FemHealth
For you, from doctors

Egg Freezing Cost

With age the fertility window and odds of natural pregnancy decline. Egg freezing is an option that many women seek out in a fertility clinic. However, high egg freezing prices are often a barrier to fertility preservation through egg freezing. The egg freezing process itself can cost up to $11,000. A study shows that out-of-pocket egg freezing expenses ranged from as little as $1000 per cycle to more than $18,000 per cycle. The average cost per cycle was $6966 (1). Remember that price shopping is a dangerous game to play when it comes to egg freezing. Patients should consider the expertise of the doctor, the lab the doctor works with, and the success rates of a particular clinic when making a decision of where to freeze their eggs. A smaller number of eggs in a more experienced clinic may yield better results than twice that number in a clinic with low success rates.Egg freezing cost also varies by geography with New York City being one of the costliest places to freeze eggs.Additionally, keep in mind that many patients may need more than one cycle to get pregnant or retrieve a number of eggs that give you higher chances of pregnancy. The more eggs you have frozen, the higher your chances are of having a live birth from them. Some clinics may also offer discounts for additional cycles done at the same clinic. Eggs frozen at a younger age are also more likely to yield a live birth and thus, patients who are older may want to freeze more eggs and undergo more egg freezing cycles than patients who are younger. On average, women undergo 2.1 cycles of egg freezing.In addition to the cost of the the egg freezing procedure, patients should also set money aside for the following costs:You will be using injectable medications that are required to stimulate the production of eggs around 10-12 days prior to the procedure. Egg freezing medications cost around $5000. There is also a fee to store the frozen eggs which can cost between $500 to $1000 per year. For USC fertility, egg freezing includes storage up to the end of the calendar year. All in all, the total egg freezing cost for one round without insurance can be up to $16,000 or maybe more depending on geography.This cost will incur at the time that you are interested to begin the fertilization process and is also not included in the egg freezing costs. Thawing, fertilization, and embryo transfer can cost $5000 or more. There are many different pathways for IVF and each of these has a different cost associated with it. In a situation where IVF is associated with a diagnosis of infertility, many states will mandate partial or entire coverage. Your ovaries develop a single egg per month. The egg freezing medications contain hormones that will stimulate your ovaries to produce more so you can have several available for retrieval. Most women above the age of 30 prefer to freeze around 20-30 eggs to maximize their chances at pregnancy.  Without the additional hormones you would not yield a high enough volume of eggs so egg freezing without hormones is generally not done. Whether insurance covers egg freezing is dependent on the terms of your insurance. It is generally not fully covered by insurance. However, if you have diagnosed fertility issues or are undergoing treatments (e.g chemotherapy), there are high chances it will be partially covered. There are many people who have insurance that covers a specific portion of the treatment. Employer: Some employer provided insurances will cover anywhere from 1 to 4+ egg freezing cycles. For example 27% of tech companies provide insurance that will cover reproductive procedures like egg freezing. This is much greater than the 14 percent of companies of those not in the tech sector that will cover such costs. (2)State: In some states, it is mandated that healthcare insurance cover fertility procedures. However, the rules on what is covered for fertility treatments can vary from state to state. According to the American Society of Reproductive Medicine there are 9 states that mandate medically necessary egg freezing (3):CaliforniaConnecticutDelawareIllinoisMarylandNew HampshireNew JerseyNew YorkRhode Island Sources: 
4 min read

PGT Testing: What Is Preimplantation Genetic Testing In IVF?

