Category: Female Fertility

Infertility: What to Expect

infertility treatmentsYou’ve just gotten an infertility diagnosis from your doctor, and you probably have a wealth of questions. What does it mean? What can you do? What’s next? What kind of infertility treatments are available? Discover answers here.

Here, we’ll discuss what to expect following your diagnosis. First, we’ll define infertility as being unable to achieve pregnancy after one year if a woman is under 35 years of age, and after six months if a woman is over 35 years of age. Women who can get pregnant but are unable to stay pregnant may also be infertile.

Don’t Panic!

Being diagnosed as infertile does not definitively mean that you will never have children. It only means that it can be more difficult or timely for you to do so. It’s important to keep in mind that human beings are the most inefficient mammals when it comes to reproduction. In any given month, a perfectly healthy couple (good eggs and sperm, a healthy uterus and open fallopian tubes) only has a 15-20% chance of conceiving.

But don’t give up hope!

Infertility Treatments

Many women don’t want to wait it out, especially older women. Whether you’re 35 or older, or if you’re simply ready to start exploring your options for infertility treatments sooner than later, there are many treatment options to choose from, ranging from basic to advanced ones. Basic treatments include:

  • Timed intercourse
  • Ovulation induction
  • Intrauterine Insemination (IUI)

More advanced fertility options include:

  • In vitro fertilization (IVF)
  • A frozen embryo transfer (FET)
  • Genetic testing (PGT)

The causes of infertility vary widely, so it’s important to consult a fertility specialist in order to narrow down which infertility treatments may be best for your situation.

Be Kind to Yourself!

It’s an emotionally taxing experience to struggle with pregnancy. There is nothing that can make you feel more alone, exhausted, frustrated, and all-around stressed out than trying to conceive without success. It is a disappointment that can’t be described unless you have experienced it. It’s normal to feel anxious during this trying time.

What Helps Along the Way?

Here are some coping mechanisms to help you through:

  • Journaling
  • Read inspiring success stories
  • Take turns carrying the burden with your partner
  • Talk about it. Seek support from those you trust.
  • Feel your feelings – you’re allowed to be frustrated and disappointed during the lows of trying to conceive. Let yourself be sad, and then pick yourself back up.
  • Focus on what you do have – like a spouse or family member who is willing to stand by you during this hardship.
  • Believe in the “impossible.”

Vios is Here to Support You Every Step of the Way!

Pregnancy isn’t always the journey you expected. Sometimes it takes longer than you’d hoped to get pregnant, especially if age or physical issues are factors. It is never too early to get a reproductive check-up. You should be empowered to ask questions and get answers sooner rather than later. In other words, there’s nothing wrong with getting checked out no matter where you are in the process of trying to conceive.

At Vios Fertility Institute, our mission is to help our patients find their way to fertility health and treatment with the highest chance of success by providing them with innovative, scientific, cutting-edge treatment options along with an unparalleled patient experience.

Fertility health, infertility treatments, and starting with a new medical practice all lead to many questions. We’ve compiled a list of the questions we get most frequently. Hopefully, these will help set your mind at ease. If you still have questions before you are ready to schedule an appointment or come in for your first appointment, just let us know. We are here to support you every step of the way!

If you still have questions, or if you’re ready to start getting some answers, schedule your consultation today!

Infertility Emotional Support: How to Find Emotional Balance

Infertility emotional supportDo you need infertility emotional support? It is normal to experience a wide variety of feelings and emotions during the pursuit of getting pregnant. At first there’s excitement and hope and even acceptance when it’s not happening for the first few months. Then, doubt, fear, frustration, anger, and sadness start to creep in as the months wear on without conceiving, or even worse – with the experience of a miscarriage.

Once the emotional rollercoaster turns into a state of constant stress, your chances of conception lower even more. We know it’s very challenging, that’s why we are here to offer infertility emotional support and recommend actions to help with your emotional wellness during your journey.

Common Emotions with Infertility

At Vios Fertility Institute, we understand how difficult dealing with infertility can be. All of our patients (and even some of us) have experienced the stress and fear that comes with the possibility of not being able to conceive when all you want to do is have a baby.

If you’re feeling any of the following emotions, we want you to know that it is okay to have these feelings and there is infertility emotional support help available to see you through this tough time.

  • Overwhelming stress
  • Frustration
  • Sadness
  • Fear
  • Anger
  • Jealousy
  • Emotional (and physical) fatigue
  • Constant worrying
  • Inability to concentrate
  • Disappointment
  • Doubt
  • Hopelessness
  • Shame; feelings of failure
  • Depression
  • Feelings of isolation

Keep reading to learn how infertility emotional support can alleviate your emotional and spiritual concerns (which also help with physical well-being too!).

How to Find Emotional Balance

Finding emotional balance can be easier said than done, but it is imperative to creating a physical environment that helps you conceive and have a healthy pregnancy. Following these practical and calming recommendations can provide a more emotionally balanced journey.

1. Learn Your Options

One of the first things we recommend to ease your mind and put hope back into your days is learning about your fertility options from a fertility doctor. If you’ve been trying to conceive for six months to a year without success, speaking with a specialist about your options will alleviate worry and take a huge load of uncertainty off your shoulders.

You can research fertility options online all you want, but until you know your specific options based on your medical profile and history and the possible costs involved, it will be hard to put your mind at rest.

Often, couples avoid seeing a doctor because they assume fertility treatments automatically mean IVF and that they can’t afford treatment. There are many affordable options available long before we even consider IVF.

