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Navigating the journey to parenthood can sometimes lead us down unexpected paths. At RGI, our team is here to help guide you through your options so you can move forward with confidence.

Two common procedures you may have heard of are intrauterine insemination (IUI) and in vitro fertilization (IVF). But should you try IUI before moving on to IVF? There is no one-size-fits-all answer to this, as fertility treatment varies significantly from one couple to another. The choice between IUI and IVF depends on a variety of factors, including the specific fertility issue you are facing, age, medical history, and financial considerations. By understanding the factors influencing where you start your journey, and in consultation with a fertility specialist, you can make the decision that best suits your unique situation.

Understanding IUI and IVF

What is IUI?  

Intrauterine insemination (IUI),involves taking sperm and placing it directly into the uterus. On the day of the IUI, the sperm is typically washed and concentrated to include a dense volume of mobile sperm. Ideally, this is done just prior to ovulation and helps increase chances of fertilization by making it easier for the sperm to reach the egg.

IUI is helpful for those with mild male factor infertility such as mildly low sperm counts or motility but may also be recommended in conjunction with oral medications such as clomid or letrozole (Femara) for patients or couples with unexplained infertility, anovulation and PCOS. It is used as a first-line treatment for many couples who have been unsuccessful in becoming pregnant on their own.  

What is IVF?

In vitro fertilization (IVF) is a treatment in which eggs are fertilized with sperm outside of the body in a laboratory setting before being transferred to the uterus. First, eggs must be retrieved from the ovaries. This is done by stimulating the ovaries to produce multiple eggs using a series of injectable medications, followed by an egg retrieval procedure performed under anesthesia. Once the eggs are retrieved, they are placed with a sperm sample in a lab to facilitate successful fertilization and embryo formation. Then, an embryo is transferred into the uterus.

The entire process can take around three months and is a good first choice for people who have issues with their fallopian tubes, poor sperm quality, unexplained infertility, severe endometriosis, and more.

IUI is often considered a less invasive and less expensive option when compared to IVF and may be recommended as a first step in fertility treatment for certain conditions. Per cycle, IUI is typically lower chance of success than IVF. IVF may be recommended directly in cases of more severe infertility issues.

The decision between starting with IUI or going directly to IVF depends on various factors:

• Age: As fertility declines with age, especially for women over 35, some may opt for IVF directly to increase their chances of success in a shorter timeframe.
• Medical History: Certain medical conditions may make IVF a better first choice. IVF may be best for those with damaged, blocked, or absent fallopian tubes, severe endometriosis, or people with severe male factor infertility.
• Previous Treatments: Couples who have already undergone several unsuccessful IUI cycles may choose to move on to IVF.
• Ideal Family Size: IVF may be recommended sooner if you plan to have multiple children. This offers more time, opportunities for multiple IVF cycles if needed, and control over the timing of pregnancies.
• Personal Preferences: Your decision might also be influenced by personal preferences, including concerns about the invasiveness of procedures, and the emotional and physical toll.
• Financial Considerations: Starting with IUI may be a preference for some couples due to the higher cost of IVF treatments. Some insurance companies might also require a couple to attempt pregnancy with IUI before covering IVF treatments.

The Pros and Cons of Starting with IUI vs. IVF

When considering fertility treatments, it’s essential to weigh the pros and cons of each option. IUI and IVF each have their own set of advantages and disadvantages.

The Pros of IUI:

Less invasive: IUI is less invasive than IVF, involving a simple procedure where sperm is inserted directly into the uterus. This makes it a less physically demanding process, with few side effects.

More affordable: Generally, IUI is significantly less expensive than IVF – with the cost of a single cycle ending at around $1,000 – making it a more accessible first option for many couples.  

Shorter treatment cycle: IUI cycles are typically shorter and less complicated than IVF cycles, often requiring less medication and monitoring. IUI cycles align with your natural menstrual cycle, so it generally takes two to four weeks from start to finish. With IVF, patients can expect a six to twelve-week process from the start of treatment to the pregnancy test.

The Cons of IUI:

Lower Success Rates: IUI generally has lower success rates per cycle compared to IVF, especially in cases of severe infertility issues. The success rate for IUI is around 7-20% per cycle and is more effective in people under 35.

Multiple Cycles May Be Needed: Many couples may require several IUI attempts before achieving pregnancy, which can increase the overall cost and emotional strain.

Limited Effectiveness for Certain Conditions: IUI may not be effective for all types of infertility, such as significant tubal damage or severe male factor infertility.

The Pros of IVF:  

Higher Success Rates: IVF typically offers higher success rates per cycle, especially for women over the age of 35 or those with certain types of infertility. IVF has a 70% chance of success when the embryo is genetically normal.

Treatment for a Wide Range of Fertility Issues: IVF can be effective for a variety of infertility diagnoses, including blocked fallopian tubes, severe male factor infertility, and severe endometriosis.

Genetic Screening: IVF allows for the option of preimplantation genetic testing (PGT), which can identify embryos with genetic abnormalities before transfer, reducing the risk of genetic disorders and increasing the chances of a healthy pregnancy.

