Infertility Insights

Sperm Quality and Age

2007-02-01T14:00:00.000-08:00

My colleagues and I occasionally field questions from patients about age having an impact on sperm quality. This is an interesting topic and my colleague at Pacific Fertility Center, Joe Conaghan, PhD, High-complexity Clinical Laboratory Director (HCLD) has been kind enough to share his expertise on this issue. Although there is no strong evidence that sperm suffer the same age related...

How Do I Buy Sperm?

2007-01-26T11:31:00.000-08:00

My colleagues and I occasionally field questions from patients about purchasing a sperm sample. This is an interesting topic and my colleague at Pacific Fertility Center, Joe Conaghan, PhD, High-complexity Clinical Laboratory Director (HCLD) has been kind enough to share his expertise on this issue. At our clinic, Pacific Fertility Center (PFC), when it comes to finding a sperm bank and...

Sperm Samples at Home

2007-01-26T09:53:00.000-08:00

My colleagues and I occasionally field questions from patients about whether they can collect a sperm sample at home. This is an interesting topic and my colleague at Pacific Fertility Center, Joe Conaghan, PhD, High-complexity Clinical Laboratory Director (HCLD) has been kind enough to share his expertise on this issue. At Pacific Fertility Center (PFC), where I practice, sperm samples can be...

Follicles and Fertility

2007-01-19T16:40:00.000-08:00

My colleagues and I occasionally field questions from patients about what fertility physicians are looking for in conducting an antral follicle count. This is a fascinating topic and my colleague at Pacific Fertility Center, Isabelle Ryan, MD, has been kind enough to share her expertise on this issue. Women are born with all of the eggs (oocytes) that they will ever have. This is a set number,...

Allergic to Sperm?

2007-01-17T09:14:00.000-08:00

My colleagues and I occasionally field questions from patients who have concerns about sperm “allergies”. This is a fascinating topic and my colleague at Pacific Fertility Center, Isabelle Ryan, MD, has been kind enough to share her expertise on this issue. Many people say that they are allergic to their partner’s sperm, and that can mean different things, depending on the testing done. True...

Tubal Problems

2006-12-01T17:35:00.000-08:00

The fallopian tubes are the pathway to fertility. Sperm travel upward through the fallopian tubes to find an egg. After fertilization, the embryo travels back through the tube to the uterus. The fallopian tubes are a two-way path that allows the sperm and egg to meet and combine and the embryo to arrive in its resting place, the uterus. The tube has three sections, the cornu, the isthmus, and...

Treatment: Donor Insemination (DI)

2006-12-01T17:32:00.000-08:00

Donor insemination (DI) is the process of inseminating a woman with sperm obtained from a sperm donor. The sperm is usually obtained as a frozen specimen from a sperm bank or may come from a known sperm donor. Most women seeking donor insemination are doing so because they are single, are lesbian, or their husband has no sperm production at all. Donor insemination is usually performed in...

Insurance Policies - Part 2 (Overview)

2006-12-01T17:30:00.000-08:00

Be your own insurance advocate: You may need pre-certification or predetermination or preauthorization. At Pacific Fertility Center, we have financial consultants who will assist you by providing insurance-specific codes for the services to be rendered. We recommend that you request predetermination in writing. • Pre-certification: Your benefits will not be paid if you commence treatment before...

Insurance Policies - Part 1 (Overview)

2006-12-01T17:22:00.000-08:00

The insurance aspect of infertility treatment can be confusing. Below you will find information in an effort to help clarify the basic categories and coverage available to many patients. These categories of coverage pertain to IVF as well as other forms of fertility treatments and procedures. Where I practice, Pacific Fertility Center, San Francisco, we have financial consultants who are...

Shedding Holiday Pounds

2006-11-22T17:32:00.000-08:00

The Holiday Season is upon us. As many of us know all too well, Holidays and weight gain can go hand-in-hand. While exercising away those extra pounds is typically the right thing to do, for those who are conceiving, exercise habits need to be tempered a bit. My colleague Philip Chenette, MD was kind enough to share his insights on this issue: Before you jump on that bicycle, be aware that...

3D Ultrasound Enhances Diagnosis

2006-11-22T17:21:00.000-08:00

For some women, infertility is caused or exacerbated by having a uterus with congenital abnormalities that cause it to be misshapened. These uterine anomalies can lead to greater difficulty with embryo implantation and/or cause higher rates of miscarriage. Until recently, a physician’s capacity to properly diagnose this problem has been limited to a hysterosalpingogram (x-ray with dye); a MRI...

Endometrial Lining and Post-Transfer Bed Rest

2006-11-22T17:18:00.000-08:00

I recently saw a patient in my practice, Pacific Fertility Center, who had recently undergone a retrieval and she inquired about a couple matters that I get asked about all the time. For starters, she inquired as to what is the optimal endometrial lining on the day of the HCG shot (i.e. 36 hours before egg collection); i.e. 9 mm, 10 mm, 11mm, 12 mm, or greater; additionally, she inquired about...

