What to Expect at the Initial Infertility Visit

Once you schedule an appointment with a fertility specialist like IVF Plano’s Dr. Jim Douglas, you may feel nervous about the visit. Usually, this appointment will take about an hour. Preparing in advance can ease your concerns and help you make the most of your time with the doctor and staff.

Gather all the information

Make sure to have your medical records sent to the clinic before your appointment. Because doctors’ offices receive multiple requests for this type of information, follow up to ensure that your records arrived in the clinic. Some patients request an additional copy of the records and bring them to the appointment.

It takes two

If possible, your partner should join you for the first visit. Not only will it help to have another set of ears to absorb critical information, but any plans will affect your partner, so the decisions should be made as a couple.

Make a list of questions

You will likely have lots of questions for the fertility specialist. It will probably help to prepare a list ahead of time so that you don’t forget anything important.

Consider the financial aspect

Once you have met with the fertility specialist and developed a plan for moving forward, you will probably want to discuss the payment policies with the financial office. It will expedite the process if you bring current insurance information and contact your provider in advance to find out about coverage levels. You and your partner may want to discuss how you plan to cover the additional costs.

Don’t let fertility issues keep you from starting or expanding your family. Making a first appointment with a qualified fertility specialist like Dr. Douglas can start you on the path to parenthood.

For more information, please visit www.ivfplano.com. To schedule a consultation with Dr. Douglas, contact our office.

Giving Nature a Hand

During ovulation, a mature egg is released from the ovary and then travels down the fallopian tubes towards the uterus so that it can be fertilized by the male partner’s sperm. Certain ovulatory disorders like anovulation, PCOS, and other infertility issues can disrupt the normal process. Without ovulation, you can’t achieve pregnancy.

After completing your fertility workup, Dr. Douglas may suggest Clomid as a first line treatment for ovulation issues. Through various hormonal mechanisms, Clomid increases production of LH and FSH, hormones required for ovulation, to foster a mature ovarian follicle and the release of the ovum. Generally, patients take Clomid for about five days at the beginning of a cycle. Actual dosage and length of use will depend on the patient’s specific case.

Like all medications, Clomid can have some side effects. The most well-known is an increased chance for multiples in a pregnancy. Clomid users have up to a 10 percent chance of twins as compared with 3 percent in the general population.

For the best results, Dr. Douglas typically only prescribes Clomid for three to six cycles before other treatment options are considered. Pregnancy rates with Clomid drop off dramatically after this point. If Clomid doesn’t work, Dr. Douglas may suggest other therapies such as intrauterine insemination (IUI) or in-vitro-fertilization (IVF).

Wanting a baby and not having success with that goal can feel frustrating. Dr. Douglas and the team at IVF Plano can help find the right therapy, including Clomid, to increase your chances of becoming pregnant.

For more information, please visit www.ivfplano.com. To schedule a consultation with Dr. Douglas, contact our office.

“When you’ve experienced the heartbreak and frustration of infertility, you know the importance of finding a good fertility specialist,” says one mother of two who experienced infertility. “You can search the Internet, ask friends and family, and seek referrals from others who have had trouble getting pregnant, but I wanted to know which specialists other doctors recommend.”

Dr. Douglas, of IVF Plano, earned the Top Doctor™ award in 2006 and again in 2011. He was nominated by his peers and then evaluated by a panel of physicians and researchers to make the final cut.

By the numbers: The 2011 compilation includes 27,000 physicians from cities across America. Of the 4,000 reproductive endocrinologists (fertility specialists) practicing in the U.S., only 293 earned the Top Doctors™ designation.

Finding America’s Best Fertility Doctors

When doctors refer patients to a fertility specialist, they choose someone reputable; someone they know provides excellent diagnostic and patient care. Castle Connolly Medical LTD accepts peer nominations and amasses the names of these recommended doctors in its annual Top Doctors™ list.

“As a fertility specialist, I work closely with ob-gyn doctors and urologists every day and feel honored every time I receive a referral,” says Dr. Douglas. “This national recognition is especially meaningful to me and every member of the IVF Plano family because it affirms our commitment to excellence.”

