Fertility Treatment FAQ

Q. How long should I wait before I see a fertility specialist?

A. Generally speaking, a fertile couple has a 20% chance of pregnancy per month. This means that about 90% of women will have conceived after trying for one year. If you are under thirty years of age and find yourself in the remaining 10%, you should consult a fertility specialist. Women over the age of thirty should seek medical advice if they have not conceived after six months of trying. It is recommended that women over the age of forty consult a fertility specialist at the time they decide they would like to conceive.

Q. I am over fifty. Can I still be seen for an evaluation?

A. Yes. We will evaluate female patients from eighteen years old to fifty-five years old.

Q. Can I get pregnant if I am in menopause?

A. If you are actually menopausal and want to get pregnant, you will need to consider egg donation.

Q. Do you only treat married couples?

A. No, SMF provides treatment for married and unmarried couples, same sex couples and single individuals.

Q. How long do the various treatments take?

A. This includes ovarian stimulation, ovulation and the insemination itself. In vitro fertilization (IVF) can take from 4-6 weeks for the process leading up to egg retrieval. The embryos are transferred 3-5 days later.

Q. How many embryos are usually transferred?

A. This depends on age and personal preference.

Q. What are your success rates?

A. We discuss our success rates here.

Q. When is the best time to measure urine for ovulation?

A. We recommend that urine be tested in the afternoon between 12:00 noon and 1:00 pm. measuring in the morning can yield a false positive, as urine is concentrated at this time.

Q. Do you offer male infertility evaluations?

A. We work closely with an andrologist who can perform male infertility evaluations. Please contact our office for more information.

Q. What Are The Effects of Alcohol on Fertility?

A. The data regarding the effects of moderate alcohol intake on fertility is inconclusive at this time. The largest prospective studies conducted in Europe indicate that high levels of alcohol consumption are associated with greater difficulty conceiving. One small Danish study identified a slight delay in conception even with alcohol ingestion of 5 drinks or less per week. However, this research relies on self-reporting of alcohol consumption which may be inaccurate. In many cases, the studies do not fully account for other factors that could be affecting fertility.

Don’t Overdo It
When you are attempting to conceive, taking a moderate approach to alcohol consumption is the wisest course of action. If having an occasional beer or glass of wine once or twice a week is part of your normal lifestyle, this is unlikely to have a significant effect on your ability to conceive. Drinking every day or consuming several drinks at one sitting is behavior you should avoid. High levels of alcohol can negatively affect many aspects of your health and is probably not good for eggs or sperm development either.

Alcohol and Pregnancy
If you think you might be pregnant, it’s time to stop consuming alcohol. Fetal harm from exposure to alcohol in the womb can lead to lifelong health problems. In fact, Fetal Alcohol Syndrome (FAS) caused by maternal alcohol consumption is the leading identifiable cause of neuro-developmental disorders and birth defects in babies. No “safe level” of prenatal alcohol exposure has been identified, so pregnant women are advised to abstain from alcoholic beverages altogether.

Q. Can some sexual positions boost my chances of getting pregnant?

A. No sexual position increases the likelihood of pregnancy. Neither does having the female partner stand on her head or lie with her legs up in the air after intercourse. The natural angle of the vagina promotes pooling of semen right where it is supposed to be. Changes in cervical mucus leading up to ovulation help sperm move efficiently into the uterus.

Q. Are there techniques I can use to make sure I conceive a baby that is the gender I want?

A. It is not possible to consistently select the sex of a baby through any means when conceiving naturally. It is possible to increase the likelihood of having a baby of the desired gender through sperm sorting prior to artificial insemination. The only way to be certain of selecting the desired gender is by screening embryos prior to transfer during IVF treatment.

Q. Do men need to rest up for a day or more between sexual encounters to increase the potency of their sperm.?

A. Men with normal sperm can have sexual intercourse daily. This doesn’t decrease the likelihood of a couple achieving a pregnancy.

Q. Are there pills and supplements you can take to increase female fertility?

A. There is no magic supplement that enhances fertility. No herb, vitamin, dietary supplement, or wonder food will increase your chances of getting pregnant or help you get conceive sooner.

Q. Is this true that infertility is a problem for women but not for men.

A. Actually, in 40% or more of infertility cases, it’s the male factor that is the underlying cause. This is why both partners are tested during fertility treatment.

