Joan Moody, RN, CNP IVF Coordinator

1. Is infertility a common problem?

Overall, about 20% of couples wishing to have a baby will have an infertility problem of some kind.

2. Is infertility just a woman's problem?

Infertility is not just a woman's problem. After a diagnostic work up, about 40% of cases will involve a female factor, while 40% of the time we will diagnose a  male factor. In about 15% of cases there will be a combination of both male and female factors. In 5% of infertility cases the cause is unexplained.

3. What causes infertility in men?

Infertility in men can be caused by a number of reasons. There may be hormonal, genetic, environmental, chemical (including medications), trauma and anatomical factors. Vasectomy can often be treated by our non-surgical technique (PESA). Our Male Infertility Division is staffed by an Endocrinologist and a Urologist specializing in the prompt diagnosis and treatment of male infertility.

4. What causes infertility in women? 

Infertility in women may be caused by previous abdominal surgery or pelvic inflammation resulting in scarring of the fallopian tubes or an unfavorable pelvic environment. Endometriosis, polycystic ovaries and hormonal imbalances are addiditonal causes of female infertility. The uterus itself can also be affected by structural problems such as fibroids or polyps, a uterine septum and internal uterine scarring also called 
Asherman's Syndrome. These problems can be diagnosed and possibly treated by Laparoscopy or Hysteroscopy.

5. How does age affect a woman's ability to have children? 

A woman's age can be a major issue for reproduction because women never generate new eggs after they are born. All the eggs that a woman will possess for life are already present in her ovaries at birth.  Due to the normal aging process, potentially unfavorable molecular changes occur within the eggs, resulting in Down Syndrome, miscarriages and overall lower pregnancy rates. We offer special treatment strategies
which may improve the outcome in certain cases.

 6. How will doctors find out if a woman and her partner have fertility problems? 

Our trademark Level One Testing includes a rapid and efficient assesment of the most important fertility factors: 1) Ovarian Reserve and egg quality; 2) Fallopian Tube Status; 3) Male Fertility Potential.  The results of Level One Testing help us to quickly arrive at a diagnosis and to recommend targeted, customized therapy for our patients.

7. How often are Assisted Reproductive Technologies (ART) successful? 

Assisted Reproductive Technologies (ART) is a collective term that includes any procedure that may assist our patients in achieving a pregnancy. ART can include stimulating ovulation with Clomid or Gonal-F;
artificial insemination and if necessary, In-Vitro Fertilization (IVF), ICSI, PGD and PGS, Gender Selection, PESA, Assisted Hatching, Blastocyst Culture and others. The success of ART therapies depends on several factors such as age, fallopian tube status, health of the uterus and sperm function.
Usually, women less than 37 years will have a better outcome, highlighting the importance of early and prompt diagnosis and treatment.   

8. How do you determine the first day of your cycle? 

Many women have slight spotting before the onset of their period. For planning testing or ovulation timing consider cycle day one the first day of full flow.

9. How many times should I try IUI before moving on to IVF? 

How many time a couple attempts IUI may depend upon many factors. Diagnosis, type of medications used to induce ovulation, sperm wash results, even financial concerns may determine the right time to move forward with IVF. If pregnancy is not achieved in three cycles, a consult may be helpful to review previous attempts and steps to follow.

10. What are normal ranges in a semen analysis? 

Semen ranges may vary depending on which lab the tests is performed.

11. How long should my partner abstain before the IUI? His semen analysis is normal. 

If semen parameters are within normal limits the number of days of abstinence may not be critical. Two to five days of abstinence is adequate.

12. Should we try a hamster test to determine if we have male factory infertility? 

The hamster test and the BBT are now considered rather outdated. There are now more acurate tests that can be performed to determine sperm concentration ability and ovulation timing.

13. I am concerned that I may have poor egg quality. How can I determine my egg quality? 

Hormone levels drawn in the first 2-4 days of the menstrual cycle is one way to gather information regarding ovarian function. But even young women with normal hormone levels can have poor egg quality. Depending upon history of previous pregnancy attempts, an IVF laboratory examination of eggs may be revealing.

14. Do Insurance Plans Cover Infertility Treatment? 

Insurance coverage will vary based upon your individual contract and policy. It is possible to be insured with an insurance company and have different levels of benefits and exclusion.