Coping Through the Holidays

2006-11-22T17:12:00.000-08:00

Following Halloween, the holiday season suddenly looms. Excited children, crowded stores, decorations, and holiday parties are all set to descend on us. Yet because the winter holidays tend to celebrate families and children, these usually joyous occasions can bring up painful feelings when you are struggling to create and celebrate with a family of your own. In order to feel as good as possible...

How Embryos Make the Grade

2006-11-17T11:56:00.000-08:00

Where I practice, many patients are curious as to how we evaluate the quality of an embryo. My colleagues Carolyn Givens, MD and Joe Conaghan, PhD, HCLD, where kind enough to share their insights on this topic: Patients are often awestruck when they see a photo of their embryos for the first time on the morning of their transfer. That morning each embryo is carefully observed under a powerful...

Clomiphene Citrate Challenge Test

2006-11-17T11:54:00.000-08:00

There are a variety of diagnostic tests for infertility. One that you might have heard of is the clomiphene citrate challenge test (CCCT), also referred to as the Clomid challenge test. It is a method of assessing the age-related decline in fertility or “decreased ovarian reserve.” As women age, so do the eggs in their ovaries, which over time leads to lower pregnancy rates and higher...

AFRAID of IVF?

2006-11-17T11:51:00.000-08:00

You’re not alone. Many couples, when faced with the possibility of needing to undergo fertility treatments, much less in vitro fertilization, react with disbelief and fear. Most of what we know about fertility treatments are the unpleasant things we hear in the media, from well-meaning friends, family and even from the most casual of acquaintances. Yet it is possible that many women you know have...

Intrauterine Insemination

2006-11-17T11:47:00.000-08:00

I’ve spent a significant amount of time discussing the infertility treatment in-vitro fertilization (IVF). While IVF is an outstanding treatment for many patients, there are instances when the treatment intrauterine insemination (IUI) is a viable option. Most fertility clinics, including where I practice—Pacific Fertility Center, perform IUI. Intrauterine insemination (IUI) is the process of...

Hydrosalpinx

2006-11-10T18:54:00.000-08:00

A hydrosalpinx is a fallopian tube that is filled with fluid. Injury to the end of the fallopian tube, the ampulla, and its delicate fingers, the fimbria, causes the end of the tube to close. Glands within the tube produce a watery fluid that collects within the tube, producing a sausage shaped swelling that is characteristic of hydrosalpinx. Causes The tubes are prone to injury. The fimbria...

Polycystic Ovary Syndrome (PCOS)

2006-11-10T18:52:00.000-08:00

Polycystic ovary syndrome (PCOS), also called Stein-Leventhal Syndrome, is the most common endocrinologic disorder in women of reproductive age. Approximately 5-10% of reproductive age women have PCOS. This syndrome can have many symptoms. However, the two key components defining this disorder must include chronic anovulation (inability to ovulate an egg) and clinical hyperandrogenism (elevated...

Unexplained Infertility

2006-11-10T18:50:00.000-08:00

People often approach infertility testing with some trepidation, as they may be concerned about discovering abnormalities, and undergoing treatment. However, it is even more frustrating to have completed a fertility evaluation and be told at the end of the process that there is "nothing wrong". About 85-90% of patients will have at least an educated guess about what is keeping them from...

Approaching IVF Treatment Options

2006-11-10T18:48:00.000-08:00

There are only a few causes of infertility for which In Vitro Fertilization is the only treatment option. These causes are the following: blockage of, or severely damaged fallopian tubes and extremely low sperm count or no sperm in the ejaculate. For most all other causes of infertility, it is possible that a patient or couple may be able to conceive without assistance or with a less aggressive...

Embryo, day three transfer versus Blastocyst, day five transfer

2006-11-02T17:10:00.000-08:00

Transferring embryos at the blastocyst stage may be an option for patients in an IVF cycle. As background, a blastocyst is an embryo that has undergone multiple cellular divisions with the formation of a cavity within it. A fertilized egg reaches the blastocyst stage usually 4 to 5 days after fertilization. We encourage the majority of patients in my clinic to have their transfer earlier, on day...

Sperm Donation

2006-11-02T17:04:00.000-08:00

Some patients in our clinic require the use of a sperm donor. There are a variety of scenarios when a sperm donor is used (i.e., heterosexual couples, lesbian couples and single women). However, for this post, I’m going to keep the focus centered around the use of a sperm donor for a heterosexual couple. As background, sperm donation is the use of sperm from a sperm bank or a known donor. Men...

Assisted Hatching

2006-11-02T16:57:00.000-08:00

A human blastocyst (left side of picture) hatching from its shell (right side) The human egg is surrounded by a protein shell called the "zona pellucida". This shell has several important functions. Most importantly, it allows only one sperm through to fertilize the egg. After fertilization, the egg divides into 2 cells and this surrounding shell prevents these 2 cells from becoming separated....

Infertility FAQs

2006-11-02T16:52:00.000-08:00

Quite often discussions surrounding infertility can get a little complicated. Therefore, I decided to shift gears with this post and keep things simple by discussing some of the frequently asked questions that my colleagues and I receive at Pacific Fertility Center. I suspect most people who are dealing with infertility have wanted to ask (if they haven’t done so already) many of these questions....