The Cons of IVF:

More Invasive: During IVF, patients will undergo a few different treatments; including injectable medications, egg retrieval, and embryo transfer. Injectable medications will need to be self-administered typically for 10-12 days. The egg retrieval is a more invasive procedure (done under anesthesia). The embryo transfer is similar to an IUI however done in a procedure room with close proximity to the lab.

Emotionally and Physically Taxing: The steps involved in IVF can cause a few different side effects, including nausea fatigue, injection site reactions, mood swings and emotional changes, abdominal cramping, vaginal bleeding, and bloating. The process can also be long and emotionally taxing, especially if multiple cycles are needed to achieve pregnancy.

Higher Costs: The cost of IVF is significantly more per cycle than IUI. This can make it less accessible for some couples without insurance coverage or financial resources. One cycle of IVF can run anywhere between $12,000-15,000, with additional costs for medications, testing, and other necessary procedures.

Who Might Benefit from Starting with IUI?

• Couples with unexplained infertility who have been trying to conceive for at least a year.
• Cases of mild male factor infertility, such as slightly low sperm count or motility. In these cases, sperm count and motility are likely to compromise the sperm’s ability to reach and fertilize the egg, in which case IUI can be a simple solution.
• People with conditions that affect the cervix and prevent sperm from easily entering the uterus. In these cases, the sperm cannot reach the egg, and this issue is bypassed through IUI.

• Couples using donor sperm, including single women, gay or trans couples, or heterosexual couples with severe male infertility.
• People with mild endometriosis who may have endometrial tissue obstructing the sperm’s path to the uterus or pelvic inflammation. IUI places the sperm directly into the uterus, thus bypassing these issues.
• People with ovulatory disorders, such as polycystic ovary syndrome (PCOS). IUI can be used in conjunction with medications such as clomiphene citrate (Clomid) or letrozole (Femara) to stimulate ovulation and increase the chances of timing insemination correctly.

Who Might Benefit from Starting with IVF?

• People over the age of 35, especially those over 40, may opt for IVF due to the higher success rates per cycle. This is crucial given the declining egg quality and quantity with age.
• People with very low sperm count, poor motility, or abnormal morphology. In this case, IVF with intracytoplasmic sperm injection (ICSI) is recommended.
• People with blocked or severely damaged fallopian tubes will need to begin with IVF, as the process of IVF bypasses the fallopian tubes entirely. Without functional fallopian tubes, the egg will not be able to travel to the uterus on its own.
• People with severe endometriosis where the quality of eggs or the ability of sperm to reach the egg is affected.
• Couples with a risk of passing on genetic disorders can benefit from preimplantation genetic testing (PGT) to ensure healthy embryos. If this is desired, IVF is recommended.

How Do I Decide What Treatment Is Best for Me?

Deciding how you approach your treatment can be confusing; we recommend a thorough discussion about which is best for your specific situation with your fertility specialist. Some couples may start with IUI due to its less invasive nature and lower cost, while others might opt for IVF directly to potentially shorten their journey to parenthood.

At RGI, we’re committed to guiding you through every step of your fertility journey with compassion, expertise, and the latest reproductive technology. Whether it’s IUI, IVF, or another path to parenthood, we’re here to support you through your decision-making process.  

Ready to discuss your fertility options? Contact us today to speak with one of our specialists. Together, we can build your path to parenthood.

Infertility is a common struggle for many people who want to build a family. Worldwide, about 1 in 6 people deal with infertility. Luckily, there are many ways to treat infertility, including a medication called letrozole. But how, exactly, does letrozole work?

How Does Letrozole Work?

Some people experience infertility because of ovulation problems. Letrozole boosts fertility by promoting ovulation. It does so by suppressing estrogen production in the body, which ultimately leads to increased follicle-stimulating hormone (FSH) levels. This stimulates follicle growth and egg development, increasing the chances of ovulation.

When is Letrozole Needed in Fertility Treatment?

Ovulation problems stem from different causes, such as Polycystic ovarian syndrome (PCOS). Therefore, letrozole may be recommended for those with PCOS, unexplained infertility, or low egg count.

Letrozole is also commonly used as part of an intrauterine insemination (IUI) During IUI, sperm is inseminated into the uterus around the time of ovulation. Letrozole is often used during  IUI to stimulate ovulation and thus increase the chances of becoming pregnant.

Success Rates and Evidence of Letrozole

Success rates vary from person to person, depending on the root cause of infertility and your unique situation. Evidence suggests that letrozole is more effective than other medications in people with PCOS, and studies show that letrozole appears to help treat infertility stemming from endometriosis or unexplained causes.

Other Fertility Medication Options

Clomiphene is another medication that's commonly used to promote ovulation. According to research, letrozole is more effective than clomiphene for PCOS patients. Letrozole may also cause fewer side effects than clomiphene. Some people may not respond to clomiphene, making letrozole a good alternative.

Gonadotropins are hormonal medications given by injection and sometimes used during an IUI or IVF cycle. Gonadotropins include FSH and luteinizing hormone (LH), two hormones that stimulate follicle production and egg release in the ovaries. Sometimes, gonadotropins may be used alongside letrozole during fertility treatments.