At Vios Fertility Institute, we hear it all the time, “We wish we had talked to you sooner!” There is palpable relief when our couples know they have help and a plan. And that relief lessens the stress, allowing for a more favorable environment for conception.

2. Communicate

Communication with your partner, friends, and family about how you’re feeling will go a long way to feeling less isolated, minimizing the self-doubt and self-blame that adds to your fear, and alleviating loneliness and frustration.

If you are sad, afraid, or hopeless, it’s important to tell someone and share that burden. You’re not “bothering” your partner or your best friend – when we love people, we want to be there for them and help them. Don’t be afraid to communicate.

If you’re feeling really low and unable to cope, we recommend seeing a therapist. There can be an amazing sense of relief when speaking with a professional who can give you coping mechanisms and objective emotional support.

3. Set Boundaries

It’s also important to set boundaries with everyone. Kindly ask those who continually ask about your pregnancy status to stop asking and giving advice. Let them know you appreciate their excitement and will share your news with them when you’re ready.

4. Find an Infertility Emotional Support Group

This option may not be for everyone, but it can be a tremendous comfort to have someone in a similar situation to talk to and share experiences with. Support groups can be found on social media, at church, or by searching online for a local group near you.

5. Acupuncture

If you have been trying to conceive, acupuncture may be helpful in nurturing and increasing the chance of conception during fertility treatments. Treatments can focus on a variety of issues that may be preventing conception, such as stress, immune system weaknesses, hormone imbalances, and more.

6. Emotional and Spiritual Activities

We know it’s easy to say, “Take time for yourself!” But finding 10-20 minutes a day to meditate, do yoga, take a walk, and just disconnect from the stimulus of our busy lives is vital to good emotional, spiritual, and physical health, and ultimately – conception. One way to ensure that you get “me-time” is to schedule it as if you would schedule a meeting or a doctor’s appointment.

Despite how it feels, it’s important not think about down-time as selfish or slacking – the most successful people in the world all schedule “me-time.” The goal is to calm the mind-chatter that never seems to stop and allow room for healing.

If you choose to walk, take deep breaths and concentrate on the world around you – the trees, the birds, the landscape or architecture – and try to stop thinking about work or having a baby.

At first, it’s really hard to stop the chatter but after many days of consistency, you will be able to push your thoughts to the side and say to yourself, “I’ll think about that in 20 minutes,” and revel in this precious time that gives your brain and your body a break.

If you wish to learn guided meditation, there are many wonderful apps that can ease you into it and help you learn how to let go, even if it’s for ten minutes at a time. And, this becomes very handy once you have that little bundle of joy!

Whether you’re sitting in a yoga pose officially meditating, taking a hot bath and reading a good book, or getting out in nature, the release for your brain and body is like having a clamp around your midsection removed allowing you to breathe again. Your hormones will benefit dramatically from this daily break, often creating little blips of joy and priming your body for the opportunity to conceive.

Resources & Support

Are you already starting to feel better? We’re certain that if you learn what your specific fertility options are and create a plan, keep communication open and set boundaries for those around you, connect with a support group or a friend going through the same thing, and take time daily to meditate and/or get a little exercise, your emotional state can improve and so will your chances of conceiving.

Our goal at Vios Fertility Institute is to provide resources and support to reduce the stress associated with the infertility journey from a medical, emotional, and financial perspective.

Contact us today to schedule an appointment and learn about your options so you can rest easy.

Fertility Preservation & Fertility Options After Cancer Diagnosis

fertility preservationRecently, I was thinking about Breast Cancer Awareness Month, and I thought I would take a moment to answer some important questions when it comes to fertility after cancer and about fertility preservation.

Did you know that breast cancer is the most common cancer affecting women with 1 in 8 women developing breast cancer at some point in their lives? It is also the most common cancer among reproductive aged women with about 15% of breast cancer cases occurring before the age of 40. Given how common breast cancer is, it is very likely that you or someone you know will be diagnosed with breast cancer at some point. As a fertility doctor, whenever I hear “cancer,” I always think about life AFTER cancer as up to 91% of women diagnosed with breast cancer are still alive at 5 years. (1)

How does chemotherapy affect fertility?

Well, it depends on the kind of chemotherapy being used. In general, the most common chemotherapies used for breast cancer age the ovaries by about 10 years. The earlier you are when you start the chemotherapy, the more likely you will be able to conceive after chemotherapy, but there is no guarantee. The BEST option to ensure future fertility is to freeze eggs or embryos for use later which is called fertility preservation.

How long does fertility preservation take?

At Vios, we make oncofertility patients a priority and will make sure any cancer patient can get in to see a Vios provider within 24-48 hours. After the initial consult, we can usually start the process growing eggs to freeze or fertilize within 1-2 days of seeing a patient and finish the process in as soon as 2 weeks. We understand the importance of moving forward with cancer treatment as quickly as possible, so we do everything in our power to minimize the delay before moving through with treatment.

What is involved in fertility perservation?

Preserving fertility for the future involves freezing either eggs or embryos for use later through the process of IVF or in vitro fertilization. In a normal menstrual cycle, women start to grow numerous eggs each month and 1 or maybe 2 eggs grow bigger than the rest and are chosen to be ovulated. When we do IVF, we try to get as many eggs as possible to grow and we take them out of the body just before ovulation.

