How long do I need to wait between cycles? Should I take a break? When can we start the next procedure? Do I need to wait? These are all questions Arizona Center for Reproductive Endocrinology & Infertility get asked quite frequently—and truthfully, the answers can vary.

We know how stressful and heartbreaking it can be when a fertility procedure isn’t successful. When it happens, we often see couples want to go in two directions with their journey: pause it and recuperate or keep moving along full speed.

Our approach is to carefully evaluate every treatment and cycle to be able to make the right decision for the next one. Here are some things to consider after a failed procedure and what we think are typically the best next steps.

Wait Time Between Treatments

The length of time you should wait between fertility treatments depends on several factors. Not too long ago, it was believed that back-to-back procedures would reduce fertility, but now research indicates that repeated attempts may actually be more effective.

This is especially true if you are person with ovaries who’s 35 years or older, because the longer you wait between treatments, the more the quality and quantity of your eggs decrease. For example, if you have your first procedure at 38, then wait six months or so before trying again, your chances of a successful pregnancy can decrease dramatically.

Attempting another procedure directly following an unsuccessful one also gives us a chance to adjust our approach or potentially try something new. If you don’t get pregnant on the first try, we’ll analyze what happened—considering ovulation, timing, sperm quality and quantity—and use that information to enhance the next treatment. We work closely with our patients to choose the next treatment cycle to help them conceive in the shortest amount of time. Using this method to individualize treatment plans for each patient increases their chance of pregnancy.

Reasons to Consider a Break

All that being said, there are some legitimate reasons to take a break between cycles. Here are the most common reasons our patients do decide to wait a while between treatments.

Financing

Some people need to take a break for financial reasons. Unfortunately, most insurance plans will not full cover every fertility treatment you may need, so it might be necessary to pause treatments as you make financial arrangements for the next one. But you can rest assured, our team at AZCREI works with you to get the most out of your insurance benefits; we also do our part to reduce the financial burden of the tests and procedures to make overall treatment costs more reasonable.

Physical Wellbeing

There are sometimes physical reasons to take a break between cycles. Some of the hormone medications used for ovarian stimulation may cause inflammation; so, for example, if we’re completing an IVF procedure using fresh embryos, we may wait for the inflammation to subside before starting another cycle of treatment. However, if we’re using frozen embryos there appears to be no physical side effects (which there rarely are), we should be able to continue to move forward with your treatment plan.

One of the most common stumbling blocks we’ve seen over the years is abandoning treatment after a failed attempt. Sometimes the treatments get too difficult or arduous, or patients get too disappointed or depressed because they haven’t yet been successful. We encourage our patients to stick with it, but your comfort is always the most important thing to our team. We make sure you have all the information you need to make your decision and won’t push you one way or another.

At AZCREI, we have the confidence that we can help you achieve your dreams of having a family, and we’ll stay the course along with you—even if you decide to take a break—until you’re ultimately successful in getting pregnant. If you’d like to find out more about our center or schedule a visit, contact us online or call (520) 326-0001.

The concept of a ticking fertility clock is a somewhat modern one, but it’s pretty pervasive in our society. So, let’s talk about the idea of a ‘biological clock.’ 

The concept revolves around the fact that people with uteruses have a limited amount of time to get pregnant. Because of this, many of the cautions about running out of time are aimed at career women, who put off starting a family to focus on their careers. These types of conversations add pressure to how women feel about their fertility and decisions about their own bodies.  

At Arizona Center for Reproductive Endocrinology & Infertility, we want to help clear up any misconceptions and perhaps alleviate some of the pressures of your biological clock. Here’s what you should know about its true impact on fertility.  

The biological clock is a real thing. 

Unfortunately, the biological clock isn’t a made-up concept or metaphor; it is indeed a real thing. It’s actually located in the hypothalamus, a part of the brain that controls basic biological activity. Your natural circadian rhythms send messages to the body and regulate day-to-day functions, like your metabolism and sleep cycle. These rhythms, or your ‘clock,’ are also responsible for other systems, like hunger, mood, stress, alertness, respiratory rate, heart rate, immunity, and fertility. Interestingly, it isn’t just humans that have a biological clock—birds, mammals, and reptiles have them as well.  

