PREPARATION + CONCEPTION
Need to know more?
We’re here to answer any question.
This is where we get to know you—where you’re at in life and what your expectations are for having children—and you get to know us and what we offer.
What to Expect
To start, you’ll meet with Medical Director, Dr. Matt Macer, who will go over the various ways to optimize your fertility or clinical procedures such as IVF. He’ll also be able to address any questions you may have.
From there, you’ll meet your team and get a tour of our facility, including our state-of-the-art, open-concept embryology lab.
After your consult, Dr. Macer will give you a personal plan that includes the recommendations for your medical work-up along with wellness options and estimated costs.
Questions
At what point should I seek out fertility assistance?
While you should feel comfortable reaching out to us at any time, there are some general guidelines for when we would more strongly recommend you speak with us.
- Women younger than 35 who aren’t pregnant after one year of regular, unprotected sex.
- Women aged 35-40 who aren’t pregnant after six months of regular, unprotected sex.
- Women of any age who have irregular menstrual periods or a gynecological condition known to affect fertility.
- Women over the age of 40 who decide they want to get pregnant.
- Men with any known testicular trauma, or history of chemotherapy/radiation.
- Same sex couples who want to consider their options.
- Single parents who want to consider their options.
What does a work-up consist of?
First, a full medical and surgical history is taken to assess any health factors that could affect getting pregnant. From there, we perform a physical exam and, depending on the results, recommend certain tests. The best way to understand what “tests” will be performed is to understand the common causes of difficulty conceiving, including sperm and ovulation abnormalities along with structural and endocrine issues.
We believe that the mind and body are extremely interconnected, and as such, many facets of wellness can increase your chances of conceiving and carrying a healthy pregnancy. Which is why we’ve teamed up with therapists, acupuncturists and nutritionists—all specializing in fertility.
To start, you’ll receive your own personal wellness plan. This includes access to a robust online library of easy-to-integrate daily self-care sessions designed to promote your wellbeing overall. You’ll also be offered an array of supplements to boost your immune system.
Specific sessions in our online library include:
- Acupressure with the Fertility Ball Method®
- Ayurveda and Functional Nutrition
- Breathing Exercises
- Emotional Support
- Guided Meditation
- Yoga
Ovulation Induction
To induce ovulation, medication (usually taken orally for 5 days) is used to stimulate egg growth, then the ovaries are monitored with ultrasound to determine when ovulation will occur. This method is very useful in women with irregular periods or women who may benefit from having two-to-three eggs ovulate rather than the regular one egg. It can also be paired with natural intercourse at home or with an IUI (see below).
Intrauterine Insemination (IUI)
IUI is one type of fertility treatment we do whereby a large number of healthy sperm are placed directly into the uterus, closest to where the egg will be waiting. This can be done either with ovulation induction or with your natural menstrual cycle.
What to Expect
IUI is timed so that sperm are placed into the uterus on the day an egg is released from an ovary. To do this, medication is used to stimulate ovulation and then the ovaries are monitored with ultrasound to determine when ovulation will occur.
Sperm are then sorted, examined and eventually placed into the uterus using a syringe with a long, thin catheter. By “bypassing” the cervix and being released near the fallopian tube, sperm have a better chance of fertilizing an egg.
Questions
When should I consider having an IUI done?
Ultimately your fertility team will come up with the best strategy to get you pregnant. But there are some situations in which IUI’s are useful, such as using a sperm donor to conceive in a normally ovulating patient or when the fertility work-up results show only a mild issue with your partner’s sperm.
Does it hurt?
No, the catheter is very thin and usually not felt. Placing the sperm usually takes no more than five minutes.
In Vitro Fertilization (IVF)
This procedure involves the fertilization of eggs with sperm outside of the uterus in order to create an embryo that will be placed back inside the uterus. It is by far the most successful way to get pregnant.
What to Expect
To start, the ovaries are stimulated with hormones identical to the ones made in the brain. This is done to produce many eggs as opposed to a single egg that is normally grown with each menstrual cycle. Once mature, the eggs are removed and fertilized with sperm. The resulting embryos are then placed inside the uterus or kept frozen and preserved for future IVF procedures. The entire process usually takes from 10 to 12 days.
Questions
How are the eggs retrieved?
When the eggs are mature, they’re retrieved using an ultrasound to gently guide a needle through the vaginal wall and into the ovary. The procedure is performed under conscious sedation without any pain and recovery time is typically less than an hour.
How is an embryo transferred?
After the embryos are made and you are ready to conceive, the best quality embryo(s) is transferred into the uterus using a long, thin tube using ultrasound guidance. The process is very quick and painless.
What are the advantages of a fresh versus a frozen embryo transfer?
Current evidence suggests there is a higher pregnancy rate when transferring frozen embryos. Not only does this allow the uterine environment time to recover from egg stimulation, but it also allows the lab to perform genetic testing on the embryos, if desired. The embryos can be frozen for at least 20 years without a decline in their potential to result in a live birth.
What are the success rates of IVF?
All other factors aside, when you do IVF and create a genetically “normal” embryo, transferring the embryo into the uterus leads to pregnancy up to 60-70% of the time.
What are the risks involved?
Overall, IVF is an extremely safe and effective way to get pregnant. The main risks occur less than 1% of the time and are associated with either over stimulation of the ovaries or the egg retrieval process itself. IVF CAN increase the risk of pregnancy-related issues such multiples (i.e. twins) and ectopic pregnancies (1-2% of the time), especially in unique cases where you chose to have two embryos transferred.
Evidence at this time does not support an increase in cancer or any significant birth defects.
Genetic testing is another way of saying, “screen the embryos to make sure they have the correct number of chromosomes.” Every person has 23 sets of chromosomes. If there is an extra or missing chromosome, it can lead to miscarriages or birth defects. Additionally, we are also testing the sex chromosomes and are able to tell you the gender of the embryos.
What to Expect
After embryos are made through IVF, 3 to 5 cells are removed from tissue that would ultimately be the placenta and sent to the lab for analysis. We can also test for specific disease-causing mutations that may run in your family, such as cystic fibrosis or cancer related BRCA mutation.
Questions
Am I more likely to conceive with genetic testing?
The success rate after transferring a genetically normal embryo is 60-70% compared to 30-50% without it. You are more likely to get pregnant sooner and with fewer attempts or miscarriages.