To get the eggs to grow, we give medications called gonadotropins in the form of injections in the belly. There are usually multiple injections a day for about 2 weeks until the eggs get to the point where they are ready to be taken out of the body. An egg retrieval is done under anesthesia (so you are asleep) using a vaginal ultrasound probe with a tiny needle attached. The needle goes through the wall of the vagina and directly into the ovary, so you will not notice any incisions when you wake up. The eggs are floating in fluid in the ovary so we remove the fluid with the needle and give the fluid to the embryologist who identifies the eggs under the microscope.

If we are planning on freezing eggs, we do so within hours of the retrieval. If we are planning to make embryos, we use sperm from the patient’s partner or a sperm donor to attempt to fertilize the eggs. We find out how many eggs fertilized the day after the retrieval and we watch the eggs that do fertilize (now called embryos) for up to 7 days to see if they can make it to become a blastocyst which is the stage where we freeze the embryos. An embryo that makes it to the blastocyst stage has the best chance of becoming a baby, but is not a guarantee of a baby.

Some women/couples choose to do genetic testing of the embryos to see if the embryos have normal chromosomes which further increases the chance the embryo will be a baby, but still does not guarantee success.

What is the difference between freezing eggs and freezing embryos?

When we are doing an egg retrieval, we have the option of removing eggs and freezing them immediately or attempting fertilization and creating embryos. If eggs are frozen, they will need to be fertilized in the future before they can become an embryo and then a baby. In order to fertilize eggs, we need to have a sperm source.

Whenever a retrieval is done, we get a certain number of eggs, but not every egg that is retrieved is a good egg. We can only work with mature eggs. Of the eggs that are mature, we expect about 70% of them to fertilize and about 50% of those eggs that fertilize to make it to the blastocyst stage where the embryo can be frozen or transferred. At each stage in the process, you lose quantity, but gain quality.

When you freeze eggs, we expect about 90% of the eggs to survive when we thaw them. After thaw, we still expect around 65-70% to fertilize and 50% to make it to the blastocyst stage. Now, those numbers are averages and you never know how many embryos are going to make it to become a blastocyst until you attempt to fertilize them. It is recommended that a woman freeze 15-20 eggs for each child that she desires (again averages).

On the other hand, when we fertilize the eggs immediately after retrieval and create embryos, we will know how many eggs fertilize, how many made it to the blastocyst stage, and the quality of those embryos which allows us to predict much better the chances those embryos could become babies. While you may need 15-20 eggs for a good chance of a baby, you might only need 2-3 embryos if they are good quality embryos. Embryos also survive the freezing and thawing process a little better than eggs and it is expected that 95% of embryos frozen will survive.

If a woman has a partner with whom she would like to create embryos, it is generally recommended to create and freeze embryos rather than eggs because we will know up front if the eggs fertilized normally and have a better idea of the chance of pregnancy in the future

I have a lot of expenses right now, how much will this cost?

For many women/couples who are interested in infertility treatment, they have time to save up funds in order to pay for the treatment, but this is not usually the case with cancer patients. Moving forward with fertility preservation usually needs to happen rapidly so that cancer treatment is not delayed. Fortunately, there are many programs available to help with the costs. LIVESTRONG and EMD Serono both have programs to help cancer patients obtain fertility medications for FREE. These programs do require an application and verification of the cancer diagnosis, but the applications are processed quickly and do not require too many hoops to jump through. Those programs may not cover all the medications needed for fertility preservation, but they do cover most of them.

At Vios Fertility Institute, we offer deeply discounted fertility preservation treatments. Our financial team can also work with patients on payment plans or loan options depending on the situation. We do not want cost to be the reason someone chooses not to pursue fertility preservation.

Can I just do IVF or fertility treatments after I have my cancer treated?

You can absolutely pursue fertility treatment after cancer treatment, but because the cancer treatment can age the ovaries, you may be less likely to have success if you wait until after the cancer is treated. It is impossible to know for sure how much your fertility will be impacted by cancer treatment. Some women are able to conceive spontaneously after treatment, but others, even those who were very young when they had treatment, may never be able to have genetic children even with aggressive fertility treatment.

There is Hope and Help for Fertility Preservation

If you or someone you know has recently been diagnosed with cancer and has any desire to have a child or children in the future, I encourage a consultation with a fertility specialist BEFORE cancer treatment. You are under no obligation to pursue any kind of fertility preservation treatment, but a fertility specialist can make sure that you have all the information you need to make the best choice for you.

To schedule an appointment at Vios Fertility Institute, you can call 866.258.8467 or reach us on our website at viosfertility.com.

References

  1. Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomized trials. Early Breast Cancer Trialists’ Collaborative Group (EBCTCG). 2005, Lancet, pp. 365:1687-717.

 

How to Get Pregnant

how to get pregnantThe answer to the question, how to get pregnant, may seem like an overly obvious, but how does a woman get pregnant? The human body is wonderfully complex, and conception is full of tiny, intricate steps that are contingent on many factors – from getting the timing just right to having all the components in working order to create life as we know it.

To understand how to get pregnant and how pregnancy occurs, it’s important to know how a woman’s menstrual cycle ties into the whole process of conception. It will help you to better understand how to calculate when you’re ovulating, the process of fertilization, and implantation, too!

