What is IVF? The steps, duration, injections and more

 

How long is an IVF cycle? What are the steps?

An IVF cycle comprising ovarian stimulation, egg retrieval (OPU), sperm collection, ICSI and embryo transfer is generally 21 to 25 days.

Does IVF hurt?

The IVF procedures include egg retrieval and embryo transfer. Egg retrieval is done under sedation and afterwards, you may feel some discomfort similar to that of a heavy menstrual cycle. The embryo transfer is a painless procedure and feels similar to a Pap smear. We are dedicated to using the best-quality tools to ensure that you experience the least possible discomfort during treatment.

As for the hormone injections, each woman is different, and some will be more sensitive than others. Some women feel slight discomfort from the medication released by the first injection but nothing that is intolerable. Most injections can be taken from the convenience of your home, and if you are feeling discomfort from the needles, you can apply a numbing cream beforehand.

Is there an age limit for IVF?

IVF Michigan Fertility Center doesn’t have a strict cut-off age as every woman is different and the possibility of conception depends on if she is still producing eggs. Some women go through menopause and stop ovulating earlier than others, but a simple blood test (AMH) can let us know if there is any egg reserve left. However, we do find that most women over the age of 40 have better success with donor eggs.

General questions: facility and appointments

 

How should I prepare for my first appointment at IVF Michigan?

When you call IVF Michigan to make your first appointment at one of our fertility clinics, we will take a full inventory of your basic information, such as name, address, phone number, insurance details, etc. We also need to establish if you’ve had any diagnostic fertility work done in the past. If so, we will work with you to obtain the appropriate paperwork so that our fertility doctors may review it. We can then schedule an appointment with one of our fertility specialists, sometimes in as quickly as a week.  We do prefer for both partners, if applicable, to attend the first appointment, although it is not required. We will email you the IVF Michigan paperwork to fill out and bring with you to your first appointment. Aside from the paperwork, there are no specific requirements to prepare for your first appointment (i.e. no fasting, no necessary stage of your menstrual cycle).

What will my first appointment be like?

As with most medical decisions, having as much information as possible makes the process smoother and less stressful for patients.  Before ever stepping foot into one of our IVF Michigan offices, we strive to provide you with a comprehensive overview of what your first appointment is like.

Having already filled out the paperwork that we sent you via email when you arrive at IVF Michigan, all we need is to collect your paperwork and make a copy of both partners’ driver’s licenses and insurance cards.  Once that is complete, you (and your partner if they are available to attend) will meet with the fertility doctor to go over your past medical history, including what steps you have already taken (if any) to try to get pregnant, and to discuss which next steps would be the best option for you.  During this initial appointment, there may be an exam or an ultrasound performed if necessary.  Once you and the doctor have decided on a course of action, you will meet with our nursing staff to discuss next steps, schedule appointments, sign necessary paperwork and address any additional questions you may have.  Finally, you may meet with one of our administrative staff members for financial counseling.  In order to make this process as clear and efficient as possible for you, we provide analysis of your insurance, detailing which expenses are covered and any additional costs associated with your treatment plan.  While some people are eager to get the process started, others need to take some time to digest all the information.  We, of course, welcome you to go at your own pace.

Are all procedures performed at IVF Michigan Fertility Center?

Yes, at IVF Michigan Fertility Center all procedures and laboratory work are conveniently performed in our facilities. Those procedures include blood tests and ultrasounds. Egg retrievals, embryo transfers, laparoscopy and hysteroscopy operations can only be done at the Bloomfield Hills office.

How soon can I get an appointment with an IVF Michigan Fertility Center doctor?

We do not have waiting lists to see our physicians. You can typically get an appointment with the physician you are interested in within 1 to 4 days.

Male infertility: low sperm count, low motility and treatments

 

What is male infertility and what are some common causes?

Technically speaking, infertility is the result of a disease (an interruption, cessation, or disorder of body functions, systems, or organs) of the male or female reproductive tract which prevents the conception of a child or the ability to carry a pregnancy to delivery.  Male infertility may be caused by a range of factors, most of which affect the quantity and/or quality of sperm.  The majority of male infertility cases are due to low sperm quantity, poor sperm quality, or both.  In the remainder of infertility cases in men, there is a wide variety of causes, ranging from hormonal imbalances or physical problems to psychological or behavioral problems.

In some cases, sperm cannot be found in the semen.  Blockages and sperm production failures in the male reproductive tract prevent mature sperm from being found in semen.  These complications can be treated in most cases.  In other cases, the bladder sphincter is damaged, allowing sperm to mix with urine in the bladder, which is called retrograde ejaculation.

Another cause of infertility in men is varicoceles, or the enlargement of veins in the scrotum. The pooling of blood caused by the varicoceles affects the circulation in the testes, changing the temperature and affecting the microenvironment of the testes. Because of this, males with varicoceles may experience low sperm count, decreased motility, and poor sperm quality.  A varicocele can be treated by a varicocelectomy at IVF Michigan.

Male infertility can also be a side effect of other medical conditions.  Endocrine and hormonal problems affect sperm production based on the particular complication.  Genetic diseases, such as cystic fibrosis, and gene mutations can also be directly or indirectly associated with sperm abnormalities.  Behavioral and psychological factors affect male infertility as well.  Stress, smoking, obesity or poor nutrition, and STDs play a role in male infertility if they are prolonged and not treated early.

If you have male infertility or are unsure if you have male infertility, IVF Michigan Fertility Center recommends contacting one of our fertility doctors to discuss your symptoms and options.  Because there are a variety of causes for male infertility, it is important to speak with a fertility specialist to get a proper diagnosis, assess the risks, and determine if treatment is possible.  In some cases, conception is still possible, but it is important to speak to an IVF Michigan fertility doctor about your male infertility treatment options.

Can you help men with azoospermia?

IVF Michigan Fertility Center has several treatment options for men with obstructive or non-obstructive azoospermia.

