InVia Fertility Specialists Blog

    How to Get the Most from Your Initial Fertility Consultation

    Posted by Dr. Vishvanath Karande on Jan 14, 2019 11:11:00 AM

    Want to get pregnant in 2019? Maybe you have been trying on your own for a year (six months if you are more than 35 years old) and nothing has happened.  You may have been keeping track of ovulation with an ovulation predictor kit, or using an app to time intercourse.  You decide it is time for you seek help. 

    Here are some tips to help you choose a fertility doctor and suggestions to get the most from your initial consultation.

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    Topics: Age and Fertility, Understanding Test Results, Infertility treatment

    Embryo fragmentation: What does it mean?

    Posted by David Hazlett on Jan 10, 2019 7:33:00 AM

    Embryo fragmentation is a fairly common occurance. It happens when there is an uneven division of the cells of the embryo.

    It's as if you were breaking apart a piece of crusty bread. When you try to break the bread apart, crumbs or fragments are formed. These fragments are of no use to the embryo and are considered “junk” pieces of cytoplasm. The higher the degree of fragmentation, the lower the likelihood of pregnancy.

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    Topics: Infertility, IVF, Embryology

    Facts on AMH Levels and Ovarian Reserve Testing

    Posted by Dr. Vishvanath Karande on Jan 7, 2019 8:20:00 AM

    AMH or anti mullerian hormone level testing and ovarian reserve testing are frequent topics of questions from people who are having trouble getting pregnant. Since my last blog on this subject, a lot of new information has been released. Below are are five additional facts about anti mullerian hormone level (AMH) and ovarian reserve testing.

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    Topics: Infertility, Infertility treatment, IVF, Diminished ovarian reserve, Top 5, AMH Levels, Understanding Test Results

    What to Expect at a Male Fertility Examination

    Posted by Dr. Robert Brannigan on Jan 3, 2019 7:00:00 AM

    Diagnostic-Male-Infertility-Test-200x300.jpgThe male partner can sometimes be overlooked when couples try to conceive. Approximately 15% of couples pursuing a pregnancy experience infertility. Within these couples, a “male factor” is the sole cause in 30%, and both male and female factor issues are present in another 20% of couples. Collectively, 50% of couples have a male factor involved as a cause of their infertility.

    Examining and evaluating the man is often invaluable in helping to optimize not only his reproductive potential, but also the reproductive potential of the couple. Here's what we look for when evaluating a man in a fertility clinic. 

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    Topics: Infertility, Infertility treatment, Male factor, InVia Fertility Specialists

    IVF at InVia:  Excellent Pregnancy Rates with Hardly Any Twins!

    Posted by Dr. Vishvanath Karande on Dec 10, 2018 8:47:00 AM

    At InVia Fertility Specialists (InVia) we have been providing fertility services to our patients for the past 16 years. Our in vitro fertilization (IVF) program has been very successful and has been consistently reporting excellent success rates.

    One of our goals has been to maintain high pregnancy rates and at the same time minimize the incidence of twin pregnancy. This is because of the increased risk of complications with twins. According to the Society for Assisted Reproductive Technologies (SART); compared to singletons, the risk of infant death is more than 4-fold higher with twins and 13-fold higher with triplets.

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    Topics: IVF Success Rates, IVF, InVia Fertility Specialists

    Does Vitamin D influence anti-mullerian hormone (AMH) levels?

    Posted by Dr. Vishvanath Karande on Dec 7, 2018 11:44:00 AM

    Anti-mullerian hormone (AMH) is now a well-established marker of ovarian reserve. AMH is released by the (granulosa) cells surrounding small (antral and pre-antral) follicles in the ovary. It prevents these follicles from becoming responsive to follicle stimulating hormone (FSH) and thus prevent them from growing into dominant follicles.

    The highest values of AMH in women are attained after puberty and subsequently decrease with age, likely reflecting the age-related decline in ovarian reserve.

    Vitamin D (25OH-D), is a regulator of calcium and phosphate metabolism, and also plays a crucial role in reproductive physiology. Vitamin D has been shown to interact with the AMH gene and increase its functionality (up-regulation).