Preimplantation genetic testing (PGT) is a way for people planning to have children through IVF (in vitro fertilization) to know if their embryos are at risk of a genetic condition prior to implantation for pregnancy. Types of PGT testingThere are three types of PGT, named for the type of genetic issue at hand: preimplantation genetic testing for aneuploidy (PGT-A, previously referred to as PGS), preimplantation genetic testing for monogenic disorders (PGT-M, previously referred to as PGD), and preimplantation genetic testing for chromosomal structural rearrangements (PGT-SR). Let’s get into what each of these means.In humans, each cell normally contains 23 pairs of chromosomes, for a total of 46. Twenty-two of these pairs appear the same in men and women. The 23rd pair is the sex chromosome pair and, thus, is different between males and females. Aneuploidy means an incorrect number of chromosomes being present in an embryo, and therefore PGT-A involves analyzing a sample of embryonic cells to determine whether it has the correct number of chromosomes (46). This approach helps identify embryos that are more likely to implant and turn into a healthy pregnancy. Embryos with an abnormal number of chromosomes will typically fail to implant, result in miscarriage, or result in fetuses with Down Syndrome, Turner’s Syndrome, or a handful of the other rare chromosomal patterns that increase the risk of birth defects and developmental delays but can still make it to live birth. Because males and females have different chromosomal makeup (46, XY versus 46,XX), genetic sex can also be identified through this type of testing. In short, PGT-A testing can help provide information on which embryos are most likely to result in a healthy pregnancy, and is particularly relevant as women age. While the majority of embryos created by a 30-year-old will likely have the correct number of chromosomes, the opposite is true by the time the late 30s are reached, and by the mid-40s, it becomes nearly impossible to obtain an embryo that tests normal by PGT-A.PGT-M screens for specific genetic mutations the embryos are known to be at risk of inheriting. This typically happens after one or both parents are found to be carriers of a relevant genetic mutations. Some genetic mutations, such as the cancer-causing BRCA1 mutation or the mutation causing Huntington’s Disease, can pose a risk even if only one parent has the mutation and passes it along (dominant inheritance). For the majority of genetic diseases in humans, both parents have to carry the same mutation and pass along the abnormal copies to the embryo for there to be a possible risk (recessive inheritance). Prior to PGT-M, even if you knew of a genetic risk, you could only find out if your child had an inherited genetic condition by undergoing amniocentesis in the second trimester, or by waiting after they were born. For a mutation with severe consequences, pregnancy termination could be considered if a diagnosis was confirmed by amniocentesis, but this is of course incredibly traumatizing for the family, and not always an easily available procedure. PGT-M allows you to learn about possible conditions in your child before you know anything about them, giving you the option of deciding whether or not you want to transfer an embryo that carries this risk.Finally, PGT-SR is performed if a parent is known to have a genetic translocation or inversion, meaning that their own chromosomes are arranged in a unique fashion. These genetic changes in a potential parent increase the chances of aneuploidy in their embryos, and thereby increase the risk of miscarriage. Therefore, if a genetic translocation or inversion has been diagnosed, PGT-SR can be performed.Being able to access this information sounds very exciting, but there can be risks as well. The risks of preimplantation genetic testing include:1. Technical error: Embryo biopsy can cause damage to the embryo, though in skilled hands this is incredibly unlikely.2. False positive/false negative results: In some cases, PGT will fail to detect a genetic disorder or give false positive results when there isn't actually any abnormality present at all. The rates of these false results vary by genetic testing laboratory.3. The chance that one of your embryos will be accidentally transferred instead of the tested embryo you wanted transferred. [not sure about including this, it’s not really a risk specific to PGT testing]4. Unclear guidance about what to do with certain embryo results. The biggest issue here is likely that of mosaicism, where certain embryos may have a mixture of cells with the correct and incorrect number of chromosomes. The risks of transferring mosaic embryos are still being researched, though likely the biggest risk is just that if the embryo primarily turns out have the genetically incorrect number of chromosomes, a miscarriage will likely follow. Embryos that may be able to turn into liveborn babies but carry certain genetic abnormalities may also be a gray area in what is considered ethical to transfer.Additionally, PGT testing is not a catch-all. There is no test that will 100% reduce the risk of genetic issues for one’s children. There are many genetic diseases that cannot yet be detected by PGT screening.When Is PGT recommended?PGT-A can be offered to anyone who desires this information and is undergoing IVF, however the increase in success rate attributable to using this technique will correlate positively with age. Typically more embryos are likely to be abnormal than normal by the mid-late 30s. That said, many couples desire having as much information as possible about their embryos, and will pursue PGT-A regardless of age. PGT-M or PGT-SR are offered and/or recommended only if at least one parent has a relevant genetic mutation that would render the technique relevant. Whether you decide to have PGT testing on your embryos is a personal decision, and it is always a good idea to discuss any concerns or questions about it with your doctor. 
5 min read
An embryologist fertilizes eggs in a laboratory

What Is Egg Freezing?

Freezing eggs is a decision that some women may want to explore based on their lifestyle or health. There are many questions that surround the process of egg freezing and it can leave many feeling overwhelmed. Today we answer the most common questions asked and we also go into detail on how the procedure is completed. If you or someone you know is interested in freezing eggs for future use, then read ahead. Freezing your eggs can be done for a number of reasons ranging from wanting to get pregnant later in life to having certain medical conditions. Egg freezing doesn’t require sperm, unlike embryo cryopreservation. However, it will require you to take fertility drugs to start the ovulation process so that your body will produce multiple eggs. Those that might want to consider egg freezing are:Egg freezing is not something you want to take lightly. The first step you want to do is find a fertility clinic that has experts in this matter. These experts are commonly referred to as a reproductive endocrinologist. Each clinic you look into should list their data of live births, pregnancies, and some will even include the ages of the women they treat. This information can be found on a clinic’s website, an in-person consultation, and the Society for Assisted Reproductive Technology has more information on the data surrounding US fertility clinics. Before you begin the freezing process, you will have to undergo various testing. These tests include:There are 3 steps to completing the egg freezing process. The first is ovarian stimulation, the second is the egg retrieval, and the third is freezing.Egg freezing doesn’t happen without any risks. There can be complications due to the procedure or fertility drugs. Some of these risks include:This will depend on your insurance company. Some will pay for medication but not the procedure or the testing. Others will pay for testing only. Overall, egg freezing isn’t covered by most insurances, but some will cover partial or full coverage if you suffer from a special circumstance such as cancer or early menopause. Those that don’t have insurance that covers this procedure or any insurance at all may find a fertility clinic that can help finance you, you can fundraise money, look into getting personal loans, or even some government and state grants can be applied for. The cost of egg freezing varies depending on a few factors. One factor is the clinic you choose. Each one charges their own prices for the services they offer, usually between $7,000 and $12,000 and that cost includes the medication, procedure, and testing. There is also variation of cost depending on which city you are freezing your eggs in.The storage fees will vary based on the clinic as well, but many charges somewhere between $500 to $1,000 a year. There is also no time limit on when you have to unfreeze your eggs, but keep in mind that if you intend to get pregnant, many clinics have cut off ages unless you plan to use a surrogate. It’s best to check with the clinic on their policies first.Another factor is how many rounds you may need to undergo. As you age, your body will naturally make fewer eggs so while someone in their early 20s or 30s may need 1 cycle, mid-30s and late 30s may need 2 or 3 cycles to get the necessary amount of eggs needed for freezing. This also can be affected by your egg quality as well. If you have poorer egg quality, you may need to do several cycles. Unfreezing your eggs when you feel it’s time to try for pregnancy can cost around $5,000 to $7,000.
7 min read

How Many Eggs Does a Woman Have?