  1. Testicular Sperm Aspiration (TESA) is a minor procedure that typically takes 5-10 minutes under sedation. TESA is generally an option for men with obstructive azoospermia where it is expected that sperm will be found easily. During the procedure, sperm is directly removed from the testes to be used in an IVF-ICSI cycle.
  2. Testicular mapping is a minimally invasive procedure during which a fine needle is placed in different areas of the testes to obtain small samples of testicular fluid. The aspirate is fixed on a slide and checked for sperm following the procedure. If sperm is found, a future sperm retrieval will be scheduled during an IVF-ICSI cycle and will be carried out from the sites where sperm was found during the original mapping.
  3. Advanced testicular mapping is a technique during which a fine needle is placed in different areas of the testes, aspirating small samples of testicular fluid that is immediately analyzed for viable sperm. If viable sperm is found, it is frozen and used in a future IVF-ICSI cycle.
  4. Micro-dissection TESE (MicroTESE) is an invasive procedure utilized to locate sperm in men with non-obstructive azoospermia or severe testicular failure. MicroTESE is especially helpful in these men as there may be very localized areas of sperm production that may be missed during blind biopsies or needle aspiration procedures. During a MicroTESE, the testes are surgically opened, tissue is inspected under a microscope and an intense search of every part of the testicle is performed to locate healthy areas that are more likely to contain sperm.
  5. Simultaneous staged sperm retrieval procedure begins with advanced testicular mapping, a technique during which a fine needle is placed in different areas of the testes, aspirating small samples of testicular tissue that is immediately analyzed for viable sperm. If adequate numbers of viable sperm are found, the procedure is terminated and Micro-dissection TESE (MicroTESE) is not needed. If no sperm is found in the aspirated samples, the surgeon immediately proceeds to perform a MicroTESE. Through simultaneous staged sperm retrieval, men get the highest chance of success with the least invasive method needed.

Is it important to have high sperm count and good motility for IVF?

If you have low sperm count or poor motility, IVF Michigan Fertility Center has treatment options available for you. At IVF Michigan Fertility Center we use Intracytoplasmic Sperm Injection (ICSI) in conjunction with IVF in order to improve chances of fertilization by injecting a single sperm into each egg. With this procedure, we can work with as little as one sperm and sperm with very low motility. We may also suggest a regime of supplements to improve sperm quality.

PGS: What is it? What are the benefits?

 

What is PGS? What are the added benefits?

Pre-Implantation Genetic Screening (PGS), also known as embryo screening, is performed to check for any chromosomal abnormalities in all 24 chromosomes caused by missing or additional chromosomes. Chromosomal abnormalities include Trisomy 13 (Patau syndrome), Trisomy 18 (Edwards’ syndrome) and Trisomy 21 (Down syndrome). PGS also includes the screening of chromosomes X and Y, making family balancing through gender selection possible.

How accurate is PGS if I want to know the gender of my embryos?

PGS when screening for X and Y (gender) chromosomes is 99.9 percent accurate.

Natural cycle IVF: What do I need to know?

 

What is natural cycle IVF?

Natural cycle IVF is an option for women who do not respond well to fertility medication or who have diminished ovarian reserve. Such women do not produce more than one natural egg per month, regardless of stimulation medication. During a natural cycle, the single natural egg created by the body is retrieved, injected with sperm and, if fertilized, the embryo is transferred to the uterus. No stimulation medication is prescribed during natural cycle IVF.

Are there any drugs taken for natural cycle IVF?

There is only one injection of HCG administered to promote full maturation of the eggs before retrieval. In the case that some (but minimal) medication is administered, that is referred to as a mini-IVF cycle.

What are the advantages and disadvantages of natural cycle IVF?

Advantages:

  • Utilizes the body’s normal hormones
  • May be repeated monthly if necessary
  • Less discomfort
  • Decreased risk of multiple births compared to conventional IVF-ICSI
  • No risk of hyperstimulation (overstimulating the ovaries with medication)

Disadvantages:

  • Only one egg (at most two) is retrieved, reducing chances of fertilization, embryo transfer and pregnancy
  • The success rate per cycle is less than that of conventional in vitro fertilization

Cancer and fertility

 

Can I get pregnant after chemotherapy treatment?

Not all cancer treatments leave men and women infertile. However, chemotherapy can often negatively affect fertility and therefore, it is recommended that before treatment begins you consider preserving your fertility through egg or sperm freezing. For women who do not have time to undergo an IVF cycle before treatment or who cannot take stimulating medication due to your condition, you may want to consider natural cycle IVF to follow ovulation during your current cycle and hopefully, one to two eggs can be retrieved and frozen for future use.

Preserving Fertility: Can I extend my fertility?

 

Can I preserve my fertility if I am single or not ready to have children?

Thanks to medical advancements, women have more options than ever when it comes to extending the longevity of their fertility.  At IVF Michigan, we offer a number of solutions for women who want to become pregnant later in life, one of which is the option to freeze their eggs. While the process was originally used primarily for women with illness-induced infertility (i.e. as a result from chemotherapy or radiation to treat a cancer diagnosis), it has now become more common among women who simply want the option to delay pregnancy for any number of personal reasons. Whatever a woman’s rationale, the fertility specialists at IVF Michigan are happy to help her navigate her biological clock.  However, it is important to note that as women age, the quality and quantity of their eggs decrease tremendously; therefore, the younger a woman is when she freezes her eggs, the better.  If a woman freezes her eggs at 28 and gets pregnant via in vitro fertilization at 38, she is essentially getting pregnant with the egg of a 28-year-old woman, which significantly lowers the risk of miscarriage and genetic defects. While it was once thought that only fertilized eggs (embryos) were able to be successfully frozen, thawed and implanted, scientific discoveries have made it possible for unfertilized eggs to be stored as well, giving women even more flexibility when it comes to preserving their fertility.

Donor eggs and sperm and surrogacy

 

Can IVF Michigan Fertility Center help me with donor eggs, donor sperm or a gestational carrier?

