FAQ

_________________________________________________________________

One of  8 couples has trouble conceiving.

On average, pregnancy occurs by 3 months of trying.  If you are age 35 or over, then you should seek medical attention if you are not pregnant after 6 months of trying.  A younger women may try for up to12 months, provided she has fairly regular menstrual periods.  If you have irregular menses or if you had pelvic surgery, then it is suggested that you see a fertility specialist.

	Be sure that the center employs board certified or board eligiblespecialists in Reproductive Endocrinology and Infertility.  Thisway you know the doctors have had extensive training in the area of infertility.
	Ask for the center's "track record"... how long have they been doing this successfully.  If you need IVF or other advanced reproductive techniques, then ask for the center's pregnancy rate.  The most important statistic is the "clinical" pregnancy rate per egg retrieval procedure.  "Clinical pregnancy" means that the pregnancy has been verified by ultrasound.  This rate should include at least a 12 month period of time to accurately reflect the overall success rather than quoting the one "lucky" month that had a high pregnancy rate.  Beware that some centers will make misleading claims, quoting inflated success rates based on "chemical pregnancies".  "Chemical pregnancies" are pregnancies that are lost early --- before it grows enough to be seen by ultrasound. Another deception used by some centers is to quote success rates "per embryo transfer" which ignores the patients who underwent an egg retrieval procedure but did not successfully recover mature eggs or where no embryos developed to be transferred into the uterus.
	Beware of hidden costs when you are quoted out-of-pocket expenses for IVF.  For example, the cost of cryopreservation (freezing) of embryos and the cost of preparing the uterine lining for the transfer of the thawed embryos may add considerably to the basic cost.  Ask the center how often they avoid the fresh embryo transfer and thus need to resort to the frozen embryo transfer.  Some programs offer egg sharing (where an infertile woman undergoes IVF and shares half of her eggs in return for receiving the fertility treatment at a reduced  cost).  You could be increasing your risk of hyperstimulation and decreasing your chance of becoming pregnant if you are receiving higher than normal doses of medication in order to produce more eggs so you can share them with someone else.

A vasectomy interrupts the tube that transports the sperm from the testicle.  If you want your husband to be the genetic father, then you need to obtain sperm in one of two ways.  A Reproductive Urologist can surgically reverse the vasectomy so that sperm can once again be included in the ejaculate.  However, the surgery is not always successful. Alternatively, you can undergo In-Vitro Fertilization(IVF) combined with a simple aspiration of sperm from within your husband's scrotum. The number of sperm obtained from within the scrotum is insufficient to allow fertilization through  insemination into the uterus.  A sperm cell obtained in this manner  needs to be placed directly into the egg through our laboratory technique called "intracytoplasmic sperm injection (ICSI) to achieve  fertilization. IVF involves obtaining your eggs so that they can be fertilized in the petri dish.   Any extra sperm obtained that are not needed to fertilize all the eggs can be frozen for future attempts at IVF if needed.  While pregnancy is not guaranteed with each IVF attempt, many men have fathered children through this technique at our center (see IVF Statistics).  A third option is to use donated sperm which can be inseminated into the uterus.  This way your husband need not undergo the sperm aspiration.  However the child resulting from donor sperm insemination is not genetically related to your husband.

This question concerns the treatment of female sterilization.  The situation is similar to the previous question that concerned male sterilization.  We can surgically put the tubes back together or you can undergo In-Vitro Fertilization (IVF).  Of the women who have the surgery to reverse their tubal ligation, 70% of them will conceive a pregnancy within one year, if they are under the age of 35. In comparison, the successful conception rate for IVF is about 40% per try -- which means that 8 out of 10 women will conceive within 3 IVF attempts.  At our center, the cost for the tubal reversal surgery is $7030, while a cycle of IVF costs  $6511 (not including medications).

Fertility generally declines after the age of 35 and the drop accelerates upon reaching 40.  The reason for the decline is that a woman is born with a limited number of eggs.  She cannot make any more during her lifetime.  The eggs that remain after age 40 tend to be less fertile.  The risk of chromosomal abnormalities in the newborn increase with the age of the eggs, though the incidence at birth is still only 4% even in 44 year olds.  Most conceptions that have chromosomal abnormalities end as miscarriages.  This could explain why miscarriage is twice as common after the age of 40 as it is in younger women.   There is a simple blood test that can measures a woman's "egg reserve".  It can often tell you if fertility treatment would be futile or not.  Even women who are approaching menopause can carry a pregnancy if they receive treatment in the form of donated eggs. These eggs are donated by younger women who want to help such couples realize their dream of building a family.  For more information see our Web Page regarding Age and High FSH.

It is true that medications designed to help a woman ovulate can increase her chances of having a multiple gestation.  Taking the oral medication clomiphene leads to a 7% chance of twins.  The risk of having greater than twins is very low (about 1 in 200). 

Home |  About Our Practice
   Insurance/Costs | FAQ | How to Find Us 
  Helpful Links | Feedback | Privacy Policy