Reframing Sex Selection in IVF

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

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

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

The history of the sex selection process

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

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

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

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

The first baby conceived through PGD was born in 1990.

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

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

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

How PGD and PGS work

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

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

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

Healthy embryos are transferred to the uterus. 

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

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

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

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

Sex selection in IVF can improve implantation rates.

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

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

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

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

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

Who is PGD and PGS recommended for

PGD and PGS can help couples have successful pregnancies.

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

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

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

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

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

What are the risks of PGD and PGS

Potential risks associated with PGD and PGS include:

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

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


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

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

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

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

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The Complete Guide to the IVF Process

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

Who is IVF right for? 

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

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

How long does IVF take? 

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

What happens during IVF? 

Graphic with 5 steps of IVF listed out.

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

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

Embryo transfer

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

Are there any risks to IVF?

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

What does IVF cost in Arizona?

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

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

IUI vs. IVF: What Are the Differences?

Over 6 million people across the U.S. struggle to conceive each year. Fortunately, fertility treatments can help aspiring parents make their dreams of parenthood a reality. Two popular options are intrauterine insemination (IUI) and in vitro fertilization (IVF). People often confuse the two, but an easy way to keep them clearly defined in your mind is to remember that the fundamental difference is in how the egg gets fertilized. Understanding the distinctions between IUI and IVF can help you determine which option might suit your situation the best. 

What is the IUI Process? 

IUIs are considered a less invasive form of fertility treatment, which is why many people may choose to start their fertility journey with IUI. The day of the IUI procedure is selected based on ultrasounds, the woman’s cycle, urinary LH tests, and the status of the developing follicle. The IUI begins with placing washed sperm, which is sperm separated from semen, directly into the uterus using a speculum. This treatment process can begin during a woman’s natural fertility cycle, though it is often performed with fertility medication that increases ovulatory function. By placing the sperm directly into the uterus, the sperm does not have to travel as far to fertilize the egg. 

The Benefits and Drawbacks of IUI

IUI can be a great option for those dealing with PCOS, other anovulation or cervical mucus problems, or sperm health issues—including in same-sex couples; single mothers by choice; and patients with unexplained infertility. IUI is fast, effective and affordable, especially compared with other techniques. The process is pain-free and relatively easy, with low chances of complications.

While the probability of success differs from case to case, IUI boosts the monthly conception rate from 1-3% up to 5-10%. It is worth noting that IUI can be less effective than other methods like IVF. However, it is a great starting point for many starting to use assisted conception. Usually, when IUI is deemed appropriate, a few attempts are made before moving on to alternative, more complex procedures. 

What Does IVF Involve? 

During IVF, the egg gets fertilized in a lab, and the resulting embryo gets transferred back into the woman’s uterus. Typically, patients receive ovary-stimulating medication that causes the body to produce multiple eggs in one cycle. During these 8-12 days, the patient will be monitored with ultrasounds and bloodwork to ensure the process is going smoothly. Then the egg can be fertilized conventionally or through ICSI, intracytoplasmic sperm injection, where a single sperm will be injected directly into an egg. 

The Benefits and Drawbacks of IVF

IVF is one of the most popular forms of fertility treatment. It is a great option for same-sex couples and couples who have not been successful with IUI. The procedure allows doctors to bypass the fallopian tubes, which makes it helpful for patients experiencing blocked, damaged, or absent fallopian tubes. During IVF, the ability to use ICSI, a fertilization process that only requires one sperm cell for each egg, means that the chances of fertilization are higher even among severe cases of male infertility. 

IVF is one of the most successful assisted conception methods, but it is also more expensive than IUI. You should consider age, budget, insurance coverage, and your individual diagnosis when choosing between IVF or IUI. Consulting with one of our fertility treatment specialists is one of the best ways to decide whether IVF or IUI is right for you.

At Arizona Center for Reproductive Endocrinology and Reproductive Fertility, we work with all people, regardless of gender preference and sexual orientation, to resolve the challenges of getting pregnant. We will guide you every step of the way to help you make an informed decision that will give you the best chance at conceiving. Give us a call at 520-326-0001, and our specialists will discuss your options at length and help you set up an appointment. Start your fertility treatment journey today.

Step-by-Step Guide to IVF Treatments

In vitro fertilization (IVF) is possibly the most effective and most common infertility treatment we perform at Arizona Center for Reproductive Endocrinology & Infertility. But unless you’ve gone through the procedure before or know someone who has, you probably don’t understand all the steps involved.

The first thing you should know is that IVF is the fertilization of the egg and sperm outside the body. It’s often performed after other treatment methods have failed to result in a pregnancy (although for some couples, it makes more sense for this procedure to be the first option).