    So, the question is, does Vitamin D influence AMH levels?

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    Topics: Infertility, Infertility treatment, IVF, Diminished ovarian reserve

    Top 10 Facts about Cycle Day-3 Follicle Stimulating Hormone (FSH) Level

    Posted by Dr. Vishvanath Karande on Dec 4, 2018 9:00:00 AM

    1) It is generally accepted that as a woman ages, her ability to reproduce will diminish and she will begin having trouble getting pregnant. There, however, is a wide range as to the age at which a woman’s ovarian reserve (reproductive potential) will diminish. Some women progress through menopause in their early thirties, while others conceive readily at age 45. A basal (cycle day 2 – 4) follicle stimulating hormone (FSH) level is a useful screening test of ovarian reserve.

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    Topics: Infertility, Infertility treatment, Diminished ovarian reserve, Top 10, InVia Fertility Specialists, Elevated FSH Levels

    Using Androgel or DHEA for infertility

    Posted by Dr. Vishvanath Karande on Nov 30, 2018 9:00:00 AM

    If you are having trouble getting pregnant and are a poor ovarian responder, you may have heard that ovarian response can be increased with testosterone during IVF.

    The possibility of using testosterone supplements such as Androgel or DHEA for infertility raises many questions, including:

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    Topics: Infertility treatment, IVF, InVia Fertility Specialists, Diminished ovarian reserve

    Top 10 Facts about Clomiphene Citrate (Clomid, or Serophene)

    Posted by Dr. Vishvanath Karande on Nov 28, 2018 10:00:00 AM

    Clomiphene citrate (CC), marketed, as Clomid or Serophene, is the most commonly used drug for ovulation induction. It was first synthesized in 1956 and was approved for clinical use in the United States by the Food and Drug Administration in 1967. Here are the Top 10 facts about CC. 

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    Topics: Infertility, Infertility treatment, Ovulation Induction, Top 10

    Top 10 Questions Our Fertility Nurses Answer

    Posted by Kim Saaby on Nov 13, 2018 8:43:36 AM

    Fertility treatment can be stressful on your emotions, your schedule and your finances. Fortunately, you have someone in your corner the entire way: your fertility nurse!

    Your fertility nurse is here to help guide you through the process and make your journey a little bit easier. Here are the ten most common questions patients tend to ask their fertility nurse.

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    Topics: Infertility, Infertility treatment, InVia Fertility Specialists, Top 10

    Bleeding During IVF - What's Normal and What Isn't?

    Posted by Dr. Aniruddha Malpani on Nov 13, 2018 7:00:00 AM

    One of the most difficult things IVF patients have to deal with is the fact that there are no external symptoms or signs of what's happening inside their bodies.

    Are the follicles growing well? Is the uterine lining maturing properly? Are you responding well to the medications? Are the eggs of good quality? Are the embryos implanting?

    An important marker of the reproductive cycle is bleeding - and this can become a major source of stress during IVF treatment. This post explains what kinds of bleeding can happen during IVF, and what (if anything) you should do about them.

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    Topics: Infertility, Infertility treatment, IVF, Early pregnancy

    No Fertilization? Why Eggs Don’t Fertilize, and What We Can Do

    Posted by Liza Roscetti Meyer on Nov 8, 2018 5:35:00 AM

    One of the hardest parts of being an embryologist is having to tell a patient that, after all their hard work getting their eggs ready for retrieval, there is nothing good to report the next morning when we check the eggs for fertilization. Hopefully this never happens to you. 

    But  there are times when we have to make that unfortunate call to patients waiting to hear about fertilization. While we expect, statistically speaking, about 75% of mature eggs to fertilize, sometimes it happens where none fertilize, despite all of our best efforts in the lab. Why does this happen? And more importantly, is there anything that can be done after the fact?

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    Topics: Infertility treatment, IVF, InVia Fertility Specialists, Embryology

    What Are the Risks of Being an Egg Donor?

    Posted by Vicki Meagher on Nov 1, 2018 8:29:00 AM

    testimonial-3-2-invia-fertility.jpgEgg donation is generally very safe with no long-term risks. Society would not permit a young, healthy woman to donate her eggs if the procedure was always dangerous.

