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Reframing Sex Selection in IVF

importblogger on December 9, 2022

Sex selection has become a popular topic amongst couples desiring children. Families seek sex selection for many reasons, including family balance and wanting to ensure that their child is healthy. At Arizona Center for Reproductive Endocrinology and Infertility, we offer sex selection services through PGD and PGS.

Preimplantation genetic diagnosis (PGD) and preimplantation genetic screening (PGS) are types of genetic testing that can be performed on embryos before implantation.

In this article, we want to open up a discussion about sex selection and dispel some of the myths that surround it. We’ll also give a more in-depth explanation of PGS and PGD and how sex selection factors into those procedures.

The history of the sex selection process

The first baby conceived through in vitro fertilization (IVF) was born in 1978. Eleven years later, in 1989, embryologist and geneticist Alan Handyside pioneered the development of preimplantation genetic diagnosis (PGD).

Handyside used PGD to screen embryos for cystic fibrosis, a disease linked to the X chromosome. His work quickly led to tests for many more conditions, including hemophilia and sickle cell anemia.

Early PGD science naturally intertwined with sex selection. For example, X-linked diseases affect males more often. Parents could choose to implant only female embryos to prevent having a child with one of these diseases.

However, this is no longer necessary. Science has evolved such that doctors can now distinguish between embryos that carry the mutation and those that will be affected by the disease.

The first baby conceived through PGD was born in 1990.

In the 2000s, multiple important sex selection breakthroughs occurred. Scientists discovered how to extract additional cells during the biopsy, allowing for more nuanced genetic testing. In addition, Array comparative genomic hybridization (aCGH) became available. This is a high-resolution chromosomal test that can quickly and accurately assess embryos.

Preimplantation genetic screening (PGS) was developed soon after aCGH. PGS screens embryos for aneuploidy, or abnormal chromosome number. Aneuploid embryos are associated with pregnancy loss and birth defects.

PGS quickly became the preferred method of sex selection because it improves implantation rates and reduces the risk of miscarriage.

How PGD and PGS work

Sex selection with PGD or PGS is performed as part of an IVF cycle.

During IVF, eggs are retrieved from the ovaries and fertilized with sperm in a laboratory.

Embryos develop for a few days before they are biopsied, and the doctor removes one or more cells. The cells are then tested for chromosomal abnormalities or the presence of a specific genetic disease.

Healthy embryos are transferred to the uterus.

PGS can be performed on all embryos, allowing couples to choose the best embryo for implantation regardless of sex.

PGD is only performed on embryos with suspected genetic diseases. These diseases could affect only males, such as hemophilia, or one that affects both sexes, such as Huntington’s disease.

Sex selection is possible with both options. However, choosing traits like hair color, eye color, or intelligence is not currently possible.

How PGD and PGS in sex selection help create more balanced families

Sex selection in IVF can improve implantation rates.

It can also help families avoid the heartache of miscarrying an aneuploid baby or giving birth to a child with a serious genetic disease.

That’s because PGD and PGS are not just used for sex selection. These tests screen embryos for a wide range of genetic diseases. We help ensure that only the healthiest embryos are transferred to the uterus by testing embryos before implantation.

For example, let’s say a couple has a family history of hemophilia. They could use PGD to test their embryos for the disease. Only unaffected embryos would be transferred, eliminating the chance of having a child with hemophilia.

PGD and PGS also allow families to balance the number of boys and girls in their family. Many couples seek sex selection because they have a child with a serious, chronic illness or they have had multiple miscarriages.

It’s impossible to predict everything that may happen, but PGD and PGS procedures give families the best chance for a healthy baby.

Who is PGD and PGS recommended for

PGD and PGS can help couples have successful pregnancies.

PGS is appropriate for parents with no known genetic abnormalities. As we explained above, PGS looks for aneuploidy or abnormal chromosomes. The affected embryos are unlikely to implant. If they do, the pregnancy will often end in a miscarriage.

Chromosome abnormalities become significantly more likely as a female ages. When that female is over 35, 50% or more of their eggs may be abnormal. That number jumps even higher when a female enters their 40s and 50s. That’s why PGS is recommended when a female is 35 and older.

However, other couples can benefit from PGS as well. The process is very helpful for couples who have experienced miscarriages or failed IVF rounds in the past.

PGS is also recommended for couples who want to balance their families through sex selection. At Arizona Center for Reproductive Endocrinology and Infertility, couples can simply come to the clinic and choose the sex they prefer.

Ultimately, any parent undergoing IVF can choose PGS. PGD, however, is only recommended when a couple has a known genetic disease in their family. By testing embryos, doctors can help ensure that only the highest quality embryos are transferred to the uterus.

What are the risks of PGD and PGS

Potential risks associated with PGD and PGS include:

Low egg count: If a female has a low egg count, the doctor may not be able to harvest enough healthy eggs for successful testing. That limits their options for treatment.
Mosaicism: Mosaicism occurs when some of the cells in an embryo have the correct number of chromosomes, but other cells don’t. Mosaicism isn’t always detected during a biopsy, which means it’s possible to transfer an embryo that appears healthy but isn’t.Or, the opposite may happen. A seemingly poor-quality embryo may be discarded when the problem would have corrected itself.
Incorrect Results: In very rare cases, the results of the biopsy may be incorrect. You might receive a false positive or a false negative.
Damage to the Embryo: The biopsy itself may damage the embryo. This is a very small risk, however – less than 1%.

Your fertility doctor knows to weigh these slight risks against the multiple advantages of PGD and PGS.

Conclusion

PGD and PGS are two procedures that can be performed during IVF. They’re both used to screen embryos for genetic abnormalities.

