So you are planning on an IVF cycle. What can you expect? IVF is the most successful infertility therapy available. It is high tech and complex but at the heart of it involves uniting an egg and the sperm and ensuring that a normal-appearing embryo arrives in the uterine cavity. Ultimately the success depends on the quality of the egg and sperm and the receptivity of the uterine cavity.
The most important IVF success factor by far is the egg quality and this is most influenced by the age of the woman providing the egg and her "ovarian reserve." The ovarian reserve is a concept which reflects the remaining number of eggs. While we cannot put a specific number on the number of eggs remaining, we can identify women who have significantly above average numbers of eggs and those that have significantly less than average.
In general the egg quality, i.e., the likelihood that the egg has the necessary 23 chromosomes to produce a healthy baby, follows quantity and most importantly decreases with maternal age. The ovarian reserve helps us estimate the chance of success and guides us in terms of the choice of drugs and dose to stimulate the ovaries to produce more than one egg.
Prior to beginning an IVF cycle, you will have completed an evaluation to make sure that the uterine cavity is normal, to determine via the semen analysis the best way to fertilize the eggs, and to exclude any preexisting condition which may reduce the chance of IVF success or complicate a subsequent pregnancy.
More detail on the steps involved in the IVF process, are detailed here. For questions specific to your situation, please contact a fertility specialist.
NOTE: In Dr. Ory's next IVF FLORIDA blog post, egg retrieval and the embryo transfer process will be explored.
By
Dr Steven J. Ory at 28 Jan 2014
"The Holiday Season." That single phrase likely conjures a mix of memories, emotions, sentiments, and anticipation. For many of us, the holiday season is an opportunity to gather with friends and family and to share in traditions both old and new. There are parties to attend, religious observances to be remembered, and shopping to be done. And then there is the food (oh, the food!) foisted upon us from seemingly every conceivable direction. My mouth still waters in thinking back to the Christmas dinner my wife prepared last year - beef tenderloin with whipped horseradish, spiced potatoes, green bean casserole, and pumpkin cheesecake for dessert. I also recall, less fondly, my pants fitting a little bit tighter and the bathroom scale coldly confirming what I already knew to be true. The New Year's resolution then invariably turns out to be some vague commitment to A) weight loss, B) exercise, C) better diet, or D) all of the above.
For couples dealing with issues of fertility, matters of weight and diet often take on an additional gravity. When meeting with patients in my fertility clinic, one of the most common questions that I am asked is, "What kind of diet should we be on to improve our fertility?" The answer to the basic concept of lifestyle change to improve fertility is nuanced and there is no "one size fits all" response to the question.
There does exist a clear relationship between weight and fertility. Women who are either
overweight or underweight can have an extended time to conception. On average, it takes women with a body mass index (BMI) greater than 35 or less than 19 twice as long and four times as long, respectively, to conceive. (There are numerous online calculators to determine your own BMI - simply use the search term "BMI calculator" to find one.) Obesity is closely associated with difficulty ovulating, poorer response to fertility treatments, and increased rates of miscarriage. In men, obesity can be linked to a lower quantity and quality of sperm, lower testosterone levels, and an increased incidence of erectile dysfunction.
A recent study from Harvard showed an improved response (more eggs retrieved) in IVF treatment in overweight and obese women who had a modest, short-term weight loss prior to initiating a cycle (Chavarro, et al. Fert Steril 2012). Moreover, a normalization of body weight in women at the extremes of BMI has consistently been shown by multiple researchers to improve pregnancy rates and pregnancy outcomes.
While a healthy diet is generally recommended to patients for reasons both related and unrelated to fertility, many patients are unclear as to what constitutes a healthy diet. Little evidence exists that dietary variants such as vegetarian diets, low-fat diets, antioxidants, or herbal supplements have a positive impact on fertility. Studies have shown, however, that there may be a benefit to increasing slowly digested carbohydrates (fiber-rich carbs) over simple sugars. In addition, reducing animal protein in favor of plant protein, using unsaturated vegetable oils, drinking whole milk instead of skim (surprisingly),and staying hydrated with water instead of sugary soda can all help improve fertility based on observational data from the landmark Nurses' Health Study.
Alcohol consumption does not have a clear association with fertility. Studies looking at the effect of alcohol on fertility have shown conflicting results. Both an increased and a decreased fertility rate with moderate alcohol consumption (up to 2 drinks per day) have been reported. Still other studies have shown no effect. A practical recommendation would be to limit alcohol consumption to less than two drinks per day while trying to conceive and most importantly, stop alcohol consumption altogether with pregnancy.
Caffeine, like alcohol, is probably best taken in moderation. High caffeine intake (5 or more cups of coffee per day or 500 mg of caffeine) is associated with decreased fertility. During pregnancy, there is evidence to suggest that 200 - 300 mg of caffeine per day (the equivalent of more than two cups of coffee) is linked to a higher miscarriage rate. One to two cups of coffee per day or its equivalent while trying to conceive or during pregnancy does not appear to have an adverse effect.