If you are interested in a donor egg or sperm donor cycle, we can help you start your family with an anonymous egg or sperm donor. We are proud to have a very high rate of success with donor cycles (up to 80%) and have egg donors from different races and ethnic backgrounds, so we are able to find the most suitable donor to help you expand your family.

IVF versus IUI: Which is right for me?

 

Many women who are struggling with infertility are curious about their treatment options, specifically the difference between IVF and IUI, and which is right for them.

In vitro fertilization (IVF) and intrauterine insemination (IUI) are the two most commonly used fertility treatment methods. Many patients come to IVF Michigan Fertility Center wondering what the pros and cons are for each method and which fertility treatment is best for them.

The experienced fertility doctors at IVF Michigan have found that while IUI has some financial and medical benefits, IVF is the more successful treatment out of the two.

During IVF, a woman has her ovaries stimulated with hormones (follicle-stimulating hormone and luteinizing hormone) to produce multiple eggs during a single cycle (women normally produce a single egg per cycle); then, the eggs are removed from the ovary (in a procedure called a transvaginal oocyte retrieval) so that they may be fertilized with sperm in a laboratory (during a procedure called intracytoplasmic sperm injection) in order to create embryos.  Finally (approximately five days later) the embryo(s) are transferred into the mother’s uterus.

 

So how does that differ from IUI?

IUI is a type of artificial insemination where sperm is inserted directly into a woman’s uterus for the purpose of fertilizing the egg.  This procedure is done one to two times following a woman’s ovulation cycle. IUI leaves higher concentrations of good sperm close to where the egg is waiting, so the odds are increased that the egg and sperm will find one another.

While many couples are intrigued by IUI because it is less expensive and less invasive, it also has a remarkably decreased rate of success compared to IVF, especially in women with advanced age. Therefore, it’s important to know the type of procedure that works best for each cause of infertility.

IUI is commonly used when fertility issues are related to unexplained infertility, mild endometriosis, low sperm count, ejaculation issues or decreased sperm mobility. IVF is recommended for women with most causes of infertility, including age (over the age of 35), low egg supply, very low sperm count, very low sperm motility, tubal issues, and fertility disorders like endometriosis and polycystic ovary syndrome (PCOS).

For patients younger than 38 years old with no previous fertility treatment, the suggested route is to proceed with two to three cycles of artificial insemination, followed by IVF. For some patients, starting with IVF would be a better option.

Patients 38 or older may benefit from proceeding with IVF sooner because of the very low success rate of IUI and reduced supply of eggs.  In some cases, delaying IVF would result in a higher total cost because of the need to repeat the procedure multiple times to get the expected results.

If you still aren’t sure which procedure is right for you, please call one of IVF Michigan’s fertility specialists at 855-952-9600, and we would be happy to discuss your fertility treatment options.

Secondary infertility: struggling to have a second child?

 

What is secondary infertility?

Secondary infertility is defined as the inability to conceive another (not necessarily second) child successfully and naturally. When a childless couple is unable to conceive, they tend to seek treatment. However, couples who already have a child and who are affected by secondary infertility are much less likely to do so because of the misconception that once you are fertile you will always be fertile.

 

Why does secondary infertility happen?

Reasons for secondary infertility tend to be the same as reasons for primary infertility. Since the last pregnancy, the husband or wife may have gained some weight, had an infection, or started eating fewer healthy foods. These small variances in lifestyle can affect reproductive health. Additionally, if it has been a few years since the last child, the quality of eggs may have begun decreasing, or the husband’s sperm may have undergone some changes. Abnormalities with sperm and ejaculate are frequently cited as causes of secondary infertility. Other common explanations for secondary infertility include:

 

How can IVF Michigan Fertility Center help me?

Many couples struggling with secondary infertility may benefit from IVF-ICSI. Schedule an appointment to discuss your history with an IVF specialist and to learn the best options available to you.

The fertility diet: fact or fiction?

 

Many female patients inquire about supplements, exercises or even diets that will help them conceive.  While there is no scientifically-endorsed diet that ensures a successful pregnancy, there have been a few studies that show women who follow a Mediterranean-style diet may have less difficulty getting pregnant.

A Mediterranean-style diet is generally plant based. Instead of meat as the main course of a meal, a Mediterranean diet would more likely feature beans, lentils, nuts, seeds, vegetables, fruit or whole grains. Because of this, people who follow this diet generally get six or more servings of fruit and vegetables a day. Fish – which is vital for its omega-3 fatty acids, protein, vitamins, and minerals such as iron – make an appearance on the table at least twice a week.  There is always debate about the amount of fish a pregnant woman should eat, so be advised that the current recommendation is 2-3 servings a week maximum.  The four types of high-mercury fish (tilefish from the Gulf of Mexico, swordfish, shark, and king mackerel) should be avoided while trying to conceive, pregnant or breastfeeding.

Where Americans love their butter, a Mediterranean diet uses olive oil, which is high in monounsaturated fat (aka “good fat”); this is also found in avocado, peanuts and cashews.  A study by the Harvard School of Public Health found that women who ate the most monounsaturated fat had up to three times the chance of giving birth via IVF as those who ate the least. Also, because more herbs and spices are used when preparing foods in a Mediterranean diet, less salt is needed. Lowering your overall sodium intake is beneficial to heart health, which is recommended when trying to conceive naturally or through IVF.  Lastly, red meats, dairy and sweets should be eaten sparsely. Calcium that you’d normally get from milk can be replaced with other sources like legumes, kale, almonds and oranges.

Whether the Mediterranean diet is a silver bullet for fertility remains to be proven, but fertility doctors can agree that a Mediterranean diet is an incredibly healthy choice and having a healthy body is always best when trying to conceive.

Natural ways to prepare yourself for a successful IVF cycle

 

One of the most common questions we hear from our patients at IVF Michigan Fertility Clinic is, “What can I do to better my chances at becoming pregnant from IVF?”