Q. What is assisted hatching?

A. In nature, an embryo must “hatch” out of the eggshell in order to implant into the uterine wall and establish a pregnancy. Assisted hatching is a laboratory technique performed to help the embryo hatch from the eggshell. There is some evidence that hatching previously frozen embryos and those derived from frozen eggs may increase the chance for pregnancy. Risks from assisted hatching are assessed to be low.

Q. What is blastocyst transfer?

A. Embryos are incubated in the IVF laboratory for 5-6 days until they reach the blastocyst stage. Culturing embryos in the laboratory allows selection of the most viable embryos. Blastocysts are assigned a single numerical (1-4) and two letter (A-D) grades. The numerical grade denotes the expansion of the embryo; the first letter – the grade of the cells that become the fetus; and the second letter – the grade of the cells that become the placenta. The letter grades are the most important as they represent the cells that will hatch from the eggshell and lead to a pregnancy. In general embryos graded BC and above are considered viable and frozen for future transfer.

Transfer of autologous frozen blastocysts yield higher births rates that fresh blastocyst transfer.

Q. What is ICSI?

A. Intracytoplasmic sperm injection (ICSI) is a technique in which a single sperm is injected directly into an egg to increase the likelihood of fertilization.

Sperm from the male partner (or donor) is provided through ejaculation, or in the case of a vasectomy, a surgical sperm retrieval procedure. ICSI is performed by selecting the robust sperm under the microscope and injecting one sperm into each mature egg.

ICSI is most useful in cases where infertility is related to low sperm counts, poor sperm quality and for cases involving PGT and frozen eggs. Most IVF programs in the United States utilize ICSI as the sole method of fertilization.

Q. What is PCOS and how can I treat it?

A. Polycystic ovarian syndrome (PCOS) is caused by an excess of testosterone and is the most frequent cause of infertility in reproductive-aged women. Conception is difficult for women with PCOS, as most experience irregular menstrual periods, often having only a few per year. High insulin levels are another symptom that can further contribute to menstrual irregularities. Additionally, Polycystic Ovary Syndrome may increase the risk of miscarriage because of the hormonal imbalance.

Polycystic Ovary Syndrome is the most common hormonal abnormality causing infertility in women. It affects fertility by suppressing ovulation. Egg follicles may begin to mature but do not ovulate or release the egg into the fallopian tube. These follicles remain as cysts in the ovaries. In women with PCOS, the ovaries also produce excessive amounts of testosterone (male hormone) that can lead to acne and hair growth. In the fat cells, testosterone is converted to estrogen, leading to excessive buildup of the uterine lining which may contribute to heavy or irregular bleeding.

Like most medical problems that are referred to as “syndromes”, Polycystic Ovary Syndrome is made up of a cluster of signs and symptoms. Women with polycystic ovary syndrome may have some or all of the following features:

  • Irregular or skipped menstrual periods
  • Obesity and difficulty controlling weight gain
  • Male pattern hair growth
  • Acne and other chronic skin conditions
  • Dark brown or black patches on the skin

Other symptoms are oily skin, acne, facial hair growth and weight problems.

Polycystic Ovary Syndrome is diagnosed based on a patient’s history, blood testing and ultrasound examination during which doctors may identify multiple small cysts on the ovaries. Diagnosis is made by evaluating the presence of multiple symptoms and ruling out other conditions.

Fertility Treatment for PCOS

High levels of insulin associated with obesity interfere with ovulation and also worsen PCOS symptoms. Minimizing insulin resistance via a healthy, safe weight loss regimen is a common first step for patients with Polycystic Ovary Syndrome who want to make conception more likely. Insulin regulating medications may also be prescribed. Some women are able to begin ovulating more normally at this point and may be able to conceive naturally.

Fertility enhancing drugs such as Clomid, Metformin and gonadotropins may be used to stimulate ovulation. This approach is tried after other potential causes of infertility have been ruled out. In Vitro Fertilization can also be used for some women with PCOS.

For women who are not trying to get pregnant, birth control pills can regulate the menstrual cycle and control the hormonal imbalance. If necessary, other medications can also be used in combination with oral contraceptives. For women who are trying to conceive, we use medications to induce ovulation and to reduce the risk of miscarriage. Weight loss also plays an important role in treatment, as it can help restore regular menstrual periods.







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