The Truth About Assisted Hatching

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

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What is assisted hatching? 

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

Who are the primary patients for assisted hatching? 

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

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

Does assisted hatching increase the chance of twins? 

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

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

Do we recommend assisted hatching? 

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

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

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

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

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

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

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.


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

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Should I Freeze My Eggs?

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 Emotional Side of Becoming a Surrogate

Surrogacy can be immensely rewarding for many women who choose to be surrogates. Giving the joy of a newborn child to a couple who were unable to conceive on their own is a priceless gift of immeasurable value. Any pregnancy can be an emotional journey with highs and lows. However, surrogacy, whether gestational or traditional, comes with its own emotional hurdles. While every surrogacy experience is unique, it can be helpful to understand what to expect.

Before Pregnancy

Women who decide to become surrogates must first apply through a surrogate agency. The application includes a detailed screening process, which will determine whether you are physically and emotionally ready for the surrogacy experience. During this time, you might ask yourself: 

  • Will I be prepared to be pregnant with someone else’s child?
  • Will I be able to commit to the lifestyle required to carry out a healthy pregnancy when it isn’t my child? 

If you believe surrogacy is right for you, you’ll then need to decide if you would prefer gestational surrogacy or traditional surrogacy. Gestational surrogacy includes carrying and delivering a child who has no biological genes of the surrogate. In traditional surrogacy, the surrogate provides the egg used for conception and carries out the pregnancy for another couple. Your preference will play a part in matching you with the intended parents. 

The next part of the process includes additional medical screening and legal contract review. Once approved, you will attend monitoring appointments to determine when your body is ready for embryo transfer. 

During Pregnancy

When you become pregnant, you are an important part of a hopeful couple’s journey to parenthood. You experience the shared joy and excitement that comes with conceiving. Prospective or first-time surrogates may be worried that they will form an emotional attachment to the baby they’re carrying. Others may be concerned about their lack of emotional attachment. Everyone’s surrogacy experience is different. 

Surrogates may still feel the emotional ups and downs of hormonal fluctuations common with pregnancy. But, many surrogates find they are better at managing their emotions because they have not bonded with the child in the same way. Often, mothers-to-be struggle with their emotions because of fears that they won’t be a good parent, won’t know how to parent, or don’t know how the child will behave. Since surrogates do not have to worry about the challenges that come with raising a child, they may be better able to separate their feelings for the child they’re carrying from feelings they have for their child. Some even choose to view their pregnancy as “babysitting.” Establishing a bond with the intended parents can help ease the transition both for you and the baby. 

Even if you feel comfortable with surrogacy, there may be times when you have conflicted feelings due to hormone fluctuations. While you can’t control your hormone changes, the feelings can be disorienting, so speaking to someone you trust, whether that includes a surrogacy professional, trusted friend or family member, or therapist can help. 

After Pregnancy

Many surrogates feel excited for the intended parents after the baby is born. However, everyone is different. If you find yourself needing support post-birth, do not be ashamed to reach out to your surrogacy support team. Pregnancy is a difficult but incredibly rewarding experience and giving another couple a chance to raise a child of their own is honorable. Seeing the intended parents’ happiness when they meet their baby for the first time is a moment you will never forget.

We believe that everyone deserves the opportunity to experience the unique happiness of raising a child. Our core mission is to guide couples every step of the way to create a treatment plan tailored to their unique situation. We offer a wide range of services that cater to every woman no matter where they are in life at the moment. Learn more


What to Expect During Your First Fertility Consultation

For anyone, the first fertility consultation can be charged with a range of emotions from apprehension to excitement, and nervousness. Trying to conceive can be as exhausting and stressful as it can be wonderful and joyful. If you’re considering seeing a fertility specialist or if you have already made the appointment, having an understanding of what you can expect before you arrive can be a big help. We’ll walk through the process so that you can feel more at ease before your first fertility consultation. 