Unfortunately, there’s not a simple answer as there are many factors to consider, such as age, weight and the cause of infertility.  However, there are a few steps you can take to prepare your mind and body for IVF and ultimately, for a successful, healthy pregnancy. Please note that none of these are required before receiving IVF treatments at IVF Michigan Fertility Center, and these suggestions are not to be taken in lieu of medically administered fertility treatments.

While it may be the most challenging instruction to follow, at IVF Michigan we tell all of our patients that they need to reduce their stress levels. Stress takes a giant toll on our bodies. We understand that it is likely impossible to eliminate everything that causes you stress, but you can implement different tactics to help manage your stress, like exercising. While exercise is recommended for stress reduction and overall health, we must advise female patients not to overdo it. We recommend women get 30 to 40 minutes of cardio, three times a week.  Add in yoga or light weight lifting on the days you’re not doing cardio. In one study, women who exercised more than four hours per week actually reduced their IVF success rate up to 30%.

Acupuncture and massage can also help reduce the stress related to infertility diagnosis and treatment. Whether they also increase the success rate of IVF remains unproven but continues to be researched. Fertility acupuncture and massaging are techniques that are thought to help support reproductive health, your menstrual cycle and your fertility. They may aid circulation to the ovaries and uterus, reduce stress levels, and promote egg health.  You can generally find a massage therapist who specializes in fertility massage or acupuncture with a simple Google search, however, IVF Michigan Fertility Center can also make a recommendation if you’d like.  These massages should only be done before and during the IVF cycle (not once you become pregnant).

Also, a balanced and nutritious diet is key in ensuring your body is in its healthiest form to host a baby. This also means that you should make sure you are at, or close to, a normal BMI range.

When it comes to smoking, not only has it been proven to be bad for your overall health, it also wreaks havoc on your fertility.  Studies show that smoking increases the chance of infertility by 60%.  Smoking may also increase the risks of miscarriage. At IVF Michigan, we advise all of our patients to quit smoking while trying to achieve and during pregnancy.

Not all caffeine is off limits during fertility treatments and pregnancy. However, caffeine intake of more than 500 mg daily (that’s more than five cups per day) can reduce fertility, and drinking more than 200-300 mg (two to three cups) may increase risk of miscarriage. Moderate caffeine consumption (one to two cups of coffee per day or its equivalent) before or during pregnancy has no apparent adverse effects on fertility or pregnancy outcomes. So, sip that single cup of coffee but call it quits once it’s gone.

Lastly, IVF Michigan’s doctors recommend that you start taking prenatal supplements and folic acid to prepare your body for in vitro fertilization and pregnancy. Remember, the mother is not the only person who should be taking care of herself and reducing her stress during this period; partners should follow these tips as well.

For any additional questions regarding the best way to prepare yourself for IVF and pregnancy, contact us at 855-952-9600.

What is low ovarian reserve?

 

A woman’s ovarian reserve is the medical term for how many eggs a woman has left.  As a woman’s ovarian reserve depletes (which happens naturally as women age), the likelihood of her getting pregnant also decreases.

Technically, when a female is still in the womb, she will have developed approximately six to seven million eggs, but egg count decreases over time. By puberty, females typically have 250,000 to 500,000 eggs. By the time women reach 37 years of age, they will only have about 37,000 and by menopause, less than 1,000.

While aging is the most common cause of low ovarian reserve, there are other reasons someone who is young could suffer from this, such as chromosomal abnormalities, like Turner Syndrome, or gene abnormalities, like Fragile X. Low ovarian reserve can also be caused by ovarian tissue damage through torsion, surgical removal of part of the ovary, ovarian cysts caused by endometriosis, benign or malignant ovarian tumors, radiation or chemotherapy, immunological conditions, pelvic adhesions, or a high body mass index.

As always, the IVF success rate for all age groups with low ovarian reserve truly depends on how many viable eggs one of IVF Michigan’s doctors can obtain. If a fertility specialist can only obtain four or fewer eggs from a patient, the odds of not getting pregnant triples.

One of the earliest clinical signs of low ovarian reserve is shortening of the menstrual cycle. Family history of early menopause can increase the likelihood of having low ovarian reserve.

Testing the ovarian reserve is simple. It requires a blood test to assess the levels of ovarian hormones, mainly the Anti-Mullerian hormone (AMH) and follicle-stimulating hormone (FSH). AMH level is becoming the most accepted test because it does not fluctuate during the menstrual cycle and can better predict the number of eggs retrieved during IVF.  Women with low egg reserve should have a complete work up to try to understand if there is an underlying cause.

Dr. Hammoud, a fertility specialist at IVF Michigan who has a special interest in this topic, suggests that testing and treating vitamin D deficiency could improve ovarian reserve for some women. In addition, when undergoing IVF, new stimulation protocols such as estrogen or testosterone priming with embryo banking can be effective.

If you have low ovarian reserve, IVF Michigan recommends sitting down with one of our doctors to discuss your options. Unfortunately, some women with low ovarian reserve may not be strong candidates for in vitro fertilization using their own eggs, however, donor eggs are another option IVF Michigan can provide.

Can hot tubs decrease a man’s fertility?

 

Rumors have been spread that men should stay away from hot tubs if they want to maintain their fertility.  What started as an old wives’ tale has recently been studied and documented by urologists.  Some studies in recent years have concluded that frequent exposure to heat can impair sperm production.  It is recommended that men avoid saunas, hot tubs, and other potential sources of heat that affect a man’s testicles if they plan to conceive a child because increasing testicular temperature hinders sperm production and motility.  Despite these findings, men should not run from their bathtubs and jacuzzis all together, but rather limit their exposure to high temperatures.

While studies initially confirm that excessive heat can have negative effects on sperm, more studies would need to be performed regarding the relationship between heat exposure and male infertility, until it is definitively known whether this level of heat exposure plays a significant role in fertility issues.  However, some studies have shown that the effects of heat exposure to the testicles can be reversed for some men with reduced exposure.  Therefore, there is no need to fear infertility if these comforts are enjoyed in moderation!

