If you’re asking, you’re already beginning to be concerned. In general, peak fertility for women is in the 18-30 age range, and fertility decreases in your 30’s and 40’s. All women are different – there is no age where everyone can get pregnant or no-one can get pregnant; having said that pregnancy is much less common at 45 years and older. On average, your fertility goes down every year from age 40 to 45.

I would start to be more seriously concerned as you get closer to the 38-40 age range, but if you have a fertility issue at 38 it would be better to find out sooner rather than later. There is a lot of individual variation in ovarian reserve or egg supply (the number and quality of eggs that a woman has left) at any age, so there are 35 year olds with good egg supply and 35 year olds with diminished ovarian reserve.

If you’re aware of your fertility but don’t want a baby yet it wouldn’t be unreasonable to do some basic tests to get an idea of how healthy your ovaries look at 35. These would be an ultrasound scan of your ovaries, looking at the size of each ovary and the number of egg-containing follicles on each side or Antral Follicle Count, and blood tests on Day 2 or 3 of your cycle for estradiol, Follicle Stimulating Hormone or FSH, and Antimullerian Hormone or AMH. Day 1 is the first day of your period. If you’re on hormonal birth control such as pills, NuvaRing, Mirena or Implanon we would skip the estradiol and FSH tests. A fertility clinic (Reproductive Endocrinology and Infertility or REI practice) can perform these tests and interpret the results.

If the results look good you can relax and wait a couple of years longer before trying. If there’s a problem with low ovarian reserve, options include freezing your eggs if you’re single or not in a long-term relationship, or freezing embryos for later use if you have a partner or wish to use donor sperm but aren’t ready to get pregnant now. You could also decide to pursue fertility treatment sooner based on the results.

Being over 40 years old is not an obstacle to be a mother, but the quality of the eggs is worse and that causes fertility decreases. In addition, from the age of 40, the risk of complications is greater. However, both things are not sufficient reason to give up being a mother.

Unfortunately, there is a biological clock, and although it starts to tick louder at different times for different people it is very probable that you are going to have some issues over the age of 40. That being said, the only way to find out exactly what your chances of success will be with your own eggs is to have a series of fertility investigations carried out. We will be able to give you a better understanding of your own fertility after that, and then help you decide between the idea of either using your own eggs or those of an egg donor.

Risks for the woman

When this age is reached, the risk of suffering diseases which are associated to this age, is greater, and therefore pregnancy can be considered a risk situation. In addition, the possibility of suffering gestational diabetes is greater, and deliveries can be prolonged in the case of new mothers.

Risks for the baby

For the baby, it carries a higher risk of chromosome disease (such as Down syndrome) or mild heart disease. It also increases the possibility of miscarriage or premature delivery.

It’s not all bad news

The good news is that the number of women who decide to have children after turning 40 is increasing, so the control of the risks during pregnancy and the good health results of the mother and child, as well.

In addition, thanks to scientific advances in fertility, it can be said that the batteries of the biological clock are day by day more durable. If you are over 40 and want to be a mother, do not focus on thinking “I already missed the boat”. Find professionals who advise and accompany you during the experience and you will reduce risks to the maxim.

If you want more information, PSFC has the perfect team to advise you. Send us an email to [email protected] or call at 91500 91800. We are waiting for you!

Pre-Menopause is an ilness which affects more and more women and it’s diagnosis can worry them as the tendency is to think they can never have children. However, it’s possible to be a mother thanks to ART.

Pre-menopause ocurrs when a woman loses her ovarian function, diminishing the flow of estrogen. The age of menopause comes determined by the particular ovarian reserve of each woman at birth, and by the rhythm at which those eggs are used up during the menstrual cycle. Generally, it ocurrs between the age of 45 and 55, but if it’s before the age of 40, it’s pre-menopause.
The reasons why menopause occurs are various. It can be due to genetic factors, which in many cases means that women with menopause have a family history of early menopause. It can also occur after carrying out oncologic treatments such as chemotherapy or radiotherapy, due to a premature ovarian failure or to an ovarian surgical intervention

Menopause implies the loss of fertility and can carry negative physical and psycological conseuqences. The first sign of pre-menopause is irregular periods that can go on for a few months. Furthermore, there can be vaginal driness, changes in mood, depression, lack of libido, hot flushes and difficulty to fall asleep.

Menopause really means that your periods have stopped forever, but in practice we consider it menopause after a year with no periods in women in the typical age range for menopause (average age is 51). There is a very very small chance of releasing an egg and getting pregnant after ‘natural’ menopause with one year of no periods. This chance is much higher in women who go through ‘premature menopause’ at a young age, which is more correctly known as Primary Ovarian Insufficiency or POI, and can happen in the 30’s or even 20’s. Obviously surgical menopause, after both ovaries have been removed, has very little chance of pregnancy at any age, though sometimes part of an ovary is left behind after surgery.

