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Infertility FAQs

Will my partner need to be tested?

Absolutely! Approximately 40% of all infertility problems are caused by sperm problems. A semen analysis is both simple and inexpensive.

How does my age affect my fertility?

Fertility peaks in women in their early 20’s and begins to decline after age 25. We recommend an evaluation for any woman 35 or older who has been unable to conceive for six months. Younger women should begin testing after one year.

If I need IVF, what are my chances for success?

If you participate in our IVF Refund Program, which allows up to six attempts for one fee, we think your chance for conception is so high that we will refund your money if you don’t have a baby.

How do I know if I’m ovulating?

There are several ways to document ovulation. Any woman who is not having regular monthly periods should be evaluated for an ovulation disorder because this is usually one of the easiest fertility problems to fix.

My doctor is treating me with Clomid. How long should I stay on it?

If you have not conceived within three months, you should be evaluated by a board-certified fertility specialist

Can fibroids cause infertility?

Yes, but it may depend on their size and location. It is important that any surgery performed for removal of fibroids be as minimally invasive as possible and that your future fertility not be jeopardized by the procedure.

My husband has a very low sperm count; is there any option for us except donor sperm?

Absolutely. Although we are not always able to make the testes produce better sperm, we are very good at better utilizing the sperm we have, such as with intrauterine insemination (IUI) or even in vitro fertilization (IVF), and with excellent success rates no matter how poor the sperm sample.

I had my tubes tied, too young, and now my new husband and I want to have a child together. What are our options?

Reversing tubal sterilization can have an excellent success rate, up to about 80%, depending on factors such as the wife’s age and the type of sterilization which was performed originally. Some types of sterilization may be less “reversible” than others, but even if the tubes were completely removed, IVF success rates are unaffected by that, since fallopian tubes are not needed at all with IVF.

I have been told I may have endometriosis; what does this mean and what can be done about it?

Endometriosis is the condition, common in women of childbearing age, in which the lining cells of the uterus, the endometrium, are found in other places in the pelvis (ovaries, rectum, bladder, etc.) where they don’t belong. They are not cancer, but they do grow into other tissues and can cause pain frequently, but the most common symptom is infertility. There are many potential reasons for this, but the best treatment for infertility (as opposed to pain alone) is most commonly laser treatment with an outpatient procedure called laparoscopy.

My doctor says I need a laparoscopy since he can’t tell why I’m not getting pregnant. What is it, and why do I need it?

A laparoscopy is an important part of the diagnostic workup for infertility since it can evaluate infertility factors in the pelvis which cannot be detected by any other diagnostic procedure. The evaluation may not be considered complete without this. Most commonly these factors are endometriosis or pelvic adhesions (scar tissue), which can be treated at the same time they are diagnosed. No one should undergo a purely “diagnostic” laparoscopy. Your physician should be fully prepared to treat these conditions at the same time they are recognized, not at a further surgery.

I have been told my infertility and pelvic pain may be due to pelvic adhesions, but I don’t know what this means or where they came from. Can you help?

Adhesions are the scar tissue that can occur when irritated or inflamed tissues lie next to one another, like the ovaries and the tubes. Any inflammation (such as endometriosis) or infection, or previous surgery, can be responsible. Adhesions are the body’s natural healing process, but in an inconvenient way, causing structures that should be separate to be “glued” together. Infertility surgeons pay special attention to the prevention of such adhesions, since they can have long-lasting effects on future fertility. No pelvic surgery in women of childbearing age should be undertaken without special attention to the potential effects on her future fertility, and a full awareness of, and expertise with, the products and tools available to the reproductive surgeon to minimize the formation of such adhesions.

Is the robotic surgery I have been reading about necessary for the best results?

Robotic surgery, such as the da Vinci® Surgery, is yet another tool in the armamentarium of the reproductive surgeon. It is an enhanced surgical technique which can simplify certain types of infertility surgery for the patient and potentially shorten post-operative convalescence.

If I have IVF I am afraid that I might end up with triplets, or worse. I want to get pregnant but I don’t want eight babies! Should I be concerned?

IVF is actually the best way to limit your chances of having more than two babies at one time with advanced reproductive techniques (ART), and our goal is always one healthy baby at a time. There are very specific guidelines established by the American Society for Reproductive Medicine that limit the number of embryos that would be transferred back to the mother’s womb, based largely on the mother’s age, to ensure that a minimum chance of a multiple pregnancy occurs, with the maximum chance of achieving a single, healthy pregnancy. Aberrations such as the “octomom” story in California can only occur when a rogue, unethical physician completely ignores the guidelines of our society. It is our duty to perform the safest and most appropriate treatments for our patients. All ethical infertility physicians were relieved to hear that the actions of this particular physician, well outside normal standards of care, ultimately resulted in the loss of his medical license.

I am 43 and finally ready to have a baby. I eat right, exercise regularly, and have regular periods. Should I anticipate any problems?

The age of your eggs is the single most important factor in the likelihood of fertility. By age 43 the success rate for any pregnancy attempt is in the low single digits, and by age 44 is rapidly approaching zero. Although there are options available to try, by far the most likely way for a patient in her low-mid 40’s and above to conceive is with donor eggs. In this way she may have a child, fathered by her husband’s sperm and that she carries and delivers herself, with success rates well above 50%. For the interested patient, this may well be an excellent option to achieve the pregnancy she has always wanted but may have waited too long to achieve using her own eggs.