    However, there are some short-term risks associated with egg donation, and some egg donors will experience complications. Knowing the warning signs and being educated about these complications will help reduce their impact drastically.

    Here are some of the most common complications you should be aware of when making the decision to donate your eggs.

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    Topics: Egg donation, Infertility, Risks

    Infertility Rates Are Rising: Should I Be Worried?

    Posted by Dr. Elizabeth Puscheck on Oct 24, 2018 10:00:00 AM

    Takeaway: If you’re having trouble getting pregnant, don’t wait. See a Reproductive Endocrinology and Infertility Specialist!

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    Topics: Infertility, Age and Fertility

    Top 5 Questions About Recurrent Pregnancy Loss / Multiple Miscarriages

    Posted by Dr. Vishvanath Karande on Oct 21, 2018 6:29:00 AM

    When a diagnosis of recurrent pregnancy loss (RPL) is reached after multiple miscarriages, there are many things to consider, including the causes, tests, and common treatments of RPL.

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    Topics: Recurrent pregnancy loss, InVia Fertility Specialists

    What is a Board Certified Fertility Specialist?

    Posted by Todd Mensik on Oct 17, 2018 7:30:00 AM

    One of the single most important things to look for in a fertility clinic is the presence of a Board-Certified staff. Much like you would in other medical fields or a variety of life situations (buying a new home, boarding a plane, or even hiring a fitness instructor) you want to put your trust in someone who has the proper credentials and qualifications.

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    Topics: Infertility, Infertility treatment, IVF, InVia Fertility Specialists

    Getting Pregnant at 44: What are the Chances and Options?

    Posted by Dr. Vishvanath Karande on Oct 16, 2018 9:00:00 AM

    A reader recently posted this question on a previous blog:

    I am 44 years old healthy non-smoker yoga practitioner, AMH 1.45 and FSH 9, high prolactin (25) but all else normal/good. Cycle regular with variation b/t 28-31 days ... married recently and trying for 6 months. My husband’s sperm is very good, he is 45. What are our chances for conceiving naturally? About to see rep. endocrinologist and view options, of which I think Clomid is one.

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    Topics: Egg donation, Infertility, Infertility treatment, IVF, Embryo donation, InVia Fertility Specialists, Diminished ovarian reserve

    Pregnancy Test After IVF is Positive! What’s Next?

    Posted by Janet Chiaramonte on Oct 9, 2018 7:00:00 AM

    pregnancy-test-after-IVF_.jpgYou've been waiting for this for so long and at last your pregnancy test after IVF is positive. Now what happens? Well, in spite of the fact that you might want to shout the good news from a rooftop, it is probably best to be cautiously optimistic for now. A positive pregnancy test is just one step in the IVF process. You've cleared another hurdle, but there are still a few more to go.

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    Topics: Infertility treatment, IVF, InVia Fertility Specialists, Early pregnancy

    A Tailored Approach to Infertility Treatments

    Posted by Todd Mensik on Oct 2, 2018 8:06:00 AM

    One of the most important things to consider when looking into infertility treatments is that no two patients are identical. In fact, every patient is unique and each should receive a treatment plan tailored to their specific needs. Going to a fertility clinic that offers a standard, "cookie-cutter" treatment plan could result in misdiagnosis and could lengthen the time you wait to have a child. The right fertility clinic for you will be sure to take several factors under consideration and treat you with a tailored approach.

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    Topics: Infertility, Infertility treatment, InVia Fertility Specialists

    Ultralow AMH Levels and IVF Success Rates

    Posted by Dr. Vishvanath Karande on Sep 28, 2018 1:11:00 PM

    We have now posted several blogs discussing the impact of anti-mullerian hormone (AMH) and fertility. AMH levels predict number of eggs that will be retrieved during in vitro fertilization (IVF) and pregnancy rates. AMH levels vary based on age and we have previously discussed what constitutes a “normal” AMH level. Young patients with low AMH levels will do better than their older counterparts. IVF success rates in patients with low AMH levels have also been discussed previously.

