity can decrease your chances of getting pregnant and having a baby. Use of alcohol, recreational drugs, excessive caffeine and certain medications also can be harmful.

The success rate of IVF clinics depends on a number of factors including reproductive history, maternal age, the cause of infertility, and lifestyle factors. It is also important to understand that pregnancy rates are not the same as live birth rates.

What are the side effects of IVF?

Like all medications and medical procedures, IVF has some risks and possible side effects. These include:

  • bloating
  • cramping
  • breast tenderness
  • mood swings
  • headaches
  • bruising from shots
  • allergic reaction to medicines
  • bleeding
  • infection
  1. Cramping and abdominal pain: Period-like cramps are common during the IVF process, along with minor abdominal pain that feels similar to your menstrual cycle. You can combat general cramps with over-the-counter pain relievers or a heat pad to reduce discomfort.
  2. Bloating: Fertility medications can heavily impact how your body retains water, leading to the dreaded side effect of bloating. This is especially common in your midsection, where fluid can build up near the ovaries (creating abdominal tenderness, too). You can combat bloating by increasing your fluid intake, and participating in light exercise such as walking.
  3. Breast tenderness: Tenderness is often felt throughout your menstrual cycle, and can be amplified by IVF medications. You can help ease this discomfort by using warm or cold compresses on your breasts (whichever feels best) or by taking a warm or cool shower. Wearing a supportive but non-restricting bra can also help.
  4. Constipation: Constipation is an unfortunate side effect that can be remedied by eating more fiber, increasing your water intake, and avoiding dehydrating beverages such as coffee and soda.
  5. Headaches and mood swings: Headaches and mood swings are common IVF treatment side effects. Over-the-counter medications can ease headaches, and while no medication can help with mood swings, knowing that they’re a normal part of IVF treatment helps. If you find mood swings are disrupting your day, be sure to seek out self-care practices such as enjoying alone time, reading a book, taking a nice bath, or sharing feelings with a friend or loved one.
  6. Hot flashes: If you suddenly feel very warm, have a flushed face, or find yourself randomly sweating, you may be experiencing a hot flash. They can appear at random during the IVF treatment process, but you can help prevent them by reducing stress, avoiding spicy foods and warm environments, and cutting back on alcohol or caffeine intake.

Your doctor can talk with you about any questions or concerns you have about IVF risks and side effects.

IVF can also be difficult emotionally, both for the person having the procedures and for their partner and/or family. Many people doing IVF treatments struggle with depression and anxiety throughout the process.

 

IVF Cost

The cost of IVF can vary greatly depending on your location, Doctor and Hospital you choose. Many couples prefer to travel to other cities with more affordable IVF treatment plans.

Other Important factors are

  • Women’s Age
  • Medical Condition of Wife
  • Medical Condition of Husband

Understanding the cost of fertility treatments can be difficult, simply because there are so many factors that impact the final bill.

Special Scenarios That Can Impact IVF Costs

Only you and your reproductive specialist can determine the best ways to utilize IVF treatments. Sometimes, that means using donor eggs or sperm, or with the help of a surrogate.

IVF Cost With Donor Eggs

In some fertility cases, it is necessary to use donor eggs. Depending on the region and clinic, this can either decrease or increase the bill for IVF treatment. Some IVF clinics claim that IVF costs with donor eggs can be dropped by up to 50 percent, partially because of the reduced medication cost and the fact that donor eggs remove the need for egg retrieval. But, how the eggs are collected and stored can make a cost difference. IVF costs with egg donation can be impacted based the clinic or donor egg bank you select.

IVF Cost With Frozen Embryos

Choosing to undergo an IVF cycle utilizing frozen embryos can reduce the IVF price tag. This is because multiple eggs are fertilized at one time, developing into embryos that can either be implanted or frozen for later use. IVF costs with frozen embryos are reduced because there is no need to retrieve more eggs, speeding up the IVF process and cutting out parts of a complete cycle.

IVF Cost With a Surrogate

Contrary to popular believe, utilizing a surrogate is common among more people than just celebrities. Surrogates allow women who are unable to carry a baby to still have children. Though, the IVF cost with a surrogate can go far beyond other kinds of fertility treatments.

IVF Cost With PGD

PGD, short for Preimplantation Genetic Diagnosis, is a form of testing done on embryos created during the IVF process to ensure there are no genetic abnormalities. PGD testing is done before embryos are transferred to the uterus, allowing doctors to select the healthiest embryos possible. Because this is an additional service, the IVF cost with PDG can increase. Some clinics will include this cost in your total cycle price, while others charge separately.

