Why do I have spotting?
- The most common cause of light spotting is caused by weak blood vessels on the cervix. Other causes include a polyp and hormonal causes due to lack of ovulation.
- Spotting in the mid-cycle or after IUI is quite common and is not a reason for concern.
- Spotting in early pregnancy is quite common and usually benign. Sometimes it means it is not a normal pregnancy. Unfortunately nothing can be done to save an early pregnancy that is destined to miscarry. Almost all of these are caused by chromosomal abnormalities in the fetus.
- When we have intercourse, the semen leaks out, does that cause infertility?
- This is a common concern of fertility patients but this is normal and does not affect fertility. Most of the discharge is composed of vaginal secretions rather than semen.
Why is fertility treatment expensive?
Several factors come into play:
1. Drugs are expensive and you should budget and check insurance coverage.
2. As you can tell in a fertility clinic, there are many more employees than in your Doctor’s office; these include nurses, phlebotomists, ultrasonographers, receptionists and laboratory technologists. These individuals are part of the team contributing to your success.
3. Laboratory standards require certain equipment and disposable supplies that are also expensive. Unfortunately this means higher cost of treatment.
When do I need a review?
Make sure you know the plan for your treatment ahead of time.
You need a review:
- After the investigation cycle;After 3 treatment cycles if unsuccessful.
- If the treatment needs to be changed because it is not effective in achieving ovulation.
- If you have unanswered questions or concerns. If you want to change your treatment plan.
- After IVF if you are not pregnant.
- After a surgical procedure to plan further treatment.
Does stress affect my chances?
Stress does affect all body functions including reproduction. Severe stress can prevent ovulation. Several studies showed that stress does not affect the pregnancy rates with IVF.
It is helpful to try and decrease your stress level at work and at home. Yoga, meditation, acupuncture and prayer are helpful. We also have counselors experienced in dealing with infertility and are available to see you.
Does weight affect pregnancy?
Yes the more your weight is outside your optimum range the more it will adversely affect your chances. This goes for both underweight and overweight. Quick weight gain and loss can also affect ovulation and your hormone levels. Body Mass Index (BMI) is an accurate measure of weight in relation to height measured in Kg/height in meters squared.BMI outside the normal range of 18.5-22.5 has been shown to affect the chance of pregnancy.
Does age affect my chances of pregnancy?
Age of the female partner is the single most important factor in achieving a viable pregnancy.
- It directly affects the quality and the number of the eggs. There is also increased risk of miscarriages and abnormalities with advanced maternal age.
- The ability to have a normal baby decreases gradually but significantly from 32 years of age to almost Nil at the age of 46.
- High FSH >10 on day 3 is the second most important factor, even in younger patients, if found it severely reduces the chances of pregnancy with any treatment including IVF.
Other signs of diminished ovarian reserve include:
- A short cycle especially if the cycle was longer before, a low number of follicles seen on day 3, elevated Estrogen levels on day 3 and poor response to Gonadotropins.
- Although successful pregnancy can occur with age above 42 and or elevated FSH, the best option is to go for Donor egg IVF. Given the right donor, this procedure is highly successful.
Some patients find this option difficult to accept and counseling is mandatory in these cases.
What are my chances of pregnancy?
Success with infertility treatment is defined as pregnancy per cycle. It is important to understand what are the chances of pregnancy with and without treatment to avoid frustration and disappointment.
- Pregnancy rate after one year of infertility without treatment is approximately 4% per cycle (i.e. 4 couples out of 100 per one month).
- After 2 years it drops to 2% per cycle and after 3 years it is <1% per cycle. With treatment there are a lot of variables that affect pregnancy rate.
- The most important variable is the age of the female partner. In general when you look at all patients using oral medication the pregnancy rates are 8-10%/cycle.
- For Injections and IUI it is 20% per cycle and 50% after 3 cycles.
- For IVF/ICSI it is around 50% per cycle.
- 85% of the pregnancies happen in the first 3 cycles, with 15% happening over the next 3 cycles of any particular treatment. In other words you have to try several cycles before moving on to the next level of treatment.
How does donor insemination work?
Therapeutic Donor Insemination (TDI) is the use of donated sperm from a sperm bank to conceive. This is indicated in single women, gay couples, in couples that have severe sperm factor or azoospermia or if ICSI is not possible or has failed to achieve pregnancy.
- It works the same way as IUI, you need monitoring to pinpoint ovulation. You may do TDI in a natural or stimulated cycle. The chance of pregnancy is around 20% per cycle and you have to try for at least 3 cycles before moving to the next level of treatment.
- Initial testing of your blood and your partner’s blood is needed for infectious diseases. You have to order your sample on or before day 3 of the cycle.
- Also you have to verify with the nurse or the lab that the sample has arrived in our centreby day 10 of your cycle. The risk of catching a disease from donor semen is extremely low much lower than from a blood transfusion since the donors are tested several times and their samples are frozen for 6 months before it is used to insure they are free of infections. Information on donors is available from a catalog and they are screened for common genetic diseases.
- They also have to pass psychological assessment before they are accepted as donors.
Do you treat same sex couples and single individuals?
At NewLife we welcome same sex couples and single individuals who are interested in having a child. Options include donor sperm, donor eggs with surrogacy and IVF.
Where can I get more Information?
www.newlifefertility.com, www.reproductivefacts.org, www.asrm.org, www.acog.org, www.myfertility.ca