There are plenty of stories of women and couples having a baby in their late 30s or early 40s, but it’s a biological fact that fertility declines as both women and men age. There are plenty of reasons to put off having children—career, finances, travel, and simply not feeling ready just yet—but having a baby later in life can be met with difficulty and some complications, simply because of age.

However, at Arizona Center for Reproductive Endocrinology & Infertility, it’s our goal to help any individual or couple have a baby, no matter their age. Here’s what we hope you’d understand about age and fertility.

Peak Fertility
A woman’s peak fertile years are during her late teens into her 20s. A woman is born with all the eggs she will ever have, so as she ages, the number (and quality) of eggs will reduce over time; this is why fertility decreases over time.

As for men, semen quantity typically peaks between the ages of 30 and 35, with a distinct decline in the 40s.

For healthy couples in their 20s and early 30s, approximately one in four women will get pregnant during a single menstrual cycle.

Fertility Decline in Women
By age 30, fertility for women starts to decline. The decline becomes more rapid in their mid-30s, and by age 45, fertility has declined so much that getting pregnant naturally—without any assisted reproductive procedures—is unlikely to happen. As they age, women are at a higher risk for disorders that can affect their fertility as well, such as endometriosis and uterine fibroids.

In fact, by age 40, only around 1 in 10 women will get pregnant per menstrual cycle.

Older age comes with other challenges aside from just achieving a pregnancy. The remaining eggs an older woman has in her ovaries are more likely to have chromosomal abnormalities. Down syndrome is the most common chromosomal disorder that occurs with late pregnancy. When a woman gets pregnant in her 20s, the risk is 1 in 1,480, but as she reaches 45 years of age, the risk increases dramatically to 1 in 35.

Preimplantation genetic screening (PGS) is available so that an older couple, or woman, can assess the risk that a baby will be born with a birth defect or genetic disorder. At AZCREI, we will review the testing options available to you to help you an informed choice on the best way to move forward with infertility treatments.

In addition to PGS, we can also conduct tests to determine the number and quality of your ovarian reserve. These blood tests look at follicle-stimulating hormone (FSH) or antimüllerian hormone (AMH) levels to assess potential fertility. An ultrasound may sometimes be used to count the number of follicles (antral follicle count, or AFC) as well. However, it is important to note that there is no single test that will perfectly measures a woman’s ovarian reserve or fertility.

Despite the challenges, many women older than 35 years can have successful pregnancies and healthy babies. While you can’t preserve fertility, you can take measures to increase the chances of pregnancy when you’re older, such as freezing your eggs while in your 20s, especially if you’re considering putting off pregnancy until later in life.

Age, Fertility, Men
For the most part, age has less of an effect on men’s fertility, but younger men do have more active and better-quality sperm than older men.

Barring any health issues, men typically produce millions of new sperm every day, but men older than 40 have fewer healthy sperm, than men at a younger age. Semen and sperm motility also decrease between the ages of 20 and 80.

A semen analysis, can help determine the number, shape, and movement of a man’s sperm to help estimate his potential fertility.

Don’t Give Up Hope
Age does make it more difficult to get pregnant, but it’s not impossible. There are several medical strategies and infertility treatments that may increase your chance of conceiving. If age has become a factor in your ability to get pregnant, schedule an appointment with AZCREI today by contacting us online or calling 520-326-0001.

 

The entire infertility-treatment process can be overwhelming if you don’t know what to expect. That’s why at Arizona Center for Reproductive Endocrinology & Infertility, we spend a considerable amount of time explaining the choices available to you, including the use of a sperm donor and sperm bank, if necessary.
While selecting and purchasing donor sperm through a sperm bank is a unique process, it doesn’t need to be complicated, stressful, or intimidating. Here are the answers to some of the questions you may have.

What exactly is a sperm bank?
A sperm bank, or cryobank, is a facility that collects, freezes, and stores sperm to be used in infertility treatments.

Why a sperm bank?
There are many reasons to use a sperm bank. The sperm stored at these banks is usually donated by men to be used by couples who need sperm donation for in order to achieve a pregnancy; this may be due to male infertility or for a same-sex female couple. In some cases, it may also be provided by men who want to preserve their own sperm, a procedure referred to as cryopreservation, for future use—typically because of a medical reason (like chemotherapy) or before a vasectomy. A transgender woman may also want to freeze her sperm before transitioning.