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    Topics: Infertility, Infertility treatment, IVF, Diminished ovarian reserve

    Use of Birth Control Pills In the IVF Process

    Posted by Janet Chiaramonte on Sep 27, 2018 8:03:00 AM

    You may be surprised to find out that in many cases, the first step in the IVF process is to take birth control pills. Though this seems to be counter-productive to your goal of getting pregnant, there are several reasons why they are used.

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    Topics: Infertility, Infertility treatment, IVF

    Intrauterine Insemination Part I: Why (And When) We Use it To Treat Infertility

    Posted by Dr. Vishvanath Karande on Sep 17, 2018 8:20:00 AM

    Intrauterine insemination (IUI) is a simple in-office procedure, which involves placing “washed” sperm inside the uterus to facilitate fertilization. With IUI, we bypass the vagina (which is acidic and where most sperm are destroyed) and the cervical mucus (which can impede sperm progression).

    By depositing the sperm directly in the uterus, we increase the likelihood that a maximum number of healthy sperm will swim into the fallopian tubes and fertilize a waiting egg, resulting in a normal pregnancy.

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    Topics: Infertility, Conception, InVia Fertility Specialists

    What is Fertility Preservation?

    Posted by Vicki Meagher on Sep 13, 2018 6:45:41 AM

    A common misconception is that fertility preservation is just for cancer patients. Fertility preservation is exactly what it sounds like; preserving your fertility. For women, it involves stimulating your ovaries to release many mature follicles to then be retrieved and cryopreserved for your own use later in life.

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    Topics: Egg freezing, fertility preservation

    Can the level of hCG in blood tell me whether my pregnancy is a healthy one or not?

    Posted by Dr. Aniruddha Malpani on Sep 10, 2018 7:26:00 AM

    You've had an embryo transfer, and now it's time for a pregnancy blood test. You may be wondering whether the hCG level in your blood predict how healthy your very new pregnancy is.

    The short answer is yes - but only to a certain extent. For a more complete answer, read on!

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    Topics: Infertility, Infertility treatment, IVF, Early pregnancy

    Ten Facts on Pregnancy After 45

    Posted by Dr. Vishvanath Karande on Sep 4, 2018 6:00:00 AM

    Now it is fairly common for women to achieve their educational goals and establish a career path before they consider having children. It often takes years to obtain these goals and this occurs during the most fertile period: ages 15 - 30. Often women will consider having a child between the ages of 35 – 45 and by then, her fertility has already starting to decline. In previous blogs, I have discussed the fact that after age 40, fertility declines precipitously, and have described treatment options for this age group. But what about women seeking pregnancy after 45? What are the treatment options available? How risky are these pregnancies?

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    Topics: Egg donation, IVF, InVia Fertility Specialists, Top 10

    New Fertility Preservation Law Covering Cancer Patients Passes in Illinois!

    Posted by Dr. Elizabeth Puscheck on Aug 30, 2018 11:21:00 AM

    On Monday, August 27, 2018, Illinois enacted a new law requiring health insurance companies to pay for freezing eggs, sperm and embryos for cancer patients!

    Thanks to Governor Bruce Rauner, State Representative Robyn Gabel, the bill's initial sponsor, and all those activists, researchers, and supporters who made this possible!

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    Topics: fertility preservation, Insurance

    Clinical IVF Trials at InVia Fertility Specialists

    Posted by Dr. Vishvanath Karande on Aug 24, 2018 2:00:00 PM

    Great news! InVia Fertility Specialists (InVia) has been selected as a study site for several IVF clinical trials! If you qualify, you could get an IVF cycle at minimal or no cost. 

    InVia has a well-established and very successful in vitro fertilization (IVF) program. We use state-of-the art technology and offer individualized care to our patients. Part of what makes us a “Center of Excellence” is continued interest in clinical research that evaluates new medications and technologies.

    Before a new drug or device is approved by the FDA, it has to be evaluated in a clinical trial using real patients. Over the years, we have participated in several clinical trials which evaluated medications that are now used routinely in clinical practice e.g. Follistim, Gonal-F.