Letrozole is an oral medication, which can make it easier to take than an injection. Some research suggests letrozole may also come with a lower risk of multiples than other medications.

Risks and Side Effects of Letrozole

Like any medication, there are potential risks and side effects when taking letrozole.

While taking letrozole, you may experience:

• trouble sleeping

• hot flashes or night sweats

• breast tenderness

• fatigue

• dizziness

• stomach upset

• spotting

• headaches

Don't hesitate to call your doctor if you have side effects that are severe, persistent, or concerning while taking letrozole.

Getting Started with Letrozole for Fertility

It's worth being evaluated by a caring fertility specialist before pursuing any fertility treatment. They can assess you to determine what might be causing your infertility and then decide on an appropriate treatment plan, which may include an oral medication like letrozole. A fertility specialist can advise whether IUI or IVF may be right for you and discuss your treatment options.

Helping You Every Step of the Way On Your Fertility Journey

Reproductive Gynecology & Infertility is committed to compassionate, personalized fertility care. We offer various advanced fertility care options to provide each person with the highest quality care possible. If you are having trouble conceiving or have questions about letrozole or other fertility treatments, contact us today to schedule a consultation.

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Navigating the IVF Process with Comfort and Reassurance

In vitro fertilization (IVF) is a fertility treatment that fertilizes eggs with sperm in a lab. Couples may choose to have IVF if they have been unsuccessful in getting pregnant on their own or if they are a same-sex couple. While you might worry about how this process will affect you and if it will be painful, our team is here to guide you through each step. 

Infertility is more common than you might think. About one in six couples globally experience infertility each year. IVF is one of the options couples may choose to conceive.

The IVF Process and What to Expect During Each Stage

IVF is a complicated process that involves extracting an egg from a woman's ovaries and combining it with sperm in a laboratory. These are the steps that you will want to prepare for during IVF:

Ovarian Stimulation

The first phase of IVF is ovarian stimulation. During this process, you will give yourself an injectable medication that contains a follicle-stimulating hormone (FSH), a luteinizing hormone (LH), or a combination of FSH and LH. Synthetic hormones encourage the ovaries to produce multiple eggs, which are gathered during the egg retrieval process.

Ovarian stimulation can cause bloating as your ovaries grow follicles from the stimulating medication. Some women experience a weight gain of five to six pounds during this phase, which can be lost after egg retrieval. Women may experience heightened emotions due to the injection of hormones during ovarian stimulation.

Egg Retrieval

Once you have stimulated your ovaries, the next step is to retrieve your eggs. This procedure requires sedation to ensure you experience no discomfort while the eggs are retrieved.

After your eggs are retrieved, you may experience cramps, pressure, or a sensation of fullness. These are all normal symptoms. You should notify your provider if you experience excessive pain, are unable to eat or drink, or have any fevers after the egg retrieval process. 

Sperm Collection

Sperm collection is when your partner provides a semen sample. The retrieval is coordinated with the timing of egg retrieval. Some couples may choose to use donor sperm. 

Collecting sperm involves your partner, or donor, ejaculating into a sample cup using masturbation. However, if a fertility specialist has identified that your partner does not contain sperm in his ejaculate, he may need to have his sperm retrieved directly from the testis or epididymis with a needle. The fertility specialist will coordinate a simple sperm retrieval to be collected some time before the egg retrieval. 

Fertilization 

Fertilization of the eggs and sperm retrieved occurs in the lab. The eggs retrieved are screened for quality once they've matured. Either a single sperm is injected directly into an egg, or a small drop of concentrated sperm is mixed with each egg. Some couples may choose to freeze eggs before fertilization to use in the future.

Embryo Transfer

After fertilization occurs, embryos will develop in five to six days. When the embryos have developed, a fertility specialist will transfer one embryo to the uterus.

The embryo transfer is usually painless, but some women may feel discomfort. This is typically less discomfort than having a pelvic exam. Sedatives are generally not needed due to the minimal discomfort.

Tips for Managing Discomfort During IVF Stages

While the side effects of IVF are minimal, women undergoing IVF can take measures during each step to maximize their comfort. Certain over-the-counter (OTC) medications are considered safe for use during IVF. Discuss this with your fertility specialist, as some medicines may interfere with fertility drugs or cause hormonal imbalances. You should avoid the following medications while undergoing IVF:

•      Non-steroidal anti-inflammatory drugs (aspirin, ibuprofen, naproxen)

•      Antidepressants and anti-anxiety medications

•      Steroids

•      Anti-seizure medications

•      Thyroid medications

•      Chemotherapy drugs

•      Skin products that contain estrogen and progesterone

Managing Injections During Ovarian Stimulation

If you fear needles, you can take measures to overcome this when giving yourself hormone injections for ovarian stimulation. When you inject, you can use breathing techniques and keep yourself hydrated to avoid fainting. You may also want to consider talking with your fertility specialist to determine if a local pain patch would be appropriate when giving yourself the injections.

For hormone injections, there are ways to reduce discomfort. Before giving yourself the injection, allow it to come to room temperature. Ensure you use a new needle with each injection and never reuse a needle. After you've given yourself the injection, apply a cold compress or ice to the site. If the injections are causing discomfort, talk with your fertility specialist about trying OTC acetaminophen. Rotate your injection sites. 

