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IVF & ICSI: Everything You Need to Know About How These Procedures Work Together

importblogger on September 21, 2017

People come from all over the world to be treated at the Arizona Center for Reproductive Endocrinology & Infertility. We’ve pioneered many different techniques and procedures to help our patients get pregnant. About 20 years ago, we received grant money that allowed us to pioneer the ICSI technique. In conjunction with IVF, it’s helped us achieve pregnancies for couples who had previously been unable to conceive together.

What Is IVF?

In vitro fertilization (IVF) is a procedure in which we retrieve all the eggs a woman naturally produces during any given month. The eggs are then paired with several hundred thousand sperm and fertilized in a petri dish in the laboratory. After fertilization, we can monitor the developing health of the embryos to make sure they’re chromosomally competent (and not likely to miscarry). Once the embryos are developed, we re-insert them back into the woman’s uterus and then follow up with the patient in two weeks to determine if she is pregnant.

What Is ICSI?

ICSI, or intra-cytoplasmic sperm injection, is also known as assisted fertilization. With this method, we are able to take a single sperm and, under a microscope, inject it through an egg’s zona pellucida to achieve fertilization.

To understand how this works, you have to understand fertilization. The egg is surrounded by a glycol-protein covering called the zona pellucida; sperm have little packets of enzymes on their heads that help dissolve the zona enough to actually penetrate the egg and cause fertilization. One sperm, or a small amount of sperm will not carry enough enzymes for the zona to dissolve and fertilization to occur. With the ICSI technique, we are able to bypass the zona pellucida and inject the sperm directly into the egg.

ICSI & IVF

ICSI must be done in conjunction with in vitro. We retrieve the eggs during the in vitro process and can then fertilize them with ICSI. Using both the procedures, we are able to achieve a fairly high pregnancy rate, and the embryo will continue to develop normally.

Who Can ICSI and IVF Help?

Men with Low Sperm Counts

When men have a sperm count so low it can’t be overcome by medical treatments or by fertility treatments (like intra-uterine insemination), we can use assisted fertilization. The advantage is that we only have to use one sperm, so even if a man has a very low sperm count, it’s typically still more than enough to fertilize the egg.

Couples Experiencing Idiopathic Infertility

We can often overcome idiopathic, or unexplained, infertility by using the ICSI technique. For example, with some couples, the reason for their infertility isn’t clear, and when we put the egg and sperm together in the petri dish, fertilization doesn’t occur. When we see that fertilization does not occur naturally, we can then use the ICSI technique to help the sperm fertilize the egg. Then once the egg is fertilized and the embryo develops, we transfer the embryo back into the uterus. The couple now has a very good chance at pregnancy because we solved the problem of failed fertilization.

Men with No Sperm in Their Semen

Some men are diagnosed with no sperm in their semen, and occasionally that is due to what we call obstructive azoospermia—a blockage in the ducts that carry the sperm prevent the sperm that’s produced in the testes from reaching the seminal fluid at the time of ejaculation. For example, cystic fibrosis is associated with congenital absence of the vas deferens; men with this disorder have sperm in their testes but not in their semen. We can overcome this through a simple in-office procedure called testicular sperm extraction (TESE). We typically perform the TESE with a urologist and perform a biopsy to obtain sperm from the testes. When we do this procedure, we usually obtain 100 to a few thousand sperm—not enough to achieve fertilization through regular in vitro, but more than enough to fertilize the egg with the ICSI technique and IVF.

Men Having a Vasectomy

Before a man has a vasectomy, the physician will offer to freeze a vial of sperm, in case they want to have kids in the future. In the past, a single vial wouldn’t be enough to achieve a pregnancy through artificial insemination. With that one vial of sperm we could perform the ICSI technique and that man would be able to have many more children.

ICSI and IVF are both highly technical procedures, but they offer an extremely high chance of fertilization. And once the egg is fertilized, the embryo should develop normally, and the couple will have a healthy, happy baby at the end of nine months. To make an appointment and learn more about how IVF and ICSI can help you achieve a pregnancy, visit Arizona Center for Reproductive Endocrinology & Infertility online or call us at 520-326-0001.

How Does In Vitro Work for Female Couples?

importblogger on September 18, 2017

Many female couples who visit the Arizona Center for Reproductive Endocrinology & Infertility are surprised to learn of the number of options that are available to help them have a baby. In vitro fertilization is one procedure that actually gives women several options for achieving a pregnancy.