Housed on the Texas Health Resources’, Plano campus, IVF Plano treats men and women dealing with the physical and emotional crisis of infertility. Dr. Douglas specializes in advanced reproductive technologies such as in-vitro fertilization (IVF), surgical treatment for infertility, and male infertility.

About IVF Plano

For over 20 years, Dr. James Douglas and the team at IVF Plano fertility clinic have served the Dallas area, offering advanced diagnostic tools, the latest treatments for infertility, and exceptional pregnancy rates. Dr. Douglas has helped thousands of patients in the Plano, TX area achieve their goals of starting or expanding their families. For more information about the clinic, please visit www.ivfplano.com

If you hope to get pregnant in 2012, achieving the commonly cited goals of getting fit, quitting smoking, eating right and drinking less alcohol can actually contribute to your chances of success.

With all of the worthy goals to reach for, there’s just one resolution that fertility specialist Dr. James Douglas wants you to focus on this year: “I will resolve this fertility crisis.”

Resolving Infertility

The first step in overcoming infertility is seeking help. In fact, 80% of patients who partner with a fertility specialist go on to get pregnant.

The journey that you are on, however, is not predictable. There is no guarantee that this month, or the next, will deliver the results you deserve to hear (“the test is positive!”). That’s why Dr. Douglas often counsels his patients to live each day with the end result in mind. Don’t focus on the day-to-day appointments and failed cycles.

Instead, remember that if you dream of becoming a parent, there’s never been a better time to pursue infertility treatment.

We will uncover the cause of infertility preventing your pregnancy, and prescribe the treatment most likely to result in a baby. That may involve in-office intrauterine insemination, or more complex and time-tested in-vitro fertilization (IVF). We can help couples overcome male infertility with ICSI, or discuss donor egg or donor embryo options for women of advanced maternal age or anyone experiencing premature ovarian failure.

Get Help to Achieve Your Goal

The IVF Plano Patient Resources page provides a list of organizations and online tutorials to help you achieve your goal of getting pregnant without sacrificing your health and wellbeing to the arduous process.

In fact, one of the non-profits that IVF Plano recommends is Resolve, The National Infertility Association. As the name implies, Resolve is committed to helping couples struggling with infertility find resolution. Local chapters offer support groups and national efforts focus on promoting reproductive health and ensuring equal access to family building options.

Midway through January, the chances increase for settling into old routines. Many good intentions fall victim to this prophecy: “A New Year’s resolution is something that goes in one year and out the other.”

Trying to get pregnant is difficult enough without adding the pressure of a long list of resolutions. Instead, resolve to refuse to let one negative test define you. Resolve to be good to yourself and your partner. Resolve to see yourself as more than a fertility patient or statistic. Resolve to resolve your dreams of becoming a parent, whether by means of a biological child, donor services or adoption.

IVF Plano wishes you health, happiness and fertility in the New Year and beyond. If you have been trying for over 1 year, or 6 months if you are over 35, it’s time to book an appointment with a reproductive endocrinologist.

To schedule a consultation with Dr. Douglas, contact our office. For more information, please visit www.ivfplano.com.

Understanding the Risks with Multiples

Although many infertile couples would love to find out they were expecting twins, multiple births come with added joy, but also additional causes for concern. For example, twin delivers can be harder on the mother and babies; typically, twins or other multiples are smaller in size and may be more likely to experience health issues after birth.

Dr. Douglas works to ensure that our patients achieve healthy pregnancies, ideally with one developing fetus. These steps include:

Monitoring patients during fertility cycles

Sometimes, we will utilize ovulation stimulation to improve the odds of conception. If Dr. Douglas prescribes a medication like Clomid, we will carefully choose the dose and closely follow the patient’s progress. For intrauterine insemination (IUI), Dr. Douglas will perform sonograms to look for signs of ovulation. If too many eggs mature at once, he may recommend postponing the cycle.

Following SART guidelines for embryo transfers

The Society for Assisted Reproductive Technology (SART) has established standards that help fertility specialists determine how many embryos to transfer back into a patient’s uterus. These directives are based on patient’s age, embryo quality, and other factors.

Recommending single embryo transfers

In most cases, pregnancy rates with just one embryo are comparable to those with multiple embryos, but without as much risk for multiples. With preimplantation genetic screening (PGS) technology, Dr. Douglas can select the healthiest embryo to increase the chances of implantation.