PGS is an option for all parents undergoing IVF, while PGD is for couples testing for a specific genetic disease.

Both procedures have a few potential risks, but the success rates are promising.

If you’re interested in learning more about PGD or PGS, please contact Arizona Center for Reproductive Endocrinology and Infertility today. We’ll be happy to answer any of your questions. Our team can help you decide if either of these procedures is the right choice for your family. Call the number at 520-326-0001 and follow us on Instagram.

Keys to a Successful IUI

importblogger on August 23, 2022

If you’re considering different fertility treatments, including Intrauterine Insemination (IUI), understanding the difference between IUI vs. IVF (In vitro fertilization) is crucial. This includes understanding the science behind the IUI procedure, how the IUI process gets conducted at Arizona Center for Reproductive Endocrinology and Infertility, and the keys to a successful IUI procedure.

What is Intrauterine Insemination?

When deciding if IUI is right for you, it is important to understand what is involved in the procedure. Intrauterine insemination, commonly known as an IUI, is a popular, cost-effective infertility treatment in which a concentrated amount of motile (active) sperm is fed through a catheter directly into a patient’s uterus to increase the chances of conception.

The procedure itself is a straightforward, fast process. Patients will lie on an exam table with their legs elevated in stirrups, as with most gynecological procedures. A speculum will be used to create a passageway for the catheter to be inserted through the cervix and into the uterus. Once this is in place, the motile sperm solution will be run through the catheter, which will then be removed along with the speculum. The patient will rest for a short time before continuing their routine as normal.

The procedure is generally considered very safe. However, potential side effects include infection, spotting, or multiple pregnancies due to the consumption of reproductive hormones.

History of IUI

Experiments with assisted reproduction in animals have been practiced for several centuries. The first successful example of artificial insemination in human beings occurred in the late 1700s when Dr. John Hunter was able to help a woman struggling with infertility become pregnant with her husband’s sperm. The first successful human pregnancy from IUI of frozen sperm was in 1953. Today, IUI treatment is commonplace, safe, affordable, and effective.

Why should I consider IUI?

IUI is a procedure recommended for heterosexual couples experiencing fertility issues, same-sex couples looking to undergo artificial insemination, and single mothers looking to start a family of their own.

Patients struggling with infertility should consider IUI a good starting point if one of the following factors is at play in their fertility struggles:

Male-factor infertility can be caused by various factors, resulting in low or inactive sperm.
Cervical-factor infertility, in which the cervical mucus does not provide ideal conditions around the time of ovulation to increase the sperm’s ability to move towards the egg.
Endometriosis, uterine scarring following endometrial ablation, postpartum Dilation and Curettage, and low levels of estrogen production may all be factored in having a low endometrium lining and difficulty in conceiving.
Patients interested in pursuing donor insemination, especially when using frozen and thawed donor sperm, should consider IUI to increase the likelihood of conception.
Some patients undergo an IUI even when there are no determinable fertility issues to increase the likelihood of conception because the procedure localizes the fertilization process and increases the chances of pregnancy. It can increase the normal monthly conception rate from 1-3% to 5-10% on average.

The difference between IUI vs. IVF?

Although IUI and IVF are forms of assisted reproduction techniques, each requiring the use of reproductive hormones, the key difference between IUI vs. IVF is in how the eggs get fertilized. The IUI procedure can be understood as a method of accentuating a natural conception process through localizing the point of insemination. IVF is a more involved process in which the ovum is extracted from a patient’s uterus, and external fertilization occurs before eggs are re-inserted into the patient’s uterus.

Both procedures usually use ultrasound to track the patient’s egg production within the uterine follicles. The consumption of reproductive hormones often accompanies these procedures. This may include clomiphene citrate or Clomid, which is taken orally to simulate higher estrogen levels resulting in the release of follicle stimulating hormones to encourage egg production. This is sometimes taken in conjunction with what is commonly called a “trigger shot,” which can vary from several different medications, including Ovidrel, Novarel, or Pregnyl, all of which contain human chorionic gonadotropin (hCG). It is administered just before ovulation occurs and helps aid in the process of releasing mature eggs from the uterus to prepare for conception. In IVF, a trigger shot is used in anticipation of egg retrieval; in IUI’s, it is used in conjunction with ovulation to ensure that implantation is successful.

IUI does have a high success rate and, when used properly, can prevent the need for in-vitro fertilization. It is more cost-effective, less invasive than an IVF procedure, and is often not painful for the patient. IVF is one of the most successful methods of assisted conception and can be a great option for bypassing the fallopian tubes for patients experiencing damaged or absent tubes. However, it is more expensive and invasive than the IUI procedure. Many factors should be considered and discussed with your physician when determining which procedure is best for a patient. For more information about the differences between IUI and IVF, we recommend reading through Arizona Center for Reproductive Endocrinology and Infertility articles on our blog site, including The Complete Guide to the IVF Process.

Where do we start with the IUI process?

When considering an IUI, patients will begin by undergoing a semen analysis to determine if there are any abnormalities leading to a low sperm count. The first step in that analysis is an exam and hormone testing to determine the issue’s root. According to Dr. Gelety, close to ninety percent of the time, the root cause of the issue is idiopathic or indeterminable through testing, potentially the result of an injury earlier in life.

During typical intercourse, much of the sperm that are ejaculated into the vagina is lost en route to the fallopian tubes. Traditional artificial insemination simply introduces the sperm to the vagina rather than directly into the uterus. During a vaginal insemination process, it is difficult to determine how many sperm will have survived a thawing process and make their way through a potentially hostile cervical mucus into the uterus for fertilization. On the other hand, the sperm harvested for the IUI procedure is typically low in volume but high in concentration as it has been cleaned free of plasma and sorted for the most viable sperm.