Pain Management After Egg Retrieval

When your eggs are retrieved, your provider will use anesthesia to minimize discomfort and pain. It is common to experience mild cramping and abdominal pain after the procedure. You can use OTC pain relievers that your fertility specialist approves to ease this pain. You can soak in a warm bath, place a warm compress over your abdomen, use deep breathing or other relaxation techniques, and ensure you get enough fluids. If you have severe pain or fevers, or cannot eat or drink after the procedure, notify your provider immediately. 

Embryo Implantation Expectations

Many women experience no pain during embryo implantation, while others experience mild cramping. If you experience mild cramping, you can try warm compresses to the abdomen, OTC medication approved by your fertility specialist, take a warm shower or bath, or practice relaxation techniques.

You can take action to improve the likelihood of a successful IVF cycle. These actions can help manage any discomforts associated with the IVF process, which include: 

•      Eat a healthy diet and stay hydrated

•      Take a prenatal vitamin with folic acid

•      Avoid chemical exposure from everyday sources

•      Take time to relax on transfer day and immediately after

•      Don’t use a hot tub

•      Keep taking your medications

•      Abstain from intercourse until approved by your doctor

•      Pay attention to what your body is telling you

•      Use stress-reduction techniques to make the wait easier

Remember not to rush taking a pregnancy test. Pregnancy tests measure the levels of pregnancy hormones in your urine. These hormones take time to build up to show on a pregnancy test. Taking a test too early could result in false results and disappointment.

Lean on your Support Team for a Comforting IVF Experience

We understand that fertility treatment can be an emotional process, making it crucial to maintain your mental health during treatment. Don't hesitate to connect with your fertility specialist or support team with questions or concerns regarding your IVF experience. 

You can take measures to keep your mental health balanced by doing the following:

•      Consider infertility counseling

•      Participate in relaxation techniques like guided imagery or yoga

•      Practice restorative breathing

•      Make sure you get plenty of sleep 

•      Take a warm shower or bath to relax

Focus on the Goal: Building Your Family

While undergoing IVF treatments may be stressful or cause discomfort, you can manage these to ensure a successful IVF cycle. IVF can help you build your family. Talk with one of our specialists today to discuss if IVF is right for you.

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Globally, infertility affects approximately 1 in 6 people, according to a 2023 World Health Organization fertility report. The Centers for Disease Control and Prevention (CDC),  reports that 16% of females in the United States experience infertility. 

Though male-factor causes of infertility account for 20-30% of infertility cases, medical experts predict that the male-factor infertility rate may worsen due to increased exposure to environmental toxins. Therefore, it is essential to raise awareness of the prevalence of infertility.

Infertility occurs when couples or individuals are unable to achieve conception after one year of trying if less than age 35 and six months if 35 years or greater. Infertility typically delays or prevents couples from starting or growing their family. However, with the rapid advances in assisted reproductive technologies such as in vitro fertilization (IVF), couples now have an alternative solution. 

This article discusses the rise of infertility, common causes, treatment options, and alternative solutions.

Infertility Statistics

The most current WHO infertility report states that 17.5% of the adult population in the world is infertile. This figure represents approximately 1.36 billion people worldwide. This is in comparison to  a 2004 WHO report which estimated that 60-80 million couples globally struggle with infertility. Personal, lifestyle, and environmental factors play a role in the swift increase in infertility.

Potential Causes and Risk Factors of Infertility

There are various causes and risk factors of infertility in men and women. Your awareness of some of these risk factors may cause you to adopt healthy lifestyle factors and understand if you should seek infertility evaluation early. Here are the common risk factors.

Age and fertility

Everyone  regardless of gender is more fertile when they are young. As an individual's age advances, fertility gradually reduces, which is more dramatic in females. With more couples waiting to build a family later in life, infertility has risen, and fertility treatment is often necessary. 

Race and ethnicity

Your race and ethnicity could also affect your fertility rate. A  report from the CDC noted that Black women are less likely to seek infertility care, take longer to seek care, and have lower success rates with fertility treatment.  Also, a 2021 women's health study found that infertility was more common among female minority groups than non-Hispanic whites.

Lifestyle factors

Unhealthy habits such as tobacco use are associated with infertility, early menopause, and poor pregnancy outcomes. Alcohol should be stopped at pregnancy due to the detrimental effects of fetal development. Marijuana exposure is also associated with infertility. Marijuana use in men is associated with lower sperm counts. Hence, individuals who use these substances are at risk of infertility.

Medical conditions

Medical conditions or treatment procedures that can affect the male and female reproductive tract can also increase the risk of infertility. Examples include untreated pelvic or genital infections, thyroid disease, uterine surgeries or abdominal surgeries, etc.

