The number of couples struggling with fertility issues is larger than you think—as many as 15% of couples. Certain fertility treatments, like IVF and assisted hatching, offer hope and provide alternatives that can increase the likelihood of successful conception. If you’re considering IVF and your doctor has suggested assisted hatching, you may have heard that it increases the possibility of twins. We’re here to set the record straight and give you all the information you need to understand whether or not assisted hatching makes sense for you and your situation. 

What is assisted hatching? 

Assisted hatching can be performed as an additional step in IVF or in-vitro fertilization to increase the chances of successful embryo implantation along the wall of the uterus. The process involves creating a small hole in the shell of the embryo (zona pellucida), increasing the probability that the embryo will hatch. Hatching refers to the process of the zona pellucida thinning and cracking open so that the embryo can emerge and implant within the uterine wall. Creating a minor defect in the zona pellucida helps the embryo implant into the uterus and is believed to improve pregnancy rates. 

Who are the primary patients for assisted hatching? 

Not all patients undergoing IVF treatment should consider assisted hatching. This procedure is typically recommended for patients that have not experienced success with IVF on multiple occasions for unexplained reasons or in specific circumstances such as:

• Are 35+ years old (esp. 38+ years)
• Have mild elevations in their third day FSH levels
• Have experienced multiple failures with assisted reproductive technology
• Have embryos with unusual shells

Does assisted hatching increase the chance of twins? 

While IVF treatment on its own can increase the chance of twins, do remember that the number of embryos transferred during the treatment process directly influences the chances of twins. In plainer terms, when more than one embryo is implanted in the uterus, the potential for a twin birth increases. These days single embryo transfer is more common, which means that conceiving twins through IVF is less common. 

There is a slightly increased risk of identical twins through assisted hatching. If the defect created on the zona pellucida is not the right size it can increase the chances of having identical twins, or in some cases, decrease the chance of pregnancy. 

Do we recommend assisted hatching? 

The short answer is no, we cannot recommend this treatment process. The assisted egg hatching process has not truly been clinically-proven. According to Dr. Gelety, there has only ever been one peer-reviewed study that showed any kind of success in the procedure. This review led to the oft-thought notion now that this procedure is best for women 37 or older. However, this procedure inherently decreases the quality of the embryos, causing a higher likelihood of unsuccessful or damaging procedures. We do not endorse procedures like assisted hatching that scientifically and statistically do not produce high-quality embryos. 

According to Dr. Gelety, another gimmicky procedure offered as an add-on to IVF is preimplantation genetic testing for aneuploidy (PGT-A), which is used to test for chromosomal anomalies. Like assisted hatching, there is little scientific evidence that these additional IVF add-ons as part of the IVF process have improved a woman’s chance of getting pregnant.  In fact, PGT-A has even been proven to harm women’s chances of pregnancy. It’s also important to note that many of these add-ons like assisted hatching and PGT-A are very expensive due to the process and technology used, making them lucrative services for many clinics while not substantially increasing pregnancy odds.

What is Arizona Center for Reproduction and Endocrinology’s alternative? 

At Arizona Center for Reproduction and Endocrinology, we believe reproductive health cannot be a one size fits all approach. Rather than offering expensive, gimmicky procedures that do not have a high likelihood of success, we are committed to our patients first. This means that we will work with you to create a fertility treatment plan that considers and eliminates any problems that might be interfering with implantation. We understand that the desire to have a baby can be so strong that hopeful parents are often willing to try as many available solutions as possible, like assisted hatching. At Arizona Center for Reproduction and Endocrinology, we aim to help deserving people meet their parental ambitions with science-based, clinically-proven fertility counseling.  

When you work with our fertility specialists, we will explore alternative treatments that provide the best outcome for you and your situation. Dr. Timothy Gelety, the Director of Arizona Center for Reproductive Endocrinology and Infertility in Tucson, AZ, has helped countless people make their dreams of a child come true. Our services are open to all people regardless of their gender preference or sexual orientation because we believe every deserving person should have the opportunity to raise a child of their own. If you have any questions feel free to call us at (520) 326-0001, or if you’re ready to set up a consultation, fill out this form, and we’ll get in touch with you soon. 

Studies show that about 1 in 6 couples struggle with fertility. If you are one of the many who run into this issue, there are a few things you can do to potentially boost fertility and increase your chances of getting pregnant. While there will always be factors beyond your control, making lifestyle, diet, and behavior adjustments are a few natural and easy ways to try and increase fertility. 

Track your period

First and foremost, period tracking can help you figure out and understand your menstrual cycle better. Being aware of when your cycle occurs can also clue you in to when your body is ovulating. Just like menstruation, ovulation varies month-to-month based on environmental and internal factors like stress, diet, and exercise. By tracking your period, you will be better able to time your conception efforts more easily. 

Keep in mind that period tracking apps can’t give an exact date on ovulation, but that doesn’t mean the information isn’t useful. Period tracking apps can provide a good basis for understanding your body better. Beyond being a pregnancy aid, tracking your period has a host of benefits that we discussed in a previous blog post. 

