Specialists Blog
Clomiphene citrate (Clomid, Serophene) is a common medication used to treat infertility. It has been used in the United States since 1967. In patients that do not ovulate, clomiphene citrate is used ... read more
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 ... read more
Many patients who have been through an in vitro fertilization (IVF) cycle have blastocysts that have been frozen. These blastocysts are cryopreserved by a process known as vitrification, which is a ... read more
A cycle day-3 follicle stimulating hormone (FSH) level and anti-mullerian hormone (AMH) level are commonly used to evaluate ovarian reserve. FSH level generally predicts pregnancy rates with in vitro ... read more
As a couple, you have most probably been on the emotional roller coaster ride that comes with infertility treatment for any length of time. Going through the sequence of treatments from fertility ... read more
“My doctor said that my embryos looked picture-perfect, yet they failed to implant – why did this happen?” This is the question in the minds of women who undergo IVF failure, and this becomes a ... read more
For successful implantation to occur, an embryo needs a “receptive” uterine lining (endometrium). A thin endometrium can result in lower implantation of the embryo. In previous blogs, Katie Koss and ... read more
Marijuana is a drug derived from the hemp plant Cannabis sativa or Cannabis indica. Its main psychoactive component is tetrahydrocannabinol (THC), which is linked to altered sensual perception, mood ... read more
Egg 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 ... read more
In many cases couples decide to cryopreserve their remaining embryos after an in vitro fertilization (IVF) treatment. They could freeze the embryos right after treatment before proceeding to a ... read more
Many couples who are trying to get pregnant think that the more sex they have, the better. The truth is that there is only a small window each month during which a woman can become pregnant. This ... read more
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 ... read more
If you're having trouble getting pregnant, you've probably heard of anti-mullerian hormone or AMH. The level of the hormone's presence in the body is directly linked to the number of growing ... read more
I’m often asked by donors how many cycles they are allowed to do and the answer is always six. But where did that number come from? Did we make it up? Can they go somewhere else and do more? read more
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 ... read more
10 days!? 12 days!? I have to wait how long to find out if I’m pregnant or not!? While patients engaged in IVF are scheduled as early as possible for their serum (blood) hCG level (pregnancy test), ... read more
The importance of egg quality in women trying to conceive can not be stressed enough. Women are born with a certain, and finite, number of eggs. Even though there may be more eggs present in the ... read more
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 ... read more
In a previous blog we discussed the expected ultrasound findings in a normal intrauterine pregnancy. Variations from the expected pattern of development are worrisome or, if major, definitive for ... read more
The time between your insemination or embryo transfer and the pregnancy test result can be stressful. Here are some tips that may help you get through this potentially challenging period. read more
1) It is generally accepted that as a woman ages, her ability to reproduce will diminish and she will begin having trouble getting pregnant. read more
Polycystic ovary syndrome (PCOS) is a relatively common hormonal disorder that is one of the leading causes of infertility. Some women who have PCOS develop insulin resistance. This occurs when the ... read more
Varicocele is the presence of abnormally dilated veins in the scrotum. Its association with infertility, treatment and indications for varicocele surgery has been discussed in previous blogs. This ... read more
In approximately half the couples with recurrent pregnancy loss (RPL) the tests will all come back normal. These include tests for checking the uterine cavity (hysterosalpingogram, sonohysterogram, ... read more
In a previous blog post, I discussed how a thin uterine lining may reduce IVF success rates. In this post, we will discuss management of a thin uterine lining in the context of artificial cycles ... read more
During in vitro fertilization (IVF) in order for implantation and pregnancy to occur, the embryos must reach a stage of development known as ‘blastocyst’. Reaching the blastocyst stage is an integral ... read more
Progesterone is an essential hormone needed to support pregnancy. It is produced naturally during both the menstrual cycle and pregnancy. In a normal menstrual cycle, once ovulation occurs, the ... read more
The number of people smoking has decreased significantly over the past 30 years. However, 30% of reproductive age women and 35% of reproductive age men in the United States still smoke cigarettes. ... read more
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 ... read more
Polycystic ovary syndrome (PCOS) affects 6 – 8% of women and is a common cause of infertility. Women with PCOS often have absent or irregular menses. They therefore either do not ovulate or ovulate ... read more