 

 

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Unexplained Infertility Explained

Unexplained Infertility Explained

The term, Unexplained Infertility is used when the sperm quality meets normal standards, the woman is likely to be ovulating regularly with a good ovarian reserve/egg supply, and a “dye test” (hysterosalpingogram) proves that the fallopian tubes are open.  Also, if the doctor suspects the answer may be within the women’s pelvis, then a surgical procedure known as laparoscopy is performed.

Approximately 30% of couples struggling to get pregnant are told that they have “unexplained infertility“. After examinations and tests, the doctor states there is no known medical reason to explain why they haven’t conceived.

An unexplained infertility diagnosis may be justified if it has been shown that,

  1. You are ovulating regularly
  2. Your ovarian reserves are good. (Evaluated with blood work and/or an antral follicle count.)
  3. Your fallopian tubes are open and healthy. (Evaluated with an HSG.)
  4. Your partner’s semen analysis is normal (including total count, sperm movement, and sperm shape.)
  5. There are no serious uterine fertility issues. (Evaluated with a hysteroscopy.)

If any of the above has not been evaluated, a diagnosis of unexplained infertility may be premature.

Reasons for unexplained infertility

1. Autoimmune Disorders

Inflammation and autoimmunity are distinct processes, though they share a common tactic: They cause the immune system to target any perceived invader, including an embryo.

Researchers have identified upward of a hundred autoimmune disorders that cause the body to mistake its own tissues for intruders. Some of the more familiar varieties — Hashimoto’s thyroiditis, rheumatoid arthritis, and celiac disease — may be linked to conception failure and recurrent miscarriage.

Some 75 percent of autoimmune sufferers are women, so an early diagnosis is key for those seeking to get pregnant. Diagnostic results, however, can take some time — an average of four years and four doctors, according to the American Autoimmune Related Diseases Association.

2. Thyroid Malfunction

Autoimmune issues involving the thyroid exert an especially potent effect on fertility. Hashimoto’s, an inflammatory response in which the body attacks the thyroid glands, accounts for 90 percent of hypothyroidism, and a 2014 study published in the International Journal of Endocrinology found that 47 percent of patients with Hashimoto’s had difficulties becoming pregnant.

Thyroid malfunction puts a woman at greater risk for anovulatory cycles, in which no egg is released, though she may still regularly get her period. Additionally, lower thyroid levels are associated with decreased sex hormone binding globulin, which can “interfere with growth and development of follicles and get in the way of proper FSH and LH [hormone] surges associated with ovulation,” according to Dana Trentini and Mary Shomon, authors of Your Healthy Pregnancy With Thyroid Disease.

3. Food Sensitivities or Intolerances

Food sensitivities trigger low-level inflammation, making them potential suspects in any case of infertility. The same is true of food intolerances, which can occur when the body is deficient in an enzyme necessary to break down certain food substances, like lactose in dairy or gluten in wheat. If you have a food intolerance, eating even a small amount of the offending food can trigger systemic immune activation, causing widespread inflammation.

4. Toxic Exposure

We’re products of our environment, and it has an impact on fertility. A 2005 study by the Environmental Working Group found 287 industrial chemicals, pollutants, and pesticides in the umbilical-cord blood of 10 U.S. newborns chosen at random. Many toxins have been shown to trigger inflammation, suppress the immune system, impair fertility, or result in pregnancy complications and birth defects.

One research study found higher blood concentrations of mercury in infertile couples. Another observed significantly higher levels of lead in the blood of infertile women. Experts posit that heavy metals damage the immune system’s ability to distinguish between the body’s own tissues and hostile invaders, creating the conditions for an autoimmune attack.

5. Chronic Stress

Chronic stress is “anything that overwhelms your body’s capacity to respond effectively to the challenges you’re exposed to,” explains Romm, and it can affect fertility by keeping the nervous system activated, triggering low-grade inflammation, and interfering with hormone production.

The pressures of infertility, of course, also contribute to overall stress loads. “The diagnosis [of] ‘unexplained infertility’ can leave people devastated and heartbroken,” says Grunewald. “It adds to the stress that could be preventing conception in the first place. There may be peace of mind in knowing what is behind your infertility, even if the news is not what you’d hoped.”