What should I look for in a sperm bank?
Generally speaking, you want to choose a sperm bank that is reputable and highly rated. However, a bigger sperm bank is not necessarily better; pricing and regulations can vary from state to state and bank to bank. Any sperm bank you consider should first and foremost be conducting comprehensive genetic and medical background tests for each of its donors. You should be offered a thorough medical history of your perspective donor. At AZCREI, we can point you in the right direction and help you find a bank that works best for your needs.

How do I choose a donor?
Once you begin working with a sperm bank, you can begin the process of choosing your sperm donor, taking both personality and physical traits into consideration. Typically, criteria include: body type, family medical history, eye color, hair color, and even religion, hobbies, and education.

What happens once I choose a donor?
During the process, you’ll likely be asked what procedure you’re planning on using the sperm for; this is so the sperm can be properly prepared before use. It’ll then be shipped to our office to use for the artificial insemination, IVF, or an IUI procedure. At AZCREI, we actually offer these services in-house, so we can take care of the entire process for you once you choose a donor. All you have to do is fill out a form, and we’ll take care of the order process, taking away some of the stress of the process.

Is sperm donation covered by insurance?
Coverage varies by insurance company and policies. However, unless you have specific infertility coverage, you will likely have to pay out of pocket for the majority, if not all, of the cryobank-related procedures and process.

Are there any special considerations for same-sex families?
Same-sex female couples need a sperm donor to become pregnant; this can be someone they know or it could be an anonymous donor chosen through a sperm bank. Same-sex female couples do have the unique opportunity to share in the pregnancy; one woman can donate her egg to be fertilized with the sperm, thereby become the genetic mother, and the other can carry and deliver the baby, becoming the birth mother. Other than that, there really are no special considerations to take into account during the process.

Sperm banks are an effective option for couples who need a donation to become pregnant. To make an appointment with us and learn more about sperm donation, visit Arizona Center for Reproductive Endocrinology and Infertility online or call us at 520-326-0001.

Polycystic ovarian syndrome (PCOS) is one of the most common hormonal abnormalities in young women. With the disorder, small, fluid-filled sacs—or cysts—grow inside the ovaries, which affects ovulation.

Many women have PCOS but don’t know it; in fact, some studies suggest that up to 70 percent of women with PCOS haven’t yet been diagnosed! At Arizona Center for Reproductive Endocrinology & Infertility, we’ve helped many women determine if PCOS is the reason they’re unable to get pregnant; this is typically what we look for.

PCOS Symptoms
The symptoms of PCOS will usually manifest during a woman’s late teens or early 20s. Not every woman with the disorder will experience all of the symptoms, and each one can vary from mild to severe.

Common symptoms of PCOS include:

Irregular or lack of periods

Because PCOS prevents ovulation, the uterine lining doesn’t shed every month so there is no regular period. Some women with PCOS get fewer than eight periods a year.

Heavy bleeding

Since the uterine lining isn’t being shed regularly, it builds up for a longer period of time. Women with PCOS typically experience heavy bleeding whenever they do have a period.

Excessive hair growth (hirsutism)

More than 70 percent of women with PCOS begin growing unwanted hair on their face, chest, stomach, back, buttocks, thumbs, or toes.

Weight gain

About half of women who have PCOS struggle with weight gain or obesity; they also have difficulty losing weight.

Thinning hair or hair loss

Women with the disorder might experience thinning hair or hair loss, which typically worsens as they hit middle age.

Headaches

The hormone changes related to PCOS can trigger headaches in some women.

Oily skin or acne

Hormone changes can make the skin oilier than usual, which may cause breakouts on the face, chest, and upper back.

 Changes in sleep patterns

PCOS can affect women’s sleep cycles; they may have difficulty falling or staying asleep and might feel tired all the time. PCOS is also related to sleep apnea.

Difficulty getting pregnant

Of course, because PCOS is one of the leading causes of infertility, women with the disorder will experience difficulty getting pregnant.