I have previously discussed the impact of the thyroid gland on female reproduction. Hypothyroidism (“low” thyroid) is fairly common and according to the National Health and Nutrition Examination ... read more
Approximately 64% of American women are overweight or obese. The highest rate of obesity is in women 20 – 29 years old. Obesity is associated with an increase in heart disease, high blood pressure ... read more
Anti-mullerian hormone (AMH) is a highly sensitive marker of ovarian reserve. It is released by the cells surrounding follicles in the ovary. AMH levels decrease with age and may be the most ... read more
PCOS stands for polycystic ovary syndrome. It is a common condition related to an imbalance of hormones. It affects as many as 1 out of 15 women, and is a leading cause of infertility as well as ... read more
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 ... read more
So, you've been through an IVF cycle. Your doctors have retrieved a good number of eggs with a good number reaching the blastocyst stage. Having counseled about the advantages of SMART IVF, you ... read more
My previous blog addressed the chances of getting pregnant after 43 and the options for those in this age group who wish to have children. read more
I have previously written a blog on how to improve your chances of success with fertility treatment. Improving your lifestyle is a big step in the right direction. Weight loss, regular exercise, ... read more
The surge in the Delta variant has prolonged the COVID-19 pandemic. Cases continue to rise, and hospital intensive care units (ICUs) are reporting that they will soon or have already reached maximum ... read more
Nothing should stop any individual or couple who wants a family from achieving that dream. There are several fertility treatment options for same-sex couples and potential single parents to grow ... read more
Human chorionic gonadotropin (hCG) is a hormone produced by the embryo after conception. Human embryos can produce hCG as early as 8 days after fertilization. During IVF, however, final egg ... read more
A uterine septum is a common anomoly of the uterus that is seen in 1 – 15 per 1,000 women (shown in the picture at right). In this condition, the cavity of the uterus is separated by a long piece of ... read more
Here are just a few examples of what patients on Ideal Protein learn about weight loss from our Health and Wellness Coach Lauren Wismer. read more
As a nurse doing consultations before IVF treatment, I'm often asked, "Does it hurt?" The IVF process can be intimidating, and many patients naturally have a fear of the unknown. To help ease this ... read more
Bleeding during pregnancy is scary, particularly when you have been trying to get pregnant for a long time with the help of a fertility specialist. In this post, I’m going to look at different ... read more
Early pregnancy bleeding is fairly common and occurs in 20 – 30% of pregnancies. Vaginal bleeding in early pregnancy can be worrying, so it's only natural that if it happens to you, you're concerned ... read more
You have had your egg retrieval and are now waiting for your embryo transfer. Instead of having your transfer 5 days later, you are told that the embryos are “dividing slowly” and the transfer is ... read more
I recently hosted a webinar for InVia Fertility covering polycystic ovarian syndrome (PCOS). If you haven’t had time to watch it, or if you’re wondering what it’s about, here are five quick important ... read more
One of our routine tests is to evaluate egg quality is a day-3 follicle stimulating hormone (FSH) level. A high FSH level indicates diminished quality of a woman's eggs (ovarian reserve). Patients ... read more
The treatment of male factor infertility was revolutionized in 1992 when Palermo and co-workers introduced intracytoplasmic sperm injection (ICSI). With ICSI, embryologists use a micromanipulator to ... read more
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 ... read more
You've seen a fertility specialist, started IVF, and gotten through the first embryo transfer. You've spent a long time waiting for good news. And finally you get it! The results of your pregnancy ... read more
When people first start trying for a baby, they are often surprised if pregnancy doesn’t happen right away. The truth is that even a healthy young couple at peak fertility will usually need to try ... read more
Women are born with all the eggs that they will ever have. In fact, when a female fetus is only 5 months along, she has approximately seven million eggs in her ovaries. By the time that baby girl is ... read more
It is now well established that elevated basal (cycle days 2, 3 or 4) follicle stimulating hormone (FSH) levels can be an indicator of being infertile. This decrease in fertility due to a reduction ... read more
If you're undergoing or researching IVF, you may have learned that not all embryos are able to implant, and therefore sometimes the decision is made not to transfer an embryo to the patient after an ... read more
For same-sex male couples, planning a family starts with a lot of questions—about getting an egg donor, surrogacy, and other fertility treatment options. Some of these questions can be answered by ... read more
Embryo freezing has become common practice, and we have been doing it successfully for more than thirty years. Previously, the technique used for embryo freezing utilized computerized freezers with ... read more