But it doesn’t stop ticking at a specific age. 

When referring to the biological clock in terms of fertility, which is typically the most common usage, there’s the idea that it stops ticking around age 35. Meaning, the fertility cutoff for people with uteruses is 35 years old. Again, the biological clock controls so much more than reproduction, so it won’t ever just stop. However, when people with uteruses do reach their mid-30s, it does become more difficult to conceive naturally. In fact, by age 40, only around 1 in 10 women will get pregnant per menstrual cycle.  

This is because, as you get older, there is a gradual fertility decline. At birth, people with uteruses are born with all of their eggs, and once they start ovulating, their ovarian reserve (or the number of eggs they have) decreases over time, so does the quality of those eggs. Yet, despite the challenges, many women older than 35 years can still have successful pregnancies and healthy babies. 

You can ‘pause’ your fertility clock. 

Often, fertility technologies—like egg freezing—are considered to be a way to ‘pause’ your biological clocks. The procedure can make getting pregnant at an older age easier, because it preserves healthier, more viable eggs from a younger age. Of course, this requires some prior planning, but if you feel like you’re hearing the ticking of your biological clock, freezing your eggs now can reduce some of that stress or pressure—allowing you to get pregnant at a later date. Egg freezing is like an insurance policy, but it’s not a guarantee; every woman’s chances of successful implantation and pregnancy are different. 

Remember, age, biology, and lifestyle all play a role in fertility—it doesn’t just come down to your ‘biological clock.’ However, if you are currently experiencing the pressure of a ticking clock and concerned that you’re running out of time to start your family, we encourage you to contact AZCREI. We’ll be able to give you a more accurate picture of your fertility and help you plan your next right steps in regards to ‘pausing’ your clock or getting pregnant sooner. To schedule a consultation with Dr. Gelety and our AZCREI team, give us a call at (520) 326-0001 or visit us online. 

These days, we use apps to manage just about every aspect of our lives—from scheduling appointments and ordering food to connecting with distant friends and online shopping. So, it figures that fertility and ovulation-tracking apps would, at the very least, seem intriguing to those trying to have a baby. In fact, there are currently over 1,000 fertility and cycle-tracking apps available on the Apple App Store.  

At Arizona Center for Reproductive Endocrinology & Infertility, we often get asked about the accuracy and helpfulness of these kind of smartphone ovulation-tracking apps. Here are a few things to know about them before you download. 

What are fertility apps? 

Fertility apps go by several names—period trackers, ovulation trackers, or fertility trackers—but, essentially, they’re all designed to do the same thing: provide you with tech-based tools to help you keep tabs on your menstrual cycle. (Thus, they’re designed for people with ovaries; there are some apps with features for male partners, but those are typically focused on tracking their general health.) 

Most women who are trying to conceive may rely on calendars, basal body temperature measurements, and cervical mucus observations to track their cycles and fertile window. Fertility apps take all that information and store it one place, in attempt to make predictions easier. 

At their most basic, apps will require that you input the start and end dates of your last period(s), and then use that information to predict how long your cycle is and when your next period will begin. 

There are also some apps that ask for even more information, like details on your emotions, symptoms, and even bowel movements. While this data is a great way to help you regularly check in with your body from cycle to cycle, it’s not necessarily helpful in predicting your next cycle. However, these data points may be helpful during fertility consultations when discussing your cycle and potential issues.  

How do they work? 

If you are looking to conceive through intercourse, the only way fertilization can happen is to have the egg and sperm meet. This means having intercourse before you ovulate.  

Generally speaking, most woman will ovulate 14 days prior to the first day of their menstrual period. Fertility apps are meant to track your cycle and alert you to when you’ll start ovulating. For example, if your cycles are 28 days long then you’ll ovulate on day 14 (28-14=14); if your cycle is 35 days long then you’ll ovulate on day 21 (35-14=21). 

