General

Shady Grove Fertility is committed to educating women and couples about their fertility options, including basic and advanced treatment and egg freezing, to name a few. To help familiarize our patients with their many fertility options, we host monthly educational events that cover a variety of topics, from general “Trying to Conceive,” and “What to Expect When You’re Not Expecting” to “Egg Freezing 101,” “Donor Egg Treatment,” and “Financial Options.”

Each live webinar or seminar is led by an SGF physician, financial counselor, or nurse practitioner and offers an opportunity for patients to ask questions to understand better their options moving forward.

The best place to find egg freezing information

In response to the growing number of women who are proactively securing their family building options by freezing their eggs, SGF offers both online and in-person events. In August, we will host two separate events, planned to best meet our patients’ availability.

August 15 In-Person Seminar

On the 15^th of August, our team will host a free seminar in our Arlington, VA office located just steps from the Ballston Metro from 6:30 p.m. to 7:30 p.m. The conversation will be led by Dr. Andrea Reh from our Fredericksburg and Arlington offices. She will discuss the details of the Egg Freezing Program at Shady Grove Fertility as well as the egg freezing process itself, from baseline screening to returning to use your frozen eggs when you’re ready to start your family.

The seminar will also cover Shady Grove Fertility’s egg freezing success rates and the many financial options we offer to make egg freezing affordable.

We invite all information-seekers and new and current patients to join us. You’ll gain a better understanding of your fertility and the long-term benefits of choosing to freeze your eggs. You’ll also have the opportunity to meet other women considering egg freezing and ask Dr. Reh questions either one-on-one or in open discussion. Register for the August 15 in-person seminar in Arlington, VA.

August 30 Online Webinar

At the end of the month, Dr. Andrea Reh will be hosting a live, free, 30-minute online webinar to cover the effect that age has on fertility and how egg freezing pauses your biological clock.

Held on August 30^th from 12:00 p.m. to 1:00 p.m., information-seekers and new and current patients will have the opportunity to learn the step-by-step process of egg freezing and what makes Shady Grove Fertility’s program and financial options unique. Dr. Reh will discuss the technology, science, and success rates of egg freezing.

You will have the opportunity to submit anonymous questions for our fertility expert to answer during the webinar, leaving you feeling educated and confident as you make future fertility decisions. Register for the August 30 online webinar with Dr. Andrea Reh.

Egg freezing offers an incredible opportunity for women to change their perspective on fertility and life and alleviates the time-sensitive pressure to have a baby that many women feel.

To get personalized egg freezing information, we invite you to meet with one of our fertility specialists and schedule an appointment or call 1-877-411-9292 to speak with a new patient liaison.

In this day and age, it seems like there isn’t much that your smartphone can’t do. You have access to different resources at your fingertips, including the ability to track your fertility. In a recent HelloFlo article, Dr. Shruti Malik of SGF’s Fair Oaks and Woodbridge, VA, offices, discusses how these fertility apps are helpful ways to estimate a woman’s best chances of conception. Dr. Malik found two key ways in which fertility apps can help you on your journey.

Fertility Apps Provide Knowledge

Apps are created with many different intentions for the users. However, fertility and reproductive health apps are intended to aid users in tracking their menstrual cycles and providing data to help them conceive. Dr. Malik says that some apps are helpful in estimating the proper timing in your cycle when conceiving can occur.

“It is important for women to remember that this is an estimate based on the assumption that ovulation is occurring and the second half of the menstrual cycle is fixed,” Dr. Malik stated. “In women who have irregular cycles, it is even more difficult to use an app to estimate the fertile window,” she said.

Malik discusses a few apps, such as Glow and Fertility Friend. If you are using the free Glow app, you can opt to contribute to an assistance program that can be used for fertility treatments if the app fails to help you conceive in 10 months. During your fertility journey, the Glow app provides fertility testing tracking, treatment cycle tracking, medication reminders, an appointment calendar, personalized insights, to-do lists, printouts of treatment details, and a supportive community.
She also notes that Fertility Friend, similar to Glow, has a free basic app and the option to sign up for an annual membership fee ($45) that gives you access to messages boards and other personalized tools to help track your fertility.