Before anything else, here’s a bit of knowledge about female eggs. Immature eggs are called oocytes, which rest in follicles in the ovaries until they start maturing. Follicles are fluid-filled sacs containing an immature egg.  Oocytes will then grow to become an ootid, further developing to an ovum (the plural word is ova), or a mature egg. For now, I'll continue referring to them as eggs or oocytes. Female babies are already born with ALL egg cells they will ever have. There will be NO new egg cells produced throughout your lifetime. When a fetus is still early in development, it will already have 6 million eggs!  The number of eggs is reduced upon birth, so the female baby will have around 1-2 million eggs. If that’s the case, why don’t babies begin the menstrual cycle? This is because the cycle will be put on hold until girls hit puberty, which would begin after the hypothalamus in the brain produces the gonadotropin-releasing hormone. The hormone will stimulate the pituitary gland, producing follicle-stimulating hormones. This is what will initiate egg development, causing one’s estrogen levels to increase.  Once girls reach puberty, they will have around 300,000-400,000 eggs. But wait, that’s far less than the 1-2 million eggs estimated during birth! What happened? Before puberty, over 10,000 eggs die every month. With that in mind, the number of eggs dying each month will decrease after puberty. After they begin their menstrual cycle, girls will lose around 1,000 immature eggs monthly, or about 30-35 eggs a day. There is no known cause as to why egg cells die, but what’s sure is that it isn’t influenced by factors we can control. However, smoking is shown to accelerate egg loss, along with certain chemotherapies and radiation.  When follicles mature, they will become sensitive to hormones during your menstrual cycle. They won’t all be winners though, as only one egg will ovulate, at least.  When one reaches her 30s, the fertility rate will start decreasing, declining further as she reaches 37 years old. Once she's 40, she will have only about 3% of her pre-birth egg supply. As you hit your 40s and 50s, your fertility will begin to decrease because of the fewer eggs left. When you run out of egg supply, the ovaries will stop making estrogen, and this is when you go through menopause. The time menopause occurs depends on the number of eggs you’re born with. If you were born with more eggs, then you’ll still be able to have biological children naturally up to your late 40s! However, this also depends on the quality of your eggs, which would decrease as you age.  Learning more about the number of egg cells women have can be very helpful if you are trying to get pregnant (or avoid it). Now that you know more about it, you're equipped with the proper knowledge to discuss your options with your doctor.  
3 min read
Does Insurance Cover Egg Freezing?

Does Insurance Cover Egg Freezing?

If you think you might want to delay pregnancy and may decide to have babies in your 40s or later, egg freezing can be a great option. But, the high cost of the procedure can make you think twice. So, does insurance cover egg freezing? Though health insurance policies cover most of the infertility diagnosis and treatment costs, procedures like egg freezing are rarely covered. This is because egg-freezing is considered elective by insurance companies.  Let’s take a look at the cost of egg freezing and help you decide if it is worth it.   A single egg-freezing cycle costs between $6,000 and $10,000. This cycle takes about six weeks and includes initial tests, injections, and retrieval surgery, excluding the annual storage fee for frozen eggs. Egg storage fees start at $600 annually.  The total cost of egg-freezing can be broken down as follows:●     Treatment: $11,000●     Medication: $5,000●     Storage: $2,000 (For four years)The costs vary depending on your location. For instance, the cost of one cycle of egg-freezing ranges from $13,800 in Boston to $17,800 in New York City. And, since most women undergo the cycle twice, the total cost can reach up to $40,000. Although egg freezing is usually not covered by your health insurance, some plans cover it when done with medical reasons. In May 2018, the federal Access to Infertility Treatment and Care Act introduced a bill to mandate insurance coverage for fertility preservation. The bill aims to support patients who undergo fertility preservation procedures, such as egg freezing, due to medically necessary procedures such as cancer treatments. In addition, some parts of the process, such as a physician consultation, ultrasounds, bloodwork, and ovarian reserve testing, may be covered by several insurance companies. Only 16 states in the USA require insurance companies to offer coverage for infertility diagnosis and treatment. You’d be surprised to know that top companies, including Google, Facebook, and Apple offer egg freezing as a company benefit to their employees. You are advised to review your insurance plan or contact your insurance company to explain the coverage to you. A study conducted by Yale Medicine revealed that there is only a 3-5% chance to have a baby with egg freezing. However, doctors often collect multiple eggs, thus increasing the chance of late pregnancy. Women considering egg freezing should not rush with their decision. Choose this procedure without any pressure and after a long discussion with your doctor. In addition, you should carefully consider your reproductive goals, health, and overall costs involved. Success also depends on the age of the woman and overall health. The older you are, the lower are your chances of getting pregnant with a frozen egg. Does your insurance cover egg freezing? If not, don’t lose hope! You can consider other funding options. Talk to your financial advisor to find some alternatives. Many fertility clinics also offer payment options for egg freezing. You can even opt for crowdsourcing and borrow from someone close to you. Summing up all points, it is safe to say that egg freezing is worth considering if your health goals and budget allow.  
3 min read
infertility depression and dealing with infertility

Dealing with Infertility and Infertility Depression - The Impact of Infertility on Mental Health

The word ‘infertility,’ often brings to mind doctor’s appointments, medications, ovulation cycles, and financial burden. While it is often not discussed, the mental toll of dealing with infertility can be equally as great, and infertility depression is just one way that can present. According to the Mental Health Professional Group of the American Society for Reproductive Medicine1, the psychological impact of infertility can invoke significant feelings of loss in people experiencing it. Between the organization and the cost of medical treatments, physiological effects of procedures, and uncertainties about results, the mental health burden can be high. MGH Center for Women’s Health - Harvard Medical School2 cites, “A number of studies have found that the incidence of depression in infertile couples presenting for infertility treatment is significantly higher than in fertile controls, with prevalence estimates of major depression in the range of 15%-54%3. Anxiety has also been shown to be significantly higher in infertile couples when compared to the general population, with 8%-28% of infertile couples reporting clinically significant anxiety4.”The Mental Health Professional Group suggests speaking with a fertility counselor or mental health professional if you’ve faced any of the following symptoms for a prolonged period of time:The primary goal of a fertility counselor is to help individuals and couples navigate and cope with the physical and mental changes that are associated with infertility. This can include managing stress, navigating partner responses (particularly if you and your partner have different outlooks and approaches to infertility), feelings of resentment about procedures and societal expectations, alternative family planning, and more. A counselor is trained to aid clients in honing existing coping mechanisms, discovering new strategies, implementing new methods, and maintaining healthy mental states while on the infertility journey. Keep in mind that many practitioners are able to practice telehealth, and counseling may be available over the phone.Finding a mental health professional comes with a few recommendations. The Mental Health Professional Group recommends that a practitioner should:Outside of finding a fertility counselor, reproductivefacts.org 5 has provided a list of coping mechanisms to use, for any persons or couples experiencing the challenges infertility brings. “Get accurate and current information to reduce anxiety. Utilize reliable sources such as the CDC, WHO and ASRM to ensure fact-based, scientific information. Sadly, nearly 1 in 8 couples experience infertility, according to the CDC. This breaks down to about 6% of married women ages 15 to 44 who have been trying to get pregnant for over a year. Men are affected as well with about one-third of infertility cases are caused by male reproductive issues. The remaining two thirds are split between female reproductive issues, and by both male and female reproductive issues or by unknown factors.6   Sources:
4 min read
Adenomyosis And Fertility