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    Topics: clinical ivf trial

    Ten Quick Tips About Endometrial Thickness

    Posted by Dr. Vishvanath Karande on Aug 24, 2018 9:05:00 AM

    Good eggs and a healthy embryo aren't enough to assure pregnancy during IVF. A receptive uterine lining (endometrium) is also critical for successful implantation after embryo transfer. A commonly used parameter for assessing the endometrium is to measure its thickness (endometrial thickness, EMT).

    During the stimulation phase of IVF, EMT usually increases in response to estrogen released by the ovaries. EMT is now routinely measured using transvaginal ultrasound during in vitro fertilization (IVF). 

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    Topics: IVF, InVia Fertility Specialists, Top 10, Endometrial Thickness

    Actually, Oral Contraceptives DO Lower Women's AMH Levels

    Posted by Dr. Vishvanath Karande on Aug 17, 2018 9:00:00 AM

    An anti-mullerian hormone (AMH) level is a test now routinely used to evaluate ovarian reserve. AMH levels were believed to NOT vary during the menstrual cycle and can be drawn any time.

    In a recent blog I had presented data which suggest that AMH levels in fact DO vary! AMH levels are also not supposed to be influenced by the use of birth control pills. A recent study from Finland suggests that this may not be true either.

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    Topics: Infertility, Infertility treatment, IVF, Diminished ovarian reserve

    I Have PCOS and I Don’t Ovulate. What’s the Best Fertility Treatment for Me?

    Posted by Dr. Elizabeth Puscheck on Aug 15, 2018 10:30:14 AM

    It is not uncommon for women with PCOS to have a problem with ovulation.  Typically, the over-the-counter ovulation predictor kits do not work for PCOS patients because many PCOS patients will get false positive tests and it may appear that you are ovulating all the time. So how do you know if you have a problem with ovulation?

    One easy way to determine if you are probably not ovulating is the frequency of your periods.  If the beginning of your period (day 1) to the beginning of the next period (day 1) is either less than 21 days or more than 35 days, there is a good chance that you are not ovulating. Another way to determine if you are not ovulating is a medical approach: by testing a progesterone level.

    You will only produce a significant amount of progesterone if you are ovulating.  If you are not ovulating regularly you should see an infertility specialist sooner than is usually recommended. There is no point in trying to conceive for a whole year if you are not ovulating because you can’t get pregnant if you are not releasing an egg from the ovary regularly.

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    Topics: PCOS, Ovulation Induction, Infertility treatment

    Symptoms after IVF Embryo Transfer - The Two-Week Wait

    Posted by Dr. Aniruddha Malpani on Aug 9, 2018 9:00:00 AM

    After months or years of having trouble getting pregnant, all the action and the excitement of taking injections, going for scans, monitoring your blood test results and admiring your embryos is now over.

    Your doctor has put your embryos back into your uterus, and now all you can do is wait for the final outcome, in order to find out whether the embryos have implanted or not. This wait is extremely frustrating: the outcome of the treatment is completely out of your hands, and there is no way of finding out what is happening to your precious embryos inside your body.

    As any IVF patient will attest, the two-week wait after the embryo transfer is the longest fourteen days of your life. The symptoms after IVF embryo transfer-- physical and emotional-- can be hard to deal with.  Do any of these sound familiar?

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    Topics: IVF, Understanding Test Results, Handling stress

    Frozen embryo transfer: natural vs. artificial cycle

    Posted by Dr. Vishvanath Karande on Aug 7, 2018 8:28:00 AM

    It is now more than 30 years since the first live birth after transfer of a frozen (cryopreserved) embryo (Zeilmaker et al., 1984).  The ability to successfully freeze embryos had a profound impact on assisted reproductive technologies. 

    It improved efficacy, encouraged the transfer of fewer embryos into the uterus and hence reduced complications arising from prematurity. Recent research indicated frozen embryo transfer babies do better than babies from fresh embryos.

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    Topics: Infertility treatment, IVF, Embryology

    Why Aren't Early Embryo Updates Part of the IVF Process?

    Posted by Kelly Schorsch on Aug 3, 2018 8:25:00 AM

    After egg retrieval, many IVF patients are anxious to know how their embryos are developing in the embryology lab. It's an exciting but difficult part of the IVF process for patients, because they want the best outcome and want to make sure everything is going well in the lab.