Setting an Appointment

If you’re thinking about fertility treatment and want to make an appointment, call us at 520-326-0001. We are happy to discuss your individual situation at length and help you discover the most suitable solution that meets your specific needs. 

You can typically expect to book an appointment for the first fertility consultation a few weeks from the date you’ve called. Our schedule is often quite busy, but we do our best to work with you to set up a time that’s convenient for you. 

Initial Consultation

To get ready for your visit, remember to bring any necessary insurance information. You’ll spend the first 15 minutes or so of your first visit filling out insurance information. This process may seem tedious but it is our goal to ensure that you have the most coverage possible for our time together. Often, insurance covers the initial diagnosis and treatment for the underlying causes of infertility.

We may also conduct a few tests that will help us determine the underlying reasons surrounding your difficulties getting pregnant. These will help us set the foundation of your infertility treatment. The testing process is completed within one menstrual cycle, after which we can use those test results to discuss the most effective treatment options with you. 


After the diagnosis has been made and we’ve worked with you to create a treatment plan, treatment typically begins in about a month, or one menstrual cycle. The duration of treatment varies from person to person. Regardless of how long it takes, we will be there to guide you every step of the way, to answer any questions, and address any concerns that may pop up along the way. 

At Arizona Center for Reproductive Endocrinology and Infertility, we have helped countless couples experience the unique joys that parenthood can bring and are proud that we’ve been able to help so many on their journey to raising a child of their own. Our fertility specialists are dedicated to helping each patient understand the options available to them so we can create a plan tailored to their unique situation. We believe that everyone deserves to start the family they have always dreamed of. Learn how we can help you. 


What Can I Do to Boost Fertility?

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

Track your period

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

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

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

Maintain a healthy diet

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

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

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

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

Cut the caffeine

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

Avoid alcohol

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

Exercise caution when exercising

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

Reduce stress and increase relaxation

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

Don’t be afraid to ask for help 

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

Why Women Should Track Their Cycle – Even While Not Trying to Get Pregnant

Period tracking is becoming more and more common thanks to apps designed to help women record and predict their next period and ovulation cycle. People may think  the benefits of period tracking are limited to aspiring mothers-to-be, but that is not the case. Period tracking is helpful even for those who are not looking to get pregnant. Not only is it useful to know when your next period is most likely to happen, but tracking your cycle can also help you learn more about your menstrual health, particularly if you have an underlying health condition like polycystic ovarian syndrome (PCOS) or endometriosis. 

Know your normal

The average cycle lasts about 29 days, but this can vary from woman to woman. Even if your cycle is pretty regular, tracking your menstrual cycle can still provide valuable information. It can help you determine what your normal cycle is so you can be aware of any deviations. The length of your cycle can vary from month to month based on your hormone levels and lifestyle factors like stress, medications, and medical conditions. Keeping note of changes in lifestyle factors can help you understand the potential cause of changes. 

Identify abnormalities sooner

If you experience changes in your cycle like an increase or decrease in period duration or flow and new or worsening symptoms, recording your monthly periods will help you remember when these changes began. This in turn can help clue you in on what the cause might be, so you can flag any symptoms to share with your doctor or healthcare provider. Irregular or absent periods can be a sign of a potential health issue, so being aware of what is happening with your body can empower you to stay on top of your health. 

Gain a better understanding of your symptoms

For women with PCOS or endometriosis, irregular periods are nothing new. Period tracking can help you predict your cycle and better understand your symptoms, while also feeling more in control of your body and less like you’re at the mercy of your body’s biological whims. You will also have more accurate information to share with your doctor, which can help you and your doctor decide on effective treatment. 

No more surprises

Period tracking can give you a wealth of information about your body and its wellbeing. Not only will you be better equipped to understand what’s regular for you, but you can also track things like sex drive, energy levels, mood, sleep cycle, and food cravings, and relate them to stages in your menstrual cycle. Getting a prediction on when your next period starts also means you can plan around big events like vacations and weddings, which is helpful if your period symptoms are particularly harsh and uncomfortable.