A Woman’s Menstrual Cycle: 28 Days Explained

The menstrual cycle is the monthly hormonal cycle a female’s body goes through to prepare for pregnancy. Your menstrual cycle is counted from the first day of your period up to the first day of your next period.

how to get pregnant

The average menstrual cycle takes about 28 days and can be broken down into two parts:

First, the Ovarian Cycle which includes:

  • The follicular phase
  • Ovulation
  • The luteal phase

And second, the Uterine Cycle which consists of:

  • Menstruation (Period)
  • The poliferative phase
  • Ovulation
  • The secretory phase

Additionally, there are four major hormones involved in the menstrual cycle:

  • Follicle-stimulating hormone (FSH)
  • Luteinizing hormone (LH)
  • Estrogen (E2)
  • Progesterone

The Ovarian Cycle

The Follicular Phase

This phase starts on the first day of your period. During the follicular phase of the menstrual cycle, the following events occur:

  • The pituitary gland (area of the brain that produces hormones) produces FSH which signals the ovaries to prepare an egg to be released.
  • Depending on your age, several follicles (the “shell” that contains the egg) begins to grow.
  • Halfway through the follicular phase, the lead (largest) egg becomes the dominant follicle and continues to mature and begins to release E2.

Ovulation

During a 28-day cycle, ovulation occurs during the midpoint of the cycle on day 14. For women with longer or shorter cycles it takes place 14 days before the start of their next period. During the ovulation phase:

  • Rising E2 levels from the dominant follicle triggers a surge in the production of LH in the brain.
  • Approximately 24-36 hours after the LH surge, the egg is released or ovulated from the ovary into the fallopian tube.
  • Once the egg is released there is a 12-24 hour window when it can be fertilized by sperm in the fallopian tube.

The Luteal Phase

The luteal phase of the menstrual cycle begins right after ovulation.

  • After it releases its egg, the empty follicle develops into a new structure called the corpus luteum, which secretes the hormone progesterone in preparation for a fertilized egg to implant.
  • If conception has occurred after intercourse has taken place, the fertilized egg (embryo) will travel through the fallopian tube to implant in the uterus and the woman is now considered pregnant.
  • If the egg is not fertilized, it will dissolve and progesterone and E2 levels drop in preparation for menstruation to start.

The Uterine Cycle

At the same time the ovarian cycle is taking place, the uterus is cycling through different stages that support conception.

Menstruation & the Proliferative Phase

Menstruation and the proliferative phase occur at the beginning of your cycle during the follicular phase of the ovarian cycle.

  • If the egg is not fertilized or the embryo doesn’t implant in the previous cycle, your next cycle starts with menstruation. Your period is the shedding of old blood and uterine tissue that wasn’t needed to support a pregnancy.
  • The proliferative phase is the time after your period ends before ovulation occurs when the uterine lining (endometrium) thickens to support a potential pregnancy conceived during this cycle.

Secretory Phase

Following ovulation, the endometrium secretes chemical messengers.

  • PGF2a and PGE2 are two prominent prostaglandins chemical messengers that cause the uterus to cramp and help trigger your period when fertilization doesn’t take place.
  • If an embryo implanted, prostaglandins production is inhibited so that the uterine lining isn’t shed.
  • How Long Does It Take to Get Pregnant? What Helps?

For those wondering how to get pregnant, most couples – on average – conceive within six months to a year, with about 80% of couples getting pregnant after six months of trying. That makes human beings one of the most inefficient mammals when it comes to reproduction! For more info, read our blog article Getting Pregnant: How Long Does It Take?

If you’re planning for a family, there are certain things that help – a balanced diet, exercise, and other healthy habits like not smoking and keeping stress levels down – to positively impact your fertility health and increase your chances of conceiving. For more info, check out our blog article on how to get your body ready for pregnancy.

There are also some apps that we recommend, helping track your periods, fertility, and more:

Vios Cares About Making Your Dreams of Parenthood Come True

Conceiving can take time. If you’re under 35 and have been trying to conceive for at least one year (or want more than one child) or if you’re over 35 and have been trying to conceive for six months, you should seek a fertility consultation. Additionally, if you have irregular periods you should seek consultation immediately, regardless of the time you’ve been trying to conceive.

At Vios Fertility, our team approach is to educate and bring awareness to your fertility health while helping you navigate the journey and make your dreams of parenthood a reality. If you are concerned or just want to know your fertility status contact us today to schedule an appointment.

What is Female Infertility?

What are Female Infertility Causes?

female infertility causesAs you research infertility, you have undoubtedly come across many answers to your questions about female infertility causes and still, you keep searching. Wanting a baby and not getting pregnant or being able to carry a child to full term can be devastating and life-altering, and lead to an unrelenting stressful search to “fix it.” Hopefully, after reading this, you will gain some peace of mind and can make a plan to ease the burden you’re carrying.

If you have been trying to conceive for over a year and you are under age 35, if you are over age 35 and have tried for six months, then you would be classified as having infertility. Furthermore, if you have known medical, menstruation, female organ issues, or male reproductive issues that may be impeding your success, you might also have an infertility diagnosis.

Infertility on the Rise

If you are struggling to conceive, you are not unusual. Millions of couples – at least 1 in 6 – have trouble conceiving. In fact, infertility is on the rise and is not just related to age, though that does play a factor.

There are many misconceptions out there about infertility and treatments; our caring fertility doctors at Vios Fertility Institute are here to help you understand the facts of female infertility and female infertility causes. Then, we are here to assist you with growing your family.

Factors That Affect Fertility

Many couples are waiting until their careers and finances are sound before starting a family, which usually means starting later in life, into their 30s and even early 40s. As we age, egg quality diminishes, as does the strength of our reproductive organs. However, waiting does not signal an end to fertility – it just may take longer to conceive.