Choosing a Sperm Donor

In order to get pregnant, female couples need a sperm donor to fertilize the egg. In fact, about 95 percent of couples utilizing sperm donation are same-sex couples. This can be a friend or family member, or an anonymous donor chosen from a sperm bank. If the couple decides to choose a donor they’re familiar with, we would screen them to verify that they are healthy and do not have any diseases that will affect the baby or pregnancy before we start the IVF process.

A sperm bank ensures the donor has already been screened in accordance with FDA guidelines, which eliminates the chance of communicable diseases. With a sperm bank, couples can choose a donor based on dozens of characteristics like ethnic background, educational background, and physical or behavioral features.

Opting for IVF

Female couples actually have two options when it comes to getting pregnant. Artificial insemination takes a concentrated sample from the chosen sperm donor and injects it into the fallopian tubes. This method has the same likelihood of achieving pregnancy as intercourse—it may take a few months before a viable pregnancy to occur. And it only allows one woman in the couple to participate in the pregnancy, since she uses her own egg and also carries the baby. In vitro fertilization is not only more successful, it also gives couples the unique option where both women can participate.

The IVF Process

In vitro fertilization (IVF), the second option female couples have to get pregnant, offers a high chance of pregnancy with the first attempt. If they choose, one woman can donate her egg, have it fertilized by the donated sperm, and then carry the baby herself as well.

However, the IVF procedure gives both women the opportunity to participate in the pregnancy if they want. One partner can donate the egg, and once it’s fertilized, it’s implanted into the uterus of the other woman, and she carries and delivers the baby. The woman who donates the egg becomes the baby’s genetic mother, and the woman who carries the baby is its birth mother.

Many of the couples who visit us have used this option to share the pregnancy responsibilities and joys between several of their children. The woman who donates her egg for the first child, will to carry the baby for the second child. And the woman who is the birth mother for the first child, will become the genetic mother and donate her egg for the second child, and so on. If the babies are conceived by the same egg donor, then they are genetic siblings, just with different birth moms.

Sometimes, though, depending on each woman’s age, one partner might be a better fit for a specific role in the pregnancy. If both partners decide to participate in the pregnancy, we recommend that the younger partner contribute the egg, and the older partner carry the baby. This is because, in general, younger eggs tend to be healthier and more likely to develop into a viable pregnancy. As long as we’re performing the IVF process with healthy eggs, anyone can carry embryos to term and deliver a healthy baby.

It’s such a joy to help female couples start their family. It’s important to us that they know their options, including IVF, and feel confident that they’ll be able to have a healthy, happy baby. To schedule an appointment at the Arizona Center for Reproductive Endocrinology and Infertility, call us at 520-326-0001 or visit us online.

Why You Shouldn’t Pay an Enormous Cost to Have a Baby

importblogger on August 14, 2017

At the Arizona Center for Reproductive Endocrinology & Infertility, we have years of experience helping couples and women have babies. Patients often travel from outside of Tucson to be treated by us, and it’s not just our long history of success that brings them here. While our primary goal is to help patients have a baby, we don’t want to put a financial strain on them in doing so. In fact, we strongly believe patients shouldn’t have to pay through the roof to start their family. Here are a few of the ways we help mitigate the costs and help you plan ahead so the fertility treatments you need can be more affordable.

We Explain Costs, Treatments, and Insurance Upfront & Take Everything One Step at a Time

When we first meet with a patient, we outline the expectations based on their age, how long they’ve been trying to get pregnant, and how long we expect it will take to get pregnant. During the first appointment, we’ll also go through the necessary tests and steps to determine why they’re not getting pregnant and the likely treatment options.

Typically, we start with the simplest and most affordable treatment options. Only when those are unsuccessful do we move on to other tests and procedures. As Dr. Gelety and our team will explain, many of these early evaluations are covered by insurance. And when insurance doesn’t cover a procedure or test, we have several packages and payment plans to make the costs of treatments less of a burden.

Not Every Couple Needs Expensive Treatments

When we follow this plan of simplest procedures to ones that are more complex, we find that many patients get pregnant quickly (sometimes even during the early part of the evaluation) and do not need more expensive treatments. Patients often come in thinking their only option is in vitro, and they’re going to have to spend thousands of dollars right off the bat. However, our goal is to identify the problem causing infertility and correct it, not push costly procedures if they are unnecessary.