The key note to remember when using these fertility apps is that you cannot rely only on mobile technology for knowledge of the right time to conceive. “Women who have been using an app without success or those with irregular cycles should consider using an ovulation predictor kit or basal body thermometers,” Malik said. “If these match up with the app’s estimate of the fertile window over two to three cycles, then it is okay to use the window provided by the app,” Malik adds.

Shady Grove Fertility recommends a fertility evaluation with a specialist if you have regular cycles and have been having unprotected intercourse without conception for 1 year if you are under 35; if you are 35 to 39, it’s recommended to see a fertility specialist after 6 months of unprotected intercourse without conception. If you are 40 or older, or if you have other warning signs that indicate it’s time to seek intervention, SGF recommends you see a fertility specialist after 3 months or right away.

Fertility Apps Provide Support

 Going through the process of trying to conceive can be quite challenging for some couples. Some fertility apps provide forums and options to connect with other couples also having difficulty conceiving.

“This can be a great resource for couples who are going through this difficult time,” Malik added.

In addition, Shady Grove Fertility offers in-person and online events to provide valuable support and education to those trying to conceive. Each week we host seminars, open houses, and webinars on various fertility topics. In addition, we host support groups on a variety of fertility topics. These groups meet once a month and are free for all participants.

Shady Grove Fertility’s Facebook page is also a great resource to find support. This online community of over 22,000 people is comprised of past and current patients and information and support seekers. SGF Sisters post words of encouragement, success stories to inspire hope, and questions for other patients on their journeys. Join the community today.

 To learn more about fertility apps or to schedule an appointment with one of our 35+ physicians, please call 1-877-971-7755 or click here to complete this brief online form.

When you are trying to conceive, it is important to take the right steps to prepare your body for pregnancy. As part of an ongoing blog series about fertility nutrition, we recently interviewed Dr. Melissa Esposito of SGF’s Harrisburg, PA and Frederick, MD offices to discuss diet and lifestyle strategies to help improve fertility and prepare your body for pregnancy.

1) Eat a fertility-focused diet

According to Dr. Esposito, “There is no one food that women trying to conceive should avoid.” She advises her patients to, “Eat as many fruits and vegetables as you can. Shop the periphery of the store, and limit processed foods, which have a lot of salt and sugar.”

A large study conducted by Harvard researchers showed that women who adhered to five or more of the following diet and lifestyle factors were at a 69% lower risk of ovulatory disorder infertility.¹

1. Increase the amount of “good” fats in your diet. Eat more avocados, nuts and seeds, and use olive oil and canola oil for cooking and salad dressings.
2. Limit foods with trans fats, such as vegetable shortenings, margarines, baked goods, pie crusts, frostings, and fried foods. Check the Nutrition Facts Panel for trans fats, and avoid packaged foods with “hydrogenated” oils.
3. Eat more plant protein. Replace a serving of meat each day with vegetarian sources of protein (beans, lentils, legumes, quinoa, nuts, seeds, or nut butter).
4. Choose low glycemic carbohydrates (dried beans, legumes, fresh fruits, non-starchy vegetables, 100% whole-grain breads, oatmeal, quinoa) for a slower rise in blood sugar levels.

A good rule of thumb is to limit processed carbohydrates such as white rice, bread, and pasta, and most crackers, chips, cookies, and other packaged foods. This is beneficial for any woman trying to conceive, and especially important if you have PCOS (polycystic ovary syndrome).

Watch: SGF’s New On-Demand Webinar, PCOS

• Eat more vegetarian sources of iron, such as spinach, beans, legumes, prunes, and cashews.
• Choose full-fat dairy, such as whole milk, full-fat yogurt, or cheese. Women who ate full-fat dairy at least once a day had better fertility compared with those who rarely ate full-fat dairy.

According to Dr. Esposito, cooking with healthy ingredients can help you adhere to a fertility-focused diet. “When you eat out, you really don’t know what is in the meal. A lot of things we think are healthy are not. We are all busy, but taking the time to cook will be better for you and will save money in the long run.”

2) Aim for a healthy body weight

Being overweight or underweight can disturb hormone production, interrupt normal menstrual cycles, and impair ovulation and fertility.