Adenomyosis And Fertility

It is controversial whether adenomyosis and infertility are linked because there are several medical factors that can contribute to infertility. For example, a patient commonly can have both endometriosis and adenomyosis at the same time. Let’s start by differentiating the two conditions.   Adenomyosis is a benign condition in which tissue from the endometrial layer (innermost layer of the uterus) grows into the muscular layer of the uterus. This causes the uterus to abnormally grow or thicken. Risk factors for adenomyosis include having multiple pregnancies, miscarriages, abortions, overgrowth of the endometrial layer, endometriosis, and a history of uterine surgery [1,2]. It can cause painful and prolonged bleeding during periods, irregular bleeding between periods, chronic pelvic pain, and possible infertility.  Read more about adenomyosis here.   Endometriosis is when the endometrial layer grows into other areas of the body that are outside the uterus, such as the fallopian tubes, ovaries, and even bowel. Endometriosis causes similar symptoms to adenomyosis and it is shown to cause infertility. In fact, almost 4 in 10 women with infertility have been found to have endometriosis [3].   Studies have shown that there is an association between adenomyosis and endometriosis in terms of the disease process [4,5], which is why adenomyosis is an important factor to consider in potential causes of infertility. Endometriosis has been shown to cause infertility in patients, though studies have not readily confirmed if adenomyosis alone can cause infertility, and studies that are available have only been done on small numbers of cases [1,6]. This poses the question of whether infertility is caused by endometriosis, adenomyosis or a combination of the two. Another factor to consider is that an increased number of women are attempting to conceive at later ages, now in their 30s and 40s, and infertility rates may be due to decreased ovarian reserve (egg supply) as the result of older age, adenomyosis or endometriosis, or a combination of the above [1,7,8]. Various studies have shown that, in general, adenomyosis alone may be associated with a decreased reproductive potential [1,9]. Additionally, adenomyosis is thought to be associated with increased pregnancy complications such as miscarriage and preterm birth [1,6]. Interestingly, patients who have pursued assisted reproductive technology (ART), including procedures such as in vitro fertilization or frozen embryo transfer, have been found to have a higher incidence of adenomyosis compared to the general population [9]. In addition, treatment of adenomyosis has been shown to improve fertility [1]. These associations demonstrate there are multiple factors involved in a potential link between adenomyosis and infertility, though a clear association has not yet been fully established.       Adenomyosis and its association with infertility is still being studied. There is various conflicting data, most of which state that it is hard to determine the exact prevalence. One study showed that in a group of patients with infertility, 24.4% of those older than 40 years of age had adenomyosis and 22% of patients less than 40 years of age had adenomyosis [10]. Patients seeking assisted reproductive technology notably have a higher incidence of adenomyosis than patients who have not sought reproductive assistance. Some reports show it to be as high as 70% of patients with adenomyosis are infertile [9]. However, another study showed that in patients who were infertile with dysmenorrhea (but did not have endometriosis), 53.8% had adenomyosis [11]. Another study’s results suggested that 24.4% of people with adenomyosis were infertile [8].    There are treatment options available for patients who want to conceive despite having a history of infertility. These include conservative surgery (such as removing the focal adenoma or surgical removal around the uterine wall) [9], hormonal therapies, and even a combination of both. In fact, studies demonstrate that patients who are treated with hormonal therapy before assisted reproductive technology have a higher pregnancy rate [7,9]. A collection of studies showed that 47% of patients with adenomyosis who received treatment were able to become pregnant (including natural conception, surgical intervention, and/or with ART) [7]. In these studies, most of the patients were at an advanced maternal age, with a median age of 38 years.For younger patients with adenomyosis, who typically have a higher ovarian reserve than that of older patients, pretreatment with hormonal therapy before natural conception is recommended. In older patients with less ovarian reserve, immediate combination ART with hormonal treatment can be used as a first-line approach. There is limited evidence for improved outcome after surgery, and it generally should be an option for patients who failed ART. If you are concerned that you have adenomyosis, have a diagnosis of adenomyosis and would like to become pregnant, or have other questions regarding fertility, it is recommended to consult your physician so you may work together to find a treatment plan that is best for you. Authors: Dr. Erika Aragona, Srijaa Kannan Sources:
6 min read