Sometimes, patients become anxious every month they don’t get pregnant, but we try to encourage them by letting them know not everyone will get pregnant the first month and that there are still treatment options to consider. We try to help them understand that if they have a more challenging obstacle preventing their pregnancy, it may take a little longer, and we may have to use more intensive treatments to ultimately help them have a baby. But we are very judicious about moving on to the next set of treatments because we do know they can be more expensive, and we always want to keep our patients’ comfort levels in mind.

The idea is that it’s not one-size-fits-all; not everyone needs in vitro or a complicated and expensive treatment to get pregnant. There are many different causes of infertility; therefore, there are many different treatment options, and each one has its own chances of success. Not every part of the infertility treatment process needs to break the bank, and that’s something we remind our clients of as we go through this journey.

At AZCREI, We’re On Your Team

There are many different fertility clinics, and when you’re choosing one for your treatments, it’s important to consider the costs, success rate, and how much the doctors and staff really care. At AZCREI, we know that the medical aspects of infertility treatments can be stressful enough, so we try to do our part to manage everything we can do reduce the financial burden of the tests and procedures to make treatment costs more reasonable.

Our patients are very eager to start or grow their family, and we’re all on the same team and working toward the same goal. Our job is to help them achieve a pregnancy and have a healthy baby, not be burdened with financial stress. For more information on what starting a family may cost you, visit the Arizona Center for Reproductive Endocrinology and Infertility online or call us at 520-326-0001.

Everything You Need to Know About Using a Surrogate

importblogger on August 10, 2017

With many infertility cases, a couple will come into our fertility clinic, and the woman will assume she needs a surrogate because she’s having such difficulty getting pregnant. However, that is rarely the case since there are very few circumstances that affect the uterus enough to prevent a woman from carrying a baby—and even then, most of those issues can be surgically corrected.

Because of this, surrogacy is not a very common fertility option. Typically, it’s a solution for women who cannot carry a pregnancy because it would kill them, or who don’t have a uterus and physically can’t carry a pregnancy. At the Arizona Center for Reproductive Endocrinology & Infertility, we correct infertility issues and do whatever necessary to help you have a healthy baby. However, because surrogacy is occasionally the only option, here is everything you need to know about the process and procedure.

Understanding When a Surrogate is Necessary 

Under ideal conditions, the patient would carry the baby, but sometimes there are medical conditions that prevent this from happening. These are some examples of rare conditions and situations it would not be advisable or possible for a patient to carry a pregnancy, and a surrogate would be necessary.

  • No Uterus: It’s not uncommon for a young woman to have a hysterectomy because of a medical reason. In those situations, we can use her eggs, fertilize those eggs with her partner’s sperm, and find a surrogate to carry the baby for them.
  • End Stage Renal Disease: A serious illness like renal disease would prevent a woman from carrying the baby because we would be worried about her surviving the pregnancy.
  • End Stage Heart Disease: This would be another situation where it would possibly be seriously dangerous for the mother to carry the baby herself. Her heart may not be strong enough to support her and a growing baby, and we would be concerned with her chances of surviving until and through delivery.

Choosing a Surrogate

Surrogacy is a more involved process than donating eggs; for that reason, there are several factors that should be taken into consideration when choosing someone to carry the baby. It’s very important when you choose your surrogate that they are motivated to be as healthy as possible during the pregnancy.

Asking Someone You Know

The best option would be asking a family member—or someone you know and trust—to carry your baby. Preferably, the woman you ask would have children of her own already. This would indicate that she does well with pregnancy and would be able to carry the baby to full term. And, if she already has her own children, it would be less likely that she will change her mind at the end of nine months and want to keep and raise the baby herself. Whether it’s your sister, cousin, best friend, or someone else who cares deeply about your family, it’s a great situation because you can still be close to the pregnancy, and they can know they’re giving someone they love the gift of a family.

Using a Surrogacy Agency

When a close friend or family member is not an option, a surrogacy agency can be consulted. At agencies, the surrogate is screened for their health, previous pregnancy history, and lifestyle choices to make sure they would be able to carry a healthy baby. One downside to this route is the cost; it can be very expensive to compensate someone adequately for carrying the baby for nine months.

Regardless of the how you find your surrogate, you want to put yourself in a situation where you can avoid any legal battles regarding custody.

How AZCREI Can Help 

When you come into our clinic, our only focus is helping you have a baby. If you have to start your family by using a surrogate, our team is here to guide you through that entire journey. We screen your surrogate to make sure she’s healthy, and then prepare her for pregnancy. We also manage the entire fertilization and implantation processes. Our role is to make it as easy as possible for you and your surrogate to go through the process and achieve a pregnancy. Once the surrogate is pregnant, we follow her through the first trimester, and if things are going well, we’ll refer her to an OB/GYN for care and delivery.