Treatment for unexplained infertility

  1. Lifestyle changes recommended (like weight loss, quitting smoking)
  2. Continue to try on your own (if you’re young and willing) for six months to a year
  3. Clomid or gonadotropins along with IUI for three to six cycles
  4. IVF treatment for three to six cycles
  5. Third-party IVF treatments (like using an egg donor or surrogate)

 

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Blocked Fallopian Tubes: Symptoms, Causes and Treatment for Fertility

Blocked Fallopian Tubes: Symptoms, Causes and Treatment for Fertility

 

Fallopian tubes connect a woman’s ovaries to her uterus, allowing an egg to travel through the fallopian tubes to the uterus. Most women have two ovaries (left and right) where your egg follicles are stored. Each month a follicle matures and it is releases an egg into the fallopian tubes. Fallopian tubes are two thin tubes, one linking to each ovary to help move the mature egg from the ovaries to the uterus. When there is an obstruction in one or both of the fallopian tubes the condition is known as blocked fallopian tubes or tubal factor infertility. This can occur on one or both tubes and is one of the main causes of female infertility.

 

Causes for Blocked Fallopian Tubes

There are a number of reasons why your fallopian tubes can be blocked:

  • Pelvic inflammation
    Pelvic inflammation is the most common cause of blocked tubes. The inflammation usually happens inside your fallopian tubes which is usually the case with sexually transmitted infections (STIs) such as gonorrhea or chlamydia. The inflammation can also occur outside your tubes due to an infection from another organ such as the appendix.
  • Blocked from birth (congenital tubal obstruction)
    A very rare condition which is present from birth.
  • Accidental damage following other surgery
    It is possible for your fallopian tubes to be blocked by excessive scar tissue from previous surgery
  • Severe endometriosis
    Fallopian tubes can become damaged or blocked in severe cases of endometriosis due to adhesions or scar tissue.
  • Endometriosis. Endometrial tissue can build up in the fallopian tubes and cause a blockage, or endometrial tissue on the outside of other organs can cause adhesions that block the fallopian tubes.
  • Certain sexually transmitted infections. Chlamydia and gonorrhea can cause scarring and lead to pelvic inflammatory disease.
  • Past ectopic pregnancy. This can scar the fallopian tubes.
  • Fibroids. These growths can block the fallopian tube, particularly where they attach to the uterus.
    Past abdominal surgery.
  • Past surgery, especially on the fallopian tubes themselves, can lead to pelvic adhesions that block the tubes.

 

Diagnosing a blocked fallopian tube

Hysterosalpingogram (HSG)

Hysterosalpingography (HSG) is a type of X-ray used to examine the inside of fallopian tubes to help diagnose blockages. During HSG, your doctor introduces a dye into your uterus and fallopian tubes. The dye helps your doctor see more of the inner fallopian tubes on the X-ray. An HSG can usually be done in your doctor’s office and should take place within the first half of your menstrual cycle. Side effects are rare, but false positive results are possible.

If the HSG doesn’t help your doctor make a definitive diagnosis, they can use laparoscopy for further evaluation. If the doctor finds a blockage during the procedure, they might remove it, if possible.

Sonohysterography

Sonohysterography is a non-invasive procedure where ultrasound imaging is used instead of the potentially more damaging x-rays. Similar to the HSG, a thin tube is placed through the vagina and into the uterus to see if there is a blockage in the tubes. The ultrasound examination can also diagnose a hydrosalpinx and other issues such as ovarian cysts, endometrial polyps and uterine fibroids. It can be carried out without a general anesthetic.

Chromotubation

Chromotubation is performed during a laparoscopy so that your specialist can see the dye spilling from the fallopian tube. The dye for this procedure is different from a HSG as it cannot be seen on an X-ray. This test is considered the most reliable way to determine if you have blocked tubes but does require surgery and a general anesthetic.

 

Blocked fallopian tubes Treatment

If your fallopian tubes are blocked by small amounts of scar tissue or adhesions, your doctor can use laparoscopic surgery to remove the blockage and open the tubes. If your fallopian tubes are blocked by large amounts of scar tissue or adhesions, treatment to remove the blockages may not be possible.

If you only have one tube that is blocked, your fertility specialist may recommend continuing trying to conceive naturally as it is still possible to conceive. If both tubes are blocked then laparoscopic surgery or microsurgery [4] may be an option to try and open one or both of the fallopian tubes. If there are only a few adhesions between your tubes and your ovaries then your chance of conceiving naturally after the surgery is good.