At IVF Plano, we understand that your goal is bring home a healthy baby. Our infertility treatments and procedures are designed to help you safely succeed in this endeavor.

For more information, please visit www.ivfplano.com. To schedule a consultation with Dr. Douglas, contact our office.

Reasons Women Struggle to Conceive

If your doctor determines that female infertility issues are the reason you haven’t gotten pregnant, several problems may contribute to your struggles, including:

Ovulation Dysfunction

Women with ovulation disorders usually don’t release an egg, or they release the egg at the wrong time in the cycle to facilitate conception. Hormone imbalances, thyroid issues, body weight, and chronic illness can all contribute to ovulation dysfunction.

Blocked Tubes

The Fallopian tubes are the part of the female anatomy where the egg and sperm meet; then, the fertilized egg is moved into the uterus so that implantation can occur. When the tubes are blocked, it is nearly impossible for a woman to get pregnant.

Polycystic Ovarian Syndrome (PCOS)

With PCOS, follicles with eggs form but do not mature properly, so ovulation does not occur. Often, women with PCOS produce an excessive amount of testosterone and androstenedione.

Endometriosis

An estimated five million women in the United States suffer with endometriosis, a condition in which the uterine lining starts to grow outside of the uterus and causes adhesions. Doctors categorize endometriosis by stages, with Stage 1 being minimal and Stage 4 being severe.

Fibroids

These benign tumors occur when uterine muscle tissue grows into a mass. Though they rarely cause fertility problems, fibroids can grow large enough to get in the way of conception.

Physical Abnormalities

A malformation such as a septate uterus, where the uterus is divided into two areas, can make conception difficult or result in recurrent pregnancy loss. These kinds of issues are usually identified through ultrasound, hysteroscopic exam or a laparoscopy.

After discovering the issues preventing you from getting pregnant, your reproductive endocrinologist will come up with infertility treatment options to help you achieve your goal of starting or expanding your family.

For more information, contact us for an appointment, or visit www.ivfplano.com.

Unlike men, who replenish their sperm supply daily, women are born with a finite number of eggs. Female fertility peaks between ages 18 to 25. At 30 years old, a woman has a 20 percent chance of conceiving in a month. Once a woman reaches 40, her odds of getting pregnant each month drop to about five percent. Dr. Douglas, however, has the training and expertise to help you and your partner become parents.

Protecting Your Fertility

Although these numbers can seem disheartening, women do have options to achieve the families they desire. The following information will help you as you make decisions about your fertility:

Know your body
Even before you decide to start a family, you should have a complete physical exam. Ask your Ob-Gyn to check your hormones and look for any noticeable obstacles that could make conception difficult.

Know when to ask for help
If you have been trying to have a baby for a year and haven’t conceived, it’s time to visit a reproductive endocrinologist like Dr. James Douglas. Women over 35 should begin investigating their fertility after six months without success. Dr. Douglas can perform a complete fertility evaluation and look for causes of female or male infertility.

Know your options
Often, celebrity moms conceive thanks to the use of eggs from a younger female donor. If you are over 40 or have poor egg quality, Dr. Douglas may suggest exploring donor eggs as an option.

Knowledge is power. Understanding the truth about your fertility will enable you to plan for the future you desire.

For more information, please visit http://www.ivfplano.com/.

Oftentimes women who delay starting a family find that when they are finally ready, it is too late.  The news media has done these women a great disservice in printing stories about getting pregnant in your 40s or even 50s.  These articles usually fail to acknowledge that nearly all of these advanced age pregnancies occur with donor eggs provided by much younger women.

If a woman knows she will delay getting pregnant until her late 30s or beyond, an effective technology now exists to preserve fertility.
Freezing eggs (oocytes) and using them at a later date provides women the flexibility of waiting to conceive.
While the cryopreservation, or freezing, of sperm and embryos has been employed for decades in helping couples overcome infertility, until recently, eggs could not be effectively thawed from a frozen state due to their fragile composition.