Peak Ovulation: 5 Ways to Track Ovulation Effectively

If you are trying to conceive, tracking your peak ovulation period is helpful to know when you are most fertile.  With that in mind, how can you monitor when you ovulate? These are the top 5 ways to track your ovulation: 1. The Calendar Method to Find Peak OvulationThis is a suitable method for those who have regular periods and if their menstrual cycle usually occurs during the same number of days every month. If that’s the case, it’s safe to say that you ovulate every two weeks before expecting your period. However, this may vary based on one’s individual menstrual cycle. For those with 35-day cycles, you may ovulate on the 21st day.  This isn’t best for those who have irregular periods.  But if you are thinking of using the calendar method, there are ovulation tracking apps and online calendars to keep you in check. (https://www.womenshealth.gov/ovulation-calculator) 2. Basal Body Temperature ChartingThis method involves taking your temperature the moment you wake up, even before getting out of bed.  When you maintain a chart of your basal body temperature throughout your menstrual cycle, you may be able to detect a sustained temperature increase, which can indicate you finished ovulated. In certain cases, this method might even hint whether or not you have conceived, using the “implantation” dip. 3. Ovulation Predictor KitsOvulation predictor kits are similar to pregnancy tests, as they are urine tests showing specific color patterns. It shows when the luteinizing hormone levels rise, which indicates that you will start ovulation within the next 12-36 hours. (https://medlineplus.gov/ency/article/007062.htm) When the test predicts ovulation, it's best that you have sex daily for the next few days if you would like to try conceiving. I recommend that you take these tests on consecutive days to detect the LH surge accurately. When testing for more than five days, there’s an 80% chance of predicting ovulation accurately. If done for more than ten days, it rises to a 95% chance. There are computerized fertility monitors that work like ovulation predictor kits, but they are more precise and can detect ovulation earlier. While extremely accurate, it’s quite a pricey option. 4. Cervical Mucus ChangesThis method isn't for all women, but it gives you a good idea of when you're ovulating. During your time of ovulation, one’s cervical mucus is thin and clear, having similar appearance and consistency to raw egg whites. This is compared to the usual creamy and sticky consistency! The reason for its thin and clear mucus is to allow sperm to pass through your cervix during sex, providing sperm a more alkaline environment for them to thrive.  This method is best used with BBT charting for more accurate results. 5. Saliva Ferning TestsSaliva testing is another way to detect ovulation, and a cheaper option compared to using ovulation predictor kits. The method works through highlighting crystal formations that develop in saliva as you ovulate. During your most fertile period in the menstrual cycle, your saliva will have chemical changes. When the saliva dries, there is residue, which shows fern-like crystals you don’t see in other stages of the menstrual cycle.  The test kit has a lens where you place a drop of saliva, and after five minutes, it will show if the crystals develop. If so, then ovulation will most likely happen within 24-72 hours. As long as you have no underlying reproductive issues, then using one of these peak ovulation tracking methods can help increase the chances of conception. But if you would like to use these to prevent pregnancy, it’s best to talk with a medical professional regarding reliable birth control options.
3 min read

Discharge Changes When You Ovulate: What to Know

A woman's body produces many fluids (that are totally normal), and cervical mucus is one of them! Also known as discharge, it usually comes in different forms throughout the menstrual cycle.  If you’re trying to get pregnant, you can track your discharge to learn more about your cycle and know when you’re ovulating, the time you’re most fertile. But how will you know if you’re ovulating based on your discharge? Read on to learn about the different  Are you already tracking your basal body temperature (BBT)? Then you might want to accompany it with cervical mucus tracking.  Your BBT will identify if you ovulated only after it happened. But tracking your cervical mucus changes can tell you when you’re about to ovulate, which can help you time sex to conceive successfully.  When ovulation is approaching, your discharge would change to a sperm-friendly consistency. After ovulation, your hormone progesterone will cause discharge to become sticky and thicker, stopping sperm from getting through your uterus. (https://www.hhs.gov/opa/reproductive-health/fact-sheets/vaginal-discharge/index.html) While all our bodies are different, these are the general changes in your discharge:             1.         Menstruation            2.         Dry or sticky consistency            3.         Creamy-like lotion            4.         Wet and watery            5.         Raw egg white consistency            6.         Dry or sticky consistency            7.         Then back to menstruation, with the cycle repeating.  When the mucus is wet and watery or in the raw egg white consistency part, then ovulation is coming. This would be the best time to have sex for more chances of a successful conception.  When checking your cervical mucus, follow these steps: 1. Wash and dry your hands or wear gloves. Make sure they are clean before touching your vagina to prevent any infections. 2. Sit on the toilet, squat, or stand up with one leg on the toilet seat, whichever position is most comfortable.  3. With your index or middle finger, reach inside your vagina carefully, making sure you don’t scratch yourself. Reach until you get a sample nearing your cervix. 4. Remove your finger and check the consistency of your cervical mucus. You can do this by looking at the mucus, rolling it between your finger and thumb. Press your fingers together, slowly separating them. 5. You can refer to the different discharge changes above and mark it down on your chart for accurate ovulation monitoring. While you can make your own handwritten chart, you can also use a mobile app for tracking and monitoring.  (https://www.med.unc.edu/timetoconceive/study-participant-resources/cervical-mucus-testing-information/) Here are some extra tips when checking your cervical mucus:             •           Do NOT check your discharge during or right after sexual intercourse. You won’t be able to tell the difference between arousal fluids, semen, and cervical mucus.            •           You can also check your discharge looking at your underwear or toilet paper after wiping. This is a good alternative if you feel uncomfortable putting your finger inside.             •           Never try to wash away your body’s natural fluids, using methods like douching. These fluids are normal and healthy, and if you use various cleaning methods, it can do more harm than good. If ever you don’t get fertile-quality cervical mucus, let your doctor know. This may be a problem with hormones or fertility, or it can be due to some medication you’re taking.  Wrapping It UpIt’s good to track your discharge changes when you ovulate, which can help you learn more about your fertility cycle. While it does take a bit of time to learn how to track it, you’ll be able to recognize your discharge changes and cycle more. That way, you have another powerful tool to help you conceive!
3 min read
fertility by age