Research indicates that obesity has a negative impact on fertility.² A recent Fertility and Sterility study found that miscarriage rates increased, and pregnancy and live birth rates decreased with increasing body mass index (BMI).³ According to Dr. Esposito, “Being successful will be a lot easier if you attain a normal BMI. Studies have shown clearly that even a 5 to 10 percent reduction in body weight can change hormonal and metabolic parameters enough to make a significant impact on your fertility.”

“Women who are obese need higher doses of medications during treatment, which puts them at a higher risk of side effects and multiple births,” says Dr. Esposito. She advises her patients to “try to clean up your diet, do some exercise each day, drink lots of water, and aim to lose 5 to 10 percent of your body weight.”

Losing weight has been shown to improve fertility⁴ and may reduce the risk of pregnancy complications such as preterm birth, gestational diabetes, preeclampsia, and certain birth defects.

3) Get active

Moderate physical activity is best while trying to conceive. If you are obese, studies show that regular physical activity improves your chances of conceiving.⁵ “I recommend getting back into exercise slowly.  Starting a strenuous exercise routine as you are embarking on fertility treatment is not a good idea,” says Dr. Esposito.

If you are underweight or normal weight, too much vigorous activity can actually increase the time it takes you to conceive.⁶ Dr. Esposito adds, “If a patient is running enough to result in irregular menstrual cycles, I advise her to decrease the amount of time she is exercising, or switch to a lower impact activity.”

According to Dr. Esposito, “Moderate, low-impact exercise, especially during stimulation, is okay. You should be able to talk through your work out, so that too much blood and oxygen is not being diverted away from the uterus.”

“Since exercise is a stress reliever for many women, telling them to stop is counterproductive. My philosophy is to allow patients to continue their normal activity, but nothing to the extreme,” continues Dr. Esposito.

The goal is to find the right balance to optimize your reproductive function. In general, 30 to 60 minutes of moderate exercise is recommended on most days of the week.

To watch our On-Demand Webinar on Weight and Fertility, click here. During this free, on-demand event, viewers will learn about the impact weight, either over or under, has on the ability to conceive and tips for maintaining and achieving a healthy body mass index (BMI).

4) Take a high-quality preconception prenatal vitamin

Shady Grove Fertility is proud to recommend Luminary Vitamins and Theralogix to offer high-quality, evidence-based nutritional supplements patients can trust. 

5) Consider other preconception supplements

Depending on your age and health history, adding certain nutrients may improve egg quality and help you conceive.

Coenzyme Q₁₀ (CoQ₁₀)

CoQ₁₀ plays a crucial role in energy production in the body’s cells, including egg cells.

As you age, your cells make less CoQ₁₀ and are less efficient at producing energy. This can lead to poorer fertilization and early miscarriage.

A decrease in egg quality is the most important factor affecting fertility with increasing age. Research indicates that CoQ₁₀ improves egg quality and potentially increases fertility in women of advanced maternal age.⁷

“For all my patients 35 and over, or for younger patients with signs of decreased ovarian reserve, I recommend TheraNatal OvaVite because it has coenzyme Q₁₀ along with the preconception vitamin,” says Dr. Esposito.

Vitamin D₃

Vitamin D is made in our skin in response to sun exposure. However, most of us are not in the sun enough to maintain an adequate vitamin D level. Our diets generally don’t provide enough vitamin D either.

Getting enough vitamin D is important before and during pregnancy. Several studies have linked “normal” vitamin D levels (30 ng/mL or higher) with higher pregnancy rates.⁸

It is important to have your vitamin D level checked when you start trying to conceive. Low vitamin D levels have also been linked to preterm birth⁹ and other pregnancy complications.

Inositol

Inositol is a B-vitamin-like nutrient that seems to have two functions for fertility. It is particularly important for women with PCOS (polycystic ovary syndrome). Studies show that inositol decreases insulin levels and insulin resistance, decreases androgen levels, and promotes regular menstrual cycles, ovulation, and fertility.¹⁰ “I like to recommend inositol to all my patients with PCOS,” says Dr. Esposito.

For women going through IVF, studies indicate that inositol may improve egg quality and the response to ovarian-stimulating drugs.¹¹

The two forms of inositol that have shown benefit are myo-inositol and D-chiro-inositol. Recent studies have shown that taking a combination of these forms, in the body’s naturally occurring ratio of 40 to 1, is more helpful than taking either form alone.¹²

In summary, eat a fertility-focused diet, exercise moderately, take the right supplements, and make other lifestyle changes to prepare your body for pregnancy. Try to incorporate these diet and lifestyle habits into your daily routine.