If you experience any of these symptoms or think you might have PCOS, talk to your primary care doctor, endocrinologist, or gynecologist. A pelvic exam, blood tests, and ultrasound can confirm the diagnosis.

PCOS Treatments
PCOS cannot be cured, but the symptoms can be managed—and with proper treatment, women with PCOS will still be able to achieve a pregnancy. These are generally the most successful treatments.

Lifestyle changes

If a woman is able to lose just 5 to 10 percent of her body weight, it can help regulate her menstrual cycle and improve PCOS symptoms. A low-carb diet and regular exercise can improve ovulation, as well as insulin levels.

Hormone medication

It’s relatively easy to correct the disorder using medication, and pregnancy will typically follow fairly quickly. Metformin—which is used to treat type 2 diabetes—can also treat PCOS by improving insulin levels and ultimately restoring normal menstrual cycles. Clomiphene (or Clomid) is a fertility drug that can help women with PCOS get pregnant. If pregnancy isn’t a concern, birth control pills will help regulate the menstrual cycle and treat many PCOS symptoms, such as hair growth and acne.

If you and your partner have been struggling to get pregnant and you suspect PCOS might be the cause, contact AZCREI today. You can schedule a consultation with our team by calling (520) 326-0001 or by visiting us online.

Hormonal imbalances, such as PCOS, are among the leading causes of infertility in women, as they can interfere with ovulation. The problem is, hormone levels are not regularly monitored by primary care doctors since we typically assume things (including hormones) are all working as they should.

While it’s normal to have hormone fluctuations throughout your menstrual cycle—these natural fluctuations actually allow your body to reproduce—a complete hormone imbalance can prevent pregnancy. Fortunately, at Arizona Center for Reproductive Endocrinology & Infertility, there are several treatments we can do to help correct hormone imbalances and help you achieve a successful pregnancy. Here’s what you need to know.

Signs of Hormone Imbalance

Hormone imbalance can manifest in many different ways. If you are experiencing any of these symptoms, it may be due to a hormone imbalance:

• Bloating
• Blurred vision
• Breast tenderness
• Changes in appetite
• Changes in blood pressure
• Changes in heart rate
• Changes in temperature/climate sensitivity
• Difficulty falling or staying asleep
• Dry skin, skin rashes
• Excessive sweating
• Frequent urination
• Headaches
• Inability to achieve a pregnancy
• Increased thirst
• Irritability
• Long-term fatigue
• Newly developed anxiety or depression
• Reduced sex drive
• Thinning or brittle hair
• Unexplained weight gain or weight loss

Hormonal Testing

When you visit AZCREI for the first time, we include hormonal testing as part of our consultation to determine the cause of your infertility. It’s important to have the correct diagnosis to provide effective treatment. When we’re looking at issues within the endocrine system, we are likely to be specifically testing these hormones:

• Thyroid hormones (TSH and free T4)—The thyroid emits TSH and free T4 hormones, which help to regulate your metabolism, amongst other things. An imbalance in the thyroid can directly impact the production of other hormones and cause irregular menstrual cycles. Thyroid imbalances are relatively uncommon (hyperthyroidism only affects about 1 percent of women), and are easily treated with medication.
• Prolactin—The prolactin hormone becomes elevated in pregnancy (it helps women produce breast milk), and can also be increased with certain medications. High prolactin levels in women may disrupt ovulation; for men, high levels of prolactin can cause erectile dysfunction and decrease sex drive.
• Androgens—Elevated androgen levels, or hyperandrogenism, are often seen in patients with PCOS, and can cause irregular menstrual cycles.
• Luteinizing hormone (LH)—LH helps regulates the production of estrogen and progesterone, which stimulates ovulation in women. The level of LH can vary daily, but should fall within a certain range based on age.
• Follicle stimulating hormone (FSH)—FSH also helps regulate the production of progesterone and estrogen, but FSH is responsible for the stimulation of ovarian follicles. Elevated FSH levels are commonly seen in patients in menopause, who experience primary ovarian insufficiency, or who have been diagnosed with PCOS.
• Estradiol—Estradiol is a form of estrogen. Low estrogen can prevent ovulation and cause irregular menstruation, while high levels can hinder embryo implantation. Although estrogen levels can fluctuate during the menstrual cycle, if there are other health concerns present (such as irregular menstrual cycles, abnormal bleeding, infertility, vaginal dryness, increased PMS symptoms, etc.), estradiol draws can be performed in combination with FSH testing.