In some cases, if surgery is ineffective, then IVF may be an option. IVF bypasses the need for fertilization to occur in the fallopian tubes by placing an embryo directly into the uterus.

Surgery to repair tubes damaged by ectopic pregnancy or infection may be an option. If a blockage is caused because part of the fallopian tube is damaged, a surgeon can remove the damaged part and connect the two healthy parts.

Complications of blocked fallopian tubes

The most common complication of blocked fallopian tubes and treatment is ectopic pregnancy. If a fallopian tube is partially blocked, an egg may be able to be fertilized, but may get stuck in the tube. This results in an ectopic pregnancy, which is a medical emergency.

Surgery that removes part of the fallopian tube also increases the risk of ectopic pregnancy. Because of these risks, doctors often recommend IVF instead of surgery for women with blocked fallopian tubes who are otherwise healthy.

 

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Polycystic Ovary Syndrome (PCOS): Symptoms, Causes, and Treatment

Polycystic Ovary Syndrome (PCOS): Symptoms, Causes, and Treatment

Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs.

The exact cause of PCOS is unknown. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications such as type 2 diabetes and heart disease.

 

PCOS Symptoms

Signs and symptoms of PCOS often develop around the time of the first menstrual period during puberty. Sometimes PCOS develops later, for example, in response to substantial weight gain.

Signs and symptoms of PCOS vary. A diagnosis of PCOS is made when you experience at least two of these signs:

  • Irregular periods. Infrequent, irregular or prolonged menstrual cycles are the most common sign of PCOS. For example, you might have fewer than nine periods a year, more than 35 days between periods and abnormally heavy periods.
  • Excess androgen. Elevated levels of male hormone may result in physical signs, such as excess facial and body hair (hirsutism), and occasionally severe acne and male-pattern baldness.
  • Polycystic ovaries. Your ovaries might be enlarged and contain follicles that surround the eggs. As a result, the ovaries might fail to function regularly.

You’ll tend to gain weight, especially around the waist, and have a hard time losing it. You’ll often grow extra hair or have thinning hair. You may get acne or dark patches of skin. Pelvic pain and depression are also possible symptoms

PCOS signs and symptoms are typically more severe if you’re obese.

 

PCOS Causes

Doctors don’t know exactly why you get it, but some researchers think high levels of insulin are at the root of the illness. If you’re overweight, your chances of developing it are greater.

Your genes play a role, too. If your mother or sister has PCOS, you’re more likely to have it. Most women are diagnosed in their 20s or 30s. But even girls as young as 11, who haven’t gotten their period yet, can have it.

The exact cause of PCOS isn’t known. Factors that might play a role include:

  • Excess insulin. Insulin is the hormone produced in the pancreas that allows cells to use sugar, your body’s primary energy supply. If your cells become resistant to the action of insulin, then your blood sugar levels can rise and your body might produce more insulin. Excess insulin might increase androgen production, causing difficulty with ovulation.
  • Low-grade inflammation. This term is used to describe white blood cells’ production of substances to fight infection. Research has shown that women with PCOS have a type of low-grade inflammation that stimulates polycystic ovaries to produce androgens, which can lead to heart and blood vessel problems.
  • Heredity. Research suggests that certain genes might be linked to PCOS.
  • Excess androgen. The ovaries produce abnormally high levels of androgen, resulting in hirsutism and acne.

 

PCOS Complications

Complications of PCOS can include:

Obesity is associated with PCOS and can worsen complications of the disorder.

  • Infertility
  • Gestational diabetes or pregnancy-induced high blood pressure
  • Miscarriage or premature birth
  • Nonalcoholic steatohepatitis — a severe liver inflammation caused by fat accumulation in the liver
  • Metabolic syndrome — a cluster of conditions including high blood pressure, high blood sugar, and abnormal cholesterol or triglyceride levels that significantly increase your risk of cardiovascular disease
  • Type 2 diabetes or prediabetes
  • Sleep apnea
  • Depression, anxiety and eating disorders
  • Abnormal uterine bleeding
  • Cancer of the uterine lining (endometrial cancer)

 

PCOS Diagnosis

There is no single test to diagnose PCOS. To help diagnose PCOS and rule out other causes of your symptoms, your doctor may talk to you about your medical history and do a physical exam and different tests:

Physical exam:Your doctor will measure your blood pressure, body mass index (BMI), and waist size. They will also look at your skin for extra hair on your face, chest or back, acne, or skin discoloration. Your doctor may look for any hair loss or signs of other health conditions (such as an enlarged thyroid gland).