Finally, stop smoking. Women who smoke enter menopause one to four years earlier on average than their non-smoking counterparts. In addition, women who smoke are 60% more likely to be infertile than women who do not. Lastly, smoking during pregnancy increases the chance of miscarriage. The evidence regarding male fertility and smoking is less established.
Taken in sum, the bottom line is to enjoy this holiday season with your friends and loved ones with moderation being the key. And if you have that extra slice of grandma's pumpkin pie or one more flute of champagne, fear not, New Year's is just around the corner and you can pledge anew that this will be the year that you will keep your resolution.
By
Dr. Daniel Christie at 19 Dec 2012
Trying to have a baby?
Join us at IVF FLORIDA for a FREE INFORMATION SESSION on October 25, 2012 from 6:00-8:00 PM at our Margate office located at 2960 N. State Rd 7, Ste 300 Margate, FL 33063 - just minutes from the Florida Turnpike, Interstate 95 and the Sawgrass Expressway.
At the free information session, the infertility specialists at IVF FLORIDA will be discussing the causes of infertility and new techniques to overcome infertility in both women and men. Ask questions and talk one-on-one with our physicians and staff, in a casual, relaxed environment. Plus you can learn about our Financing Options that can help your dreams become a reality.
We will also take you on a tour of our state of the art facility designed with the sole purpose of helping people become parents. Our Margate Fertility Clinic and Surgery Center is our flagship location offering the most comprehensive range of fertility services that include fertility treatments such as ovulation induction, IUI, IVF, and advanced embryology laboratory services, as well as testing and diagnostic services such as in-office Hysterosalpingogram (HSG), Essure & Adiana confirmation testing, and minimally invasive robotic surgery. Our state-of-the-art facility is open seven days per week, 365 days per year, and is available for weekday and weekend monitoring patients.
RSVP today as space is limited.
Call 954.247.6217 OR email: ivfflinfo@integramed.com to reserve a seat for this informative seminar.
By
IVF Florida Staff at 19 Oct 2012
Dr. Marcelo Barrionuevo, M.D., was recently interviewed for a television news segment where he discussed the possible causes of infertility and the latest available treatment options. As one of the top fertility specialists in south Florida, Dr. Barrionuevo cited that infertility may be caused by a variety of factors. He pointed that out that pregnancy complications are as different as the women who walk into his office. Infertility issues such as if a patient has cancer or has an odd shaped uterus, were highlighted in the segment. However, he pointed out that the #1 issue contributing to infertility is a woman's biological clock. Dr.
Barrionuevo also touched upon three treatment options: Oral or injected medications, intrauterine insemination (IUI), and in vitro fertilization (IVF).
Also featured in the segment was Tamika Luciano, a patient of Dr. Barrionuevo who has suffered, yet, successfully overcome infertility under Dr. Barrionuevo's care. Ms. Luciano openly discussed how she lost both of her fallopian tubes while trying to get pregnant, and how she has achieved pregnancy via IVF treatment.
To learn more about these treatment options, contact us or make an appointment.
See the video here.
By
IVF Florida Staff at 6 Jun 2012
IVF FLORIDA Reproductive Associates, a partner center of IntegraMed's (INMD) Attain Fertility Centers, is pleased to announce the acquisition of Palmetto Fertility Center in Miami Lakes, with a medical team consisting of Dr. Graubert and Dr. Cabrera along with a highly specialized team of clinicians.
The acquisition of Palmetto Fertility in Miami Lakes adds one of the leading fertility centers in Miami to the IVF FLORIDA fertility team of experts. Palmetto Fertility has been providing highly successful fertility services to patients for over 15 years. This partnership extends IVF FLORIDA's presence in Miami-Dade to now include Miami Lakes in addition to its existing Kendall location.
"Joining IVF FLORIDA provides the opportunity to take our practice to the next level," states Dr. Graubert. "We are now part of a larger, more comprehensive fertility practice comprised of 9 reproductive endocrinologists in addition to a team of over 100 highly specialized fertility experts."
"At IVF FLORIDA, we are constantly working to improve access and convenience for the thousands of people who seek our services each year and we are thrilled to provide additional service locations with highly skilled staff, which is exactly what our partnership with Palmetto Fertility allows," said Dr. David Hoffman, of IVF FLORIDA.
"We are proud to add such an impressive fertility center to our existing operations, Palmetto's success rates speak for themselves and this partnership now provides greater access to our fertility team throughout Miami." According to IVF FLORIDA's Chief Executive Officer, Justin Enoch, "We have received numerous patient requests to expand our presence in Miami and Palmetto Fertility provides the clinical excellence and synergy we were seeking."
To further expand patient access to IVF FLORIDA's fertility team of experts and its unique compassionate and personalized patient fertility treatments, IVF FLORIDA in February added a new office location in Wellington.
"We are pleased to provide the expert and customer friendly services offered by IVF FLORIDA. Our new locations in Miami Lakes and Wellington will offer patients a new alternative, in a small, intimate, and personalized setting, and provide access to the state's leading fertility program," said Mr. Enoch.
IVF FLORIDA now has six locations throughout southeast Florida: Kendall, Miami Lakes, Pembroke Pines, Margate, Wellington and Jupiter.
By
IVF Florida Staff at 3 May 2012