Causes of Hormone Imbalance

If we find that a hormone imbalance may be causing your infertility, we’ll then get to the root of the cause so we can remedy the issue. Depending on what we discover during testing, there may be natural solutions to bring your hormone levels back to normal. Some of the most common causes of hormone imbalance in both men and women include:

• Addison’s disease
• Allergies
• Benign tumors or cysts
• Birth control
• Chemotherapy and radiation therapy
• Chronic or extreme stress
• Cushing’s syndrome
• Diabetes
• Exposure to toxins, pollutants, or other harmful chemicals
• Obesity
• Poor diet and nutrition
• Steroid medication and abuse

Regardless of the reason behind a hormone imbalance, it’s our mission to help you uncover and overcome your infertility. Our team at AZCREI is here to help you achieve a successful pregnancy. Whether you think a hormone imbalance is behind your infertility or are completely unsure of the cause, we’d like to help you find out more. To schedule a consultation at AZCREI, call us at (520) 326-0001 or contact us online.

When a couple visits Arizona Center for Reproductive Endocrinology & Infertility, they’re looking for the most effective fertility solutions to help them maximize their chances of getting pregnant. At AZCREI, we’re at the forefront of innovative treatment techniques, one of which includes the blastocyst transfer procedure.

The blastocyst procedure—or blastocyst transfer—is a specialized IVF technique in which an embryo that has been matured to the blastocyst stage is transferred to the womb. For many couples, it’s a solution that brings hope and helps them have a baby, even when other treatments weren’t successful in the past. Here’s what you need to know about blastocyst transfer.

What Is a blastocyst?

A blastocyst is an embryo that has progressed to a phase where it is highly developed and ready to attach to the uterine wall (or ready for implantation). This critical point of development usually occurs five to six days after ovulation. Once embryos have matured to this phase, they are more likely to be chromosomally normal and result in a viable pregnancy.

When an egg is fertilized, the resulting embryo begins as a single cell that must develop and differentiate until it is able to “hatch” from its shell (or zona pellucida), and attach itself to the uterine wall. At this point, the embryo consists of 100-150 cells and becomes a blastocyst; as a blastocyst, the embryo is considered to be biologically fit enough to successfully implant and continue to develop into a full-term pregnancy.

The Blastocyst Transfer

The blastocyst procedure, or blastocyst transfer, is the placement of developed blastocysts into the uterus.

When an IVF embryo is transferred on the second or third day after egg fertilization, they are only at the four- to eight-cell stage, and therefore must continue to grow for another few days in order to reach the blastocyst phase and implant into the uterine wall.

If we wait to transfer and implant an embryo until it’s at the blastocyst phase, we have a greater chance of the IVF procedure resulting in a pregnancy. This is because many embryos will stop growing at the earlier stage (when they are just four to eight cells), often due to chromosomal issues; the ones that do successfully reach the blastocyst phase are more developmentally competent.

Of course, the true success rate of a blastocyst transfer is determined and affected by several factors, including the age and cause of infertility. At AZCREI, our team will discuss all the options available to your before beginning a procedure.

Benefits of the Blastocyst Procedure

A blastocyst transfer allows for the selection of embryos that have the highest chance of a successful pregnancy. This allows us to use fewer embryos during implantation while maintaining excellent pregnancy rates.

A Solution for Women with Multiple Failed Cycles

Under natural circumstances, it takes about five days after fertilization for the embryo to travel through the fallopian tube to reach the uterus. During the time of ovulation, the uterus contracts to guide the egg through the fallopian tubes and to guide any potential sperm to the egg for fertilization. Blastocyst transfer can help women who have had multiple failed cycles, because in waiting the five days for implantation, the uterus becomes more accessible; there are fewer contractions and a higher likelihood of the uterus accepting the blastocysts.

Reducing the Likelihood of Multiple Births

Another great advantage of the blastocyst procedure is that it allows the transfer of a single well-developed embryo into the uterus. This greatly reduces the probability of conceiving twins (or even triplets), as well as the complications that arise as the result of multiple births.