Remember, diet and lifestyle strategies can be an important complement to your fertility treatment but they do not replace fertility evaluation and care. At Shady Grove Fertility’s Wellness Center, we provide individual nutritional consultations with a licensed nutritionist. The nutritional program at Shady Grove Fertility is focused solely on enhancing your fertility by making changes to your diet to maximize nutrient intake, improve mood and energy levels, and keep you feeling healthy.

You should have your fertility evaluated if you are under 35 years old and have been having unprotected intercourse for 1year without conception, or between 35 and 39 years old and have been having unprotected intercourse without conception for 6 months. If you are 40 years old or older, your male partner has a known fertility issue, or you have PCOS or other known fertility issue, you should have your fertility evaluated as soon as you start trying to conceive.

 References:

1. Chavarro et al. Diet and lifestyle in the prevention of ovulatory disorder infertility. Obstet Gynecol. 2007; 110(5):1050-8.
2. Broughton and Moley. Obesity and female infertility: potential mediators of obesity’s impact. Fertil Steril. 2017; 107(4):840-7.
3. Provost et al. Pregnancy outcomes decline with increasing body mass index: analysis of 239,127 fresh autologous in vitro fertilization cycles from the 2008-2010 Society for Assisted Reproductive Technology registry. Fertil Steril. 2016; 105(3):663-9.
4. Sim et al. Weight loss improves reproductive outcomes in obese women undergoing fertility treatment: a randomized controlled trial. Clin Obes. 4(2):61-8.
5. Palomba et al. Physical activity before IVF and ICSI cycles in infertile obese women: an observational cohort study. Reprod Biomed Online. 2014; 29(1):72-9.
6. Wise et al. A prospective cohort study of physical activity and time-to-pregnancy. Fertil Steril. 2012; 97(5): 1136–1142.e4.
7. Ben-Meir et al. Coenzyme Q10 restores oocyte mitochondrial function and fertility during reproductive aging. Aging Cell. 2015; 14(5):887–95.
8. Paffoni et al. Vitamin D deficiency and infertility: insights from in vitro fertilization cycles. J Clin Endocrinol Metab. 2014; 99(11):E2372-6.
9. Zhou et al. Vitamin D and risk of preterm birth: Up-to-date meta-analysis of randomized controlled trials and observational studies. J Obstet Gynaecol Res. 2017; 43(2):247-256.
10. Unfer et al. Effects of Inositol(s) in Women with PCOS: A Systematic Review of Randomized Controlled Trials. Int J Endocrinol. 2016; 1849162.
11. Caprio et al. Myo-inositol therapy for poor-responders during IVF: a prospective controlled observational trial. J Ovarian Res. 2015; 8(37).
12. Dinicola et al. The rationale of the myo-inositol and D-chiro-inositol combined treatment for polycystic ovary syndrome. J Clin Pharmacol. 2014; 54(10):1079-92.

Medical contribution by Melissa A. Esposito, M.D.

Melissa A. Esposito, M.D., is board certified in obstetrics and gynecology and reproductive endocrinology. Throughout her career, Dr. Esposito has been the recipient of numerous awards and honors from the American Medical Women’s Association, the Philadelphia Area Reproductive Endocrine Society, and the American Association of Gynecologic Laparoscopists, among others. She sees patients at SGF’s Columbia, Maryland, and Mechanicsburg, Pennsylvania, offices.

To learn more about preparing your body for pregnancy or to schedule an appointment, please call our New Patient Center at 1-877-971-7755 or click here to complete this brief online form.

The Washington Post recently tapped SGF’s own reproductive urologist and male fertility specialist, Paul R. Shin, M.D., as they took a closer look at male fertility and reminded men that they too have a biological clock. The term “biological clock” was originally geared towards women, but today, the term now applies to both men and women, with men having just as many reasons to pay attention to their own biological clocks.

Why do men now have a biological clock?