Infertility in females

The following are common causes of female infertility:

• Ovulation Disorders: In females with ovulation disorders like PCOS, the ovaries do not release an egg for fertilization. This affects a female’s ability to get pregnant.
• Fallopian Tube Blockage: Fertilization occurs in the fallopian tubes, and damage to the tubes hinders the process. ‍
• Uterine Disorders such as adhesions, polyps, and fibroids impair the implantation necessary for conception. ‍
• Prior history of pelvic inflammatory infections (caused commonly by chlamydia) can cause scarring of the fallopian tubes, which can block the female reproductive tract. ‍
• Genetic causes involving chromosomal disorders such as Turner's syndrome. ‍
• Endometriosis: This is a medical disorder in which the cells lining the uterus, called the endometrium, are found outside the uterine cavity. Endometriosis can lower egg reserve, block fallopian tubes, and impair the sperm from finding the released egg.

Male Infertility

Causes of male infertility include:

• Genetic Causes such as chromosomal disorders like Klinefelter syndrome.
• Hormonal disorders affecting the pituitary gland
• Undescended Testis
• Blockage in Sperm Transport Tubules due to physical trauma, prior pelvic surgeries, and infections
• Prior sexually transmitted diseases can cause blockage in sperm transport tubules.  ‍
• Medications such as chemotherapy drugs or steroids like testosterone may affect sperm production and increase the risk of male infertility.  ‍
• Exposure to Environmental Toxins such as heavy metals and industrial chemicals.

It is crucial to seek help from a fertility expert for a thorough clinical evaluation and screening and schedule an appointment early if there are any risk factors for infertility. However, in some cases, the exact cause of infertility in males and females may be unknown.

Available Treatments for Infertility

If you or your partner have risk factors for infertility, consult an experienced fertility doctor for expert clinical care. The fertility specialist will typically combine findings from the clinical and laboratory evaluation to confirm the diagnosis of infertility.

The treatment option depends on the cause of infertility. Here are some treatment methods for infertility.

Medications

Women are commonly prescribed gonadotropins, clomiphene citrate or letrozole to induce ovulation. Men can also be prescribed similar medications in the treatment of male factor infertility.  

Surgery

Surgery is typically the most suitable treatment method for infertility due to structural abnormalities in the female or male reproductive tract. Surgery can help females who have fibroids, uterine polyps, blocked fallopian tubes, or uterine scarring.  

Similarly, in males, surgery may be recommended in certain cases of varicocele, undescended testis, or blockages within the male reproductive tract. 

Assisted Reproductive Technology 

Assisted reproduction technology (ART) is a broad term that covers fertility-based treatments in which the fertility doctor handles eggs or sperm to aid conception. In-vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) are the two common types of ART.

With ART, the doctor retrieves eggs from the ovaries during an outpatient procedure and then uses IVF techniques to fertilize the egg in a specialized culture medium in the laboratory. During Intracytoplasmic sperm injection (ICSI), the embryologist injects a single sperm directly into each egg.

After successful fertilization via IVF or ICSI, the fertilized egg develops into an embryo until it reaches the blastocyst stage (usually over a period of five days) until it is either  transferred into the uterus or biopsied for genetic screening.

The success rate of ART differs for each person depending on age, but the average rate for young females is up to 54%.

The Emotional Impact of Infertility and Coping Strategies

Couples experiencing infertility may face emotional distress, such as stress, social stigma, anxiety, and depression. These emotions can be worsened by the family pressure and societal expectations. 

In a study published in Fertility and Sterility reported that women diagnosed with infertility had twice the prevalence of depressive symptoms as women without infertility. s. Research has supported the availability of mental health professions for all individuals seeking infertility evaluation and treatment.    

Couples or individuals can use the following coping strategies to handle the emotional distress from infertility:

• Seek help from a mental health professional: Counseling and psychotherapy sessions from a qualified mental health professional can help resolve negative feelings or moods about infertility.
• Social support: Join support groups filled with individuals with similar interests.
• Engage in relaxation techniques such as meditation and yoga.
• Openly communicate how you feel with your partner or loved one.

Alternative Paths to Parenthood

Couples or individuals may choose other pathways to build their family such as adoption or surrogacy.

Legal Adoption

The process of adoption can be complicated and overwhelming. For individuals who cannot carry a pregnancy or who do not want to pursue fertility treatment, adoption may be the ideal way to expand your family. Gestational Surrogacy

Gestational surrogacy is the process of using a gestational carrier and assisted reproduction techniques to help a couple or an individual to create a family when they cannot do so themselves. 

The gestational carrier is not the biological parent, but her role is to carry pregnancy from an embryo(s) created using the intended parents' or donated sperm and egg.

Gestational surrogacy allows couples or individuals to become parents who are unable to carry a pregnancy themselves. However, the gestational surrogacy process involves many steps and requires a series of legal procedures and ma special contract between the intended parent(s) and the carrier.

Are You Looking for Solutions to Infertility?

Couples or individuals going through infertility face many challenges and emotional distress. However, regardless of the cause of infertility, there is a solution and support for you.

It is essential to consult an experienced fertility expert to evaluate you and recommend a solution that fits your unique health needs. Fertility treatments such as medications, surgery, and assisted reproductive techniques are tailored to each patient who is seen at Reproductive Gynecology & Infertility.

Our team of fertility experts at Reproductive Gynecology & Infertility are board-certified fertility specialists with experience and a proven record of helping couples and individuals with alternative family-building options.