What is IVF? The Steps, Duration, Injections and More
How long is an IVF cycle? What are the steps?

An IVF cycle comprising ovarian stimulation, egg retrieval (OPU), sperm collection, ICSI and embryo transfer is generally 21 to 25 days.

Does IVF hurt?

The IVF procedures include egg retrieval and embryo transfer. Egg retrieval is done under sedation and afterwards, you may feel some discomfort similar to that of a heavy menstrual cycle. Embryo transfer is a painless procedure and feels similar to a Pap smear. We are dedicated to using the best-quality tools to ensure that you experience the least possible discomfort during treatment.

As for the hormone injections, each woman is different, and some will be more sensitive than others. Some women feel slight discomfort from the medication released by the first injection but nothing that is intolerable. Most injections can be taken from the convenience of your home, and if you are feeling discomfort from the needles, we can apply a numbing cream beforehand.

Is there an age limit for IVF?

IVF Michigan Fertility Center doesn’t have a strict cut-off age as every woman is different and the possibility of conception depends on if she is still producing eggs. Some women go through menopause and stop ovulating earlier than others, but a simple blood test (AMH) can let us know if there is any egg reserve left. However, we do find that most women over the age of 40 have better success with donor eggs.

General Questions: Facility and Appointments
How should I prepare for my first appointment at IVF Michigan?

When you call IVF Michigan to make your first appointment at one of our fertility clinics, we will take a full inventory of your basic information, such as name, address, phone number, insurance details, etc.  We also need to establish if you’ve had any diagnostic fertility work done in the past. If so, we will work with you to obtain the appropriate paperwork so that our fertility doctors may review it.  We can then schedule an appointment with one of our fertility specialists, sometimes in as quickly as a week.  We do prefer for both partners, if applicable, to attend the first appointment, although it is not required. We will email you the IVF Michigan paperwork to fill out and bring with you to your first appointment. Aside from the paperwork, there are no specific requirements to prepare for your first appointment (i.e. no fasting, no necessary stage of your menstrual cycle).

What will my first appointment be like?

As with most medical decisions, having as much information as possible makes the process smoother and less stressful for patients.  Before ever stepping foot into one of our IVF Michigan offices, we strive to provide you with a comprehensive overview of what your first appointment is like.

Having already filled out the paperwork that we sent you via email when you arrive at IVF Michigan, all we need is to collect your paperwork and make a copy of both partners’ driver’s licenses and insurance cards.  Once that is complete, you (and your partner if they are available to attend) will meet with the fertility doctor to go over your past medical history, including what steps you have already taken (if any) to try to get pregnant, and to discuss which next steps would be the best option for you.  During this initial appointment, there may be an exam or an ultrasound performed if necessary.  Once you and the doctor have decided on a course of action, you will meet with our nursing staff to discuss next steps, schedule appointments, sign necessary paperwork and address any additional questions you may have.  Finally, you may meet with one of our administrative staff members for financial counseling.  In order to make this process as clear and efficient as possible for you, we provide analysis of your insurance, detailing which expenses are covered and any additional costs associated with your treatment plan.  While some people are eager to get the process started, others need to take some time to digest all the information.  We, of course, welcome you to go at your own pace.

Are all procedures performed at IVF Michigan Fertility Center?

Yes, at IVF Michigan Fertility Center all procedures and laboratory work are conveniently performed in our facilities. Those procedures include blood tests and ultrasounds. Egg retrievals, embryo transfers, laparoscopy and hysteroscopy operations can only be done at the Bloomfield Hills office.

How soon can I get an appointment with an IVF Michigan Fertility Center doctor?

We do not have waiting lists to see our physicians. You can typically get an appointment with the physician you are interested in within 1 to 4 days.

Male Infertility: Low Sperm Count, Low Motility and Treatments
What is male infertility and what are some common causes?

Technically speaking, infertility is the result of a disease (an interruption, cessation, or disorder of body functions, systems, or organs) of the male or female reproductive tract which prevents the conception of a child or the ability to carry a pregnancy to delivery.  Male infertility may be caused by a range of factors, most of which affect the quantity and/or quality of sperm.  The majority of male infertility cases are due to low sperm quantity, poor sperm quality, or both.  In the remainder of infertility cases in men, there is a wide variety of causes, ranging from hormonal imbalances or physical problems to psychological or behavioral problems.

In some cases, sperm cannot be found in the semen.  Blockages and sperm production failures in the male reproductive tract prevent mature sperm from being found in semen.  These complications can be treated in most cases.  In other cases, the bladder sphincter is damaged, allowing sperm to mix with urine in the bladder, which is called retrograde ejaculation.

Another cause of infertility in men is varicoceles, or the enlargement of veins in the scrotum. The pooling of blood caused by the varicoceles affects the circulation in the testes, changing the temperature and affecting the microenvironment of the testes. Because of this, males with varicoceles may experience low sperm count, decreased motility, and poor sperm quality.  A varicocele can be treated by a varicocelectomy at IVF Michigan.

Male infertility can also be a side effect of other medical conditions.  Endocrine and hormonal problems affect sperm production based on the particular complication.  Genetic diseases, such as cystic fibrosis, and gene mutations can also be directly or indirectly associated with sperm abnormalities.  Behavioral and psychological factors affect male infertility as well.  Stress, smoking, obesity or poor nutrition, and STDs play a role in male infertility if they are prolonged and not treated early.

If you have male infertility or are unsure if you have male infertility, IVF Michigan Fertility Center recommends contacting one of our fertility doctors to discuss your symptoms and options.  Because there are a variety of causes for male infertility, it is important to speak with a fertility specialist to get a proper diagnosis, assess the risks, and determine if treatment is possible.  In some cases, conception is still possible, but it is important to speak to an IVF Michigan fertility doctor about your male infertility treatment options.

Can you help men with Azoospermia?