As you can guess, if you have an irregular cycle, fertility apps won’t be able to offer you as accurate of a prediction of your ovulation date or fertile window. However, they can still be useful in collecting the data related to your cycles, which would be helpful during your consultation appointment with an infertility doctor.  

Which fertility app is the best? 

 With all these apps and features on the market, how do you know which one actually works the best? At AZCREI, we don’t recommend any one in particular. Most have their individual pros and cons. However, when deciding which app to download, keep these areas in mind: 

• Accuracy: Most fertility-tracker apps make their ovulation predictions based on regular fertility cycles, and may not perfectly reflect your own cycle—especially if you typically experience an irregular cycle. If you want to the most accurate prediction for your fertility window, make sure the app has the ability to input ovulation test data. 
• Ease of use: You should be able to easily navigate whichever app you end up using. Some allow you to input many data points while others are more streamlined and only require enough information to predict your next ovulation date. You may have to download a couple apps at first to see which interface you actually prefer. 
• Additional features: Again, some fertility apps come with a few bells and whistles while others are more straightforward. For instance, some integrate with thermometers and ovulation tests, while others require information to be input manually. Consider how you’ll want to use the app. What additional tools are you using to track your fertility? Do you want the ability to share your information with your partner or family? Is an online community important to you? 

When to See a Fertility Specialist 

While fertility-tracking apps can help people with ovaries be more aware of their menstrual cycle, they can’t actually help you achieve a pregnancy if you’re facing infertility issues. If you’ve been trying to get pregnant for one year (if you’re 35 or younger) or six months (if you’re older than 35), it’s time to see a fertility specialist. 

At AZCREI, we can help identify the potential causes behind your infertility and provide treatment options to help you have your baby. The information recorded in the app will provide a helpful starting point for your testing and treatment journey. To make that first appointment, give us a call at (520) 326-0001 or schedule it online now. 

Starting a family can be a stressful process; there are many things that can affect a couple’s fertility—some which you may not have considered. For whatever reason, it’s often believed that infertility is a women’s issue, so male-factor infertility is commonly overlooked. But the fact is, males are found to be solely responsible for 20-30% of infertility cases.

At Arizona Center for Reproductive Endocrinology & Infertility, we ask for a thorough medical history and plan testing—for both female and male partners before jumping into treatments.. Our goal is to help couples have a baby, and discovering the cause behind infertility (whether it be a female or male factor) is essential.

The frequent causes of male infertility are:

• Low sperm count
• Low sperm motility
• Abnormal sperm morphology (shape and/or size)
• Issues with semen structure or composition

Why might these happen? There are several factors that can affect a male’s infertility, here are the five most common ones.

Age

Most people know the impact a woman’s age can have on fertility, but a man’s age can have an effect on fertility as well. Although a man may continue to produce new sperm throughout his life, the quality of his sperm can be negatively affected by age. The amount of semen and sperm motility continually decrease as men get older. In fact, the risk of miscarriage is substantially higher for women whose male partner is older than 45 (versus those who have partners younger than 25).

Smoking

Men who smoke, or have been exposed to secondhand smoke, often have reduced fertility. Smoking has been linked to decreased sperm count, lower sperm motility, and poor sperm morphology; it may also affect the DNA contained in sperm.

Alcohol Consumption

Alcohol can lower testosterone levels, cause erectile dysfunction, reduce libido, and decrease sperm production. Prolonged or excessive drinking can also lead to liver disease, which can impact fertility. A 2014 study published by BMJ Open, found that consuming just five alcoholic drinks a week can reduce sperm quality, and that more alcohol is correlated with weaker sperm.

Weight

Weight—whether it’s being overweight or underweight—can negatively impact a man’s sperm count and can decrease libido. Healthy eating and regular exercise are necessary for general wellbeing, but both are especially important when trying to conceive.

Body Temperature

Heat, in extreme amounts, especially around the testicles, can impair sperm production and function, as well as damage the DNA in sperm. This includes heat from hot tubs, saunas, and electronics. However, this is typically only a temporary effect, and usually happens in extreme conditions or with regular exposure, so it shouldn’t be too great a concern.