Couples are now getting married later in life and having families at a later age. For the first time in U.S. history, women in their 30s are now having more babies than younger women, reported by the Centers for Disease Control and Prevention. In an urban, career-centric city like Washington, D.C., more men and women are focusing on their careers and putting marriage and family on hold. Research suggests that advanced paternal age can play a more significant role in a couple’s infertility than previously thought. A decline in a man’s hormone levels and sperm counts can have just as great an impact on achieving a pregnancy.

Unlike women, men are not trained by the medical world, or by their body’s rhythms to constantly be thinking about their fertility. However, with an increased focused on men’s health, men are beginning to take a more proactive stance on their reproductive health as they are more aware that age for both partners does have an impact on fertility.

SGF’s reproductive urologist and male fertility specialist, Paul Shin, M.D., says he sees about one or two male patients a week who come to check their sperm count and motility—sometimes before there’s even a partner in the picture, or before there’s any sign of a problem.

“I see a lot of guys who come in who are recently married or who just want to know what their fertility numbers are, because this generation kind of gets it. They take their health care seriously. They look at fertility and family-building as it should be looked at—as a joint effort as opposed to on the shoulders of women only,” remarks Shin.

Shin adds, “There is a marked cultural shift that I’ve seen since I’ve been in practice. There are a lot more men that just want to know where they stand, because they understand that men can be the problem.”

How common is male infertility?

The reality is male infertility accounts for 40 to 50 percent of all infertility cases. A simple diagnostic test such as a semen analysis can identify any potential obstacles to achieving a pregnancy with your partner. If the results signal a problem, together a urologist and fertility specialist can design a custom treatment plan based on your age and your diagnosis.

While male factor infertility can happen at any age with many causes, there are often steps a man can take to proactively combat male infertility. For many men, improving diet and maintaining a healthy lifestyle, including quitting smoking and reducing alcohol consumption can resolve issues within a few months. Also, men should review medications and supplements with their physician to see if any may have an impact on sperm count or quality.

Check out the full article at The Washington Post: A friendly Father’s Day reminder: Men, don’t ignore your biological clock.

To learn more about the male biological clock, male infertility or to schedule an appointment with our reproductive urologist or any of our 35+ reproductive endocrinologists, please call our New Patient Center at 1-877-971-7755 or click here to complete this brief online form.

At Shady Grove Fertility, we’re here to give you the caring support you deserve as you start or grow your family. As a leading fertility and IVF center of excellence, we offer patients individualized care, innovative financial options, over 30 accepted insurance plans, and pregnancy rates among the highest of all national centers. We offer patients the convenience of 19 full-service and 6 satellite locations across Maryland, Pennsylvania, Virginia, and Washington, D.C. More than 1,700 physicians choose Shady Grove Fertility to refer their patients, and more than 96 percent of our patients say they would recommend Shady Grove Fertility’s 35+ physicians to a friend. With 10 Shady Grove Fertility babies born each day, your dream of starting or growing your family are within reach.

Medical contribution by Paul Shin, M.D., one of Shady Grove Fertility’s Board Certified Urologist.

Fertility issues are often assumed to be the female partner’s responsibility; however, only 40 percent of infertility is due to female factor. A more accurate break down is 40 percent female factor, 40 percent male factor, 10 percent combined, and 10 percent unknown. Sperm quantity and quality can be negatively affected by many different environmental and lifestyle factors. In a recent Romper article, the power of seminal fluid was discussed, as well as the question: can sperm go bad?

Causes of Decreased Male Fertility

Sperm production and maturation is a dynamic, ongoing process for most men. Immature sperm originate from cells within the testis called germ cells and they go through a maturation process of approximately 2.5 months. As living cells within the testicle, they are subject to the same conditions and insults the rest of the body is trying to manage. Sperm health and reproductive potential are linked to good overall health, so the lifestyle choices that would benefit a man’s overall health dovetail nicely with good choices for his reproductive health as well.

The pathway for a sperm to find an egg is essentially a race through an obstacle course. At every step along the way there is an anatomic or functional hurdle that the sperm must overcome to continue the journey. From the point of ejaculation on the cervix to the final step of fertilizing an egg, only the strongest and luckiest sperm make it through. There is significant attrition of sperm along the way. Therefore, starting the race with as much sperm as possible is critical to achieving a successful pregnancy.

For most men with normal sperm counts, an everyday frequency of intercourse should not result in significantly lower numbers of ejaculated sperm. In some men, however, who have low sperm counts, spacing intercourse and ejaculation out every 2 to 3 days allows for better chances of achieving a pregnancy.