Surrogacy can be a wonderful option for couples to finally have a baby when other options have failed. To make an appointment and learn if a surrogate can help you, visit Arizona Center for Reproductive Endocrinology and Infertility online or call us at 520-326-0001.

5 Ways AZCREI Helps Same-Sex Couples Become Parents

importblogger on August 7, 2017

There’s no better feeling than helping a couple have a baby. The joy in their eyes when they’re finally holding a healthy, happy baby can’t be topped. When same-sex couples visit our office, they are excited to hear about their options for becoming pregnant. At the Arizona Center for Reproductive Endocrinology & Infertility, there are five ways we help these couples start their family.

1. Egg Donor and Surrogate

When a gay couple wants to have a baby, they need both an egg donor and a surrogate. The donated eggs are fertilized with one partner’s or both partners’ sperm, and then implanted into the surrogate, who carries the baby to birth.

There are two options for the egg donor: the couple can choose a woman they know or use an egg donor registry to choose an anonymous donor. Before the eggs are retrieved, the donors are screened to make sure they don’t have any diseases or illnesses that can be passed to the baby. Once the egg donor is chosen, the couple also needs to find a surrogate. The donor and surrogate can be the woman, but typically, a third-party surrogate is the most common choice. The surrogate is also screened to make sure she is healthy enough to carry the baby without any issues or complications.

2. Artificial Insemination

Lesbian couples have two options when it comes to getting pregnant; the first is artificial insemination. The couple needs a sperm donor to fertilize the egg. This person can be someone the couple knows or it can be an anonymous donor chosen from a sperm bank. The donor is screened to eliminate the chance of communicable diseases that may affect the pregnancy or baby’s health.

Once the couple has a sperm donor, we can perform the artificial insemination. While this process is relatively simple and inexpensive, it has the same likelihood of achieving pregnancy as intercourse, and may take a few months for a viable pregnancy to occur.

3. IVF

In vitro fertilization (IVF), the second option lesbian couples have to get pregnant, offers a high chance of pregnancy with the first attempt. The process begins the same as artificial insemination—the couple must choose a sperm donor to fertilize the egg. The donor is closely examined to make sure he is healthy and free from any communicable diseases.

IVF is unique in that it allows both women to participate in the pregnancy. One partner can donate the egg (making her the genetic mother), and the other woman, the birth mother, carries and births the baby. We’ve helped many women start their families using this procedure, and they switch roles for their second child; so both partners have the chance to experience carrying a baby. And when the children are conceived by the same donor, the babies are genetically siblings, just with different birth mothers.

4. Advice and Support

While we can’t offer our couples actual legal advice, we can offer them resources and guidance during their pregnancy and at the time of delivery. We are very upfront with what to expect (costs, tests, procedures, etc.) and answer all their questions before beginning their journey of having children.

5. Warm, Welcoming Environment

No matter what procedure a couple needs to have a baby, we are thrilled to help them start their family. Our entire staff is accepting, warm, and compassionate. And once a couple is pregnant, we can refer them to doctors and OB/GYNs who are also very helpful and supportive during the rest of their pregnancy.

We welcome the chance to help same-sex couples start their families. There are many different ways for a couple to get pregnant, and it’s our job to make sure they are able to have a healthy, happy baby. Contact the Arizona Center for Reproductive Endocrinology and Infertility, by visiting us online or calling us at 520-326-0001 to schedule your appointment today.

Understanding the Important Role Your Cycle Plays in Getting Pregnant

importblogger on July 28, 2017

When couples visit the Arizona Center for Reproductive Endocrinology & Infertility, they come in with questions and concerns about why they aren’t getting pregnant. While there can be dozens of reasons why a pregnancy isn’t occurring, we always start with asking the woman about her menstrual cycle. Because it plays such a crucial role in achieving pregnancy, here’s everything you need to know about your cycle and having a baby. 

What Your Cycle Says About Your Health

The menstrual cycle is one of the most reliable predictors of a woman’s health, stress level, and overall wellbeing. Cycles that are very regular and predictable usually suggest regular ovulation. However, women who have unreliable, irregular, or non-existent cycles will have issues with conceiving because the success of the ovulation is disturbed in some way.

Issues with a woman’s cycle—whether it’s irregular, very heavy, or painful—can be signs of serious endocrine or medical conditions, like endometriosis. So paying attention to the menstrual cycle and any changes that occur to it is very important not only in terms of a woman’s fertility, but for her health as well. 