So assuming you are around 50 and have had no periods for a year, the chances are very slim of getting pregnant naturally – close to zero but not impossible. Egg donation is very successful (75% to 80% success rates and higher) for women with POI or menopause of any age who want to get pregnant, but most clinics have a maximum age for treatment. If there is no disease of the uterus success rates are as high as for younger women, but there can be more pregnancy complications and a higher risk of C/section. Some women have medical problems like kidney disease which may make pregnancy inadvisable. Talk to your Ob/Gyn or see a Fertility MD if you do want to have a baby.

We do not make any judgments against single women seeking treatment and all infertility investigations are going to be carried out the same as they would be for the female half of a couple. The only difference is that you will need to use sperm from a donor, but there are plenty of donor sperm banks that have a wide range of different donors to choose from. We are able to use sperm from a number of these different banks and we will advise you the best way of proceed with that selection.

In the case of a vasectomy, there are a few options open to you to try and conceive. Potentially the simplest treatment is to use donor sperm.  This is not always an option that some couples would like to take, and there are ways to attempt to obtain your partners sperm after the vasectomy. The first is to actually reverse the vasectomy, a surgical procedure that is carried out by a urologist. A potential benefit of this is that if the reversal is successful, you may not need any more intervention to achieve a pregnancy. The problem though is that there are often a lot of other issues that come with that surgery that dictates the need for further treatment such as IUI or even IVF anyway. Another option is to attempt surgical sperm retrieval, again in a urology office. This will, in most cases, also require the woman to undergo an IVF cycle, but depending on the length of time since the vasectomy was originally carried out it may be more appropriate.

As far as same sex couples go there are several different ways that treatment can be carried out.

When we are talking about treating a female couple then we can either do an intrauterine insemination with donor sperm or we can move to IVF if needed, again with the use of donor sperm. If the treatment is going to be IVF, then it is possible to use the eggs of one of the couple and then after insemination with donor sperm, the other woman could have the embryos transferred into her uterus. In this situation it will potentially allow them both to feel more connected to the child.

In the case of a male couple, it is going to be a little more complicated as there is going to need to be an egg donor and a surrogate to carry the pregnancy.  This could potentially be in the form of traditional surrogacy when an IUI with the sperm of either of the guys is used, or more commonly when an egg donor undertakes an IVF cycle, and the resultant embryos are transferred into a separate surrogate.

In any of the above-mentioned situations there will need to be legal documents drawn up and we can point you towards appropriately informed experts.

ORH does not require a referral, but your insurance company may require that you have one. Check with your insurance plan if you need a referral or if you must register with them to get fertility coverage. If you are referred by a physician or other health professional, please let us know. It is helpful to request records of your previous testing and treatment so that we can review them. Many of our patients are referred by friends, coworkers, or family members, including former patients of ours who have been successful.

Reproductive Endocrinology and Infertility or REI MDs are sub-specialists: we train in Obstetrics and Gynecology (OB/Gyn) then do advanced study of male & female hormonal conditions (endocrinology) and infertility testing and treatment including IVF. REI should be board-certified, except for a few older docs. Ob/Gyn MDs offer prenatal care, delivery, gynecologic care & surgery. Fertility specialists can help you get pregnant, including women with recurrent miscarriage, and look after you in early pregnancy, before transferring your care to an Ob/Gyn when you’re ready to graduate from our program!

You may consult a fertility physician (Reproductive Endocrinologist or REI) any time if you have difficulty conceiving. You can try for up to a year if you are 34 or under, or for up to 6 months if you are 35-39. See a REI right away if you are 40 or over, if you have irregular cycles, if you have had a previous ectopic pregnancy, chlamydia, or Pelvic Inflammatory Disease, if you have had endometriosis or ovarian surgery, or if your partner has known sperm issues.

Yes, it is possible. A woman who has entered menopause means that her ovulation (ability to produce own eggs) has stopped but that does not prevent donor eggs to be inseminated with her partner’s sperm as is done in a regular IVF procedure.

While commonly asked by couples anticipating fertility services, the answer is a resounding “No”. In fact, infertility in women and men is almost identical, attributed to females 1/3 of the time, males 1/3 of the time, and unidentifiable the last ⅓ of time.

Genetics can be a factor in determining fertility. There are many different conditions that can be passed from mother to daughter, such as endometriosis (which affects 10% of women). For males, DNA abnormalities of the Y chromosome can lead to problems with infertility.