The effects of older paternal age on sperm and a man’s reproductive capacity are very active areas of current research. Men, like women, go through a reproductive and hormonal decline as they age, but this change is drawn out over many years. Even though new sperm are constantly manufactured, older paternal age seems to be associated with a longer time to conception as well as an increase in some neurocognitive disorders on the autism spectrum.

Does sperm go bad?

Does sperm go bad? In a word, no. Despite the added challenges in achieving pregnancy and the higher risk of autism spectrum disorders, most older fathers go on to achieve normal pregnancies in a timely manner. The central theme of earlier testing and urologic evaluation can improve a couple’s chances of success.

A semen analysis is often often recommended to evaluate a man’s reproductive potential. The main parameters that are evaluated are the volume, concentration, pH (level of acidity), motility, progression, consistency, shape, total motile sperm count, and the presence other cells. At Shady Grove Fertility, we are proud to have our own board certified, fellowship trained reproductive urologists to help patients diagnose, treat, and ultimately overcome male factor infertility.

To watch our On-Demand Webinar on Male Fertility, click here. During this free on-demand event, viewers will learn about the simple tests used to evaluate male fertility, common causes of male factor infertility, lifestyle changes that can improve a man’s fertility, effective treatment options and treatment success rates.
 

Editor’s note: This blog was originally published in August 2017, but was reviewed for accuracy in June 2018.

When trying to conceive there are all sorts of new terms, phrases, and even products at the pharmacy you didn’t even know existed. You’ll likely find yourself taking your temperature first thing in the morning to determine your basal body temperature and spending more time than ever thought you would in the “Family Planning” aisle at the drug store perusing various ovulation predictor kits. In the article “How long does an LH surge last? The Luteinizing Hormone is a Big Deal,” Romper talked to Eric D. Levens, M.D., of Shady Grove Fertility’s Annandale, VA location to find out what these tests/kits are designed to tell us about how long a luteinizing hormone (LH) surge lasts and why it’s so important if you’re trying to conceive.

The average couple ages 35 years or younger has, at most, about a 20 percent chance of conceiving naturally each month. Typically, that 20 percent chance decreases with age. Since many couples are waiting longer to build their families, knowing and understanding the timing of ovulation and the LH surge, is really important.

Ovulation and the LH Surge

Ovulation is the time during your monthly cycle when it is possible to conceive. Using an over-the-counter ovulation predictor kit (OPK), you can test your urine to help detect when the LH surge is approaching. If you can pinpoint when the LH surge happens, you can estimate that ovulation will happen in the next 30 hours. Getting the timing right is crucial to conceiving during that small time frame each month. It’s important to focus on having sex once a peak is detected or schedule an insemination, the article states.

Dr. Levens tells Romper, “the endogenous LH surge lasts approximately 12 to 24 hours, and the onset precedes ovulation by approximately 36 hours.” While the focus is oftentimes on the female partner, Levens cautions not to forget about the sperm. He says, “Because sperm can survive for upwards of a week in the fallopian tube, avoiding intercourse during the LH surge alone is not sufficient to provide contraception.”

The article closes with the perfect bit of advice: “Fertility can be a tricky thing to figure out. But, getting to know your body and the way it operates can help you to take control of your fertility.”

If you’ve been having unprotected intercourse without conceiving for over a year and are 35 or younger, or 6 months if you are over 35, it may be time to see a fertility specialist. To schedule an appointment with Dr. Eric Levens call 1-877-971-7755 to speak with a representative in our New Patient Center.

At Shady Grove Fertility, we’re here to give you the caring support you deserve as you start or grow your family. As a leading fertility and IVF center of excellence, we offer patients individualized care, innovative financial options, over 30 accepted insurance plans, and pregnancy rates among the highest of all national centers. We offer patients the convenience of 19 full-service and 6 satellite locations across Maryland, Pennsylvania, Virginia, and Washington, D.C. More than 1,700 physicians choose Shady Grove Fertility to refer their patients, and more than 96 percent of our patients say they would recommend Shady Grove Fertility’s 35+ physicians to a friend. With 10 Shady Grove Fertility babies born each day, your dream of starting or growing your family is within reach.