Tracking Your Cycle

Since the menstrual cycle is such a significant indicator of your health and ability to get pregnant, it’s crucial to monitor and note any changes to it. The simplest way to track your cycle is to mark the day your period starts and ends on a calendar. With a few months’ worth of information, you’ll have an idea of what your cycle is like and what’s normal for you.

The length of the cycle can vary even in women with normal ovulation; it isn’t always exactly every 28 days. The time from ovulation to the next menstrual period is usually the most constant time, and variation in the cycle has to do with how long it takes for ovulation to occur.

From the beginning of the cycle to ovulation is typically about 10 days. A woman’s period starts 14 days after ovulation, resulting in a 24-day cycle. But if her period begins every 35 days, for example, that means she’s ovulating much later in the cycle, probably at day 18 or 20.

The time of ovulation is what is important to know when you’re trying for pregnancy; however, the biggest misconception most couples have is that there’s a very narrow window for conceiving during ovulation. The truth is, your chances of getting pregnant are very high for about 5-7 days before you ovulate and 5-7 days after ovulation. This is because subtle changes in the cycle can cause you to ovulate on a slightly different day. So if a healthy couple is frequently having intercourse and still not getting pregnant, timing is typically not the problem; there’s probably something else to blame.

What We Need to Know About Your Cycle

When we evaluate the patient and her partner for infertility, we take a very careful history regarding the woman’s menstrual cycle, and then we do a physical examination to determine if there are any other medical problems that may be preventing pregnancy. We make it a point to talk about the woman’s cycle and ask questions like:

  • When did your last cycle start?
  • Have you been on birth control? If so, what type?
  • What was the purpose of your birth control (to prevent pregnancy, to regulate your cycle, etc.)?
  • Are your periods ever heavy? Painful?
  • Have there been any recent changes to your menstrual cycle?

With answers to these questions, we’re able to have a better understanding of the woman’s health and the regularity of her ovulation. For example, heavy bleeding or painful periods can be an indicator of a medical problem like fibroids, polyps, or endometriosis. And changes to the cycle can be caused by increased stress, weight fluctuation, or something more serious, like diabetes or a renal disease.

It’s very important for us to determine the underlying cause of the disruption of the menstrual cycle because they can be very innocuous and common, or it can be something very serious. About half of infertility issues that are related to a woman are due to irregular ovulation or a lack of ovulation. Thankfully, most medical conditions and hormonal problems are very easy to correct and when they are corrected, the woman is able to ovulate regularly and quickly achieve pregnancy.

At the Arizona Center for Reproductive Endocrinology & Infertility, we can work through the problems within a woman’s cycle to help her conceive and have a healthy baby. If you have any questions about your struggles with fertility or would like to make an appointment, contact us today by calling 520-326-0001 or visiting us online.

3 Reasons Every Woman Should Consider Freezing Her Eggs

importblogger on July 25, 2017

Many of the couples we work with who have infertility issues wish they had taken the steps to freeze their eggs when they were younger.

Egg freezing isn’t for everyone. For example, if a woman starts her family early in life, it wouldn’t make sense for her to freeze her eggs. However, egg freezing does offer several benefits to women who might wait to start a family for several different reasons.

1. It gives you the option to have children later in life.

Egg freezing gives women the ability to preserve the possibility of having children as they get older, wait to get married, or start a family. If a woman knows it’s going to be a while before she has children, but thinks she might want children in the future, the earlier she can freeze her eggs, the better.

The procedure gives a woman peace of mind that she will be able to have children later in life. Once her eggs are frozen, she can focus on other aspects of her life until she’s ready to have a baby. It’s a tremendous advantage that prevents women from having to deal with infertility issues once they do decide to start their family.

2. The eggs are healthier the younger you are.

As a woman ages, her fertility begins to decline significantly. The younger she decides to go through with the procedure, the more eggs we’ll be able to work with and the more likely we are to freeze eggs of high quality to increase her chance of pregnancy later on. Freezing eggs early on reduces the chance of miscarriages and other complications when a woman is older and ready for children.

Women actually reach their peak fertility at age 22, so the younger a woman is, the better the chances of freezing healthier eggs. However, several studies have shown that the ideal age for elective egg freezing for women is between 35 and 37. This is because fertility begins to decline when a woman is in her mid- to late-30s; yet freezing her eggs in her 20s isn’t always optimal since she can still easily start a family naturally within a few years.