We offer a personalized treatment plan that is specific to your peculiar needs. To get professional help from one of our experts, contact us today.

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Egg freezing is a process in which a woman’s eggs are harvested from her ovaries and frozen (in a process called oocyte vitrification), and stored in a liquid nitrogen chamber until the woman would like to achieve a pregnancy. A woman’s ability to conceive declines with age but egg freezing is an effective method for preserving or extending her reproductive potential.

The process takes about 9-11 days of ovarian stimulation with fertility medications followed by the egg retrieval procedure 2 days later. Patients can go on with their routine schedules over this 11-13 day process and only need to take the day of retrieval off of work.

Should you freeze your eggs?

There are many reasons why women delay childbearing. Women opt to freeze their eggs for several reasons:

• They may not have found their life partner
• To delay starting a family
• To preserve their fertility before beginning cancer surgery, chemotherapy or radiation.
• To avoid the creation and freezing of extra embryos after an IVF cycle.

Life circumstances may also influence your decision to freeze your eggs. For some women, knowing they have preserved eggs brings them peace of mind in a time of life that may not be the ideal time to become pregnant. Many women with demanding careers or the inflexibility of academic calendars may wish to delay family building. Here are a few guidelines to help you determine whether you are an appropriate candidate for egg freezing:

• You are in your 20s to mid-30s. (Women over the age of 37 may consider egg freezing on a case-by-case basis).
• You would like to start a family, but aren’t quite ready and would like to preserve your ability to have children later.

Women may also choose to freeze their eggs if they have a medical condition (malignancy) that could potentially harm their fertility. Here are some reasons in which egg freezing would be a viable option for preserving a woman’s ability to have a baby:

• You are newly diagnosed with a cancer, which may threaten your fertility.
• Your planned medical treatments involve chemicals that have been linked to infertility.
• You’ve been diagnosed with early ovarian insufficiency.

When should you freeze your eggs?

When it comes to your egg supply, age is a factor, since the quality and quantity of eggs rapidly deteriorate after age 35. Egg freezing allows you to preserve the optimal years of your fertility when you’re ready to conceive later in life.

As a woman, you are born with all the eggs you will ever have. With time, your eggs decrease in both numbers and cellular integrity. This decline is in large part why women in their 40s have only about a five percent chance of becoming pregnant each month. So, to answer the question, 'at what age should I freeze my eggs?' the simple answer is: Freeze your eggs in your prime reproductive years of your 20s and early 30s. This allows you to take advantage of premium egg quality and quantity.

If you know you want to start a family someday, but the time isn’t ideal for you right now, contact Reproductive Gynecology & Infertility to explore your options. In addition to providing expert IVF treatments and other solutions for infertility in Columbus, we also offer egg freezing in Columbus, Youngstown, Akron and Canton, Ohio. We will present the facts about egg freezing—how it works, the limitations and the likelihood of a successful outcome.

What You Need To Know About Egg Freezing

In 2018, the New York Times reported more than 20,000 American women elected to freeze their eggs. This number has risen sharply since 2009, when there were only 475 women freezing their eggs. The process of egg freezing involves stimulating the ovaries with hormones to produce multiple eggs. Once the eggs are mature, they are retrieved from the ovaries, taken to the lab and cooled to sub-zero temperatures. Frozen eggs can be stored for over 10 years, until you’re ready to start a family.

What's the process of egg freezing?

If you’re considering cryopreservation, or egg freezing, here are a few things you need to know:

• The timing – Generally, fertility begins to decline in your late 20s or early 30s and falls more rapidly after the age of 35. Consider freezing your eggs sooner rather than later, to ensure you are giving your future self the best chance at having a baby.
• The process – Egg freezing typically involves 8-11 days of hormone injections to stimulate your ovaries, 5-7 doctor appointments, blood draws and transvaginal ultrasound exams.
• The medications – The specialized hormone medications will not be available at your local pharmacy. Instead, your reproductive endocrinologist will recommend a pharmacy that specializes in medications for egg freezing and other fertility treatments.
• The procedure – Once your eggs are mature, you will be placed under mild anesthesia so your physician can retrieve them during a brief 10-15 minute surgical procedure. Using ultrasound guidance, a needle is inserted through the vaginal wall into each ovary. The needle is attached to a catheter that’s connected to a test tube.
• The egg freezing – Once the eggs are successfully retrieved, your physician will hand them over to a skilled embryologist who, using a fast-freezing method called vitrification, will transform the eggs into a glass-like frozen state and store them in a liquid nitrogen storage chamber until they’re needed.

What's the egg freezing timeline?

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The he basic steps and how it works.

• Consultation (~1 hour): Discuss patient's medical history and ask questions.
• Testing (~30 minutes): Undergo ultrasound and lab tests.
• Reviewing Results (~30 minutes): Treatment team goes over the results with you.
• Medication and Monitoring (10-12 days): Receive fertility shots and regular monitoring.
• Egg Retrieval (~1 hour): Anesthesia is administered, and eggs are retrieved for freezing.
• Recovery (4-5 days): Take time to recover from any discomfort or bloating.
• After retrieving the eggs, patients can consult their physician regarding additional egg-freezing cycles. Once the eggs are frozen, patients have the freedom to plan their family according to their own timeline and can return for an IVF cycle when they are ready.