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    Topics: Infertility treatment, IVF, InVia Fertility Specialists, Embryology

    Timeline with images of embryo development in IVF

    Posted by Liza Roscetti Meyer on Aug 2, 2018 7:00:00 AM

     

    Many fertility patients are curious about what exactly happens in the embryology lab, from the time their eggs are retrieved to the time they are transferred. When people have answers to their questions about the details of embryo development, IVF can become a less mysterious process for them.
     
    With that in mind, here is a day-by-day timeline of what happens in the embryology lab in IVF.
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    Topics: Infertility, Embryology

    Top 5 Things You Should Know about Egg Quality and IVF

    Posted by Liza Roscetti Meyer on Jul 31, 2018 7:22:00 AM

    When undergoing an IVF cycle you have a lot on your mind. If you are like most people, egg quality is typically not first on the list.

    However, egg quality is one of the single most important aspects of a successful IVF cycle. With high egg quality, IVF is more likely to succeed. Good quality embryos come from good quality eggs.

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    Topics: Infertility, Infertility treatment, IVF, Conception, InVia Fertility Specialists, Embryology, Top 5

    How Many Sperm are Needed for Intrauterine Insemination?

    Posted by Dr. Vishvanath Karande on Jul 26, 2018 1:35:37 PM

    Intrauterine insemination (IUI) is a reasonable first step in patients with unexplained infertility, minimal or mild endometriosis and mild male factor.

    The pregnancy rate with IUI vs. intercourse in natural cycles is similar. Therefore, we will generally perform IUI along with fertility drugs (clomiphene citrate, letrozole or gonadotropins).

    During intrauterine insemination, the semen sample is “washed” in a centrifuge so as to separate the sperm from the seminal plasma (which contains prostaglandins that can cause severe cramping). The motile sperm are then loaded in a tube (catheter) and deposited in the uterine cavity when the woman is ovulating.

    Prior to IUI the total motile sperm count (TMSC) in the sample is usually estimated. Generally speaking, a post-wash TMSC greater than 10 million is considered optimal. The pregnancy rates with a TMSC are very low and these patients are generally considered unsuitable for IUI. But, is this really true?

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    Topics: Infertility, Infertility treatment, Ovulation Induction

    Trouble getting pregnant with low AMH level?

    Posted by Dr. Vishvanath Karande on Jul 24, 2018 2:40:00 PM

    One of the commonest questions I get is from women with low AMH (anti mullerian hormone) levels who are having trouble getting pregnant. These women are often frantic and worried that they will never be able to get pregnant.

    They often feel that having a low AMH level is the end of the world and it makes pregnancy impossible. Not necessarily true! Read on.

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    Topics: IVF, InVia Fertility Specialists, Diminished ovarian reserve

    Understanding Progesterone, the Hormone of Pregnancy

    Posted by Dr. Vishvanath Karande on Jul 20, 2018 6:00:00 AM

    Progesterone is a steroid hormone involved in the female menstrual cycle and is essential for pregnancy. Progesterone also has many roles relating to the development of the fetus.

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    Topics: Infertility, Infertility treatment, IVF, Conception, InVia Fertility Specialists

    Is There Really a Male Infertility Crisis?

    Posted by Dr. Elizabeth Puscheck on Jul 17, 2018 12:16:05 PM

     

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    AMH level and menopause. Does AMH level predict age at menopause?

    Posted by Dr. Vishvanath Karande on Jul 11, 2018 7:02:00 AM

    Anti-mullerian hormone (AMH) level is now routinely used to evaluate ovarian reserve. AMH levels decrease with age and are a more consistent predictor of “ovarian age” than antral follicle count on ultrasound, inhibin b, or FSH levels. The ovary produces AMH and this is confirmed by the fact that AMH levels are undetectable after surgical removal of ovaries as well as menopause. It is therefore reasonable to ask, “Does AMH level predict age at menopause?”

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    Topics: Infertility, Infertility treatment, Conception, Diminished ovarian reserve

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