Medical factors that play a part in female infertility include ovulatory disorders, polycystic ovary syndrome (PCOS), endometriosis, ovarian failure or primary ovarian insufficiency “POI,” recurrent pregnancy loss, and other medical issues.

Lifestyle factors such as being overweight or obese, smoking, excessive drinking, high levels of stress, diet and nutrition, and not exercising or getting quality sleep also play a large part.

With the help of your doctor or fertility specialist, medical and lifestyle factors can be addressed, managed, and in many cases, overcome for a successful pregnancy.

Fertility Myths

“Infertility” is such a final-sounding word, but dealing with infertility does not mean you cannot have a baby. It means you have issues that need to be addressed in order to conceive. We’ve listed some common myths and misconceptions here, but for more thorough information, download our “Common Misconceptions About Fertility” document to help ease your mind and give you hope moving forward.

I’ve been pregnant before, so I’ll get pregnant again – Just because you and/or your partner have had children previously does not mean your systems are functioning 100% properly in order to conceive again. The CDC estimates that 11% of couples have what’s called “secondary infertility” or difficulty getting pregnant despite having had a child previously. Infertility affects men and women, so we recommend you both get tested.

All the women in my family get pregnant at the drop of a hat – Whether your mother or grandmother had children easily or did not have children easily does not automatically guarantee the same results for you. Genetics are a good guide but not the be-all, end-all of what you will experience.

Smoking doesn’t matter that much – Recent research has found that smoking can be associated with up to a 40% lower fertility rate in both sexes. In fact, it is estimated that 13% of infertility in the United States is caused by smoking! We know that smoking prematurely ages eggs and decreases egg count, even in very young women. If you quit, fertility can improve.

Sex several times a week means we should be pregnant – This is not a guarantee that you will get pregnant. Women ovulate once a month and the egg can only be fertilized for ~12-24 hours after ovulation, so there is a very short window of time when the sperm and the egg can meet. The best time to have sex to maximize pregnancy is on the day of or day before ovulation which occurs about 2 weeks prior to your expected period. Sperm can actually stay in the female reproductive tract for up to 5 days, so it’s always better to err with intercourse before ovulation rather than after ovulation. There are ovulation calendars/apps and predictor kits that can help pinpoint your timing.

Age doesn’t matter anymore – Though it’s true that age is not as big of a factor as before (thanks to fertility treatments), women are born with all the eggs they are ever going to have and once they are gone, they are gone. Because of exposures to such things as radiation, chemicals, smoking, and alcohol, eggs can be damaged as women live their lives which increases the risk of chromosome problems (like Downs Syndrome) as women age. Fertility treatments are MOST effective when they are begun early. Many women who are in their 40s will actually require eggs from a younger woman (in her 20s) for a successful pregnancy

There are other myths out there, like the fact that when you see a fertility doctor, he or she will automatically jump to IVF. This is most certainly not true, and in fact, it’s usually a last step after trying other options.

Infertility is not just a woman’s issue. Many men have fertility issues as well.

There is Hope and Help for Fertility

If you’ve been trying to get pregnant for six months to a year without success or the ability to carry a baby, then it might be time to meet with a fertility specialist. Thankfully, in our wonderful world of science and technology, the majority of couples who see a fertility doctor and work together on solving infertility, succeed.

If you have questions about why you can’t get pregnant, female infertility causes, and would like to learn more about the many options in the fertility process, contact us today to schedule an appointment. Our experienced, caring physicians at Vios are here to help.

Miscarriage and Recurrent Pregnancy Loss

recurrent pregnancy lossWhen most women think of fertility specialists, they about difficulty conceiving a pregnancy, but fertility specialists (also known as Reproductive Endocrinology and Infertility Specialists) also see women who can get pregnant but have difficulty staying pregnant because of miscarriage or recurrent pregnancy loss.

Egg Health

As women age, the number of eggs in their ovaries decreases and the quality of those remaining eggs can also decline. Eggs that are less healthy have a higher chance of fertilizing incorrectly, leading to an embryo that has either too many or too few chromosomes to produce a viable pregnancy. This change in the eggs over time is why miscarriage risk goes up with the age of the woman. The risk for miscarriage is approximately 25% of pregnancies in women age 35-39, 50% in women age 40-44, and as high as 90% in women 45 or older.

Diagnosing Recurrent Pregnancy Loss

Because having one miscarriage is so common, the diagnosis of recurrent pregnancy loss (RPL) is made after a woman experiences two or more miscarriages that are far enough along to either see the pregnancy with an ultrasound or confirm the pregnancy by looking at the tissue under a microscope. This means that very early, or biochemical, pregnancies that stop developing before this stage don’t technically count toward making the diagnosis of RPL.

If a woman is diagnosed with recurrent pregnancy loss, it’s important to have a thorough evaluation done to check for preventable reasons for the miscarriages and improve the chance that the next pregnancy will be healthy. Some of the tests that may be done include blood tests for genetic, autoimmune, or hormonal issues as well as a 3D ultrasound of the uterus to check for any anatomic problems like a uterine septum or scar tissue in the uterus. If an infection of the uterus is suspected, testing for that will be recommended as well. It is also important to screen the male partner for certain genetic or sperm quality concerns that may be contributing to the pregnancy losses.

October is Infant and Pregnancy Loss Awareness Month and a good opportunity to discuss miscarriage openly. It is not something to be ashamed of or kept secret. In fact, once the miscarriage conversation is started, you realize how many women have been affected. Having a miscarriage can be incredibly difficult emotionally and having multiple miscarriages can feel devastating. It is important to know that help is out there and many reasons for miscarriage are treatable. Most women will go on to have a successful pregnancy! The first step toward success is seeking help.