Greater Opportunity for Freezing Viable Eggs

Because we only need one or two blastocysts for a successful transfer instead of three to four early-stage embryos, we have more embryos available for cryopreservation. This gives us a greater opportunity for frozen embryo transfer (FET) cycles in the future.

We want you to rest assured that you have options when it comes to overcoming your infertility and having a baby. Our patients appreciate that we take the time to educate them throughout the entire process so that they can make a well-informed decision. To make an appointment and learn more about blastocyst transfer options, call us at 520-326-0001 or visit us online.

Endometriosis (or, “endo”) is a common health problem for women; in fact, it affects at least 11 percent of American women between the ages of 15 to 49. That’s more than 6.5 million women in the U.S. alone! Worldwide, it’s estimated that the condition affects 176 million women. 

Many women who have endometriosis are able to get pregnant, but it can be a challenge for others. As many as one in every two women find it harder to get pregnant. Research has found that 70 to 90 percent of infertile women have been endometriosis, and 30 to 50 percent of women diagnosed with endometriosis face issues with fertility.

At Arizona Center for Reproductive Endocrinology & Infertility, we assist women who are dealing with endometriosis achieve a successful pregnancy. If you’ve been diagnosed with the condition and are having difficulty conceiving, don’t give up hope! Here’s how our team can help you have a healthy, happy baby.

 

What is Endometriosis?

The leading theory for development of endometriosis is due to menstrual tissue leaking into the pelvic cavity during menstruation and then growing outside the uterus. 

Its symptoms—painful cramps, pain during or after sex, chronic lower back and pelvic pain, digestive problems, heavy bleeding, spotting, fatigue, and infertility—are often “normalized” as regular symptoms of a menstrual cycle. In some cases, women may not feel any pain or cramping at all. 

If you believe you have endometriosis, talk with your doctor. It’s difficult to diagnose the condition based on a pelvic exam ultrasound or even MRI; a definitive diagnosis requires a diagnostic laparoscopy.

Treatments for endometriosis include medications and procedural strategies to increase the chances of pregnancy, including in vitro fertilization or laparoscopic surgery to remove the endometriosis. 

 

The Effects of Endo on Fertility and Pregnancy

Not every woman with endometriosis will struggle with infertility, however, it is a very common cause. Unexplained infertility oftentimes is the result of endometriosis. It is still unclear exactly why endometriosis affects infertility in all cases, but some possible reasons are:

• The endometriosis or scar tissue may block the fallopian tubes.
• Endometriosis can distort the normal relationship between the ovary and fallopian tubes, making it more difficult for the sperm to find and fertilize the egg.
• The lining of the uterus where implantation occurs, the endometrium, may be affected by the presence of endometriosis, making pregnancy and embryo growth unachievable. 
• Endometriosis also causes inflammation, which can interfere with the delicate balance of hormones a woman needs to achieve a successful pregnancy.

 

Overcoming Infertility Caused by Endometriosis

At AZCREI, we have more than 30 years of experience evaluating and treating the causes of infertility in order to help women achieve a pregnancy. If a patient has already been diagnosed with endometriosis, we have several options available to improve her chances of pregnancy. Laparoscopic surgery allows us to remove the endometriotic implants and build up through ablation, using either cautery or laser techniques.

For many patients, this is enough and they are able to become pregnant. However, achieving a pregnancy within a short period of time is important in order to prevent the reoccurrence of endometriosis, which may lead to infertility in the future.

If laparoscopic treatment is unsuccessful, in vitro fertilization is a common option. Some couples may want to skip laparoscopic surgery altogether and jump straight into IVF. Skipping the treatment of endometriosis may mean the couple will require IVF again to achieve any future pregnancies.

While endometriosis does not necessarily make a pregnancy difficult, once it’s been achieved, it can lead to some complications. Your baby may be born early, and you may experience bleeding and/or high blood pressure. Once pregnancy is achieved, our team will monitor your health for the first trimester; after that, your OB/GYN will likely keep a close eye on your baby’s development. 
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If you’ve been struggling to get pregnant or have been diagnosed with endometriosis, we can help you grow your family. Contact AZCREI today by visiting us online or calling 520-326-0001.