So you are reading your instructions or your prescription bottles and there are all these letters and symbols. What do they mean and why are they used? read more
Takeaway: If you’re having trouble getting pregnant, don’t wait. See a Reproductive Endocrinology and Infertility Specialist! read more
There are often social challenges endured by LGBT families and parents. There is a lot of confusion and information to be sorted through, from friends, family members, Internet searches, and even ... read more
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 ... read more
Single people and same sex couples that would like to have children that are theirs, biologically, can use this blog as a guide to starting the single and same sex parenting process. read more
Letrozole (marketed as Femara in the U.S.) is a drug that is approved for the treatment of breast cancer after surgery. It is also used (“off label”) for ovulation induction. I have discussed its ... read more
Embryos have been successfully frozen (cryopreserved) since the early 1980’s. Worldwide literature has confirmed that there is no increase in birth defects in children born from frozen embryos. The ... read more
In order to maximize pregnancy rates in an egg donor program, it is very important that a good egg donor is selected. You may already know that it's important that the egg donor be in good health, ... read more
We often talk about follicles (affectionately called "follies") during the IVF process. But IVF patients often don’t understand the difference between follicles and eggs. If eggs aren't follicles, ... read more
A pregnancy test, in an IVF cycle, is generally scheduled approximately two weeks after an embryo transfer. This involves a blood test to measure the hormone of pregnancy - hCG (human chorionic ... read more
So, you are going through a treatment cycle and have had an intrauterine insemination or an embryo transfer. You are now in the two week waiting period for the pregnancy test results that will be a ... read more
There is an obesity epidemic in America today. More than four in ten women of reproductive age are overweight or obese. Obesity increases the risk of a number of health conditions: high blood ... read more
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, ... read more
The thyroid is a butterfly-shaped gland in the base of your neck just below the Adam’s apple. It produces several hormones, all of which play an important role in your body's metabolism-- and your ... read more
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 ... read more
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 ... read more
Fertility drugs are used to stimulate the ovaries to produce multiple follicles. Their use is associated with multiple ovulations and often with high estrogen levels. It would therefore be reasonable ... read more
What is adenomyosis? Adenomyosis is defined as the presence of endometrial tissue, which normally lines the uterus, which has grown into the muscular wall of the uterus. It can be diffuse or ... read more
Adenomyosis is a gynecological disease where the glands from the lining of the uterine cavity (endometrium) are present within the uterine musculature (myometrium). Historically, adenomyosis was ... read more
Let me be the first to say that before infertility smacked me in the face, I may have hurt or offended others by asking insensitive or even ignorant questions about their fertility struggles. I want ... read more
The world has now been living with COVID for over a year. Over one hundred million infections have been documented, and over two and a half million people are known to have died from COVID. During ... read more
Endometriosis happens when the lining of the uterus (womb) grows outside of the uterus. It affects about 5 million American women. Endometriosis is especially common among women in their 30s and 40s; ... read more
Endometriosis affects one in ten women in the United States, and can cause fertility problems. At InVia Fertility, we have treated many women who have this condition over the years. Here are the top ... read more
I often get questions from patients with low sperm morphology (shape) during semen analysis. A typical question is “My sperm morphology is only 3% normal forms; what can I do?” or “What is the best ... read more
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 ... read more
One year after the first cases were detected, the COVID-19 pandemic continues to affect daily life in the United States. It is difficult to take in the full impact of the disruption, illness and loss ... read more
Infertility is a profoundly stressful experience, physically and psychologically, write Dr Alice Domar and Lauren Prince in their recent study in Sexuality, Reproduction and Menopause. The study ... read more
In a previous blog, I discussed data that showed a significantly reduced pregnancy rate in obese in vitro fertilization (IVF) patients. This was in regular IVF patients attempting to conceive with ... read more
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 ... read more
Age-related infertility is something fertility clinics are seeing increasingly, as more couples work on getting pregnant after 40. It is a fact that one cannot change one's biological age. The ... read more
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Fertility Specialists