Couples seeking fertility services often ask, “Why are we infertile?”. At PSFC, we break it down to male and female infertility. Common female infertility is caused by anatomical abnormalities and problems with ovaries or egg quality. Male infertility includes issues related to quantity and quality of sperm production, immunological disorders, and anatomical issues.

There are several options, though your doctor will need to advise on what most increases your odds of success. Some people need more intervention than others. Some female patients have success conceiving with oral fertility hormones such as clomiphene citrate. Some will need injectable ones such as gonadotropin. The treatment of male infertility on the other hand, often requires IVF with intracytoplasmic sperm injection (ICSI).

Yes! This is one of the most popular in vitro fertilization (IVF) frequently asked questions. The success of treatment has a direct correlation with the woman’s age. The younger the better! Overall, 70-80% of women under the age of 40 should expect a successful outcome. If you’re over 40, treatments can  still be effective. However, the average success rates decrease once beyond this point in life. Please note that treatment outcomes can vary widely from individual to individual.

The most important factor for a woman is her age. As her age increases, especially after 40, fecundity decreases, and her chances of conceiving are diminished. Of course, if her partner also has infertility problems, such as a low sperm count, the probability of infertility also increases. For men considering infertility treatment, low sperm motility or other infertility can be avoided through ICSI, PGD/PGS, and more.

Of all of the in vitro fertilization (IVF) frequently asked questions we get from hopeful parents, the health of their children is often at the top of the list. There are conflicting reports that suggest a slight increase in the congenital anomalies with IVF. you should speak with a medical expert before making any decisions. If you want to learn more about IVF, browse our website or for specific questions, or simply contact PSFC today.

Depending on the services you require, infertility treatment can range from $200 to many thousands of dollars. Everyone faces different infertility challenges, so diagnosing and treating patients is highly variable. However, for individuals struggling with finances, we offer payment plans and financial support throughout this process. To find out more about fertility treatment expenses, visit PSFC

It depends. Like above, because everyone faces different infertility challenges and requires different treatments, you may receive none, partial, or full coverage. To determine what your insurance will cover for infertility treatment, contact us with a picture of your insurance card (front and back) and your date of birth. We would be happy to run an insurance authorization check to let you know what’s covered. Additionally, contacting your insurance provider and employer will be important to determining what coverage you receive.

After fertility testing, we rarely see ‘unexplained infertility’. We used to think 15-20% of infertility was ‘unexplained’ (with regular cycles, open tubes, and good sperm) – with modern testing it’s under 1%. Ovarian reserve testing (ultrasound for ovarian volumes and antral follicle count, Antimullerian Hormone or AMH and the Clomid Challenge test) ‘explains’ a lot but there are other possible factors. See a board-certified Reproductive Endocrinology and Infertility or REI specialist for more detailed testing and to give you treatment choices: inseminations (IUI) combined with medications to increase the number of eggs IVF can be appropriate depending on your case.

Roughly two weeks after conception, or about 15 days after a positive ovulation test. If your pregnancy hormone levels are high enough, home pregnancy tests may turn positive a few days before the date of your ‘missed period’. Blood pregnancy tests are more sensitive.

See a Reproductive Endocrinology and Infertility or REI MD, who will review your medical history and your partner’s history, examine you, and recommend appropriate fertility tests for both of you. These may include blood work to check your ovarian reserve (egg numbers and quality) and to check for hormonal problems, an ultrasound scan of your uterus and ovaries, a Hysterosalpingogram (HSG) to check your tubes, and a Semen Analysis for him.

Be careful what you wish for … twins are more high risk than a single baby, although most twins do fine with good OB and neonatal care, some twins have long-term problems, some are premature and some don’t even make it to viability and are born before 24 weeks. The risk of cerebral palsy, a serious birth defect, is 4 – 5 times higher in twins compared to a single baby. You have a higher chance of pregnancy complications including serous ones like preeclampsia or placental abruption, a higher risk of C/Section, and even a very slight increase in divorce rate.

I know the baby photographers all love to show pictures of cute twins all dressed up … the kids with cerebral palsy are generally not shown on the front cover of a magazine.

Couples who need treatment for infertility, from simple treatments like Clomid to advanced treatments such as In Vitro Fertilization (IVF), often have an increased risk of twins if more than one egg is released with fertility medications, or if more than one embryo is replaced into a woman’s uterus after IVF.

If we’re treating couples for infertility who can’t get pregnant on their own twins may be an acceptable risk of the treatment. Many couples tell me they want twins – they have been trying for a baby for one or many years, and many couples want two babies total and would love to have twins and ‘be done’. We do our best to avoid triplets or more, though. In this case the risk of twins is justified by the benefit of treatment of their infertility.