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Start Your Family When You’re Ready With Egg Freezing In Columbus

We are proud to say that Reproductive Gynecology & Infertility has achieved successes where others have not. From egg freezing to IVF and more, we provide individual infertility solutions with the utmost compassion, convenience and commitment.

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If you are interested in egg freezing in Ohio, contact the fertility specialists at Reproductive Gynecology & Infertility. We are ready to help you build your family. Call 866-537-2461 to schedule your appointment today.

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The 'two-week wait' is the time between fertility treatment (IVF or IUI) and either a positive pregnancy test or your period. During this period, you’ll probably feel various emotions, from hope to fear. You may wonder if conception took place and what to do next. It can be a stressful time, but you can take steps to make the wait easier.

During the two-week wait, life can be an emotional rollercoaster. You may find yourself swaying between anticipation and joy, fear, sadness, anger, hope, frustration, or even guilt from one moment to the next. It can be exhausting and mentally draining, and you might find it hard to concentrate on anything else. But focusing on other things is exactly what you should do.

How to Cope with the Two-week Wait: The Dos

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While there’s no magic formula for getting through the two-week wait, being kind to yourself is essential. While you’re waiting, do the following:

• ‍Practice self-care. Get enough rest, eat well, drink water, and avoid alcohol and caffeine. Treat yourself to something relaxing, like a massage, a bath, or a hobby.‍
• Seek support. Reach out to your partner, family, friends, or a support group. Talk to your doctor or a counselor if you have any worries or questions.‍
• Stay busy. Keep yourself occupied with positive activities. Here are some ideas to pass the time:
  - Work on a project (Try these craft ideas)
  - Read a book
  - Go to the theatre and watch a new movie or stay in and watch a classic
  - Play a game
  - Go for a walk
  - Plan something fun after the two-week wait, like a trip you’ve been wanting to go on or a dinner with friends at the new spot in town you’ve wanted to try.‍

• Write down your feelings. Write a journal entry, a letter, or a list of hopes and fears. Expressing your thoughts and emotions on paper can help you release stress and gain perspective.‍
• Maintain healthy habits. Exercise moderately, eat nutritious foods, avoid certain medications, and quit smoking.

Communicate with your doctor and partner. Contact your doctor for guidance if you have any doubts or questions about the treatment or the wait. Keep your partner informed and involved in the process.

Behaviors to Avoid During the Two-Week Wait

Being patient for two weeks is hard, and you may be tempted to overthink things or over-test for pregnancy. These behaviors will make the wait more agonizing, so avoid them if possible: 

• Taking too many pregnancy tests. They’re often wrong 12 days after ovulation or ten days after embryo transfer, and testing too soon can stress or disappoint you with false results.
• Obsessively worrying. Worrying too much can increase stress levels and affect your immune system and hormone balance. Focus on the positive aspects of the treatment and the potential outcomes instead of the negative ones.
• Symptom searching. Many symptoms can be caused by other factors besides pregnancy. Also, some people may not experience symptoms until later in their pregnancy. Symptom searching can increase your anxiety and disappointment if you don't feel anything or your symptoms change.‍
• Drinking and smoking. In the two-week wait, prioritize caution. Steer clear of drinking, smoking, or engaging in any risky activities that could harm a developing pregnancy. If you already exercise regularly, it's okay to continue but hold off on starting any intense new workout routines for now.

Getting Through the Two-Week Wait with Patience and Joy

The best thing you can do during the two-week wait is to let your body do its work. Don’t hurry the process or expect quick results. Trust that your treatment team has done their best to help you and that nature will do its part. Be patient and kind with yourself, find joy in the small things, and celebrate every step you take.

When most think of problems with fertility, they tend to attribute the cause to the female partner. However, male infertility is responsible, directly or indirectly, for 60% of fertility-related issues in reproductive-age couples. Even considering this statistic, male infertility is still often under-evaluated or dismissed. Evaluating the male partner for infertility improves the precision of infertility diagnoses and the results of subsequent treatment and management.       

Do men need to get their semen analyzed? Evaluating male fertility is a key piece in determining the best treatment path for acouple struggling to get pregnant. One of the important fertility tests for infertile couples is a semen analysis test. Also referred to as a sperm count test, a semen analysis encompasses more information than just a sperm count.   

What Causes Male Infertility?

The main indicator of male infertility is the inability to impregnate a partner. There may be no other obvious symptom or sign. If you and your partner have not conceived a child after a year of regular, unprotected intercourse, it's time to visit a reproductive specialist who could identify underlying problems, such as hormonal imbalances, dilated veins around the testicles, or possible inherited disorders. Certain conditions or events may be associated with male infertility.

• History of genital infections or inflammation of the prostate
• Early or late onset puberty
• Hernia repair
• Injury to or torsion (twisting) of the testicles
• Genitals exposed to high temperatures
• Undescended testicles

Certain prescription medications may also place a male at risk. Discuss any new medications with a pharmacist.  

How Is a Semen Analysis Done?