The menstrual cycle is how a woman’s body prepares for pregnancy after ovulation, the release of a mature egg. For women tracking their periods, irregular menstrual cycles can be an indication that the normal menstrual cycle has been disrupted and ovulation has not occurred. If your period cycles have been irregular or if you have had normal cycles and have been trying to conceive without success for more than six months, you might consider seeking fertility treatment. At the Arizona Center for Reproductive Endocrinology & Infertility, we offer a wide range of services to meet every woman’s individual needs. Learn more.

Egg Freezing & Other Ways to be Proactive About Your Fertility

Fertility is often far more complicated than many people realize. There are many factors that can affect your reproductive health and ability to get pregnant. If you are thinking about having a baby—whether it’s your first, second, or third—there are several steps you can take now to be proactive about your fertility.

At Arizona Center for Reproductive Endocrinology & Infertility, we’re committed to giving you all the information you need to help you feel in control of your reproductive health. And that includes giving you a few actionable things you can do to prepare yourself for kids, whether you’ll be trying soon, a few years out from now, or you’re still uncertain of when or if you’ll want to start your family at all. Here are five ways to get proactive about your fertility.

Get familiar with your cycle and when you ovulate

If you’re not already tracking your period or menstrual cycle, now is a good time to start. Tracking your cycle will help you understand when you’re ovulating or alert you to irregular ovulation, which can make it more difficult to get pregnant. If you’re planning on getting pregnant relatively soon, you can use an ovulation predictor kit (OPK) to help you figure out your fertile window, or when you’ll be most likely to conceive. 

Learn about your genetics and your medical history

When you come in to AZCREI for your first consultation, we’ll always ask you about your and your family’s medical history. It’s a solid starting point to help us determine what may deter a successful pregnancy. Besides knowing your medical history, it’s a good idea for you (and your partner) to get an STI test, in order to rule out any potential issues that may be related to complications from an STI.

You can also get ahead by digging into your genetics and family medical history now. Specifically, if you are a person with ovaries, finding out everything you can about your mother and grandmother’s health can help you anticipate any potential fertility issues that you might have in the future. Some questions you want to know the answers to are:

  • When did your mother start menopause?
  • Did your mother have any issues with getting or staying pregnant?
  • Are there any thyroid or endocrine issues that run in your family?
  • Do you have a family history of polycystic ovary syndrome (PCOS)?

Talk to your doctor or OB/GYN or fertility specialist

If you have questions about your reproductive health you should discuss your options with your doctor, OB/GYN, or a fertility specialist (like AZCREI). There are many health conditions that impact fertility, including hormone imbalances, PCOS, thyroid disorders, uterine fibroids, damage to the fallopian tubes, endometriosis, and STIs. Age, BMI, and your family medical history can all affect fertility as well. You may want to write down your questions ahead of time, before your visit, so you can get all the answers you need to create a plan for your next steps.

Evaluate your lifestyle and habits

A chat with your doctor may spur you to evaluate a few of your lifestyle choices and habits. Since BMI can affect fertility, you may want to gain or lose weight before you start trying to conceive in order to increase your chances of a successful pregnancy. Exercise, regardless of your BMI, is also important for your general health. If you smoke, you’ll want to quit right away; the chemicals in nicotine speed up the loss of eggs (which naturally die off as you get older) and damage sperm. Smoking can also result in ectopic pregnancy, preterm labor, and birth defects, so the sooner you quit, the better.

Consider freezing your eggs

There are many reasons people with ovaries choose to freeze their eggs—the quick and simple process can have long-lasting benefits. If you are still uncertain of when you want to have kids, egg freezing gives you the ability to wait until you want to or are ready to. The procedure also increases your chances of a successful pregnancy later, since your eggs are of higher quality and healthier when you’re younger. Freezing your eggs now, even when things are up in the air, is like having an insurance plan that ensures you do have the option to get pregnant whenever you choose to do so.