Fertility by Age

 Fertility changes with age for both men and women. However, men’s fertility decreases to a lesser extent compared to women’s.  So, what is the change in fertility by age? For women, the peak reproductive period is between the late teens and late 20s. Fertility starts to decline as we reach 30, and it drops even faster once you reach your mid-30s.  After crossing 45 years of age, women’s reproductive potential has declined so much that getting pregnant can become difficult or lead to complications.   According to a PLoS One study, by age 35, women are only 12 percent likely to get pregnant within a specific three-month period, and by age 40, that number declines to 7 percent. Fertility decreases with age because both the quality and number of eggs gets lower. An egg is transferred from the ovaries to the womb every month after puberty to menopause. When sperms bind with the egg in the womb, you get pregnant.  A woman’s body does not make new eggs every month. Instead, women are born with all the eggs they ever have. As you age, eggs get older naturally and progressively. This decline is gradual until early 30 but accelerates after the mid-30s.  Older mothers often face difficulties like stillbirth, miscarriage, and babies with health issues. Such women are more likely to have a higher risk of complications, such as preeclampsia and gestational diabetes. Pregnant women aged 40+ years develop a higher risk of preeclampsia. It is because they tend to have more health issues before getting pregnant compared to younger women. Regardless of this, studies have shown that older women can still have complicated pregnancies solely due to the age factor even without any health conditions.  Late childbearing is troublesome not only for the mother, but for the baby also. It increases the risk of having a baby with damaged, missing, or extra chromosomes. Down syndrome is one common chromosome issue associated with later childbearing.   The success rate of infertility treatments like IVF, egg freezing, and other fertility treatments is lower among older women than in younger women. On top of that, these could impose the risk of mental and physical health problems, especially if you already have a medical disorder, like diabetes or high blood pressure. But, it does not mean you cannot get pregnant. Despite the challenges mentioned above, many women aged above 35 years and even 40 years have healthy pregnancies and babies. We just said that chances are less, but it’s not impossible.  Ideally, you should consult with a reputed gynecologist and fertility specialist and discuss your condition with them transparently. Seeing professional health care and receiving good prenatal care while you are pregnant can help a lot.   Women’s reproductive potential progressively declines as women get older. But, the time and rate of decline vary widely in women. If you age 35 or above and want to get pregnant, you should obtain information and appropriate treatment while being realistic about everything.  By learning about your options, you will be in a better position to make the right decision.
3 min read
Online Fertility Calculators

5 Online Fertility Calculators You Can Use Today

If you’re trying to conceive, then one of the things you should begin doing is to understand your body and its cycles. This means tracking your menstrual cycle and days you ovulate. One way to do that is using an online fertility calculator. Today’s technology has made it even easier to track your ovulation, showing your most fertile days for higher chances of conception.  But of the many different mobile apps and online tools we can use, which are the best fertility calculators and trackers? Read on for the top five choices and reviews! 1. Clue Period Tracker, OvulationThis free mobile app takes the clue and guesswork out of your cycles, hence the name. This period tracker app utilizes research and science to help you conceive.  It comes with an ovulation calculator with fertility predictions, as well as a platform to log in your basal body temperature, giving you more useful information. 2. Glow Cycle and Fertility TrackerWhat’s great about the Glow Cycle and Fertility Tracker is that it doesn’t only provide an ovulation calculator, but a tracker as well.  You can track your cycle and record sexual activity, any symptoms experienced, as well as your daily moods. All these can improve your chances of conception! This is a free mobile app that has garnered many positive reviews thanks to its accuracy and ease of use. 3. Clearblue Ovulation CalculatorThe Clearblue Ovulation Calculator is a great online tool that shows when you are most likely to ovulate. Simply put in the date your last period began, and your usual cycle length.  The website will also show you more information regarding your ovulation calendar results. They have a Frequently Asked Questions section below the calculator, sharing basic and useful information on fertility. 4. Tommy’s Ovulation CalculatorTommy's is an organization centered on women, tackling pregnancy-related research and information. Their website offers a straightforward ovulation calculator that shows accuracy and quick results.  What makes them a suitable online tool is how easy it is to use and understand the results. They will also show different useful information right after, such as the best times to conceive, how the menstrual cycle works, and spotting the signs of ovulation 5. Office on Women’s Health Ovulation CalculatorThe Office on Women's Health provides a variety of tools you can easily access online, including their ovulation calculator. It's very easy to navigate the website, and the ovulation calculator is straightforward, sharing what the tool is about.  Put in the start date of your period and average length of your menstrual cycle, then you’ll get instant results. You can also learn more about your fertility with their other tools, and articles to help you conceive or find a suitable birth control method. With all these tools in mind, they are best used as a basis of your ovulation, but shouldn't be the sole method to track your cycle. These tools help you know more about your cycle and the approximate times you'll ovulate, but every woman's body is different, despite having a similar period start dates and menstrual cycle lengths. For a more accurate basis, there are other ways you can track your ovulation alongside these free tools. There are ovulation tests, among other methods to help you know more about your body. Wrapping It UpTracking your ovulation and fertility doesn’t need to be so challenging, as there are online tools you can use on your phone! Not only will it assist you in tracking your cycle, but they also hold useful information for conception, birth control, among more valuable advice for women.  Begin using any of these fertility calculators today and good luck!
4 min read
Questions to ask Fertility Doctor