There is Hope and Help

If you have questions about recurrent pregnancy loss and miscarriage and would like to learn more about the many options in the fertility process, contact us today to schedule an appointment. Our experienced, caring physicians at Vios are here to help.

Nutrition and Fertility

pregnancy dietIf you are currently trying to get pregnant or planning to try for pregnancy in the next several months, it’s time to start thinking about your nutrition. A healthy pregnancy diet can improve your chance for pregnancy as well as shorten the time it takes to get pregnant.

Importance of Body Mass Index

By now we have all heard that having a normal body mass index, or BMI, gives you your best chance for getting pregnant and your lowest risk for miscarriage. What you may not know is that regardless of your BMI, making healthy dietary changes can still have a very beneficial effect.

Standard American Diet

Unfortunately, most Americans eat what is called the Standard American Diet that includes high amounts of meat, dairy products, and processed foods while consuming too few fruits, vegetables, and whole grain carbohydrates. Over time, this type of diet and can lead to chronic inflammation throughout the body that is thought to be the starting point for many diseases. The Standard American Diet has led to not only obesity, cancer, heart disease, and type 2 diabetes, but can also contribute to fertility problems in men and women.

Choosing the Best Pregnancy Diet Food

There are a few simple changes that you can make that can start you on the path to better health and improved fertility.

  • Increase your consumption of whole grains like whole wheat bread, quinoa, and brown rice
  • Add more fruits and vegetables to your plate and try to mix it up so you get a wide variety of colorful food for maximum phytonutrients
  • Try to get most of your daily protein from vegetables (yes, veggies have protein!) or low mercury-containing fish rather than from meat and dairy
  • Avoid processed foods and choose healthy snacks like nuts instead
  • Limit refined sugar and simple carbohydrates like white rice and white flour
  • Eliminate sugary beverages! This includes soda, sweetened tea or coffee drinks, and juices
  • If you’re craving a treat, 2 small squares of dark chocolate per day is good for you!

Prenatal Vitamins

Now of course one final thing to mention is the importance of starting a prenatal vitamin a few weeks before you conceive. Starting your vitamin early means that you will have the best chance for adequate folic acid levels to reduce the risk for certain birth defects that can start developing before you even know you’re pregnant.

Check my Instagram discussion of fertility nutrition and wellness @healthyfertilitymd

Common Causes of Infertility

causes of infertilityAccording to The American Society for Reproductive Medicine, infertility is defined as the inability of a sexually active couple who are not using birth control to get pregnant after one year of trying, and for women who are 35 or older, that window shortens to 6 months. Causes of infertility can be due to the woman, the man, by both the woman and man, or due to unknown problems.

Out of the 15% of couples that have trouble getting pregnant, female infertility affects about 10% of women of reproductive age and approximately 7% of all men.

Common Causes of Infertility in Women

The most common cause of infertility in women is due to ovulation disorders, accounting for about 1 in 4 infertile couples. Every month during the female menstrual cycle, an egg is released from the ovaries into the fallopian tubes in a process called ovulation. Prior to being released, follicles – each containing an immature egg – in the ovaries must grow and develop into mature eggs. While a woman’s body has many immature follicles, each month only one becomes the dominant follicle that matures and is released during ovulation. For conception to be achieved, ovulation must occur.

If you have an ovulation disorder, you may have irregular or absent menstrual periods, meaning there is no egg (or an immature egg) available to be fertilized.

PCOS

Polycystic ovary syndrome (PCOS) is the most common cause of infertility in women and is responsible for 70% of infertility issues in women who have difficulty ovulating. The condition is caused by problems with the regulation of reproductive hormones that results in a series of small cysts on the ovaries. PCOS is defined by an erratic menstrual cycle, meaning your periods can be irregular or even no period at all for a few months at a time. According to the PCOS Foundation, 10 percent of women of childbearing age are affected, but less than half are diagnosed.

The ovulation-inducing oral medications clomiphene citrate (also known as clomid) and letrozole are the principal treatments used to promote ovulation. For women not responsive to these medications, even with diet and lifestyle modification, there are additional treatment options available such as stimulating the ovaries to produce eggs with follicle-stimulating hormone (FSH) injections followed by an intrauterine insemination (IUI) or in vitro fertilization (IVF).

POI

Problems in the ovary can also cause ovulation disorders, such as with primary ovarian insufficiency (POI), in which a woman’s ovaries stop functioning normally before she is 40. It’s less common than PCOS, affecting 1 in 100 women younger than 40, and the main cause is from hormonal imbalances. The first sign of POI is usually menstrual irregularities or missed periods. Additionally, some women with POI have symptoms like those experienced by women who are going through natural menopause.

For patients diagnosed with POI, the most common fertility treatment includes donor eggs. For young patients who are beginning to experience the symptoms of POI, fertility preservation may be an option.

Endometriosis

Endometriosis is a disorder where uterine lining tissue develops outside of the uterus on the pelvic organs. The uterine lining continues to function like it would in the uterus by thickening and breaking down with each menstrual cycle. However, this displaced tissue has no way to exit your body which leads to pain, adhesions, and scarring. Endometriosis can affect the fallopian tubes, ovaries and other pelvic tissue which can affect your chances of conceiving. This can also disrupt the implantation of a fertilized egg in the uterus.