If you’re at all considering having kids in the future, there’s no downside to taking proactive measures about your fertility. For more information on your options, give us a call at (520) 326-0001 or visit us online to schedule a consultation and talk to our doctor.

What It’s Like to Be a Surrogate?

Becoming a surrogate is not an easy decision to make, but for some women, it’s an obvious choice—something they were called to do. At Arizona Center for Reproductive Endocrinology & Infertility, we’ve seen many, many women become surrogates and give the priceless gift of a baby and endless joy to another family.

But even if you’re sure you want to be a surrogate, you’ll need to consider everything involved in the process. If this is the first time you’ve seriously thought about becoming a surrogate, you may be nervous about what to expect. While every woman’s experience is different, here is a glimpse of what it’s like to be a surrogate and what you can expect during your surrogacy journey.

Before the Pregnancy

When you first apply to be a surrogate, you will have to go through an extensive screening process to make sure you’re physically and emotionally ready for this undertaking. After you’ve completed and passed the screening, the time you may wait to be matched with intended parents can vary drastically. 

Once you’ve been paired with a couple and you mutually decide that you’re a good fit for each other, you’ll have to sort out the legalities and sign a contract. The contract will likely address sensitive topics like the number of embryo transplants you’re comfortable committing to, selective reduction (the possibility of reducing the number of fetuses if more than one embryo successfully implants), and the financial compensation you will receive. It’s best to use this time—before signing—to ask whatever questions you have about what’s expected of you and establish an open, honest relationship with the intended parents.

If you choose to sign the contract and move forward with surrogacy, you will begin to go through extensive fertility treatments to regulate your cycle and make your uterus as fertile as possible for the incoming embryos. Typically, these treatments include daily fertility shots and regular doctor’s appointments and tests to ensure you’re physically ready and able to carry and deliver a child.

It’s important to note that embryos may not successfully implant in the first cycle; it often takes several embryo transfer attempts to achieve a successful pregnancy.

During the Pregnancy

Once an embryo successfully implants, the rest of the pregnancy is relatively normal. You may have several appointments with the infertility clinic that performed the embryo transfer in the early weeks of the pregnancy to make sure everything is developing properly, and from there, you’ll see your OB-GYN for regular check ups. Usually, all your copays are covered by the intended parents, and depending on what you agreed upon, they may attend the doctor visits and check ups with you.

As you go through the pregnancy, you may want to take extra steps to create memories and bonding moments for the baby and intended parents. Most moms-to-be will create ‘baby books’ to document the pregnancy and surrogacy journey. You will also want to prepare the baby for the emotional transfer of going home with their parents; you can ease the transition by having the intended parents talk to the baby whenever you’re with them and familiarizing the baby with sounds from their parents home (like their favorite music or recordings of them talking to the baby). 

After the Pregnancy

If you’ve bonded with the intended parents, you’ll likely feel joy and excitement once you give birth. Seeing the intended parents hold their baby for the first time will be a memory you’ll never forget. Most surrogates are just happy to be able to give them the baby they’ve been dreaming of, however, everyone is different, and you may struggle emotionally after your pregnancy and surrogacy journey is over—that’s normal too (and may very well be due to pregnancy hormones). If you are having a difficult time after birth, reach out to a surrogacy support group, your surrogacy agency, or infertility clinic for support. In some cases, you may be able to reach out to the intended parents as well; contact with the intended parents and baby varies from family to family and is usually something that’s decided upon before you even become pregnant.

Whether you struggle post-pregnancy or not, it’s important to have a support system to lean on during this time. 

If you have more questions about becoming a surrogate mother or what surrogacy entails—or if you’re curious about building a family through surrogacy—you can contact us at AZCREI for more information, by calling (520) 326-0001 or visiting us online.

Sex Ed: How Birth Control Works

Many times, when a woman or person with a uterus visits us at Arizona Center for Reproductive Endocrinology & Infertility after months of not getting pregnant, their fear is that the birth control they’ve used in the past has affected their fertility now. Sadly, there is a lot of lore and misconceptions out there that warn against using birth control precisely for this reason. The good news, however, is that is rarely ever the case. 