5 Questions to ask Fertility Doctor

Social media, the internet, and even friends and family may make pregnancy seem like a simple task. But for some, pregnancy doesn’t come so easily.Approximately 12% of women between the ages of 15-44 have issues with their fertility. Males are the partner with an identifiable cause of infertility in about 8% of all heterosexual couples who are seeking help with having a child. (CDC.gov)When do you have to visit a fertility specialist? How do you know what to expect? And what Questions to ask Fertility Doctor?Fertility in women decreases with each year of life, with a more dramatic decline beginning at age 35. According to the ASRM, a healthy woman in her 20s or early 30s has a 25-30% chance of conception each month. By the age of 40, chances are 10% or less. Experts suggest that if a woman is under 35, she should try to conceive for one year. If unsuccessful, it’s time to visit a fertility specialist. This recommendation changes with women who are over 35 - the window to try and conceive is 6 months before speaking with a specialist. A prospective parent should also visit a specialist if they have a history of miscarriages or a family genetic history that may impact pregnancy.Trying for a baby can be a challenging experience if it doesn’t come as easily as the world makes it out to be. Visiting a specialist may seem like a stressful or daunting experience, but it doesn’t have to be negative.We’ve compiled a list of the five questions you should ask on your first visit, so that you can feel empowered, in control, and confident about the path you’re about to take.So many factors impact fertility. Some issues aren’t within a person’s control, such as anatomical abnormalities, endometriosis, genetics, and aging. Other contributing factors to fertility are more manageable by the person trying to get pregnant, like smoking, alcohol usage, weight gain or weight loss, emotional stress, caffeine intake, sleep, and nutrition. A fertility specialist may be able to recommend lifestyle changes that increase fertility. Be honest about your habits - it allows a specialist to get a big picture and details about your life and make the best recommendation for you.A doctor may ask if you’ve tried certain methods to aid conception - timing sexual intercourse to fall within the right time in a menstrual cycle, basal temperature measurements, and monitoring ovulation.It takes two to create a baby - and tests should be run on both prospective parents to navigate the best treatment. A thorough medical history is the first step in recommending testing.A fertility specialist will ask a wide range of questions: both partners’ medical histories, family histories, occupations (some are more high risk than others), previous sexual relationships, forms of birth control used in the past, smoking, alcohol and drug usage, any history of sexually transmitted diseases and more. Be honest! Once again, this gives the fertility specialist an idea about what direction to take testing and treatment, if they are needed.Testing may include any of the following (or more):Each treatment takes into account the health of the parents, their anatomy, their hormones, age, and whether the pregnancy will be viable. Sometimes one person needs treatment. Sometimes both do.Some treatments include:Make sure to ask your doctor what the rate of success is for each procedure. Some treatments may be better for you than others, and success rates may vary.Fertility treatments can be expensive, both emotionally and financially. Insurance does not always cover fertility treatments. Unfortunately in the United States, many procedures are considered elective. Ask your doctor how much various procedures will cost, whether insurance will cover them, and how their payments are paid (installations or at one time). Don’t forget to verify this with your insurance company after your appointment! Without insurance IVF can cost anywhere from $5,000 to $15,000 per cycle.You may want to consider the success rate of each procedure as you evaluate the financial cost that these treatments may set you back. Talk to your doctor about what the best recommendation is and how your finances may tie into those options.What does our process look like from here?Going to a fertility doctor may be stressful, upsetting or uncertain. But going in informed, being honest about your health, and asking questions can soothe any nerves you may have about this sometimes-daunting process. Your doctor should be able to go over a plan with you so that you leave the appointment feeling content about how your future will look as you try to conceive.
6 min read

How to know if you have PCOS or Polycystic Ovarian Syndrome?

PCOS is also known as Polycystic Ovarian Syndrome. It is a hormonal imbalance that occurs in some women and adolescent girls. The condition is so common, up to 10% of all women may have PCOS. (Dumesic, Daniel A et al. )That means that one in every 10 girls or women have PCOS. So for example, if there is a room of 100 girls, 10 of them will have PCOS. Girls with PCOS have problems with their period. Some girls have no periods, whereas others can have very frequent periods. If your period happens more often than every 21 days or less often than every 45 days you should see your doctor as this can be a sign of PCOS. Some girls can go a year or more with no periods. It is important to understand, however, that menstrual periods can be irregular for up to two to three years after a girl starts having her period. Most physicians will wait to diagnose PCOS until a girl hs had her period for at least 2 years before saying it is irregular. (Legro, Richard S et al. Girls with PCOS can also have increased hair on their bodies in places that girls and women do not like to have hair such as their face, stomach, chest and lower back. Some girls with PCOS can also have severe acne. Girls with PCOS can also have a harder time losing weight or can gain weight more easily. Girls and women with PCOS also can have a higher risk of developing high blood sugars or a condition like Type 2 diabetes. Some girls with PCOS can also have feelings of sadness, anxiety or depression. If you are diagnosed with PCOS, this does not mean that you have “cysts” on your ovaries. Girls with PCOS usually have normal looking ovaries but they may look slightly bigger than normal. The enlarged ovaries usually do not cause any pain.Doctors don’t know the exact cause of PCOS but it is thought to be genetic, meaning that someone in the girl’s family most likely has PCOS as well but this is not always the case. In PCOS, there are specific hormones called androgen hormones that are higher than normal. One of these androgens is called testosterone and it is higher than normal. This imbalance in androgen hormones can cause the periods to be irregular because these hormones can prevent an egg from being released from the ovary every month. The higher testosterone level can also cause girls to have an increase in facial and body hair and can cause acne.
Usually your doctor will talk to you first about your symptoms and family history. Then they will want to do a physical exam. They will usually want to order some blood tests to help figure out if you have PCOS. Sometimes, an ultrasound of the ovaries is done to help understand if you truly have PCOS.The treatment of PCOS is geared towards what specific symptoms you have and what is bothering you the most. If you have irregular periods, usually the first line treatment is birth control pills. Many of the symptoms of PCOS like irregular periods, acne and frequency of growth of hair on the face and body can be controlled with birth control pills. You may also need to be treated by a dermatologist or laser specialist for acne and hair growth.For girls that are overweight, doctors will recommend weight loss with diet changes and exercise to prevent further weight gain or to start a weight loss program.Exercise and weight loss sometimes can help periods become more regular and they can help prevent diabetes. Exercise is also help with mood symptoms including anxiety and depression. Another commonly prescribed medication is metformin which is a medicine used to treat diabetes. Sometimes at higher doses of this medication, menstrual periods can return to normal.( Legro, Richard S, et al).Once girls are treated for PCOS, they generally are very well controlled. Girls and women with PCOS may be an increased risk of developing type 2 diabetes in the future. They may have a hard time getting pregnant in the future but this is not always the case. Girls and women should still use birth control pills to help prevent unwanted pregnancies if they are sexually active.Your doctor is always a good resource if you have other questions.Dumesic, Daniel A et al. “Scientific Statement on the Diagnostic Criteria, Epidemiology, Pathophysiology, and Molecular Genetics of Polycystic Ovary Syndrome.” Endocrine reviews vol. 36,5 (2015): 487-525. doi:10.1210/er.2015-1018Legro, Richard S et al. “Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline.” The Journal of clinical endocrinology and metabolism vol. 98,12 (2013): 4565-92. doi:10.1210/jc.2013-2350Witchel SF, Oberfield SE, Peña AS. “Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls. J Endocr Soc. 2019 Aug 1;3(8):1545-1573. doi: 10.1210/js.2019-00078. eCollection 2019 Aug 1. Review. PubMed PMID: 31384717; PubMed Central PMCID: PMC6676075.Carmina E, Oberfield SE, Lobo RA. The diagnosis of polycystic ovary syndrome in adolescents. Am J Obstet Gynecol. 2010 Sep;203(3):201.e1-5. doi: 10.1016/j.ajog.2010.03.008. Epub 2010 May 1. Review. PubMed PMID: 20435290.
5 min read
Egg Freezing Process