Pelvic exam: Your doctor may do a pelvic exam for signs of extra male hormones (for example, an enlarged clitoris) and check to see if your ovaries are enlarged or swollen.
Pelvic ultrasound (sonogram). This test uses sound waves to examine your ovaries for cysts and check the endometrium (lining of the uterus or womb).
Blood tests. Blood tests check your androgen hormone levels, sometimes called “male hormones.” Your doctor will also check for other hormones related to other common health problems that can be mistaken for PCOS, such as thyroid disease. Your doctor may also test your cholesterol levels and test you for diabetes.


Once other conditions are ruled out, you may be diagnosed with PCOS if you have at least two of the following symptoms:

  1. Irregular periods, including periods that come too often, not often enough, or not at all
  2. Signs that you have high levels of androgens:
    Extra hair growth on your face, chin, and body (hirsutism)
    Acne
    Thinning of scalp hair
  3. Higher than normal blood levels of androgens
  4. Multiple cysts on one or both ovaries

 

PCOS Treatment

PCOS treatment focuses on managing your individual concerns, such as infertility, hirsutism, acne or obesity. Specific treatment might involve lifestyle changes or medication.

Lifestyle changes

Your doctor may recommend weight loss through a low-calorie diet combined with moderate exercise activities. Even a modest reduction in your weight — for example, losing 5 percent of your body weight — might improve your condition. Losing weight may also increase the effectiveness of medications your doctor recommends for PCOS, and can help with infertility.

Medications

To regulate your menstrual cycle, your doctor might recommend:

  • Combination birth control pills. Pills that contain estrogen and progestin decrease androgen production and regulate estrogen. Regulating your hormones can lower your risk of endometrial cancer and correct abnormal bleeding, excess hair growth and acne. Instead of pills, you might use a skin patch or vaginal ring that contains a combination of estrogen and progestin.
  • Progestin therapy. Taking progestin for 10 to 14 days every one to two months can regulate your periods and protect against endometrial cancer. Progestin therapy doesn’t improve androgen levels and won’t prevent pregnancy. The progestin-only minipill or progestin-containing intrauterine device is a better choice if you also wish to avoid pregnancy.

To help you ovulate, your doctor might recommend:

  • Clomiphene (Clomid). This oral anti-estrogen medication is taken during the first part of your menstrual cycle.
  • Letrozole (Femara). This breast cancer treatment can work to stimulate the ovaries.
  • Metformin (Glucophage, Fortamet, others). This oral medication for type 2 diabetes improves insulin resistance and lowers insulin levels. If you don’t become pregnant using clomiphene, your doctor might recommend adding metformin. If you have prediabetes, metformin can also slow the progression to type 2 diabetes and help with weight loss.
  • Gonadotropins. These hormone medications are given by injection.

To reduce excessive hair growth, your doctor might recommend:

  • Birth control pills. These pills decrease androgen production that can cause excessive hair growth.
  • Spironolactone (Aldactone). This medication blocks the effects of androgen on the skin. Spironolactone can cause birth defect, so effective contraception is required while taking this medication. It isn’t recommended if you’re pregnant or planning to become pregnant.
  • Eflornithine (Vaniqa). This cream can slow facial hair growth in women.
  • Electrolysis. A tiny needle is inserted into each hair follicle. The needle emits a pulse of electric current to damage and eventually destroy the follicle. You might need multiple treatments.

 

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First Fertility Clinic Visit

First Fertility Clinic Visit

A visit to the fertility clinic does not have to be a daunting experience. Many couples think they are responsible for figuring out the reasons for their lack of fertility on their own (or with Dr. Google’s help). A visit to the fertility clinic does not represent a failure in this regard – it’s actually just the opposite! Seeing a fertility doctor can help to ease the stress of trying to conceive by taking the burden of medical expertise off a couple’s shoulders. Ideally, this means you can get back to trying for a baby and spend less time thinking about trying for a baby!

 

The main goal of this first appointment is to build a road map of your fertility journey: where you’ve come from and where you are headed. During the consultation, you will meet with your doctor and nurse coordinator for an in-depth evaluation of your medical history. Once the team has a strong understanding of your case, they can begin to outline diagnostic and treatment plans. This initial visit can take anywhere from 30 to 45 minutes.