The steps involved in a Semen Analysis include:

• Collection of Semen: The patient provides a semen sample by masturbating into a sterile container. The sample should be collected after 2-7 days of sexual abstinence.
• Preparation of the Sample: The semen sample is allowed to liquefy for about 30 minutes at room temperature. The liquefied sample is then mixed to ensure that the sperm are evenly distributed.
• Evaluation of Quantity: The quantity of semen is measured by using a calibrated pipette. The volume of the semen is usually between 1.5 and 5 milliliters.
• Evaluation of Quality: The quality of the sperm is evaluated by examining the sample under a microscope. The sperm are assessed for their motility, morphology, and concentration.
• Motility Assessment: The motility of the sperm is evaluated by measuring the percentage of sperm that are moving and the quality of their movement.
• Morphology Assessment: The morphology of the sperm is evaluated by examining the shape and size of the sperm. Abnormalities in the shape of the sperm can affect fertility.
• Concentration Assessment: The concentration of the sperm is evaluated by counting the number of sperm in a specific volume of semen. A low sperm count can affect fertility.
• Other Tests: In some cases, additional tests may be performed, such as testing for the presence of white blood cells in the semen or testing for infections.

A semen analysis may need to be repeated to ensure accuracy and to monitor changes in sperm parameters over time. If there are any abnormalities in the initial semen analysis, a repeat test may be necessary.

• Information Learned Through Semen Analysis

Analysis of a semen sample involves more than just counting the number of sperm present. In fact, a semen sample normally contains less than 5% sperm. It includes mucus and other fluids that make up the healthy environment for the survival of the sperm within the male's ejaculate. A sperm analysis test usually provides the following information.

Sperm Concentration

The number of sperm found in one milliliter of semen is the sperm concentration number. There should usually be approximately 15,000,000 sperm/milliliter in a healthy sample. A low sperm concentration number may show an overall low sperm count and may indicate an unusually high ejaculate volume.   

Sperm Motility

Motility is the percentage of sperm in a sample that moves. If the sperm are incapable of swimming up the female reproductive tract to meet the egg, fertilization will not take place. A healthy semen sample should include about 40  of the sperm capable of moving. A scale of zero to four measures movement rate, which should be a three or higher if showing proper movement quality.       

Viability or Vitality

Semen analysis reveals the percentage of live sperm in the sample. This is sperm viability or vitality. If sperm motility is low, it is especially important to determine viability. There should be at least 50% of the sperm cells which are viable, but if more than half are immotile, it may require further testing to determine viability.

Morphology

Morphology speaks to the shape of sperm cells. The three portions of the sperm — the head, the midsection, and the tail — are measured, and the proportions between each are recorded. For the sperm to swim effectively and fertilize, at least 4% of sperm need to have a normal shape.      

Liquefaction

Ejaculated semen is normally thick and gelatinous, which helps it adhere to the female cervix. It should liquefy in about 20 minutes to enable sperm to swim effectively. If there is a delay in the liquefaction, more testing is generally indicated. SSemen pH

This analysis measures how alkaline or acidic the semen is. A balanced solution is ideal, with seminal vesicle fluid being more alkaline and prostate fluids being more acidic. If the semen is too acidic, it may kill the sperm or impair fertilization. The pH of the semen sample should be between 7.2 to 7.8. Low semen pH usually goes hand-in-hand with other abnormal measurements, such as a low sperm count or a low volume of semen.    

Diagnosing Male Infertility Through Semen Analysis

Any male with one or more health issues that lower the chances of his partner becoming pregnant may need evaluation for infertility. While there are many causes for infertility in men that can be hard to diagnose, most often, the problem is with sperm delivery or sperm production. 

Diagnosis begins with a physical exam and a full history. An exam usually includes blood work and semen analysis, along with a visual and tactile exam of the male sex organs. The results of baseline blood work will determine the need for more tests.

Semen analysis is most often done at least twice. Abnormal sperm numbers or compromised motility may necessitate further sampling. Semen analysis does not test for sperm function but is the cornerstone of baseline laboratory evaluation for male infertility. Analysis of the semen may provide useful data from which a fertility prognosis or a diagnosis of infertility can be determined.

Low sperm numbers or even no sperm production doesn't indicate irreversible or permanent infertility. It may only illustrate a problem with the growth or delivery of sperm. More testing may further define the problem and suggest possible treatments.

Plan Your Semen Analysis Today 

Sometimes all that's needed are lifestyle changes to improve sperm health, viability and increase sperm count. A few examples include:

• Get plenty of exercise and sleep
• Maintain a healthy weight

• If you smoke, stop
• Enjoy alcohol in moderation
• Support a diet rich in antioxidants with vitamin D and calcium supplements

Avoid underestimating the possibility of male infertility. A correct diagnosis is imperative when determining the best path to building your family. A detailed, precise medical history, physical examination, semen analysis, and other lab work are key to nailing down a diagnosis. 

If twelve consecutive months of trying to conceive have been unsuccessful, it's time to see an endocrinologist specializing in reproduction. The doctors at Reproductive Gynecology & Infertility can diagnose and treat male infertility. Give them a call today!

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