Egg Freezing Process

Here are the essentials to know about the egg freezing process.Egg freezing, or “oocyte cryopreservation,” is a rising trend amongst womxn to preserve fertility. Eggs, or oocytes, are drawn out through ovarian stimulation and frozen, using cryoprotectants (which keep the egg from developing ice crystals and impacting critical proteins). These eggs can then be used in combination with sperm during an IVF procedure to have a child. First, you’ll make an appointment with a fertility clinic - specifically, a reproductive endocrinologist. They may order a few tests:Next, you’ll undergo ovarian stimulation. Typically, ovaries produce one egg a month. During the egg freezing process, a doctor may prescribe injectable drugs to stimulate your ovaries to produce more eggs. They may also prescribe an injection that prevents premature ovulation.You’ll be monitored throughout the process. Blood tests are usually required either daily or every other day so that the doctor can monitor hormone levels. An ultrasound is also done several times a week so that the ovaries can be observed and the development of follicles (fluid-filled sacs where eggs develop) can be monitored. The whole process typically lasts around 2 weeks and is individual based on how your body reacts to the medications.After 10-14 days, depending on your cycle, an injection of human chorionic gonadotropin or another medication may be given to help eggs mature.Egg retrieval is done under sedation. You’ll go into your doctor’s office, be sedated, and, commonly, a transvaginal ultrasound locates the follicles on the ovaries. A needle and suction device are then guided through the vagina to the follicle, where eggs are removed. The more eggs, the better the chances of future success.Eggs are then frozen through a process called vitrification, which prevents ice crystals from forming and damaging the proteins inside the egg through the use of cryoprotectants. (Mayo Clinic)According to this article on the NCBI, “The American Society for Reproductive Medicine - Society for Assisted Reproductive Technology practice guideline estimates that the survival rate of oocytes after vitrification and thawing is 90%–97%, the fertilization rate is 71%–79% and the implantation rate is 17%–41%. The clinical pregnancy rate per vitrified and thawed oocyte is 4.5%–12%.” The American Society for Reproductive Medicine has stated, “Embryos from previously vitrified oocytes show rates of fertilization, implantation, and clinical pregnancy that are comparable to those for embryos from fresh oocytes, although there can be variation among clinics.”It is critical to speak to a few different fertility clinics and doctors, learn about their procedures and processes, and hear about their rates of success. It’s also critical to note whether facilities keep their eggs on-site, whether they freeze them elsewhere, whether there are storage costs associated with the egg freezing, and how long the eggs are kept for.Egg freezing has increased amongst womxn in the United States for a few reasons. According to the American Society for Reproductive Medicine, the rate of first births to womxn between the ages of 35-39 has risen since the 1970s, and is currently at a plateau. The rate of first births to womxn between 40-44 has increased since the 1980s. This can be attributed to socioeconomic factors, education levels, societal norms, and more, but an important takeaway is that the period of career advancement in a person’s 20’s and 30’s often coincides with their most fertile years.The Cleveland Clinic states, “Egg freezing is a newer technology, but it is no longer considered experimental and may be an ideal option for young women, women without a partner, or patients who have personal concerns about embryo freezing."Other reasons for freezing your eggs can include cancer treatments which may affect fertility, illnesses such as lupus, gender diversity, and more.Some of the limitations of egg freezing include cost and insurance coverage. Learn more about if egg freezing is covered by insurance here.According to this article from the American Society for Reproductive Medicine, there are a few elements of egg freezing that have yet to be studied.Data on long-term safety and efficacy of oocyte cryopreservation aren’t complete yet. The process was approved within the last fifteen years, and enough time hasn’t passed for significant numbers of womxn to take on the process, have children, and observe those children to recognize whether there are negative effects from the process.In addition to physically putting one’s body through large hormonal shifts, as well as the emotional changes one may experience, there are additional aspects to consider. The financial burden of egg freezing, particularly if it isn’t covered by insurance, can be considerable. After a person has paid for the procedure itself, there is also a yearly storage fee, which can be close to $1,000 a year. Additionally, a person may want to evaluate how they may feel if the oocytes are never used, such as if they are able to get pregnant naturally or change their minds about childbearing. In addition to never using them, it’s important to think about how you may feel about destroying the oocytes if they are never used. Destruction of any oocytes may present a moral dilemma for some.
5 min read
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