For more accurate and detailed ovulation detection, try tracking basal body temperature, breast sensitivity, and cervical mucus. You can even purchase ovulation tracking kits at your local pharmacy.

Maintain a healthy diet

As mentioned previously, diet is one factor that impacts your menstrual cycle and ovulation. There are certain foods that you can incorporate into your diet that have been shown to increase your fertility. Eating antioxidant-rich foods may help boost fertility in both women and men. This includes foods like fruits, vegetables, nuts, and grains which are packed full of beneficial antioxidants like vitamins C and E, folate, beta carotene, and lutein.

Aside from antioxidants, be sure to incorporate healthy fats like avocado and olive oil. Avoid trans fats commonly found in hydrogenated vegetable oils, margarine, fried foods, processed products, and baked goods. Trans fats have been found to negatively impact ovulation levels. Studies have found a correlation between a diet higher in trans fats and lower in unsaturated fats and infertility for both men and women. 

For women with polycystic ovary syndrome (PCOS), following a low-carb eating plan can help improve hormone levels and increase the odds of getting pregnant. Minimizing refined carbs can help you maintain a healthy weight and lower levels of testosterone and insulin, hormones that contribute to infertility. 

Opt for full-fat dairy instead of skim and low-fat dairy products. Studies show a connection between consuming full-fat dairy and fertility. Women who had consumed one or two servings of high-fat dairy products had been found to have higher chances of getting pregnant than those who consumed low-fat dairy.

Cut the caffeine

Many of us cannot live without our daily cup of coffee, but consuming too much caffeine may make conceiving more difficult. Studies have not conclusively proven that caffeine has a direct effect on fertility, but consider limiting your caffeine intake to one or two 6- to 8-ounce cups of coffee a day to err on the side of caution. 

Avoid alcohol

Alcohol has been proven to negatively affect fertility and decrease the likelihood of pregnancy, though it is unclear how much alcohol needs to be consumed for this effect to take place. Though a few sips of alcohol here and there are okay, most doctors will likely recommend avoiding alcohol completely or at least avoiding excessive consumption. 

Exercise caution when exercising

There is such a thing as too much exercise. For women trying to boost fertility, vigorous daily exercise can decrease the body’s production of the hormones that stimulate ovary function. This can cause the ovaries to become less active and stop producing eggs and estrogen. This risk increases with exercise duration and intensity. Moderate exercises like walking, yoga and barre that are low intensity are great ways to stay active, while high-intensity exercises like running, cross-fit, and spin classes should be avoided for the time being. 

Reduce stress and increase relaxation

If you’ve been trying to get pregnant for a while, you may have felt more stressed out than normal. The added stress of trying to conceive can increase levels of cortisol, which can cause irregular cycles. Take the time to sit back and relax. Engage in more activities like meditation, deep breathing exercises, or even cognitive behavioral therapy. Find activities that help you unwind like doing yoga, watching your favorite movies or shows, drawing a bath for a nice soak— basically whatever helps you. 

Don’t be afraid to ask for help 

Although there is no singular cure-all to boost fertility, making a few lifestyle changes can increase your chances of getting pregnant. Still, many couples struggle to get pregnant at no fault of their own. Reproduction is a complicated process that requires getting the timing right in balance with other bodily systems. Sometimes, unknown factors can make pregnancy more complicated. If you have been trying to conceive without success for more than a year, you might consider seeking fertility treatment. At the Arizona Center for Reproductive Endocrinology & Infertility, we offer a wide range of services to meet every woman’s individual needs. Learn more.

When was the last time you really thought about the menstrual cycle? Our guess is high school sex ed or health class—at least until fertility became a struggle. The fact is, the menstrual cycle, which is far more than just a monthly period, plays an important part in fertility for people with uteruses.

Understanding the different phases of the menstrual cycle and knowing where you are in yours can be helpful in many ways. During your initial consultation at Arizona Center for Reproductive Endocrinology & Infertility, we’ll ask about your medical history, which includes information about your menstrual cycle, as irregularities can be a sign of a reproductive health condition that can hinder a pregnancy, like polycystic ovary syndrome (PCOS). Tracking your cycle is also important when it comes to insemination and similar procedures.

For that reason, here’s what you should know about the menstrual cycle—from its purpose to phases.

The Basics

The main purpose of the menstrual cycle is to prepare the body—specifically the uterus—for the possibility of pregnancy. Each month, follicles in the ovaries are stimulated, an ovary releases an egg, and the menstrual cycle begins. Once the last phase of the cycle ends, the first one begins again, and the cycle continues—until a pregnancy occurs or until menopause (which is the end of the menstrual cycle).

The menstrual cycle can last between 24 to 38 days, with an average length of 28 days. And it can be impacted by several factors, including age, lifestyle, health conditions, and hormonal birth control.

The Phases

Menstrual cycles can be broken into four phases: the follicular phase, ovulation, the luteal phase, and the menstrual phase.