3. It’s insurance in the event a serious medical issue arises.

Sometimes a woman is faced with a medical situation, like cancer or leukemia, and needs therapies and treatments that could render her sterile in the future. Although most modern treatments are successful and don’t end up affecting a woman’s fertility, freezing her eggs before she starts treatment gives her reassurance that she will definitely be able to have children after she’s healed and healthy.

Three Questions Every Woman Should Ask Herself

Before you elect to freeze your eggs, there are three questions your should ask yourself.

  • Am I serious about having children in the future?
  • Would I be willing to take steps to make sure that is going to be more likely rather than just hoping for the best?
  • Am I willing to go through the financial investment and the small investment in time for the simple medical procedure to have that done?

Just because you elect to freeze your eggs, doesn’t necessarily mean we have to use those eggs to achieve a pregnancy. Even if you wait until later in life to get pregnant, there is still the chance that you can conceive and have a baby naturally. The frozen eggs are more of an insurance policy that ensures you do have the option to get pregnant whenever you choose to do so.

If you have specific questions regarding egg freezing or would like more information in deciding if it’s a treatment option you should consider, we’re here to help. Schedule an appointment for a consultation or procedure and contact the Arizona Center for Reproductive Endocrinology & Infertility today by calling (520) 326-0001 or visiting us online.

What to Expect Now That You’re Pregnant Through a Fertility Clinic

importblogger on July 21, 2017

A lot of couples we work with have experienced difficulty not only getting pregnant, but staying pregnant. These couples know that getting pregnant doesn’t necessarily mean they’ll be holding a healthy, happy baby at the end of nine months. At Arizona Center for Reproductive Endocrinology & Fertility, we know conception is just the beginning, and we are with you through every step of your pregnancy journey.

Once you do get pregnant, here’s what you should know and expect.

Understanding the Stages of Pregnancy

Conception occurs when the egg and sperm meet, and that, in itself, is not complicated; but conception doesn’t always lead to a viable pregnancy. So instead of focusing on conception, we look at fertilization rates, which is how often the sperm fertilizes the egg, and cleavage rates, which is how the cells of the early embryo divide.

Once the embryo is implanted and we have evidence of pregnancy, we consider it a chemical pregnancy because the hormones of pregnancy are starting to be produced. Once the pregnancy begins growing in the uterus and we see clinical, concrete evidence that the patient is pregnant, we call it a clinical pregnancy. Finally, once we see that the pregnancy is healthy and the fetus is growing, that’s a viable pregnancy.

Our goal isn’t even necessarily a viable pregnancy. We want to get through the pregnancy and make sure the couple delivers a healthy baby. So ultimately, we’re concerned with the live birth rate at AZCREI.

Determining Pregnancy

We know as soon as possible—the day of a patient’s missed period—whether or not she’s pregnant. We use very sensitive tests to find out if a patient is pregnant, and as soon as we know that she is, we schedule an ultrasound for the following week (five weeks from the patient’s last menstrual period), to see if the pregnancy is growing and if it’s actually in the uterus. At six weeks from the last menstrual period, we can hear the baby’s heart beat on the ultrasound, and that’s a very reassuring sign that the pregnancy is progressing.

By the end of the first trimester, which is at the end of 12 weeks, we can be confident that most of the problems that could have already occurred, like miscarriage or ectopic pregnancy, have been eliminated. When we’re very certain that the pregnancy is going as good as it can, that’s when we send our patient to her OB/GYN.

Getting Through Pregnancy to a Healthy Delivery

It’s getting through pregnancy that could potentially be the biggest challenge. There are pitfalls and complications that can arise during the nine-month journey, and we need to make sure the baby is healthy, born on time, and doesn’t have medical problems later in life. That’s why our clinic is constantly checking in throughout the whole process; we want to make sure the developing baby is doing well as it is in utero and until its birth.

Once a patient is pregnant, we see them weekly or every two weeks depending on the circumstances, risk, and how things are progressing. The good news is that insurance is bounded by law to cover a patient’s pregnancy, so from here on out, tests and appointments are paid for by insurance, reducing some of the financial strain and stress. And then we follow them very closely with ultrasounds and blood tests, giving them additional reassurance that the pregnancy continues to be healthy.

Working to Prevent Complications During Pregnancy

It’s so important to us that we check in because there is a possibility for a lot of complications early on in the pregnancy. With obstetrics and modern medicine, we’re trying to eliminate problems and deal with them as they come up.