For women with endometriosis, there are different treatment options based on the severity of their disorder. It is also important to note that endometriosis may worsen with time and a consultation with a fertility specialist at a younger age can help guide the patient on their chances of success as they age.

Common Causes of Infertility in Men

Causes of infertility in men is usually due to deficiencies in the semen, such as low sperm production, abnormal sperm function or blockages that prevent the delivery of sperm. The following are some common male fertility conditions:

  • Varicocele – The most common (and reversible!) cause of male infertility is varicocele – a condition of swollen testicle veins that is present in about 15% of all men and in about 40% of infertile men.
  • Klinefelter Syndrome – a chromosomal defect that occurs in males early in the womb that results in smaller testes which reduces the levels of testosterone and sperm production that naturally occurs.
  • Immune infertility related to antisperm antibodies – when the immune system mistakes sperm for a harmful intruder cell and tries to destroy them is considered the cause of infertility in roughly about 20% of infertile couples.

There are several ways in which a male’s sperm production can be considered abnormal, the most common being:

  • Oligospermia – when there is a low concentration of sperm in the semen. Often, exhibiting a higher percentage of abnormal sperm cells.
  • Azoospermia – when there is no measurable level of sperm in the semen.
  • Necrospermia – when the sperm is either immobile or dead.

While published statistics tend to focus on the woman, it is important to note that male infertility diagnoses are just as common. In most cases, there is no obvious sign that a man is infertile without testing.

Unexplained Causes

Approximately 1 in 4 fertility challenged couples will be told there is no explanation for why they can’t conceive. It may be important to note, however, that in many cases, the odds of conceiving on your own may be higher than it is for most infertility diagnoses.

At Vios Fertility, Conception is Our Life

At Vios, we are here to make your dreams of parenthood come true. Not being able to conceive a child can be stressful and frustrating, but a number of infertility diagnostic tests and treatments are available. We work with you to show you your chances of success utilizing different treatment plans based on your specific medical situation. During your consultation, we will discuss your goals for family building, your medical history, and review needed fertility testing to determine the best treatment path for you.

To understand your specific options concerning fertility diagnosis and treatment paths, schedule a consultation today.

Am I Fertile?

Fertility and Ovulation

fertileFertility is defined by the ability of a woman to conceive and bear children through normal sexual activity. Ovulation, on the other hand, refers to the actual day in a woman’s menstrual cycle when pregnancy is possible and occurs when hormone changes trigger an ovary to release an egg. A woman’s fertile window varies but is generally the day an egg is released from the ovary (ovulation) and the five days beforehand.

So, how do you know if you are fertile? The odds are with you because only about 12% of women have trouble getting or staying pregnant, according to the National Center for Health Statistics. However, it can be hard to know your fertility until you try to conceive. Here are some things that can give insight into your fertility health:

  • Your age – a woman’s fertility declines with age. Fertility is at it’s peak when we’re young adults with average fertility declines starting in the mid-30s and ending with menopause.
  • Regular menstrual cycles – show hormones are in sync and you are ovulating.
  • Healthy teeth and gums – research show those with gum disease take longer to conceive and good dental health reduces risk of miscarriage.
  • Pelvic pain – long heavy, painful periods or pelvic pain could be a sign of fibroids or endometriosis which can affect your ability to conceive. Pelvic trauma or past surgeries can also affect fertility.
  • Unchecked STDs – pelvic inflammatory disease (PID), a byproduct of certain STDs, can damage your reproductive organs and increase your risk of infertility. Practice safe sex, and if you think you have an STD, see your doctor right away for treatment.
  • Healthy lifestyle – eat a healthy diet, get good exercise, lower stress, don’t smoke, and limit alcohol intake to help improve your fertility.
  • Healthy weight – a body mass index (BMI) that is too low can cause ovulation to stop as the body tries to conserve energy. A BMI that is too high can disrupt hormone levels. Insulin resistance can inhibit ovulation and affect egg quality as well as embryo/fetus development. A healthy BMI range is from 20-24.

Also, knowing about ovulation and the changes in a woman’s body will give clues about the best time to conceive. Here’s how you can recognize the signs that can indicate when you’re ovulating:

  • Cervical mucus – More estrogen causes cervical mucus to become stretchy and clear, like egg whites. This helps sperm survive and swim. After ovulation, cervical mucus becomes stickier and thicker.
  • Abdominal pain – A mild ache or pain in the lower abdomen that comes on suddenly, usually on the side of the ovary releasing the egg, called Mittelschmerz. This can occur just before ovulation when follicle growth stretches the ovary or when the follicle ruptures and the egg is ovulated.
  • Breast soreness/tenderness – This usually begins around ovulation and is caused by the rush of hormones.
  • Light spotting or discharge.
  • Increased sex drive

Some women find it helpful to use a fertility calendar to track their fertile days and ovulation. We recommend Glow, Fertility Friend, or Clue, apps for fertility and more. Other tracking tools are over-the-counter ovulation predictor kits like those made by Clearblue. These kits are designed to detect increased hormone levels in urine and signal when you’re most fertile.

Let’s Talk About Infertility

What is infertility? Infertility affects about 10% of women aged 15 to 44 and is defined as the inability of a sexually active couple who are not using birth control to get pregnant after one year of trying, according to The American Society for Reproductive Medicine.

For women who are younger than 35 and aren’t pregnant in a year or for women who are 35 or older and aren’t pregnant in 6 months, plan to see a fertility specialist. Around 85% of couples who are trying will be pregnant within a year, so if you can’t get pregnant now, it could be a sign that something medical is preventing you from conceiving and you may need extra help to achieve your goals of a family.