The Follicular Phase

The follicular phase starts on the first day of your period and ends with ovulation—around 14 or 15 days later (based on a typical cycle). During this phase, the pituitary gland releases two hormones, follicle stimulating hormone (FSH) and luteinizing hormone (LH). These hormones stimulate the ovary to produce around five to 20 follicles; the first one matured is then released as an egg, or ovum. The immature follicles that haven’t developed enough for ovulation are reabsorbed and die off. While this is all happening, the body’s levels of estrogen increase, which prompts the uterine lining to thicken in preparation for implantation.

Ovulation

Ovulation is the next phase, and only lasts one day. This is when one of the ovaries releases a matured egg for possible fertilization; then fimbriae, which are finger-like tendrils along the fallopian tubes, move the egg through the tube and into the uterus. The five days leading up to and the day of ovulation are considered your “fertile window,” when chances for conception are the highest.

The Luteal Phase

The last phase of the cycle is the luteal, or secretory, phase—which lasts about 14 days. In this phase, the ruptured follicle (that released the egg during ovulation) transforms into the corpus luteum, which increases progesterone levels and thickens the uterine lining to make it a receptive home for a fertilized egg to implant itself. If pregnancy does occur, the corpus luteum will continue to produce progesterone and the implanted embryo will begin to produce human chorionic gonadotropin (hCG), which is what pregnancy tests use to determine a pregnancy. However, if fertilization does not occur during this phase, then progesterone levels will fall again and your period will start.

The Menstrual Phase

This is the time of your cycle when your period, or menses, occurs; this phase typically lasts four to seven days. Your period is a visual marker that helps you distinguish the beginning and end of ovulation. When you have your period, estrogen and progesterone levels decrease and your body sheds the uterine lining that was created during the previous cycle.

If you have any questions about your menstrual cycle, we are here to answer them! We want you to feel knowledgeable and confident in what’s happening in your body, and how it may be affecting your fertility. You can make an appointment for a consultation by calling us at 520-326-0001 or visiting us online.

You may have heard of the ‘rhythm method’ in regards to birth control, but it can be used to promote fertility as well. In fact, as birth control, it’s highly ineffective for preventing pregnancy, but when the principles are reversed—to determine your fertile window, or peak fertility days—it can be very helpful.

When couples or people with uteruses are struggling with getting pregnant and come to visit us at Arizona Center for Reproductive Endocrinology & Infertility, we always ask them about their menstrual cycles and history. With the rhythm method—regardless of how you plan to use it—it’s extremely important to keep close tabs on your cycle, and therefore can help you relay crucial information to our team.

Here’s what you should know.

What is the Rhythm Method?

The rhythm method, which is also sometimes called the calendar method or the calendar rhythm method, is a form of natural family planning. It can be used as a way to promote fertility or as a method of contraception, by helping you determine the best days to have or avoid unprotected sex. When you’re trying to get pregnant, you can use the rhythm method to determine when you’re at your peak fertility, and should be having intercourse.

(In contrast, you could also use the rhythm method to avoid pregnancy, using it to determine which days you’re most fertile and avoid having unprotected sex on those days. Some women choose to use the rhythm method if a medical reason limits their traditional birth control options, or for religious reasons. It’s important to note, however, that several factors, including medications, stress, illness, and underlying medical issues, can affect the exact timing of ovulation. This is why using the rhythm method as a form of natural birth control can be ineffective, especially if your cycle is irregular.)

How It Works

Using the rhythm method to achieve a pregnancy requires careful record keeping and persistence. For the most accuracy, you must keep detailed track of your menstrual history in order to predict when you’ll ovulate. Again, this helps you determine when you’re most fertile and most likely to conceive. This is how you’d do it:

1. Record the length of six to 12 of your menstrual cycles. Use a calendar or notebook to write down the number of days in each menstrual cycle, beginning from the first day of one period to the first day of the next period. There are also several period tracking and fertility tracking apps that can help you record these dates.
2. Based on what you’ve tracked, determine the length of your shortest menstrual cycle. Then subtract 18 from the total number of days in your shortest cycle. This number represents the first fertile day of your cycle. For example, if your shortest cycle is 24 days, subtract 18 from 24; your answer is six. In this example, the first day of your cycle is the first day of your period, and the sixth day of your cycle is the first day of your fertile window.
3. Now, determine the length of your longest menstrual cycle. Subtract 11 from the total number of days in your longest cycle. This number represents the last fertile day of your cycle. For example, if your longest cycle is 35 days, subtract 11 from 35; your answer would be 24. Again, in this example, the first day of your cycle is the first day of your period, but the 24th day is the last day of your fertile window.
4. Plan for intercourse during your fertile days.

For the most accuracy using the rhythm method, it’s important to update your calculations every month, since the length of your cycle—which affects your fertile window—can change.

Relying solely on the rhythm method to achieve a pregnancy doesn’t work for everyone—especially if your cycles are irregular or if you’ve tried to conceive for several months with no success.

At AZCREI, we want to help you realize your dreams of having a happy, healthy baby, and we have several options to help you do so. If you’d like to discuss the rhythm method as a fertility or birth control method or to get started on your fertility journey, schedule an appointment with our team by calling (520) 326-0001 or visiting us online.