Some complications we’re looking out for are bleeding, abnormal pain, cysts, or ectopic pregnancies. But the most common issue, especially related to age, is an early miscarriage. Even with the best, high-tech evaluations early on, we can’t entirely eliminate the risk of miscarriage. We try to prevent couples from miscarrying early on, and if a miscarriage does occur, we figure out why and try to prevent it from happening again for the same reason in the future.

Our job is to get through the pregnancy so the baby is born on time and healthy, and that we’ve done all the appropriate things during the pregnancy to make sure that happens. Because couples have gone through so much difficulty to get pregnant, we’re heavily invested in making sure their pregnancy is viable. At Arizona Center for Reproductive Endocrinology & Infertility, we want to help you not only get pregnant, but have a healthy, happy baby. Contact us today by calling 520-326-0001 or visiting us online to start your journey.

Everything You Need to Know About IVF

importblogger on June 16, 2017

Many couples who come into the Arizona Center for Reproductive Endocrinology & Infertility for the first time have several questions, concerns, and misconceptions about in vitro fertilization (IVF). The procedure is becoming much more commonplace, and today’s technology has helped simplify the process while making it more successful. In fact, the rate of success with in vitro is dramatically better than it’s ever been; in general, two out of three patients will get pregnant on the very first attempt.

Because it is such a common procedure and so many patients have questions about it, here are seven things to know about IVF.

1. Not Every Couple Will Need In Vitro

At our clinic, we try to treat the medical causes of infertility before jumping into IVF. Because of modern technology, we can overcome almost any infertility problem and almost every woman can achieve a pregnancy. Not everyone will need in vitro to get pregnant, but it is an extremely successful procedure to fall back on when a couple does need it. And when it is necessary, IVF is not as difficult or expensive as many people believe it to be, so it’s a very viable option.

2. IVF Can Be Used to Overcome a Variety of Infertility Problems

IVF is designed to retrieve the eggs from a woman, fertilize them with sperm, and bypass the fallopian tubes to place the embryos directly into the uterus to achieve pregnancy. 20 to 30 years ago, IVF was ideal for women who had blocked fallopian tubes. Today, it is an effective and routine treatment option for a variety of problems that cannot be corrected through standard techniques.

For example, we can use IVF for problems with ovulation; if it’s difficult to get eggs or the eggs are poor quality, IVF can be used to circumvent that problem. The procedure can also be used with male-factor problems. For example, when the sperm is not able to naturally fertilize the egg, we can fertilize the eggs with the in vitro process to ensure they’re fertilized before they’re placed back into the uterus.

3. IVF Can Be Used to Screen for the Genetic Health of the Baby

At our clinic, we use IVF technology to screen for genetic problems or recurring miscarriage before the woman becomes pregnant. After the eggs are retrieved and fertilized, the resulting embryos can be tested to make sure they’re genetically normal and will have a lower chance of miscarriage. This increases the chances of a patient getting pregnant with the healthy embryo and being able to carry it to full term.

IVF gives us the ability to have a trove of information about the baby before a patient is even pregnant. We can even take testing a step further and make sure the baby is a boy or girl, or that the baby doesn’t carry the gene for cystic fibrosis, for example.

4. Babies Born Out of an IVF Procedure are Just As Healthy As Babies Conceived Naturally

Because we can test for the genetic health of the embryos, babies born out of in vitro are just as healthy—if not healthier—than babies born naturally. In fact, the chances of having a healthy baby can be increased because we can screen out those problems that would cause a miscarriage or other pregnancy issues. The chance for miscarriage or Down syndrome isn’t influenced by having in vitro; it’s determined by the age of the woman at the time she conceives, because it’s the eggs that she’s ovulating at that time that determines the chance of a healthy pregnancy and baby.

5. There Are Several Factors that Affect the Success of IVF

While the rate of success is generally high for IVF, the true success is very patient dependent, and determined by three important factors:

  • Age: Young women are typically more capable of getting pregnant naturally; older women sometimes have difficultly conceiving naturally as they age. A woman’s age at the time of in vitro is a dramatic determinant of the pregnancy’s success.
  • Cause of Infertility: The underlying problem that’s preventing pregnancy is also a very strong determinant of that pregnancy’s success. For example, a woman who has had children in the past but had her tubes tied, will have a tremendously higher chance of getting pregnant through IVF than a woman who has been trying to conceive without success for 20 years.
  • Number of Embryo Placed in the Uterus: For every embryo we place in the uterus, there’s a finite chance of pregnancy. If we put more than one embryo in the uterus, there’s more of a chance of pregnancy, but there’s also a higher chance of multiple births; so it becomes a slight balancing act that we discuss with each couple individually.