Dr. Rebecca Reus, an embryologist from the University of Valencia, states that the ideal motile sperm count for undergoing an IUI procedure is above 5 million sperm per milliliter (ml) for a procedure to be successful. Patients with twenty to thirty million per ml of semen before washing and sorting has taken place is an ideal range. Patients with lower sperm counts may want to consider IVF or other forms of fertility treatments.

The clinic may undergo further testing after intercourse on the night before or the morning post-coital test to check how the sperm and cervical mucus interact during ovulation. This can highlight potential cervical inflammation or any sperm antibodies which may be preventing fertilization to help determine whether an IUI is a recommended procedure, but it is not a fool-proof diagnosis method. A test may result poorly, but natural conception could still occur.

Keys to a successful IUI

The most important thing in ensuring a successful IUI is that the patient attempts to avoid stressful situations that may reduce the likelihood of a successful IUI. Greeting your appointment feeling knowledgeable and confident in the procedure you are about to undertake can vastly reduce stress and anxiety surrounding an IUI. Consulting with a knowledgeable physician at Arizona Center for Reproductive Endocrinology and Infertility is an important first step in starting your journey.

The use of hormone stimulation can aid in ensuring a successful IUI. Consult your doctor about which hormone treatment is right for you and what side effects these treatments may have. Doing extensive research is essential in researching an IUI procedure.

Male patients involved in the IUI procedure should avoid ejaculation before giving their semen samples to the doctor. This will increase the volume of sperm available for selection and thereby the likelihood of having a strong motile sample.

Finally, as with any effort to increase the likelihood of getting pregnant, maintaining a healthy lifestyle is paramount. Habits like staying active, consuming healthy food, getting sufficient rest, and avoiding the consumption of harmful substances such as alcohol, tobacco, and drugs will increase the likelihood of a successful pregnancy.

More information about the IUI process and tips to ensure a successful IUI can be found here and in this informative podcast series.

Where to go from here

We understand that you may be at the beginning of your journey with infertility, or you may have been researching the best step forward for months or even years. We know that educating yourself on the best step forward can be overwhelming. We hope this article has provided you with a starting point in researching IUI as a potential option for your future.

To learn more about our procedures at Arizona Center for Reproductive Endocrinology and Infertility, we recommend contacting our clinic at 520-326-0001, subscribing to our newsletter, and following us on social media. We look forward to hearing from you.

Happy Pride! LGBTQIA+ Families Welcomed

importblogger on June 15, 2022

This June, in honor of Pride Month, Arizona Center for Reproductive Endocrinology and Infertility is proud to celebrate our commitment to ensuring LGBTQIA+ couples can navigate their unique path to becoming parents. Our team understands that every family is different, and we are dedicated to providing personalized care for all patients who walk through our doors.

LGBTQIA+ Fertility Options

The first step in starting a family is understanding your fertility options. At Arizona Center for Reproductive Endocrinology and Infertility, we offer a variety of services to help LGBTQIA+ couples conceive.

Same-Sex Male Couples

Male couples who want to grow their families can pursue fertility treatments such as in-vitro fertilization (IVF) with donor eggs.

Same-Sex Female Couples

For lesbian couples, we offer IUI with donor sperm as well as IVF using one partner’s eggs and donor sperm. If both partners wish to use their own eggs, we can help them conceive through separate IVF cycles and then transfer the embryos into the uterus of the partner who will carry the pregnancy.

Transgender and Nonbinary Couples

We understand that transgender and nonbinary couples may have unique fertility needs and we are here to help. There are various options, including cryopreservation of eggs or sperm before gender-affirming surgery. We also offer fertility treatments such as IUI and IVF for couples who wish to conceive with the use of donor sperm or eggs.

LGBTQIA+ Fertility Rights

Unfortunately, LGBTQIA+ fertility rights are not guaranteed in every state. Discrimination is still common when seeking fertility care. For instance, in many states, same-sex couples have limited access to fertility treatments such as IVF.

Pride Month is a time to reflect on how far we’ve come and rededicate ourselves to the fight for full equality. Every worthy person deserves the chance to become a parent if they want to.

The team at Arizona Center for Reproductive Endocrinology and Infertility is committed to ensuring all patients have access to the fertility treatments they need, regardless of sexual orientation or gender identity. We are proud to be a part of the LGBTQIA+ community, and we will continue fighting for equality.

No matter what your family looks like, we are here to help you grow it in a way that is right for you. If you have any questions or would like to learn more about our fertility services, visit us on Facebook or Instagram. We are proud to serve the LGBTQIA+ community and look forward to helping you build the family of your dreams.

Happy Father’s Day!

importblogger on June 15, 2022

Happy Father’s Day from Arizona Center for Reproductive Endocrinology and Infertility! This is a time to celebrate all the amazing dads and dads-to-be. Our team of specialists is dedicated to helping families start and grow, and we know that fathers play a crucial role in that process.

A Brief History of Father’s Day

The modern Father’s Day was created in the early 20th century when Sonora Smart Dodd of Spokane, Washington, heard a Mother’s Day sermon. Dodd’s mother had died when she was young, but she still had a father, and she felt that he deserved to be honored too.

Dodd proposed the holiday to several churches in her area, and on June 19, 1910, the first Father’s Day celebration took place at the YMCA in Spokane. In 1916 President Woodrow Wilson went to Spokane to speak at a Father’s Day celebration; soon thereafter, Congress passed a joint resolution designating the third Sunday in June as Father’s Day. In 1972, President Richard Nixon established a permanent national observance of Father’s Day to be held on the third Sunday in June.