IVF Michigan Fertility Center has several treatment options for men with obstructive or non-obstructive azoospermia.

  1. Testicular Sperm Aspiration (TESA) is a minor procedure that typically takes 5-10 minutes under sedation. TESA is generally an option for men with obstructive azoospermia where it is expected that sperm will be found easily. During the procedure, sperm is directly removed from the testes to be used in an IVF-ICSI cycle.
  2. Testicular mapping is a minimally invasive procedure during which a fine needle is placed in different areas of the testes to obtain small samples of testicular fluid. The aspirate is fixed on a slide and checked for sperm following the procedure. If sperm is found, a future sperm retrieval will be scheduled during an IVF-ICSI cycle and will be carried out from the sites where sperm was found during the original mapping.
  3. Advanced testicular mapping is a technique during which a fine needle is placed in different areas of the testes, aspirating small samples of testicular fluid that is immediately analyzed for viable sperm. If viable sperm is found, it is frozen and used in a future IVF-ICSI cycle.
  4. Micro-dissection TESE (MicroTESE) is an invasive procedure utilized to locate sperm in men with Non-Obstructive Azoospermia or severe testicular failure. MicroTESE is especially helpful in these men as there may be very localized areas of sperm production that may be missed during blind biopsies or needle aspiration procedures. During a MicroTESE, the testes are surgically opened, tissue is inspected under a microscope and an intense search of every part of the testicle is performed to locate healthy areas that are more likely to contain sperm.
  5. Simultaneous staged sperm retrieval procedure begins with advanced testicular mapping, a technique during which a fine needle is placed in different areas of the testes, aspirating small samples of testicular tissue that is immediately analyzed for viable sperm. If adequate numbers of viable sperm are found, the procedure is terminated so the man is spared the open surgical Micro-dissection TESE (MicroTESE). If no sperm is found in the aspirated samples, the surgeon immediately proceeds to perform a MicroTESE. Through simultaneous staged sperm retrieval, men get the highest chance of success with the least invasive method needed.
Is it important to have high sperm count and good motility for IVF?

If you have low sperm count or poor motility, IVF Michigan Fertility Center has treatment options available for you. At IVF Michigan Fertility Center we use Intra-cytoplasmic Sperm Injection in conjunction with IVF in order to improve chances of fertilization by injecting a single sperm into each egg. With this procedure, we can work with as little as one sperm and sperm with very low motility. We may also suggest a regime of supplements to improve sperm quality.

PGS: What is it? What are the benefits?
What is PGT? What are the added benefits?

Pre-Implantation Genetic Testing (PG), also known as embryo screening, is performed to check for any chromosomal abnormalities in all 24 chromosomes caused by missing or additional chromosomes. Chromosomal abnormalities include Trisomy 13 (Patau syndrome), Trisomy 18 (Edwards’ syndrome) and Trisomy 21 (Down syndrome). PGS also includes the screening of chromosomes X and Y, making family balancing through gender selection possible.

How accurate is PGS if I want to know the gender of my embryos?

PGS when screening for X and Y (gender) chromosomes is 99.9 percent accurate.

Natural Cycle IVF: What do I need to know?
What is Natural Cycle IVF?

Natural cycle IVF is an option for women who do not respond well to fertility medication or who have poor ovarian reserve. Such women do not produce more than one natural egg per month, regardless of stimulation medication. During a natural cycle, the single natural egg created by the body is retrieved, injected with sperm and, if fertilized, the embryo is transferred to the uterus. No stimulation medication is prescribed during natural cycle IVF.

Are there any drugs taken in a natural cycle IVF?

There is only one injection of HCG administered to promote full maturation of the eggs before retrieval. In the case that some (but minimal) medication is administered, that is referred to as a mini-IVF cycle.

What are the advantages and disadvantages of natural cycle IVF?

Advantages:

  • Utilizes the body’s normal hormones
  • May be repeated monthly if necessary
  • Less discomfort
  • Decreased risk of multiple births compared to conventional IVF-ICSI>
  • No risk of hyper-stimulation (over stimulating the ovaries with medication)

Disadvantages:

  • Only one egg (at most two) is retrieved, reducing chances of fertilization, embryo transfer and pregnancy
  • The success rate per cycle is less than that of conventional in vitro fertilization
Cancer and Fertility
Can I get pregnant after chemotherapy treatment?

Not all cancer treatments leave men and women infertile. However, chemotherapy treatment can often negatively affect fertility and, therefore, it is recommended that before treatment begins you consider preserving your fertility through egg or sperm freezing. For women who do not have time to undergo an IVF cycle before treatment or who cannot take stimulating medication due to your condition, you may want to consider natural cycle IVF to follow ovulation during your current cycle and, hopefully, one to two eggs can be retrieved and frozen for future use.

Preserving Fertility: Can I Extend my Fertility
Can I preserve my fertility if I am single or not ready to have children?

Thanks to medical advancements, women have more options than ever when it comes to extending the longevity of their fertility.  At IVF Michigan, we offer a number of solutions for women who want to become pregnant later in life, one of which is the option to freeze her eggs.  While the process was originally used primarily for women with illness-induced infertility (i.e. as a result from chemotherapy or radiation to treat a cancer diagnosis), it has now become more common among women who simply want the option to delay pregnancy for any number of personal reasons.   Whatever a woman’s rationale, the fertility specialists at IVF Michigan are happy to help her navigate her biological clock.  However, it is important to note that as women age, the quality and quantity of their eggs decrease tremendously; therefore, the younger a woman is when she freezes her eggs, the better.  If a woman freezes her eggs at 28 and gets pregnant via in vitro fertilization at 38, she is essentially getting pregnant with the egg of a 28-year-old woman, which significantly lowers the risk of miscarriage and genetic defects. While it was once thought that only fertilized eggs (embryos) were able to be successfully frozen, thawed and implanted, scientific discoveries have made it possible for unfertilized eggs to be stored as well, giving women even more flexibility when it comes to preserving their fertility.

