So you're in the IVF process, and now you’ve waited the long 10-16 days for your first pregnancy test. Your hCG level comes back positive. Congratulations! Then the panic sets in. Is my number too ... read more
Once a healthy, developing embryo is successfully transferred into your uterus, it has to attach itself to the uterine lining and then grow there, a process known as implantation. For successful ... 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
Embryo transfer is arguably the most critical step in the IVF process. On the surface, it seems like a relatively simple procedure. The embryos are loaded in a catheter and the physician deposits ... 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 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
With the monitoring of your blood and stimulation medication injections, fertility treatment can make you start to feel like a pin cushion! Nobody likes having their blood drawn and most people do ... 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
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
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
"Is there a male fertility crisis? I hear sperm counts are decreasing!" There has been controversy about this topic and many, many news outlets have reported on it. Researchers are also studying it. ... 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
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
One of the first steps in fertility testing for any male infertility issues is a semen analysis. A semen analysis gives a good representation of the male’s quantity and quality of sperm, as shown in ... 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
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
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. read more
We have been offering embryo donation at InVia Fertility Specialists since its inception in 2002. Although adoption has been around throughout history, the use of donated embryos for building ... 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
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
There are a few things that I would really like patients to know about PCOS and infertility. Yes, it is upsetting to get this diagnosis. However, I find this diagnosis is the BEST of all infertility ... read more
Endometrial polyps are growths that are attached to the inner wall of the uterus that extend into the uterine cavity. They are usually benign (not cancerous) and are a common finding in women of ... 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
Polycystic ovary syndrome (PCOS)is the most common cause of infertility in women. PCOS is often associated with obesity. Obesity, however, is NOT a diagnostic criteria for PCOS, as it can also occur ... 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) 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
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
I am frequently asked by patients whether to get vaccinated for the flu. The answer is an unequivocal yes! Whether a woman is trying to conceive, just found out she is pregnant, or is well into her ... read more
The technologies for successfully freezing embryos have now been available for more than twenty-five years. With improved freezing techniques, the success rates with frozen embryo transfer (FET) are ... read more
Can’t I just take the meds and have intercourse instead of inseminations? Doing an insemination around the time you are ovulating will increase your chance of achieving a pregnancy. During ... read more
As with smoking cigarettes, there's a connection between marijuana and fertility, and it's not a good one. Use of marijuana has a negative impact on trying to conceive, for both male and female ... 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
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 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
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
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
Many years ago there was a show on TV called “Kids Say the Darndest Things.” The host would ask kids questions, and they'd come back with priceless comments that were spontaneous and socially ... 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
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 ... 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
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
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
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
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
For many decades, we focused mainly on sperm count and motility when doing a semen analysis. For the past 25 years or so, especially with the advent of in-vitro fertilization (IVF), fertility ... 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
Recent studies have suggested a relationship between the diet of both partners and fertility, including the impact of obesity. Dietary supplements for fertility are one of a number of things that ... read more
Christy and Ryan H. first became patients of Dr. Karande’s back in 2001. All four of their children have been born with help from him and InVia Fertility Specialists! Here, Christy explains the ... 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
My husband and I met at the young age of 19. We met one night in Philadelphia through a mutual friend and essentially fell in love. I know it’s extremely cheesy, but it’s the truth. We were both in ... read more
The 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 ... read more
There are many choices to make in starting a family as a gay male couple. Let's say you've chosen a fertility clinic that has a track record of success serving same-sex couples, and you've secured an ... read more
A common question patients ask is, “what is the difference between IUI and IVF?” To some that may come as a relatively easy question to answer, but without the background knowledge of either term one ... 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
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
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
For more than a decade, we have been screening embryos for chromosomal number abnormalities (aneuploidy) at InVia Fertility Specialists. The technical term used for this process is preimplantation ... read more
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 ... read more
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 ... read more
Feeling stress is part of our biological survival mechanism as human beings. It is a signal that danger is impending and action must be taken to seek safety. While it is a simple matter to obey ... read more
With the use of COVID-19 (COVID) vaccines, we are slowly recovering from the COVID pandemic. There, however, remain a significant percentage of individuals that refuse to take the vaccine due to ... read more
The number of people infected by COVID-19 (COVID) is decreasing and the pandemic appears to be in the process of resolving. A major contributor to the control of COVID is the availability and wide ... read more
A recent study showed the majority of parents of egg donor conceived children intend to tell their children – but many put off that conversation. If you've used an egg donor, there are many things to ... read more
How can you determine if you need an egg donor as opposed to doing IVF using your own eggs? Many factors come in to play in making this decision. Ultimately, it's all about the egg quality. In this ... read more
It’s a scary, unexpected thing, when as an egg donor you have your hormones drawn and an ultrasound performed, and then are told you don’t qualify medically for an egg donor program. In addition to ... read more
This post is from an anonymous egg donor who responded to a comment on the blog. I liked it so much that I am posting it as a separate post. I would also like to take this opportunity to thank her ... read more
Endometriosis is a condition in which the lining of the uterus (endometrium) “escapes” and implants on structures outside the uterus. The endometrial tissue outside the uterus is affected by hormones ... read more
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 ... read more
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 ... read more
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 ... read more
Endometriosis is a condition where the lining of the uterus (endometrial-like glands and stroma) is present outside the uterus. These implants are sensitive to hormonal changes and result in chronic ... read more
I have by now answered several questions from readers who tell me they have a positive pregnancy test. They will often give me their pregnancy test result and ask me if the level is okay. On further ... read more
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 ... read more
I have written previously on the role of progesterone (P) and the various methods of administering P. Historically, during the early days of IVF, P was administered exclusively via intramuscular (IM) ... read more
Morning sickness in pregnancy is common. In fact, over half of women will vomit during pregnancy, and 80% will have some level of nausea. In most cases, these symptoms improve by the end of the first ... read more
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. read more
Having trouble sleeping? 1 in 3 people do, according to the CDC. For women who are trying to conceive, chronic sleeplessness can interfere with hormone balance, affecting ovulation and menstruation. ... read more
The sudden resurgence of COVID-19 cases due to the omicron variant has once again upended our lives. In recent months, medical and media attention has been on the impact of COVID infection on ... read more
A failed IVF cycle is heart-wrenching. Your dreams of a pregnancy are shattered, your hard-earned money has gone down the tube, and you do not know what to do next! As humans we all need explanations ... read more