Father’s Day is now recognized all over the world. It’s a day to reflect on the importance of fathers and father figures in our lives and to celebrate the joys and challenges of fatherhood.

Trends and Instances in which Men Could Struggle with Infertility

Unfortunately, infertility is a problem that affects millions of men. About one-third of couples struggling to conceive are facing male infertility. There are several trends, lifestyle choices, and medical circumstances that can cause the problem.

For example, men who smoke are more likely to have lower sperm counts than men who don’t smoke. Obesity can also lead to decreased sperm count and motility. And while it’s not necessarily a trend, age can also play a role in male fertility; as men get older, their sperm quality declines. Certain medical conditions such as diabetes or an undescended testicle can also cause fertility problems.

Factors that may increase the likelihood of male infertility include:

A family history of infertility
Exposure to certain chemicals or toxins
Certain infections
Previous surgery in the groin area
Use of anabolic steroids

Treatments for Men at Arizona Center for Reproductive Endocrinology and Infertility

In honor of Father’s Day, we wanted to take a moment to highlight some of the procedures offered at our clinic that are designed for dads-to-be. If you or someone you love is dealing with infertility, know that there is help available. Every deserving man aspiring to be a father should have the opportunity to experience that blessing.

Fathers day occurs during June, which also happens to be Pride Month! In the spirit of all deserving men wanting to be fathers, the LGBTQ community may benefit from our services as well. We offer a variety of procedures and services specific to men or that apply to men. These include:

Intracytoplasmic sperm injection (ICSI)

ICSI is a procedure in which a single sperm is injected directly into an egg. This is often used when there are problems with sperm motility or morphology (shape).

Testicular sperm extraction (TESE)

TESE is a surgical procedure in which sperm are retrieved from the testicle. This is often used when there is no sperm in the ejaculate.

Microsurgical epididymal sperm aspiration (MESA)

MESA is a surgical procedure in which sperm are retrieved from the epididymis (a tube near the testicle that stores and transports sperm).

Preimplantation genetic diagnosis (PGD)

PGD is a procedure in which embryos are tested for certain genetic conditions before they are implanted. This may be used when there is a family history of a particular genetic condition.

Egg Donation

Egg donations and gestational carriers help same-sex male couples become parents. Once the egg is fertilized, the embryo is implanted into your chosen carrier using IVF.

Sperm and Egg Freezing

Sperm and egg freezing helps transgender men and women control their reproductive destiny. This way, they can have children that are genetically related to them at a later time.

We understand that starting or growing a family is a very personal and sensitive decision. Our goal is to provide you with the information and resources you need to make the best decisions for your specific situation. If you have any questions about our services, please don’t hesitate to contact the clinic. We’re here to help! You can also follow us on Instagram.

The Complete Guide to the Egg Donation Process

importblogger on June 13, 2022

The egg donation process is an increasingly popular option for couples and women struggling with infertility. 93% of fertility clinics in the United States offer egg donation services, and Arizona Center for Reproductive Endocrinology and Infertility is no exception.

While the egg donation process certainly has its merit, aspiring parents mustn’t get swept up in the promises of egg donation without fully understanding their options. This is why the science behind the egg donation process is the driving force behind the way Arizona Center for Reproductive Endocrinology and Infertility consults its patients.

In this guide, readers can expect the following:

We debunk the three common myths associated with the egg donation process.
We dive into the 5-steps behind the egg donation process. This covers everything from legal considerations to scientific procedures.

Debunking the Myths of Egg Donation

First thing is first, let’s debunk a few myths about the egg donation procedure. After all, a lot of fertility clinics take a business-first approach to consulting their patients, which is often to the detriment of aspiring parents who happen to be in a vulnerable place in their fertility journey.

Myth #1: The egg donation process is at least $20,000-$30,000.

The cost of egg donation can reach as much as $30,000, but as you’ll see in the following sections, many variations within the egg donation process can inflate or deflate the total cost. This primarily includes determining the source of the egg donor, and the logistical variables like location and travel costs that come with that person.

Myth #2: If you’re struggling with getting pregnant, an egg donation is your only option.

At Arizona Center for Reproductive Endocrinology and Infertility, we exhaust all options before advising that patients seek a third-party donor. We don’t assume that age or a decreased ovarian reserve negates the ability of a woman to use her eggs to get pregnant. We like to discuss with patients IVF treatments that use your eggs first, before even discussing an egg donor.

Myth #3: There are a lot of legal processes involved in egg donation.

This is not necessarily true, as often the legal work is already taken care of at the point of donation. You’ll see as we get into the process how the legal aspect of egg donation often takes care of itself regardless of the option you select.

The Complete Egg Donation Process

At Arizona Center for Reproductive Infertility and Endocrinology, we take a science-based approach to working with our patients. You’ll never see our clinic recommending gimmicky procedures to vulnerable patients. We take a science-based approach and lean on clinical trials to guide our recommendations.

To that end, Arizona Center for Reproductive Endocrinology and Infertility leans on a five-step process for egg donation.

Step 1: Initial Screening

In the beginning, Arizona Center for Reproductive Endocrinology and Infertility likes to determine conclusively that an egg donation is truly necessary. It doesn’t need to be stated that most aspiring parents want to be able to have their “own kids,” meaning the pregnancy occurs from their biological eggs. Therefore, Arizona Center for Reproductive Endocrinology and Infertility wants to exhaust other options before turning to a third-party egg donor through the IVF process. This all gets done at the initial screening and consultation.

Step 2: Source the Donation

If IVF with a patient’s eggs proves to be unsuccessful, and it’s determined that an egg donation by a third party is necessary, a patient’s options as far as sourcing the egg donation then become a personal, financial, and logistical decision. In the opinion of Arizona Center for Reproductive Endocrinology and Infertility, there are three primary sources of egg donation.