Of all cases, infertility can be due to the woman (33%), the man (33%), by both sexes, and due to unknown problems (33%), approximately.

The best way to know if your fertile is to get a fertility checkup to check your hormone levels and egg health.

At Vios, Conception is Our Life

Just as each individual is unique, the same is true of their fertility.  During your consultation, we will discuss your goals for family building, your medical history, and review needed fertility testing to determine the best treatment path for you.

To understand your specific options concerning fertility diagnosis and treatment paths, schedule a consultation today.

How Does Age Affect A Woman’s Ability to have a Baby?

Age and Fertility

age and fertilityWhen you are trying to conceive, it can be daunting to look at the charts that indicate your chances of getting pregnant in your 20s, 30s, and so on. But how do age and fertility go together to really affect a woman’s ability to have a baby?

“Your biological clock is ticking” is an unwelcome statement most women have heard at some point during their life. Unfortunately, your ticking clock is based on clear data and time will run out. However, just how much one’s chances fall as one ages can be unexpected. The undeniable truth is that age is the most significant factor that affects a woman’s fertility and chance to have a healthy baby, and it affects men too!

Best Years

A woman’s best, physical reproductive years are in her 20s. During this time, she has a 25-30% chance of getting pregnant each month. Even though the 20s are prime time for a woman’s body, that isn’t always the case when it comes to being ready to have a child. In fact, an increasing number of women are choosing to wait to have children.

In fact, when the Centers for Disease Control studied birth rates in 2016, they found that “rates for older women continued to rise, resulting in a higher birth rate for women aged 30–34 than for women aged 25–29 for the first time since 1940 when the data became available.”

Even though, most women reach peak fertility between the ages of 23 and 31, your chances of conceiving in your early 30s are only slightly lower than in your late 20s.

So, while a woman’s fertility starts to decline in her early 30s, that decline doesn’t start impacting most women until it begins to speed up after age 35. That means there is a big difference in try to conceive in your early 30s compared to your late 30s.

The Dreaded Decline

It’s a pretty well-known fact that age 35 is a significant milestone for women when it comes to fertility and starting or growing your family. By age 40, the chance of getting pregnant every month drops from 25-30% in your 20s down to just 5% every month, with about 25% of women over 35 experiencing difficulties becoming pregnant.

What Aging Does to The Body’s Reproductive System

For women, the number of eggs you’re born with are all the eggs you get. That set number of eggs age with you throughout your lifetime and decrease in quality and total amount over time. A newborn baby girl is born with 1 to 2 million eggs and by puberty, that number goes down to about 250,000-500,000 eggs. By early to mid-30s, a woman has around 25,000 eggs left. Just as leading a healthy lifestyle can slow the decline of egg quality, bad habits can age eggs faster. Unfortunately, you can’t reverse the damage once it’s been done.

As men get older, it is a decline in testosterone that affects fertility. Male fertility generally starts to decline around age 40 to 45 years of age. The volume, quickness (motility), and overall quality of the sperm declines as men age. While the decline of male fertility is subtler, it still presents increased risks for the health of the child.

Chance of Conception Decreases While Risks Increase

It’s important to understand the increased complications of advanced maternal age and be as proactive in addressing and mitigating these risks the best way possible. We know aging reduces the overall chances of pregnancy and increases time to pregnancy (how many cycles it takes to conceive), but aging on both the man and woman’s parts can negatively affect your pregnancy and the baby’s health.

Genetic abnormalities increase as the age of the parents rises, leading to a higher chance of miscarriage as well as pregnancy-related complications like an increased risk for an ectopic pregnancy. The rates of gestational diabetes, and high blood pressure. Furthermore, c-sections also increase for those over 35 compared with mothers in their 20s. Additionally, complications for the baby, including preterm birth, poor fetal growth, low birth weight, and neonatal mortality increase with advanced maternal age. Most significantly for aging men, fathers aged 40 or over are at increased risk of having children with mental health and developmental disorders.

Understanding YOUR SPECIFIC Risks

While this all may sound scary, it is important to note every couple is different. Try to keep in mind that most healthy women over the age of 35 have healthy pregnancies and healthy babies. A consultation with a board-certified OB/GYN or reproductive endocrinologist (REI) will help you understand your specific risk factors based on a comprehensive overview of your medical history and overall health as a couple. Your physician can also review additional steps (like lifestyle changes) or tests (like genetic testing) that can be done to increase your overall chances for a successful outcome.

Ready or Not, You Have Choices

As with all things pregnancy-related, fertility is different for each individual woman, but experts say that women age 35 and older need to get serious if they want to have children and especially if they want more than just one child.

If you aren’t ready for children as you approach that 35-year milestone, you do have options if you still want children one day. Some women choose to freeze their eggs. This option literally freezes the eggs at the age the woman is at retrieval. With egg freezing you can pursue other goals without giving up your dreams of parenthood! While there are more options available the younger a woman is, women over 35 still have choices about building a family. A consultation with a fertility expert can give you more information on options that might be the right fit.

Help If You Need It – Vios Cares About Making Your Dreams of Parenthood Come True

Our mission, at Vios Fertility Institute, is to help our patients find their way to fertility health and treatment with the highest chance of success by providing them with innovative, scientific, cutting-edge treatment options along with an unparalleled patient experience.

Contact us today to schedule an appointment,  and we can discuss options for achieving your ideal family!