If you don’t have any problems getting pregnant your natural chance of twins is about 1%. I don’t recommend going to an Ob/Gyn or Fertility MD just because you want twins (wanting twins for social reasons””) – if you end up with complications to you or the babies” would it be worthwhile compared with just having two more kids separately? I would not recommend “getting fixed” in your early 20’s until you are 100% sure that you’re done either we have great birth control options like the Mirena IUD which is about as effective as having your tubes tied but reversible if you have one more child and then want another one later.

About 85% of couples get pregnant after a year of trying. It could still happen ‘naturally’ (at two years it’s over 90%) but if you have been trying for more than one year or more (under 35 years of age), 6 months or more (36-40 years of age) or if you are over 40 years of age this is a good time to see a Fertility specialist (Reproductive Endocrinology/Infertility or REI) to find out why your partner is not getting pregnant and to help you to get to that first child.

REI physicians train in Ob/Gyn before specializing in fertility medicine. They can do tests to check the number of eggs left in the female partner’s ovaries (ovarian reserve) which can go down as women get older. She should also be checked for hormonal problems which can stop her from getting pregnant including thyroid problems or polycystic ovarian syndrome (PCOS), and the MD will check her uterus for fibroids or polyps and perform a hysterosalpingogram or HSG test to make sure that her fallopian tubes are both open and look normal.

It takes two to get pregnant of course, and the man has a sperm problem in 40-50% of couples trying to conceive, so you will need a semen analysis (sperm test). If there is a sperm issue, it may be the only reason that the female partner is not pregnant yet, or a contributing factor along with problems on the female side. Most REI docs like to see you both partners as a couple, but it is not mandatory that you come to the first visit.

After these tests there are specific treatments for improving fertility depending on the cause(s) we find, such as Clomid can help her ovulate (release an egg) or release more than one egg in a month. Clomid can be combined with Intrauterine Inseminations (IUI) where the sperm is washed and placed inside her uterus. Some couples may need more intensive treatment such as In Vitro Fertilization (IVF).

In short, see a specialist for testing and to come up with an individualized treatment plan to help your wife get pregnant. Lifestyle changes may help if needed as well – quit smoking, avoid heavy drinking and drug, and aim for a normal weight applies to both of you.

It is now possible for women interested in knowing their reproductive potential to obtain a detailed fertility assessment. Our new Fertility Snapshot program lets women know just how easily they will be able to get pregnant in the next couple of years without going through costly testing.

Yes, there are many services available.  Through PSFC we can arrange psychologist support who offer individual and couples counseling, acupuncture, The Mind Body Program and nutritional counseling with a registered dietician. Also we have an in-house psychologist staff at PSFC who can counsel you.

In addition to undergoing the genetic screening process, part of our Ultra IVF is the fact that we determine, or measure, all of the components that could impact the embryo environment. These components consist of the air quality. We have installed in our labs several hepa air filters, which have allowed us to be certified as a “Clean Room.”

What a Clean room means is that there’s not very much dust, dirt or contamination in the air, very much like what is done when people are working on a microchip. You cannot let dust land on a microchip because then it will cause it to short circuit. Same thing with an embryo, an embryo is microscopic and any piece, no matter how small, of dust or contamination can cause that embryo not to progress.

Providing a Certified Clean Room is a very expensive process. The level of filtration that you need in order to reach those standards is very expensive. We have provided that because of the fact that I care about whether or not the patient gets pregnant. I will do everything within my power to provide the right environment for that embryo to succeed and so I believe heavily in anything that I know that contributes to the embryo’s progression. I want those factors controlled and that’s what we do in PSFC. We control the temperature, the pH of the environment. All of these things are tightly controlled so that the embryo goes through a lot less fluctuation.

I have also actually provided more incubators in the lab than what is needed to carry out the number of cycles that we are doing because to me, the individual incubation plays a huge role in whether or not the embryo will be successful. The more the door is open to the embryo’s, the more fluctuation they undergo when they are trying to progress and develop into what’s going to be a baby someday so therefore, we like to limit the amount of times we need to open and close the doors to the incubator and by having individual incubation units, we can do that here at Red Rock Fertility Center. We’ve seen that not only are the success rates high, but the babies are smart, beautiful and everything you’d love them to be.

The difference between a certified clean room and right now we’re at a class 1000 and regular room air is that a certified clean room is 1000 times more pure air than the regular environment. If IVF were conducted in a regular room like this office, it is 1000 times more likely that a speck of dust would land in the dish of an embryo here than in the IVF lab.