Option #1 – A Known Donor
A family member or close personal friend can be an egg donor. A key advantage to having a relative donate their eggs is that it can help lower the cost of the overall procedure if they choose to waive a donation fee. For reference, at Arizona Center for Reproductive Endocrinology and Infertility, our IVF procedure is a $5,300 fee not including the costs of the egg donor, the donor’s medication, logistics related to any travel, and agency or donation bank markup. With a known donor, it stands to reason that a family member might simply offer the eggs for free, taking much of the financial stress off of the situation.

Furthermore, a family member possesses many of the same genes, meaning the baby will likely inherit many of the traits that it would had it been your eggs in the pregnancy. Financially and scientifically speaking, this option is desirable because from a family member you will be able to receive all the eggs from the donor’s cycle, unlike an egg bank’s frozen eggs (more on that below). If you have someone in your life willing to donate their eggs, Arizona Center for Reproductive Endocrinology and Infertility will bring them in for a screening, and hopefully, as a team takes as much stress as possible out of this delicate process.

Option #2 – An Anonymous Donor:
At Arizona Center for Reproductive Endocrinology and Infertility, we regularly meet with donors who are screened for family history, and any history of disease or drug use. Just like how we do with sperm donors, we screen and clear our egg donors, and from there try to match them with those receiving the donation with as many physical traits as possible (if desired). As with a known donor, a patient will receive all the eggs from an anonymous donor’s cycle to boost the number of eggs, increasing the odds of a pregnancy. However, this option usually incurs a fee on top of the base $4,500 IVF fee, making an anonymous donor a mid-tier option cost-wise.

Option #3 – Egg Bank:
Much like sperm banks, egg donation banks make it possible to coordinate your donation from anywhere in the world. These egg donation agencies allow aspiring parents to pick and choose the physical traits they desire and have the eggs frozen and shipped to their location for the IVF procedure. While this sounds like an ideal option, keep in mind that these agencies must pay their donors, and markup the services for their own company’s profit. With the potential need to coordinate the logistics of shipping the eggs to your location, the cost can quickly escalate.

From a scientific standpoint, this process also has its drawbacks. Namely, the risks of freezing and shipping the eggs, then having the clinic thaw and fertilize any surviving eggs, and then develop those surviving eggs into embryos and establish a pregnancy leave a lot of room for error. This is evidenced by the fact that only about 50% of these types of donations result in pregnancies. According to Dr. Gelety, the Head Doctor at Arizona Center for Reproductive Endocrinology and Infertility, egg donations from an egg bank are “the most expensive, and the least effective” option.

Step 3: Documentation
Once you’ve selected your donor type, it’s time to ensure that any legal documentation has been taken care of. As we said earlier in the article, the “legal” components of an egg donation are not as prominent as they’re often made out to be (myth #3). Remember the three main sources of donation and ask yourself the motivation for any of them dragging a donation through a legal process:

A known donor, like a friend or family member, likely won’t require a long legal process. If they do, then they may not be the right family member or friend to have to be your egg donor.
An anonymous donor, like the vetted, approved donors enlisted through Arizona Center for Reproductive Endocrinology and Infertility is going to have the legal work already done before the donation.
An egg bank will also handle the legal aspects of their donors to ensure a smoother process for the recipient.

Regardless, as you’re going through the process, make sure to confirm that no paperwork or legal steps are required by the clinic or agency that you’re working with. By and large, if you’re going through a loved one or reputable donor, this should be a quick check of a box before we get into the procedure itself.

Step 4: Stimulation of the Donor’s Ovaries
Next, the scientific process truly gets to take over. In the case of a donation where a known or anonymous donor is providing the eggs, and the eggs are not being purchased from an egg bank, the woman donating the eggs must be scheduled for ovarian stimulation.

Ovarian stimulation is done with the intent of sourcing multiple, healthy eggs for an IVF treatment. The stimulation process takes place over a few weeks. In the beginning, the donor begins preparing her ovaries for stimulation by taking oral estrogen, or estrogen-progesterone pills. These are similar to what is found in standard birth control pills.

As the donating woman nears her cycle, and at a time specified by the doctor, the donor has FSH and LH injected into her ovaries to make multiple eggs develop. Remember that a woman’s body normally only prepares 1-2 eggs per cycle, so by injecting the FSH and LH you are boosting the size of the follicles to help boost the quality of the retrieval.

While this is happening, the donating woman may be given medication that delays their ovulation, since the eggs being donated must be retrieved before the cycle. This only needs to happen until your follicles have reached the required size, and at which point the donating woman is administered an hCG shot, which is the final medication given that triggers the eggs for retrieval.

Step 5 – Retrieval!

The fifth and final step in the egg donation process is egg retrieval. This is generally done 1.5 days (~36 hours) after the hCG shot has been administered. During egg retrieval at Arizona Center for Reproductive Endocrinology and Infertility, the donor is administered conscious sedation. Once the sedation has been administered, the patient experiences a painless procedure in which a small needle punctures the follicle in the ovary where the eggs are located, and is extracted.

Once this is complete, the woman receiving the donation goes under a normal IVF procedure using the donated eggs.

Although there are a few known side effects to egg donation, this is a safe and common procedure.

Summary

Remember, if you are struggling with infertility, the first thing you should do is seek a medical screening to determine whether your eggs are not viable for pregnancy. Only then should you consider alternative options like egg donation. There are a lot of predatory tactics at fertility clinics that put profits before science and offer procedures that have not gone through proper clinical trials or peer review.

At Arizona Center for Reproductive Endocrinology and Infertility, we are committed to helping women and couples who want to get pregnant using a science-first approach, and that starts with looking at your unique case and circumstances.