While there may be some variation in how the procedure is completed, in general, it can be broken down into five steps. Here’s a step-by-step look at the process.

Step 1: Preparation (Testing and Ovarian Stimulation)

Before beginning your infertility treatments you’ll have an evaluation of your uterus and fallopian tubes to make sure there are no outlying issues that need to be remedied before starting IVF. If it’s been determined that IVF is a viable option, you’ll begin taking medication to stimulate your ovaries to mature multiple eggs for the retrieval process. This medication usually needs to be taken for about 21 days; during this time, you’ll be frequently monitored through hormone-level testing and vaginal ultrasounds.

Step 2: Egg Retrieval

Once we determine you have a sufficient number of retrievable eggs, you’ll receive a “trigger shot” of hCG or other medication, which finishes the maturation process so that the eggs are capable of being fertilized. Thirty-six hours later, you’ll have a surgical procedure to retrieve the eggs from the follicles in your ovaries. During the procedure, an ultrasound is used to guide a small needle through the top of the vagina into each ovary. At AZCREI, we use conscious sedation during the procedure, which results in a faster recovery time; so, you may feel a little pressure, but typically no pain. The actual procedure takes less than 10 minutes but we do keep patients in our office for about an hour after the procedure is completed so we can monitor their recovery. You may feel some minor cramping in the day or two following retrieval.

After the eggs have been retrieved, they’re placed in a test tube along with the follicular fluid. It’s then given to an embryologist who uses a microscope examine the eggs for maturity and quality.

Step 3: Fertilization

The mature eggs are transferred into a special culture and placed in an incubator for the fertilization process.

Fertilization can occur in two ways: through conventional insemination (where sperm is added to the culture in a small petri dish to eventually fertilize the eggs on their own) or through intra-cytoplasmic injection (ICSI). The most appropriate fertilization process for your situation depends on a number of factors, our team will discuss these options with you and help you determine the best one.

Step 4: Embryo Transfer

The embryo transfer will usually take place around three days following the egg retrieval—unless there are other factors that require us to wait; in that case, we may allow the embryos to mature up to five days or freeze them for a later date. If you opt for preimplantation genetic screening (PGS), the embryos are sent out to be biopsied and then returned for a five-day transfer. The remaining embryos that are not transferred on day five can be cryo-preserved.

For the procedure, a soft, thin catheter is used to transfer the embryo into the uterus at a spot that’s optimal for implantation to occur. If the transfer is successful, the embryo will “hatch” and implant itself in the uterine lining within one to two days following the procedure. Pain and discomfort are rare; many patients compare the experience to the feeling of a pap smear.

Any good embryos that have not been used in the transfer can be frozen and used in another cycle, or if you decide to have more children later.

Step 5: Pregnancy Test

About two weeks after the embryo transfer, you’ll have a blood pregnancy test. Once we confirm the pregnancy, we’ll continue to monitor your progress with additional testing and ultrasounds. After 12 weeks, when we’re very certain that the pregnancy is going as good as it can, you’ll be referred back to your OB/GYN for the remainder of your pregnancy.

At AZCREI, about two out of three of our patients will get pregnant on the first try using IVF; it’s an amazing solution that offers women and couples the chance to finally have a baby. To make an appointment and learn more about in vitro options, contact us online or call at 520-326-0001.

The 5 Biggest Misconceptions About the Cost of IVF

There are tons of misconceptions when it comes to infertility treatments, specifically in vitro fertilization (IVF). Many of these misconceptions have to do with the costs of the procedure. So many of our patients visit us with the expectation of leaving with a horribly expensive bill, but that’s not the case at Arizona Center for Reproductive Endocrinology & Infertility.

At every consultation, we take the time to educate our patients, answer their questions, and give them all the information they need to feel financially confident in their decision to grow their family. Here are five of the most common misconceptions we hear, and what you really need to know about the cost of IVF.


1. It’ll cost the same at any clinic.
The cost of fertility treatments vary state to state and clinic to clinic. Something as seemingly inconsequential as the cost of rent can affect the overall price you pay. Some centers, like ours, offer IVF package pricing to help make the cost reasonable. We understand that paying for something this significant can be stressful and we don’t want cost to be a factor in your decision to fulfill your dream of becoming a parent. We actively try to keep costs low; two of the ways we do this by offering in-house lab testing and giving you the freedom to purchase your own medications outside of our clinic, which allows you to find the cheapest option.


2. I’ll need to save for years and years to afford it.
It’s important to us to be able to help all our patients achieve a pregnancy, regardless of their income. Several couples do save for years to be able to pay for treatments, but that isn’t a necessity for everyone. We also offer pre-pay for services to patients in order to ease the burden on the day of procedure.