There are several different methods of birth control for uterus owners—IUD, shots, vaginal ring, patch, pills, condoms, even the rhythm method—but they all have the same end goal: to prevent conception and pregnancy (for the time being). These are considered ‘reversible’ birth control methods as they don’t involve surgical removal of reproductive organs. So, in theory, once you stop using one of these methods, your chances of getting pregnant go back to normal. 

Different forms of birth control work in different ways, so here’s a quick look at how birth control works and its true affect on your fertility.

Understanding Conception

To understand how birth control prevents conception, you first need to understand what it takes for conception to occur. There are three main events that have to happen:

  1. Ovulation: A healthy, developed egg needs to be released into the fallopian tubes so it can be fertilized; fertilization needs to occur 12-24 hours after its release.
  2. Fertilization: Once the egg is released, it needs to meet with a sperm. Sperm needs to make its way past the cervix and through the uterus to the fallopian tube and ovulated egg. If the sperm and egg meet, the sperm needs to get through the zona pellucida, or egg’s outer membrane, for fertilization to occur.
  3. Implantation: If fertilization does happen, the new embryo needs to successfully implant in the uterine lining, which supports the embryo’s development.


A snag in any of these steps can make conception difficult, or even impossible. Birth control works by creating these obstacles in the conception process. 

Preventing Conception

Now, let’s talk about those obstacles. Again, most birth control methods work to create one or more obstacles in the three major events of the conception process.

Preventing Ovulation

The majority of reversible hormonal birth control methods work by preventing ovulation. When the birth control hormones are released, they actually inhibit the production of FSH and LH, which then prevents follicular stimulation and development. (You can read more about the phases of the menstrual cycle here.) No egg is matured or released, so ovulation doesn’t occur. Combination pills, some IUDs, the ring, patch, and birth control shot usually prevent ovulation.

Thickening the Cervical Mucus

When you’re in your fertile window, your body produces a special type of cervical mucus that actually helps sperm get past the cervix and into the uterus and fallopian tube to find an egg. This thinner mucus is the result of high estradiol and low progesterone levels. Hormonal birth control reverses these levels (by raising progesterone or lowering estradiol) which thickens the cervical mucus and makes conception much more difficult and highly unlikely. Combination pills, minipills, IUDs, the ring, patch, and birth control shot are methods that cause this thickening of cervical mucus to happen.

Preventing Thickening of the Uterine Lining 

For a fertilized egg to develop and grow, implantation needs occur. In typical menstrual cycles (where birth control is not being used) progesterone and estradiol hormones thicken the uterine lining and make it more welcoming of a fertilized egg. Hormonal birth control methods work by limiting these hormone levels, which makes the uterine lining too thin for an embryo to successfully implant and thus, develop. Combination pills, minipills, IUDs, the ring, patch, and birth control shot are methods that prevent the thickening of the uterine lining.

Lasting Effects of Birth Control on Fertility

Numerous studies have shown that the long-term use of birth control does not negatively affect future fertility. You are as likely to conceive if you used birth control in the past as a woman who has never used hormonal contraceptives.

Once you discontinue the use of birth control, your cycle will typically return to normal within one to three months. (Or six months to one year if your birth control method was the shot.) It’s important to note that if your menstrual cycle was irregular before using birth control, it will likely still be irregular once you go off birth control; some uterus owners mistake an irregular cycle as a side effect of birth control. 

So, what happens if you’ve stopped birth control, your cycles have returned, but you’re not getting pregnant? Chances are, there’s an underlying issue—completely independent from your birth control use. If you’ve been off birth control and are currently struggling to get pregnant, it may be time to visit a specialist.
At AZCREI, we can answer your questions and help identify the reason behind your struggles. Make an appointment now by calling 520-326-0001 or visiting us online.