If it’s determined we need to explore an alternative option like egg donation, we then proceed with the process. If you have any questions, get in touch with us by sending an email to schedule an appointment. You can also follow us on social media.

This Mother’s Day We Celebrate the Moms Out There!

importblogger on May 2, 2022

Mother’s Day is an opportunity to celebrate the importance of mothers and express gratitude to the women who have raised us. This special day dates back to the 1850s and wasn’t always a day centered on heartfelt cards, bouquets, brunches, and gifting.

History of Mother’s Day

The idea of Mother’s Day began when women in West Virginia organized Mother’s Day work clubs that fought to reduce infant mortality rates and improve sanitary conditions for mothers and families. These groups also tended to wounded soldiers during the Civil War. After the war was over, the women organized Mother’s Friendship Day picnics to bring Union and Confederate loyalists together progressively and harmoniously. Many of these events were organized by Ann Jarvis. After she passed, her daughter Anna Jarvis, held the first Mother’s Day observances in 1908 to honor her memory. Other cities followed suit, and by 1914, President Woodrow Wilson named the second Sunday in May an annual national holiday.

These days, Mother’s Day is widely celebrated in a myriad of ways. Regardless of how you celebrate, the primary goal of Mother’s Day is to express respect, honor, and love towards our mothers. The day is an opportunity to honor the selflessness of mothers, and acknowledge the importance of maternal bonds and the role maternity plays in our society. While we should always take time to appreciate family, Mother’s Day and Father’s Day are still nice days to set aside to make the people who raised us feel extra special.

Our Mission at Arizona Center for Reproductive Endocrinology and Infertility

At Arizona Center for Reproductive Endocrinology and Infertility, we want to celebrate deserving mothers. We believe that aspiring mothers should have an opportunity to raise a child and start the family of their dreams. We welcome people from all walks of life and all genders and sexual orientations. In our experience, LBTQ+ couples are often unaware of the variety of fertility options available to them. Our specialists are happy to work with those couples and help them understand how they can have a child of their own. Fertility treatment is not limited to heterosexual couples, which is why we’re committed to providing our services to LBTQ+ couples worldwide.

While motherhood doesn’t always come easily, if you have been struggling to get pregnant we want to assure you that you’re not alone! Studies show that about 1 in 6 couples struggle with fertility. The medical expertise at Arizona Center for Reproductive Endocrinology and Infertility is guided by advancements in science and technology and enables our fertility specialists to help women struggling with fertility issues. We work closely with our patients to develop a treatment plan that is unique to their case and provides the best outcome for them. Dr. Gelety, Head Doctor of Arizona Center for Reproductive Endocrinology and Infertility, always takes a peer-reviewed, clinical-trial-based approach to fertility treatments—and the results speak for themselves.

What does this mean? Our process for recommending treatments and offering counsel involves looking at each patient’s circumstances and evaluating them as a whole. We do not recommend gimmicky, non-clinically proven procedures like assisted hatching and PGT-A. Oftentimes, procedures like these are uncorrelated with increased fertility or rates of pregnancy. These expensive IVF add-ons tend to be pushed by fertility clinics to hopeful mothers willing to try whatever it may take to get pregnant. At Arizona Center for Reproductive Endocrinology and Infertility, we understand why many women explore these IVF add-ons and want to assure you that we will use our expertise and understanding of your unique case to determine a fertility treatment plan that will increase the likelihood of pregnancy.

Dr. Timothy Gelety has helped countless people make their dreams of a child come true. He believes that motherhood is a beautiful experience, which is why our facility is open to all. If you’re ready to take the first step towards another chance at parenthood, give us a call at (520) 326-0001, or set up a consultation by filling out this form. For even more informative blogs on pregnancy, fertility, and more subscribe to our newsletter or follow us on Facebook.

The Complete Guide to the IVF Process

importblogger on March 22, 2022

IVF or in-vitro fertilization is a medical process where sperm is fertilized in a lab instead of inside the body. During IVF, the sperm and egg are mixed and incubated in a lab with the resulting embryos inserted into the woman’s uterus. IVF is a common solution for those struggling or unable to conceive and offers many another chance to start the family of their dreams. It’s also a favorable option for LBTQ+ couples looking for fertility treatment. If you’ve been considering IVF treatment, this is what you need to know to make your decision.

Who is IVF right for?

Many people benefit from IVF. You may be a good candidate for IVF if you or your partner fall under the following categories:

You have not had success with Intrauterine Insemination (IUI), also commonly known as artificial insemination
You suffer from severe endometriosis, which can adversely impact your eggs and prevent pregnancy as a result of scar tissue inside your fallopian tubes
You are over a certain age recommended by a specialist
You have a Diminished Ovarian Reserve (DOR)
Your fallopian tubes are damaged or even completely absent
You have a known genetic disorder and want to eliminate the risk of your baby having the same disorder
You do not have a uterus and need to create embryos for transfer to a gestational carrier
The male partner has male factor infertility, making conceiving challenging without the use of IVF

How long does IVF take?

The IVF process typically takes about four weeks once medication starts, slightly longer than the length of a normal ovulation cycle. This time includes ovarian stimulation, retrieval, and transfer, though the process can take longer in some cases. Unfortunately, there are no guarantees when it comes to IVF. Some people may need to undergo several cycles because the chances of falling pregnant on IVF are different for everybody.

What happens during IVF?