Struggling to have a second child?
Donor Eggs and Sperm and Surrogacy
Can IVF Michigan Fertility Center help me with donor eggs, donor sperm or a gestational carrier?

If you are interested in a donor egg or sperm donor cycle, we can help you start your family with an anonymous egg or sperm donor. We are proud to have a very high rate of success with donor cycles (up to 80%) and have egg donors from different races and ethnic backgrounds, so we are able to find the most suitable donor to help you expand your family.

IVF versus IUI: Which is right for me?

Many women who are struggling with infertility are curious about their treatment options, specifically the difference between IVF and IUI and which is right for them.

In vitro fertilization (IVF) and intrauterine insemination (IUI) are the two most commonly used fertility treatment methods. Many patients come to IVF Michigan Fertility Clinic wondering what the pros and cons are for each method and which fertility treatment is best for them. 

The experienced fertility doctors at IVF Michigan have found that while IUI has some financial and medical benefits, without question IVF is the more successful treatment out of the two.

During IVF, a woman has her ovaries stimulated with hormones (follicle-stimulating hormone and luteinizing hormone) to produce multiple eggs during a single cycle (women normally produce a single egg per cycle); then, the eggs are removed from the ovary (in a procedure called a transvaginal oocyte retrieval) so that they may be fertilized with sperm in a laboratory (during a procedure called intracytoplasmic sperm injection) in order to create embryos.  Finally (approximately five days later) the embryo(s) are transferred into the mother’s uterus.

So how does that differ from IUI? IUI is a type of artificial insemination where sperm is inserted directly into a woman’s uterus for the purpose of fertilizing the egg.  This procedure is done one to two times following a woman’s ovulation cycle. IUI leaves higher concentrations of good sperm close to where the egg is waiting, so the odds are increased that the egg and sperm will find one another.

While many couples are intrigued by IUI because it is less expensive and less invasive, it also has a remarkably decreased rate of success compared to IVF, especially in women with advanced age. Therefore, it’s important to know the type of procedure that works best for each cause of infertility.

IUI is commonly used when the fertility issues are related to unexplained infertility, mild endometriosis, low sperm count, ejaculation issues or decreased sperm mobility. IVF is recommended for women with most causes of infertility such as women over 35 years old, women with low egg supply, very low sperm count, very low sperm motility, women with tubal issues, and women with fertility disorders like endometriosis and polycystic ovary syndrome (PCOS).

For patients less than 38 years old with no previous fertility treatment, the suggested route is to proceed with two to three cycles of artificial insemination, followed by IVF. For some patients starting with IVF would be a better option.

Patients 38 or older may benefit from proceeding with IVF sooner because of the very low success rate of IUI and reduced supply of eggs.  In some cases, delaying IVF would result in a higher total cost because of the need to repeat the procedure multiple times to get the expected results.

If you still aren’t sure which procedure is right for you, please call one of IVF Michigan’s fertility specialists at 855-952-9600, and we would be happy to discuss your fertility treatment options.

The Fertility Diet: Fact or Fiction?

Of all the questions we hear at IVF Michigan, “what can I do to increase my chances of getting pregnant?” has to be the most common.  Many female patients inquire about supplements or exercises or even diets that will help them conceive.  While there is no scientifically endorsed diet that ensures a successful pregnancy, there have been a few studies that show women who follow a Mediterranean-style diet may have less difficulty getting pregnant.

A Mediterranean-style diet is generally plant based. Instead of meat as the main course of a meal, a Mediterranean diet would more likely feature beans, lentils, nuts, seeds, vegetables, fruit or whole grains. Because of this, people who follow this diet generally get six or more servings of fruit and vegetables a day. Fish – which is vital for its omega-3 fatty acids, protein, vitamins, and minerals such as iron – make an appearance on the table at least twice a week.  There is always debate about the amount of fish a pregnant woman should eat, so be advised that the current recommendation is 2-3 servings a week maximum.  The four types of high-mercury fish (tilefish from the Gulf of Mexico, swordfish, shark, and king mackerel) should be avoided while trying to conceive, pregnant or breastfeeding. 

Where Americans love their butter, a Mediterranean diet uses olive oil, which is high in monounsaturated fat (aka “good fat”); monounsaturated fat is also found in avocado, peanuts and cashews.  A study by the Harvard School of Public Health found that women who ate the most monounsaturated fat had up to three times the chance of giving birth via IVF as those who ate the least.
Also, because more herbs and spices are used when preparing foods in a Mediterranean diet, less salt is needed. Lowering your overall sodium intake is beneficial to heart health, which is recommended when trying to conceive naturally or through IVF.  Lastly, red meats, dairy and sweets should be eaten sparsely. Calcium that you’d normally get from milk can be replaced with other sources like legumes, kale, almonds and oranges.

Whether the Mediterranean diet is a silver bullet for fertility remains to be proven, but fertility doctors can agree that a Mediterranean diet is an incredibly healthy choice and having a healthy body is always best when trying to conceive.

Natural Ways To Prepare Yourself For A Successful IVF

One of the most common questions we hear from our patients at IVF Michigan Fertility Clinic is “what can I do to better my chances at becoming pregnant from IVF?

And, unfortunately, there’s not a simple answer as there are many factors to consider, such as age, weight and the cause of infertility.  But there are a few steps you can take to prepare your mind and body for IVF and, ultimately, for a successful, healthy pregnancy. Please note that none of these is required before receiving IVF treatments at IVF Michigan Fertility Center, and these suggestions are not to be taken in lieu of medically administered fertility treatments.

While it may be the most challenging instruction to follow, at IVF Michigan we tell all of our fertility clinic patients that they need to reduce their stress levels. Stress takes a giant toll on our bodies. We understand that it is likely impossible to eliminate everything that causes you stress, but you can implement different tactics to help manage your stress, like exercising. While exercise is recommended for stress reduction and overall health, we must advise female patients not to overdo it. We recommend women get 30 to 40 minutes of cardio, three times a week.  Add in yoga or light weight lifting on the days you’re not doing cardio. In one study, women who exercised more than four hours per week actually reduced their IVF success rate up to 30%.