3. I’ll have to pay for everything out of pocket.
Unfortunately, there is partial truth to this misconception. While some great companies (such as Starbucks, Bank of America, Pinterest, and Intel) offer infertility insurance coverage, most do not, and many of our patients do need to pay out of pocket for at least a portion of procedures. However, even if you don’t have specific fertility coverage, several of the underlying medical conditions that cause infertility may still be covered. In fact, some, if not all, procedures and evaluations are covered by some type of insurance for at least 90 percent of our couples.


4. IVF is my only option, and it’s expensive.
When you come in for your initial consultation, we review all your infertility treatment options. Sometimes, IVF makes the most sense to try, that isn’t always the case. We’ll always try to start with the most basic, low-tech, low-cost option for solving your infertility before jumping into IVF. This means you may never have to pay for the costlier treatment. Even if IVF does become a need, we do our best to keep our costs reasonable.


5. I’ve got to figure this out all on my own.
At AZCREI, we know that the medical aspects of infertility treatments can be stressful enough, so we try to do everything in our power to reduce the financial burden and make the cost of treatments affordable. Our team is on your side and we’ll work with you to examine your insurance coverage and explore your cost options. You don’t have to take this journey alone in any sense; we’re here to answer your questions and walk with you through it all.


Our goal is to help you 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.

10 Reasons You May Want to Jump Straight into IVF Treatments

In vitro fertilization (IVF) is the solution for the millions of people across the country who are affected by infertility. During the procedure, the sperm and egg are mixed and incubated in a lab, and the resultant embryos are then inserted into the woman’s uterus.


At the Arizona Center for Reproductive Endocrinology & Infertility, we don’t usually begin our treatment plan with in vitro. Instead, our approach is to solve the issue and allow the woman to get pregnant, and that sometimes means starting with simpler, low-tech tests and procedures and then move to IVF as needed. However, every person’s pregnancy journey is different, and for some couples and women—depending on the cause of their infertility—it makes more sense to try IVF first.


In vitro fertilization is an effective treatment for a wide variety of infertility problems that can’t be overcome through standard techniques. Here are some instances where IVF might be the most successful solution.


Blocked Fallopian Tubes


When IVF was first developed 20 to 30 years ago, it was primarily used in situations where women had blocked fallopian tubes. This can occur because of surgery, infection, or previous tubal ligation, to name a few examples. With IVF, we’re able to bypass the fallopian tubes by surgically retrieving the eggs and placing the fertilized embryos into the uterus to achieve a pregnancy.


Low Sperm Count


If we determine that the cause of infertility is low sperm count, we might try medical treatments to increase the number of sperm a man produces. However, when the sperm count is extremely low, it is very unlikely that we can get enough sperm to the egg to cause fertilization during situations of timed intercourse or artificial insemination. In those circumstances, IVF can increase the chance of fertilization by bringing the sperm and egg together in our lab.


Low Sperm Motility / Weak Sperm


When sperm have trouble penetrating the egg’s glycol-protein covering, the zona pellucida, we can use IVF in conjunction with ICSI (intracytoplasmic sperm injection) to assist in fertilization. With this method, we are able to take a single sperm and, under a microscope, inject it through an egg’s zona pellucida and directly into the egg to achieve fertilization.


Obstructive Azoospermia


Men who are diagnosed with obstructive azoospermia produce sperm in the testes but have no sperm in their semen. This might happen because of a blockage in the ducts that carry the sperm from the testes into the seminal fluid at the time of ejaculation. Sometimes this is caused by the genetic disorder cystic fibrosis, which is associated with congenital absence of the vas deferens.


A simple way to overcome obstructive azoospermia is through a procedure called testicular sperm extraction (TESE), where we obtain sperm directly from the testes. When we do a biopsy like this, we do it in conjunction with ICSI since we want to make sure the limited amount of sperm that we obtain is able to successfully fertilize the egg.


Late Reproduction Age


Age is a significant factor in ovulation problems; women who are 35 years or older are more likely to have issues with producing healthy, quality eggs. IVF can help with this, in that the woman’s ovaries are stimulated by fertility drugs to produce multiple eggs, which can then be fertilized in the lab. If a woman comes in and is in her mid- to late-30s or early 40s, we often recommend jumping straight into IVF because it is such a successful procedure, and it saves us valuable time in trying other treatments first.


Irregular Ovulation


IVF can also be used to circumvent the problem of irregular ovulation. The process begins with hormone injections, which are designed to override the body’s natural hormonal production. We can control ovulation with medication, including helping a patient to ovulate. These medications cause multiple egg follicles to develop while preventing ovulation, so that way multiple eggs can be successfully retrieved for the IVF procedure.