The IVF process includes several steps for a full cycle — ovarian stimulation, egg retrieval, sperm retrieval, fertilization, and embryo transfer. Briefly summed up:

Stimulation: In the beginning, you take medication that enables your ovaries to produce multiple eggs rather than the typical single egg per month. This is important because it gives you a greater chance of producing a fertilized egg in one cycle. This stage typically takes around 2 weeks. To determine if your eggs are ready for retrieval you will undergo ultrasounds and blood testing.
Egg Retrieval: Egg retrieval is a simple procedure that takes only 7-9 minutes. It is carried out under light sedation, so there is no discomfort. Each ovarian follicle is punctured, and the fluid containing the eggs gets drawn out using a fine needle. Several hours after the retrieval, an embryologist will count how many retrieved eggs have matured. Then the eggs are ready for fertilization.
Fertilization: During fertilization, the sperm and egg get mixed together. This process may include the additional step of ICSI, where a single sperm gets directly injected into each egg.

Embryo transfer

In this procedure, Dr. Gelety will insert a long, thin, flexible tube into your vagina to transfer the embryo. If successful, a fresh embryo will implant in the lining of your uterus about three days after egg retrieval. However, it can be as long as a five day transfer if the testing was performed on embryos.

Are there any risks to IVF?

As with any medical procedure, IVF does have its risks. These include soreness and the chance of multiple births. During the stimulation phase, there is the risk of ovarian hyperstimulation syndrome (OHSS), which can cause weight gain, nausea, abdominal distention/bloating, and potentially shortness of breath.

What does IVF cost in Arizona?

At Arizona Center for Reproductive Endocrinology and Infertility you can expect one IVF procedure to cost $5,900. Keep in mind that prices will vary from clinic to clinic and depending on your insurance coverage. At Arizona Center For Reproductive Endocrinology and Infertility in Tucson, AZ, you can speak with a financial consultant to discuss treatment costs. We will work with you to come up with an affordable plan. In fact, we think our pricing is competitive considering the other clinics in the surrounding area, and the fact that Dr. Gelety’s track record of success is superior to other infertility specialists. We’re one of the few fertility clinics in Arizona that report their results to SART.

Our mission is to help all aspiring parents make their dreams of parenthood a possibility. We welcome people from all backgrounds and sexual orientations because everyone deserves to experience the unique joys of raising their own child. If you have any further questions, do not hesitate to call us at (520) 326-0001. We can help you understand your options to increase your chances of conceiving.

Egg Donation Side Effects

importblogger on March 22, 2022

While deciding to become an egg donor is an incredibly rewarding choice, it’s important to fully understand the potential egg donation side effects involved. To briefly summarize the egg donation process, screening typically takes place to determine if the donor is suitable. Once accepted, a donor will undergo a series of tests that involve ultrasound monitoring and blood tests. You will then be required to administer a series of injectable medication daily to stimulate egg production. Regular visits are also required to monitor progress before the eggs can be retrieved. If you’d like to learn about egg donation in greater detail, read our blog post on how long the egg donation process takes.

As with any medical procedure, egg donation does have its potential complications. Many women feel very minor or no discomfort during the donation cycle, while others have varying symptoms that generally resolve after egg retrieval. Side effects and health risks are rare but possible. Regardless, these are the egg donation side effects you should know and discuss with your physician to make an informed decision.

Medication Side Effects and Risks

Egg donation side effects include weight gain, mood change, bloating, pressure, abdominal pain and swelling, breast tenderness, and moodiness from the hormone medications, which will go away by the next menstrual period. The blood tests and hormone injections are usually well tolerated. However, some women experience pain, redness, or minor bruising at the injection site. Allergic reactions to injection are rare.

During an egg donation cycle, there is a small risk of ovarian hyperstimulation syndrome (OHSS). OHSS can occur after egg retrieval and it involves the enlargement of the ovaries, significant increases in fluid retention within the abdomen, and concentration of the blood within the blood vessels.

Mild OHSS can lead to discomfort which typically resolves within several days. In very rare severe cases, about 1 percent of donor cycles, hyperstimulation could lead to enlarged ovaries and an increased susceptibility to develop blood clots. If hyperstimulation, resulting in blood clots, does occur, some cases may require hospitalization for additional monitoring to ensure the situation doesn’t worsen. While the condition is serious, it usually lasts no more than a week.

Procedure Health Risks

Transvaginal ultrasound is the method used for egg retrieval. The risk of severe complications from this procedure is rare — about 1 in 1,000. In the unlikely event this does occur, complications include bleeding, infection, and injury to the bowel or blood vessels. Surgery may be needed to repair damage to internal organs or to control significant internal bleeding, in extremely rare situations.

While time isn’t a side effect, it is still important to remember the fact that egg donation is a lengthy process. You will receive compensation for your time and generosity, but do keep the time commitment in mind if the time aspect is not convenient for your schedule.

Egg donation involves undergoing a medical procedure with side effects, just like any other medical procedure. Many women who decide to become egg donors feel gratified to give someone a second chance at parenthood. Egg donation helps other women achieve their dreams of raising their own children. Learn more about our egg donation process. If you have any further questions, call us at (520) 326-0001 to schedule an appointment to speak with one of our friendly fertility specialists. We’re here to discuss your situation at length so you can understand the options available to you no matter what stage of life you’re in.

AZCREI’s Process for Screening and Clearing Sperm Donors in Arizona

importblogger on March 1, 2022

For those looking for a sperm donor in Arizona, look no further. At Arizona Center for Reproductive Endocrinology & Infertility in Tucson, AZ, we help walk our patients through the process of selecting a sperm donor. Using a sperm donor is a great option for single women, lesbian couples, or couples with a male partner challenged with male factor infertility. We’ll walk you through our process, so you can feel confident that you have the knowledge you need before you arrive at your appointment.