Treating Male Infertility

If you are worried about your fertility or possible conditions that may lead to infertility, our team at AZCREI can help. During your initial consultation, we’ll discuss possible causes and then schedule the appropriate tests to help us determine the best treatment options (for either male-factor infertility or female-factor infertility).

In general, male infertility may be treated through medical, surgical, or assisted reproductive therapies. Typically, we will try to treat the underlying medical cause of male infertility first. If that doesn’t solve the problem, we will move on to more advanced treatments, including Intracytoplasmic Sperm Injection (ISCI) or utilizing a sperm donor.

Ultimately, it’s our goal to help every couple have a healthy, happy baby. There very well might be a combination of both male and female factors that are causing the difficulty behind conceiving. As we go through testing and creating a treatment plan, we always try to optimize fertility—on both sides—and correct any problems to achieve a pregnancy.

For more information on how AZCREI can help you have a baby or to schedule a visit, give us a call at (520) 326-0001 or contact us online.

Going to see an infertility specialist for the first time can be daunting, overwhelming, exciting, and full of hope. When people visit Arizona Center for Reproductive Endocrinology & Infertility for the first time, we know that there are a lot of emotions and questions running through their minds.

During your initial consultation, Dr. Gelety spends a considerable amount of time making sure you understand all aspects of the diagnosis, testing, and treatment processes. With more than 20 years in the industry, he’s able to anticipate our patients’ questions and concerns and address them. However, it’s still a good idea for you to have a list of questions ready to ask when first seeking infertility treatments, because several of the answers will be specific to your personal circumstance.

If you feel comfortable sharing your situation, we’d encourage you to ask family or friends who have gone through similar experiences for advice on what they thought was helpful to ask their specialist. There are also several websites, online support groups, and forums that may offer advice on what information is necessary or beneficial. Based on our own experience at AZCREI, these are six questions you’ll want to ask—and the reasons why their answers are so important—before starting treatments.

1. What is my diagnosis?

While it’s difficult to make an exact diagnosis during your first meeting with Dr. Gelety, he may have an idea of the potential causes behind your infertility. (He’ll ask you and your partner questions about your medical history and lifestyle to help him make this determination.) This assessment will dictate the next steps forward and which diagnostic tests he’ll recommend.

2. Are there lifestyle habits that might be affecting my/our fertility?

Smoking, excessive alcohol consumption, mental stress, and poor diet can affect hormone levels and increase the risk of infertility. Sometimes, making healthier lifestyle choices such as quitting smoking, managing stress, or losing weight can correct hormone imbalances and boost your fertility.

3. How can I/we manage the stress of infertility and treatments?

If stress is increasing the risk of infertility, managing that stress can have beneficial results. Understanding all the resources available to you—and more importantly, what may work best for you—can help support you and keep you going through the treatment process if things become difficult.

4. What do you think will be the best treatment plan for me/us?

The tests and treatments you’ll need will directly affect how much the overall process may cost. At AZCREI, we always start with the simplest, least invasive, and most economical procedures first, but understanding each potential step in your treatment plan will prepare you for the possibility of a more expensive treatment later. Plus, being aware of your full treatment plan will help you keep things in perspective if a procedure isn’t immediately successful.

5. What success rate can I/we expect with each treatment?

There are many variables that determine the success rate of treatments, and knowing the likelihood that a specific treatment will result in a successful pregnancy in one, two, or three cycles will help you prepare emotionally and mentally, and plan financially.

6. What will my insurance cover? What out-of-pocket expenses should I/we expect?

For about 90 percent of our patients, some portion of evaluations or procedures are covered by insurance, however it can vary greatly depending on policy. Typically, insurance might cover: expenses related to diagnostic testing only, full coverage of all services, a combination of testing and treatments, or absolutely nothing. Asking this question up front will help you create a financial plan to help with the costs.

Our goal is to help you achieve a pregnancy and have a healthy, happy baby. We want you to feel comfortable with your options and confident in your treatment plan—and we’re always here to answer any questions you may have along the way. To schedule an appointment with us, call (520) 326-0001 or visit us online.