6. There Isn’t Too Much Involved in the IVF Process

It’s important to know what’s involved with the IVF process before embarking on the journey. During our first appointment with a couple, we go over all the procedures involved—ultrasounds, blood tests and the process for removing the woman’s eggs and placing the fertilized embryos. Patients are often surprised that they don’t have to really interrupt their lives to complete the procedure; the office visits are often short, and they only need to come in a few times.

Women have to keep in mind that the process is very dependent on their cycle, and we will need to know when they ovulate and begin their hormone medication.

7. IVF Does Not Affect Future Fertility

Many patients are concerned that IVF is somehow harmful or that it can cause problems with achieving a natural pregnancy later in life. That’s completely untrue.

Every month, a woman develops a certain number of eggs, and just one of those eggs ovulates—this one egg is what gives a woman her natural chance of pregnancy. All the other eggs a woman produced are discarded. This cycle continues until the woman hits menopause, when all the eggs in the ovaries have developed and been discarded. With the in vitro process, we’re simply taking advantage of all the eggs that are available that month, including the one that would have ovulated and all the others that would have been discarded. It has no effect on menopause at all.

In vitro fertilization offers women and couples a safe and effective way to finally have a baby. Visit the Arizona Center for Reproductive Endocrinology & Infertility online or call us at 520-326-0001 to make an appointment and learn more about in vitro options.

What Does a Fertility Clinic Cost? Breaking Down the Costs Associated with Bringing You a Baby

importblogger on June 12, 2017

Historically, getting pregnant at a fertility clinic was an expensive ordeal; procedures were less commonplace and the technology was less refined, making conception a costly endeavor. So we understand why couples are very concerned about the cost of getting pregnant when they come in to visit us at the Arizona Clinic for Reproductive Endocrinology & Infertility.

It’s our goal to help these couples have a baby without the conception process becoming a financial burden. We’d rather have them spend their money furnishing a nursery than on tests and procedures. We always have an upfront discussion with patients about what they should expect. When a couple is contemplating a certain procedure—like sperm donation or IVF—we give them the best estimate of not only what it will cost, but how many times they should anticipate having to do the procedure before we achieve pregnancy. Having this conversation gives patients realistic expectations about the different areas and items they’ll have to pay for.

In-House Costs 

With the tests and procedures we are to perform in-house, we try to keep costs low because we don’t want to add any more stress to patients’ lives. We utilize as many insurance benefits as possible and to keep costs as minimal as possible.

Medical Evaluations

Medical evaluations—such as blood tests, ultrasounds, and x-rays—are usually covered by patients’ insurance. In instances when they’re not covered, we offer discounted rates and packages so patients don’t pay more than $40 or $50 for each one of these tests.

Procedures 

Because patients’ medical insurance typically doesn’t cover infertility benefits, we understand that the out-of-pocket costs for some procedures can be overwhelming. For those patients, we offer self-pay packages and payment plans to help mitigate the financial burden. With the discounted packages, patients know the total cost for the procedure (including office visits and tests), and can pay for everything in installations without worrying about finance charges or additional fees.

Outside Costs

With costs that are outside of our clinic—like the cost of sperm or medication—we counsel patients to help them find the best options and prices.

Medication

Medication can be one factor that increases the overall costs of fertility treatments. But most of the medication can be bought generic and purchased at a local pharmacy and our staff will inform you if any of the medicine is covered by your insurance benefits. We’re very cognizant of what the costs should be in general so we can give patients an idea of what is a reasonable amount to pay. Our patients are always giving us feedback so we can actually point other patients to the local pharmacy or mail order pharmacy that has the medication at the lowest price. When our patients walk out of the office they know where to go and have a good idea of what it’s going to cost.

Sperm / Egg Donor

If you need an egg or sperm donor, the cost of that is unfortunately controlled by the bank or registry. Different facilities might have different prices for the product or shipping. Many times, the cost of using a donor can be significantly reduced if the couple chooses to use a known donor, like a friend or family member.

The most important thing we emphasize to patients is that not everybody needs expensive infertility treatments, and in circumstances when it’s unavoidable, we work with you to alleviate the financial stress. Our goal is to help families have a baby, not be burdened with pricey procedures. For more information on what starting a family may cost you, visit the Arizona Center for Reproductive Endocrinology and Infertility online or call us at 520-326-0001.