The Screening Process

We only order from donor agencies that follow a strict screening process for sperm donors. For context, of the numerous sperm donors who enroll in a sperm donation program, only 1% of sperm donations are selected to be stored at the sperm bank. The donor agencies we recommend typically require several screenings and processes to determine donor viability. These include:

Complete physical examination
Blood and urine tests for infectious and genetic diseases
Testing for hemoglobin-related blood disorders
Specific genetic screening for certain donors based on their ethnicity
Evaluation of sperm quality
HIV risk assessment
Sperm count and post-thaw assessment
Quarterly testing for HIV, Hepatitis B & C, chlamydia, gonorrhea, and syphilis
Semi-annually updating HIV risk assessment and medical & genetic history
Annual physical examination

The Selection Process

Choosing a sperm donor is an important decision. But for some, it can also be a difficult decision. Here are some things we’ve learned from helping others along their journey to parenthood.

While selecting the right sperm donor is important, don’t get lost in the details. It’s perfectly fine to have a checklist of qualities and traits that you’d like your donor to possess. However, we urge you to please keep in mind that there is no “perfect donor” who possesses every single trait on your wishlist. Remember that having a child is the end goal, and choosing the sperm donor is just one of the steps in this process. Narrow down your list to absolute must-have requirements and then shortlist the donors who match that criteria.

Don’t just look at physical traits. For example, if you would like to have an athletic child, opt for a sperm donor who is also athletic. Take a look at the potential donor’s medical history. If your family has a history of a specific genetic condition, it might make sense to rule out a donor who has a history of the same genetic condition. Why? Because this will increase the chances that your child will have the same genetic condition.

For many, IQ is important. But, higher education does not necessarily mean greater intelligence. Some donors may have personal, undisclosed reasons for not completing college but may still be very intelligent. An alternative way of measuring intelligence is by reading through a donor’s personal statement. This can also be a great indicator of their personality and help tip the scales in favor of a specific donor if you’re having a difficult time choosing between your shortlist.

Remember:

It’s okay to change sperm donors. Sometimes it takes a few tries before you get the right match, and that’s completely normal.

At Arizona Center for Reproductive Endocrinology & Infertility, we love being able to help people from all backgrounds, regardless of their sexual orientation, achieve their pregnancy goals. Everybody’s situation is uniquely different. With this in mind, we offer many services tailored to meet you where you are, whether that involves searching for a sperm donor, IVF, or egg donation. If you have any additional questions about sperm donation or anything else, feel free to give us a call at (520) 326-0001.

Should I Freeze My Eggs?

importblogger on January 24, 2022

Egg freezing is a process that preserves a woman’s ability to get pregnant in the future. It provides many women an alternative for conceiving a child. On a basic level, it involves retrieving mature eggs from a woman’s uterus and storing them for later use. In the future, the frozen egg can be fertilized and implanted in the woman’s uterus via in vitro fertilization (IVF).

Who might consider egg freezing?

Any woman whose body is still producing eggs can opt to freeze their eggs. Some women may choose to preserve their eggs for personal or professional reasons. They might want to focus on excelling in their careers now but still maintain their ability to have kids in the future. Egg freezing enables women to store eggs while they are in their most fertile stage in life.

However, egg freezing can be especially helpful for women in certain situations, such as women who have a health condition that impacts their fertility. These might include endometriosis, lupus, PCOS, and others. Women undergoing intense medical procedures that affect their fertility, like cancer treatment, also may opt for egg freezing.

What is the best age to freeze your eggs?

While egg freezing can be done at any age, as long as the woman is still producing eggs, we recommend that women be between the ages of 21 and 38 for the highest chance of success at pregnancy in the future. Many women choosing to freeze their eggs tend to be in their 30s.

Before deciding to freeze, you should reflect on your life goals and financial situation and discuss issues related to reproductive wellness with your physician. Freezing your eggs can be a more involved process than you might think and it should not be decided purely on a whim.

What does the egg freezing process involve?

The egg freezing process is intensive. Before the process begins, the woman undergoes several tests including blood tests, ultrasounds, and ovarian reserve testing to determine the quantity and quality of the eggs.

After testing, egg harvesting begins, which requires the woman to take hormonal medications up to two times a day to stimulate the ovaries to produce multiple eggs in one ovarian cycle. During this time, the woman will be monitored with ultrasounds and blood tests to track her body’s response to the medication.

When the eggs are mature and ready for retrieval, they will be collected and stored for future use. The whole process can take about 20-30 minutes and may lead to cramping and discomfort.

What are the success rates of pregnancy using a frozen egg?

Due to the vitrification process, a procedure that strengthens the water in the egg without letting ice crystals form, eggs have an increased rate of surviving thawing. For women under the age of 38, the pregnancy rate is about 50%. It is important to remember that egg freezing will not guarantee that you will have a successful pregnancy later on, but it does give you more options later on in life when your natural fertility may have decreased.

Egg freezing may not be right for everyone, but it can provide another opportunity for women looking to be pregnant at a later stage in their life a second chance at having a child. At Arizona Center for Reproductive Endocrinology and Infertility, we believe in offering solutions that will help people looking to start a family of their own. We have helped people from all walks of life, sexual orientations, beliefs, and cultures experience the joy of raising a child. If you think egg freezing is right for you, give us a call today at 520-326-0001.

The history of the sex selection process

How PGD and PGS work

How PGD and PGS in sex selection help create more balanced families

Who is PGD and PGS recommended for

What are the risks of PGD and PGS

Conclusion

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What is Intrauterine Insemination?

History of IUI

Why should I consider IUI?

The difference between IUI vs. IVF?

Where do we start with the IUI process?

Keys to a successful IUI

Where to go from here

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Debunking the Myths of Egg Donation

The Complete Egg Donation Process

Summary

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