 

What to bring along with you

Copies of medical records. Every piece of background information that you supply could be a vital piece of the puzzle, so having access to your up-to-date medical records is important. You can streamline this process by authorizing and arranging for each office to fax your records to the fertility clinic ahead of your visit.

  • Your primary care physician
    Your OBGYN
    Any previous fertility evaluations or treatments

A list of questions for your doctor. It is a very good idea to have your questions written down or printed out before you go into the visit. Your fertility team will be asking you a lot of questions, but it is just important that you ask yours. Having a list of questions at hand will ensure that you don’t forget or miss your chance to ask them. See below for a list of suggested questions to get you started.

A notebook to write down any instructions or details. With so much ground to cover in the first visit and the possibility of intense emotions surrounding the event, “information overload” is a common experience. Taking notes during the visit can help you process and remember important details.

Your partner, if you like. It is not necessary to bring your partner to your first visit, but they are both invited and encouraged to attend. This visit is an opportunity for your partner to be included in the process and having them there may be helpful for you and your fertility team. They can provide emotional support and will also be able to answer questions with you, offering your team extra insight into the case. They will also be able to ask questions of their own, which can help them feel supported and clear up any fears or misgivings they may have about fertility treatment.

How to prepare for First Fertility Clinic Visit

Your medical records will have a lot of vital information for your fertility specialist, but they are only part of the picture. Your own recollections and facts are also very important. Take some time to write down and organize the following information ahead of your visit.

List any medications, vitamins, herbs or other supplements you take.

  • Don’t be afraid to get detailed here. List everything, no matter how insignificant it may seem.
    Include the amount of each dose and how often you take them.

List key medical information.

  • Any medical conditions that you or your partner may have.
    Previous evaluations or treatments for infertility.
    Age of first menstruation.
    Details about your cycle. Is it regular? How long is your average cycle? Is the flow especially heavy/light? Do you suffer from PMS or especially painful periods?

List details about your attempts to get pregnant.

  • How long you have been actively trying to conceive.
    Frequency of intercourse.
    If you have been keeping records of basal body temperature, results of ovulation predictor kits, or fertility charting, this can be very helpful to bring along.

Talk to relatives about family history of infertility.

  • Check with both sides of the family. Until recently, infertility struggles were often kept very private, so unless you ask directly you may not know if your relatives experienced infertility.

Check into your infertility insurance coverage.

  • Talk to your HR representative at work and directly to your insurance company about coverage options.
    If you are near an open enrollment window with your insurance, you may be able to switch to a plan with more coverage.
    Even without insurance, there are many ways to finance fertility treatment. You may want to prepare for a consultation with your clinic’s finance specialist.

During your initial consultation

What to ask your fertility specialist. This is a list of questions to ask during your first visit. Be sure to add any of your own. This one-on-one time with your specialist is an important opportunity to get answers and set your mind at ease.

Fertility evaluation: What specific tests would you recommend to diagnose my infertility? How much do they cost? This is important information for you to bring back to your insurance company.

Diagnosis: How long will it take to diagnose our issues? Every case is different, and your physician may not have an exact answer, but they may be able to give you some idea of the timeline.

Treatment:
Based on the results of those tests, what are my treatment options?
What is the national success rate for those treatments in terms of live births? What are this clinic’s success rates?
What are the side effects and risks of these treatments?

About the clinic:
Does your clinic provide emotional counseling, or can you refer me to a counselor who deals with fertility problems?
What role does your nursing staff play in patient treatment and contact?
Where will the testing/procedures take place? On site or at a separate facility?
How many patients do you see who are in my age group? How many have my fertility problem?
What are the live-birth success rates for my age group and with my treatment options?
How is communication handled at the clinic?
What are the office hours and what number should I call with problems or questions?
Is there an out-of-hours emergency line?

Tests administered. Multiple tests are a regular part of fertility treatment, allowing your team to monitor progress throughout the process. At this first consultation, the tests are to help diagnose your fertility issues, establish a baseline for future tests, and to screen out any problems that could interfere with fertility treatments. At your first visit, you are likely to encounter the following tests:

  • For women:
    Ultrasound to assess ovaries
    Standard blood tests (to check for individual hormone levels) such as:
    FSH (follicle stimulating hormone)
    LH (luteinizing hormone)
    TSH (thyroid stimulating hormone)
    PRL (prolactin)

 

  • For men:
    Sperm sample
    Infectious disease panel before IUI (intrauterine insemination) or IVF (in vitro fertilization)

 

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