New Egg Freezing Technology is Available

A new technique called vitrification enables embryologists to reliably freeze and thaw a woman’s eggs.  While still considered experimental, published data establishes vitrification as the new standard in oocyte cryopreservation.  The Presbyterian IVF lab now employs vitrification
after an investigational review board accepted the protocol for use in patients.

Thanks to vitrification and advances in egg freezing, women can proactively plan to start families on their own timetables. IVF Plano focuses
on enhancing, protecting and preserving fertility so every woman can experience the joy of pregnancy.

Over the last few years, studies have revealed that the practice of PGD biopsy on day three did not increase pregnancy rates.

In fact, implantation  rates actually fell when preimplantation genetic diagnosis was utilized in an IVF cycle.  This drop in implantation rate and the corresponding pregnancy rate is likely due to the trauma associated with removing one of the eight cells from the early day three embryos.  In the past, PGD biopsy required that the embryo biopsy always occur on day three of the IVF cycle. This timeframe allowed the lab to isolate and analyze the genetic material and return the test results to the clinic by the fifth day of the IVF cycle.  Day five is the optimal day to transfer embryos, now 60 to 90 cells in size, back into the uterus to maximize the chance for implantation and normal pregnancy progression. Newer technology now allows the embryo biopsy to occur on Day 5, at the blastocyst stage (60-90 cells), and removes two to four cells for testing.  Researchers believe this new
PGD technique is less traumatic to the embryo and generates a more accurate sample for testing since more than one cell’s genetic material is analyzed.

The older technology, called FISH or Fluorescent In-Situ Hybridization, required 48 hours for screening, and was only able to test for 6
to 10 of the most commonly known genetic mutations, such as Downs Syndrome and Tay Sachs.   Now with the newer testing method, called Micro array, we can test all 46 chromosomes.

Patients using this newer Micro array technology do have an additional hurdle to overcome. Since the Micro array biopsy is conducted on day
five embryos (60 to 90 celled embryos) and the results of the biopsy take 48 hours, the embryos must be frozen and transferred back to the  patient’s uterus in a subsequent in-vitro cycle.

The Fertility and Sterility Journal Paper on PGD by William Schoolcraft of Colorado Center for Reproductive Medicine will address pregnancy rates after an embryo has been biopsied, frozen and thawed in what will likely be the landmark article on this newer technique. The study found excellent pregnancy rates and very low miscarriage rates. It is quite possible that in the near future many or most embryos will be tested and fewer will need to be transferred since we will know they are genetically normal.

Unfortunately, 10 to 15 percent of couples are diagnosed with unexplained infertility. This term is used when the initial tests Dr. Douglas performs to evaluate ovulation, the fallopian tubes and semen are normal, but a couple has difficulty conceiving because of some inefficiency in the conception process.

Resolving Unexplained Infertility

Receiving a diagnosis of unexplained infertility can produce frustration and disappointment. Not finding a reason to explain your infertility can make it seem like you are out of options. Although Dr. Douglas may not be able to identify the exact cause of your problems, he will work with you and your partner to achieve a successful outcome: pregnancy and a healthy baby.

Unexplained fertility is a bit confusing. What it really means is that something is wrong at the level of the egg and sperm, how they interact with each other, or their interaction with the female reproductive organs. For example, you can have sperm that appear normal under a microscope, but do not adequately perform the function of fertilization. As well, you could have normal sperm but poor quality eggs, which means they fertilize at a lower than expected rate or not at all.

Several treatments are available to help couples struggling with unexplained infertility:

Clomid and Intrauterine Insemination (IUI)

Using an ovulation induction medication like Clomid with IUI is designed to increase the number of eggs present and help give the sperm a better chance of making it to the egg so that fertilization can occur.

Injectable Medications and Intrauterine Insemination (IUI)

If you have had three failed attempts with Clomid and IUI, then Dr. Douglas may move on to IUI combined with injectable gonadotropins like hMG or FSH as a more aggressive treatment.

In-vitro Fertilization (IVF)

Often, couples with unexplained infertility achieve the desired result with in-vitro fertilization. Dr. Douglas will stimulate egg production, retrieve viable eggs, and fertilize them with your partner’s sperm in the laboratory to produce embryos. Then, he will transfer the healthy embryos back to your uterus so that implantation can occur.

For more information, please visit www.ivfplano.com.