Low Quality Eggs


Unfortunately, when egg quality is extremely low, implantation—even with IVF—may not be successful. However, the option for pregnancy is not closed to them. A woman can still experience the joy that comes with carrying a baby and giving birth through IVF with the use of an egg donor. Once a healthy, donated egg is fertilized, we can place it into a woman’s uterus, and often, a pregnancy will be achieved without any complications.


Screening for Recurring Miscarriage


IVF can be used to screen for genetic problems or recurring miscarriage. When the eggs are retrieved and fertilized, the resulting embryos can be tested to make sure they’re genetically and chromosomally competent, and will have a lower chance of miscarriage.


Fertilization Using Frozen Sperm and/or Eggs


If a woman chose to freeze her eggs at an earlier age, they would be thawed and fertilized with the woman’s partner’s sperm or a donor’s sperm through the standard in vitro process. We perform the same procedure if a man decided to freeze his sperm for medical reasons. While a man might donate two to three samples to freeze, potentially creating multiple vials to use, we are often working with a limited supply of frozen eggs, and in that case, we would opt for IVF, which has a higher success rate than artificial insemination.


Pregnancy for Same-Sex Couples


Male couples require three participants to achieve a pregnancy: the sperm donor, an egg donor, and someone to carry the baby. Fertilization can be achieved through artificial insemination if the egg donor and surrogate are the same woman, but if they are two different women, we would need to perform IVF.


On the other hand, IVF allows both women in a female couple to participate in the pregnancy. One woman would donate the egg to become the biological mother, and the other would carry the baby as the birth mother.



At AZCREI, about 2 of 3 of our patients will get pregnant on the first try using in vitro fertilization; it’s an amazing solution that offers women and couples the chance to finally have a baby. To make an appointment and learn more about in vitro options, visit AZCREI online or call us at 520-326-0001.



Sharing in the Parenting: How Male Partners Can Utilize IVF to Become Fathers

Usually when couples first visit us at the Arizona Center for Reproductive Endocrinology & Infertility, they already have a strong idea of whom they want to parent their child. It’s a decision they’ve already discussed, but many times, male couples don’t consider the option of having both partners parent their future children.

Women have the benefit of participating in reciprocal IVF—where one donates the egg to become the biological mother, and the other carries the baby as the birth mother. This specific procedure isn’t available for male couples; however, they still have the option of each becoming a father. Here’s how it works and what they should consider.


The Requirements

For male couples to have a baby, one of the partners provides the sperm, but they also require a donor and surrogate. The man who donates the sperm ends up having their own genetic offspring when the baby is born.

General health should be the main consideration in deciding who should be the father. For men, age and fertility are not factors they need to worry about. As long as there are no medical problems or issues with sperm production, they can be a viable father. Even men in their 60s, 70s, and 80s can still potentially father a child.


The Options

Many of the couples we meet are excited to hear they both have the options of fathering the pregnancy. Because the majority of them are focused on the single pregnancy before them, they don’t consider future pregnancies that could allow each man to participate.

Often, we’ll retrieve several eggs from the donor. For example, in a single procedure, the donor may produce 20 viable eggs for us to use. Half of those eggs can be fertilized by one partner’s sperm, and once the baby is born, the couple can come back to have the other partner fertilize the rest of the eggs in a second round of procedures. Using the same donor allows both men to be fathers individually, and the two children will be genetic siblings.

In searching for the egg donor, couples have two options: to use an anonymous donor or to use a known egg donor (like a friend or family member). Some couples choose to keep the genetics in the family, literally, by using one man’s sperm and a relative—like a sister or cousin—of the other man as the egg donor. This option is typically ideal because asking a family member to donate their eggs is much less expensive than paying an anonymous donor to go through the process. Of course, the donor will go through all the appropriate medical screenings to ensure there are no possible diseases that might be transferred and affect the health of the pregnancy or baby.


Other Alternatives

While we typically recommend that men fertilize the eggs sequentially, they do have the option to do so simultaneously as well. We can aim for twins, with each man fertilizing one embryo, but that result isn’t always 100 percent accurate. It’s also safer and easier for the surrogate to carry one baby at a time.

Rarely, we also have couples come in and ask about the option of mixing their sperm and fertilizing the egg somewhat blindly—not knowing whose sperm was used to fertilize the embryo. This is certainly a viable choice, medically speaking, but we don’t typically encourage this since it’s relatively easy to figure out who the father is once the baby is born and because it can cause doubt and confusion during the pregnancy.

No matter what the couple decides they want their path to having a baby to look like, it’s our joy to walk with them through the process. To hear more about all the options available to gay couples, contact the Arizona Center for Reproductive Endocrinology & Infertility by visiting us online or calling us at 520-326-0001.

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

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 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?

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.

Everything You Need to Know About IVF

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.