Acupuncture and massage can also help to reduce the stress related to infertility diagnosis and treatment. Whether they also increase the success rate of IVF remains unproven but continues to be researched. Fertility acupuncture and massaging are techniques that are thought to help support reproductive health, your menstrual cycle and your fertility. They may aid circulation to the ovaries and uterus, reduce stress levels, and promote egg health.  You can generally find a massage therapist who specializes in fertility massage or acupuncture with a simple Google search; however, IVF Michigan Fertility Clinic can also make a recommendation if you’d like.  These massages should only be done before and during the IVF cycle (not once you become pregnant).

Also, a balanced and nutritious diet is key to ensure your body is in its healthiest form to host a baby. This also means that you should make sure you are at, or close to, a normal BMI range.

The research of Dr. Jorge Chavarro helped delineate what we now call the “fertility diet.”  The fertility diet focuses on avoiding some of the nutritional characteristics found in the diet of a group of infertile women with ovulation problems.  Patients interested in following this diet should do the following:

  • Reduce the intake of saturated fat compared to mono unsaturated fat
  • Reduce the intake of rapidly digested carbs (breads, cereals, sugars, fruits and some starchy vegetables) compared to
  • slowly digested carbs (vegetables, whole grains, seeds, nuts, beans, peas and legumes)
  • Reduce animal protein compared to plant protein
  • Reduce high protein compared to low protein
  • Increase the amount of whole milk products

When it comes to smoking, not only has it been proven to be bad for your overall health, it also wreaks havoc on your fertility.  Studies show that smoking increases the chance of infertility by 60%.  Smoking may also increase the risks of miscarriage. At IVF Michigan, we advise all of our patients to quit smoking while trying to achieve and during pregnancy.

Not all caffeine is off limits during fertility treatments and pregnancy.  However, caffeine intake of more than 500 mg daily (that’s more than five cups per day) can reduce fertility and drinking more than 200-300 mg (two to three cups) may increase risk of miscarriage. Moderate caffeine consumption (one to two cups of coffee per day or its equivalent) before or during pregnancy has no apparent adverse effects on fertility or pregnancy outcomes. So, sip that single cup of coffee but call it quits once it’s gone.

Lastly, IVF Michigan’s doctors recommend that you start taking prenatal supplements and folic acid to prepare your body for in vitro fertilization and pregnancy. And, remember, the mother is not the only person who should be taking care of herself and reducing her stress during this period; your significant other should also follow these tips as well.

For any additional questions regarding the best way to prepare yourself for IVF and pregnancy, contact us at 855-952-9600.

What is Low Ovarian Reserve?

A woman’s ovarian reserve is the medical term for how many eggs a woman has left.  As a woman’s ovarian reserve depletes (which happens naturally as women age), the likelihood of her getting pregnant also decreases.

Technically, when a female is still in the womb, she will have developed approximately six to seven million eggs. But egg count decreases over time. By puberty, females typically have 250,000 to 500,000 eggs. By the time women reach 37 years of age, they will only have about 37,000 and by menopause, less than 1,000.

While aging is the most common cause of low ovarian reserve, there are other reasons someone who is young could suffer from this, such as chromosomal abnormalities, like Turner Syndrome, or gene abnormalities, like Fragile X. Low ovarian reserve can also be caused by ovarian tissue damage through torsion, surgical removal of part of the ovary, ovarian cysts caused by endometriosis, benign or malignant ovarian tumors, radiation or chemotherapy, immunological conditions, pelvic adhesions or a high body mass index.

As always, the IVF success rate for all age groups with low ovarian reserve truly depends on how many viable eggs one of IVF Michigan’s doctors can obtain. If a fertility specialist can only obtain four or fewer eggs from a patient, the odds of not getting pregnant triples.

One of the earliest clinical signs of low ovarian reserve is shortening of the menstrual cycle. Family history of early menopause can increase the likelihood of having low ovarian reserve.

Testing the ovarian reserve is simple. It requires a blood test to assess the levels of ovarian hormones, mainly the Anti-Mullerian hormone (AMH) and follicle-stimulating hormone (FSH). AMH level is becoming the most accepted test because it does not fluctuate during the menstrual cycle and can better predict the number of eggs retrieved during IVF.  Women with low egg reserve should have a complete work up to try to understand if there is any underlying cause.

Dr. Hammoud, a fertility specialist at IVF Michigan, who has a special interest in this topic, suggests that testing and treating vitamin D deficiency could improve ovarian reserve for some women. In addition, when undergoing IVF, new stimulation protocols such as estrogen or testosterone priming with embryo banking can be effective.

If you have low ovarian reserve, IVF Michigan recommends sitting down with one of our doctors to discuss your options. Unfortunately, some women with low ovarian reserve may not be strong candidates for in vitro fertilization using their own eggs; however, donor eggs are another option IVF Michigan can provide.

Can hot tubs decrease a man’s fertility?

Rumors have been spread that men should stay away from hot tubs if they want to maintain their fertility.  What started as an old wives’ tale has recently been studied and documented by urologists.  Some studies in recent years have concluded that frequent exposure to heat can impair sperm production.  It is recommended that men avoid saunas, hot tubs, and other potential sources of heat that affect a man’s testicles if they plan to conceive a child, because increasing testicular temperature hinders sperm production and motility.  Despite these findings, men should not run from their bath tubs and jacuzzis all together, but rather limit their exposure to high temperatures.

While studies initially confirm that excessive heat can have negative effects on sperm, more studies would need to be performed regarding the relationship between heat exposure and male infertility, until it is definitively known whether this level of heat exposure plays a significant role in fertility issues.  However, some studies have shown that the effects of heat exposure to the testicles can be reversed for some men with reduced exposure.  Therefore, there is no need to fear infertility if these comforts are enjoyed in moderation!