General

For some patients, taking the first step to starting fertility treatment can be scary. Don’t let these common fears keep you from achieving your dreams of growing your family. At Shady Grove Fertility, the resounding feedback we hear from our patients is that if they had to do it all over again, they wish they had started fertility treatment sooner. Sometimes, fear can even cause procrastination but that procrastination can adversely affect outcome, as fertility potential, in many ways, is affected by age. By waiting and putting off action, your options have the potential to diminish the longer you wait.

Common Fear #1: I won’t be able to afford fertility treatment. 

While it can feel unfair that you have to work so hard for something that comes free to others, the reality for many patients is fertility treatment is more obtainable than they realized. For those with insurance, 90 percent will have coverage for their initial consultation and 70 percent will go on to have some level of coverage for their testing and treatment.

When insurance isn’t an option, there are a variety of discount and guarantee programs available exclusively for Shady Grove Fertility patients. Our most popular is the Shared Help Discount Program. This program provides patients with a reduced rate on services rendered at SGF based on their income. Many patients are also eligible for our exclusive 100 percent refund option for IVF and donor egg treatment. Read more about the insurance and financial options available at Shady Grove Fertility.

Common Fear #2: IVF is my only option. 

This is one of the most common misconceptions when it comes to starting fertility treatment. While in vitro fertilization (IVF) is a popular and very effective treatment option, most people don’t start with IVF treatment unless it is medically indicated. Half of the treatment performed at SGF are more basic forms of infertility treatment, such as intrauterine insemination (IUI). This more affordable treatment is often covered by insurance and, in many cases, is required before patients can access their IVF benefits.  Learn more about IUI treatment.

Common Fear #3: I will end up like Octomom.

Not only is that a fear patients have but it is also a fear our physicians have as well! It is a well-proven fact that high-order multiples are risky and therefore something we try to avoid in all cases. Safety is a top priority for our physicians and that safely is not just for you but also for your child(ren). Our goal is always a singleton pregnancy, and for patients who do require IVF treatment, that is most frequently achieved through an elective single embryo transfer (eSET), the practice of choosing to transfer a single embryo at a time. Retrospective SGF data has shown that in women under the age of 35 without a history of failed IVF treatment, transferring multiple embryos has little impact on the pregnancy rates but does have a significant impact on the rate of multiples.  Learn more about eSET.

Common Fear #4: The subject matter is embarrassing and I’m afraid I’ll be judged.

For some people, talking about their period and the details of their sex life with someone whom they just met can be uncomfortable. Remember this “stranger” is a specially trained medical professional who understands you might not be at ease at first. However, for them, they’ve made it their life’s work to help people just like you realize your dream of a family. Many on the staff at SGF have also been in your shoes; therefore, we treat each patient who comes through our doors with utmost compassion and respect.

Common Fear #5: There is something wrong with me—I’m broken.

Don’t get me wrong, you are special, but when it comes to your ability to conceive, you aren’t as unique as you probably think. With one in eight couples who have trouble conceiving, you certainly aren’t alone and are actually in some pretty good company. There is also a good chance that the cause of your infertility might not even have to do with you. The cause of infertility is pretty evenly split, with 40 percent of infertility due to a female factor and another 40 percent due to a male factor. The remaining  20 percent is due to a combination of the male and female partner or of unknown causes. Read more about the causes of infertility.

Taking the first step to starting fertility treatment is easier than you think. It starts with a conversation. Our New Patient Center liaisons are just a phone call away. They are here to assist you and answer your questions. Make the call that could change everything: 1-877-971-7755.

Can penile fractures really happen?

As Shady Grove Fertility’s urologist and male fertility specialist, Dr. Paul Shin gets asked a lot about topics we’ve always secretly wondered about, but then thought, “nah, that can’t happen, it’s just a myth!” Well, as Self.com found out, despite common nomenclature, you can’t technically break a penis, otherwise known as penile fractures, because there is no actual bone to break. However there can be some real damage and pain when it comes to penile fractures.

“The penis is basically a spongy tube of blood vessels, or corpora cavernosa, wrapped in a very durable, almost rubbery layer,” says Dr. Shin. That layer, called the tunica albuginea, or the membrane of the penis, allows the spongy tissue to swell with blood when erect.

What are penile fractures? 

A penile fracture occurs when a membrane cracks or ruptures. “There will be an immediate loss of erection, you’ll hear a popping noise, and there will be a lot of bruising and swelling,” says Shin. You and especially your partner will know immediately that there is something wrong.

Shin describes the most common way this happens as “mistimed thrust.” Basically, the penis misses the vagina and hits the pubic bone. While this injury can happen in every sex position, Shin cautions that this isn’t very common and you don’t need to worry about every time you have sex.

It is imperative to get medical attention if this unfortunate injury should occur. Dr. Shin says, “if a penile fracture isn’t fixed immediately, a man can eventually have issues with erectile dysfunction.” Even when treated quickly, Shin cautions that scar tissue can form that can cause the penis to curve and make sex extremely difficult. Overall, Shin advises that there are no long-term effects on male fertility.

While it’s pretty scary to think about, penile fractures do heal almost all of the time. Despite occurring during the height of passion, stay calm, and go straight to the ER.

If you have been trying to conceive for 6 months to a year, it may be time to speak with a specialist. Call 1-877-971-7755 to learn more.

There are many reasons why a couple may seek the help of a fertility specialist. As defined by the World Health Organization, infertility is a disease of the reproductive system resulting in the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. What does that mean? As a general rule, women who are under the age of 35 and have been trying to conceive for a year or are over the age of 35 and have been trying for 6 months, should see a fertility specialist.

But when does that rule not apply? There are many factors, both male and female, that can impact a couple from conceiving. So if you’ve been wondering “should I see a fertility specialist?” here are five reasons you shouldn’t wait.

Should I See a Fertility Specialist? 5 Signs You Shouldn’t Wait

1. You Have Been Diagnosed or Suspect Polycystic Ovary Syndrome (PCOS)

PCOS is one of the most common ovulatory disorders. A few of the key indicators for PCOS are irregular or absent periods, and/or signs of high androgens (male hormones like testosterone) such as acne, facial hair, and trouble losing weight.  While these are indicators—no one size fits all for women with PCOS. If you think you have PCOS, it’s important to discuss it with your OB/GYN. Both OB/GYNs and fertility specialists can help many women with PCOS to conceive by stimulating ovulation, often through the aid of medications such as clomiphene citrate (Clomid, Serophene). However, if you have had 3 to 4 rounds of Clomid with your OB/GYN without achieving pregnancy, it is time to see a specialist, who will be able to develop a personalized treatment protocol for you.

2. You’ve Had Two or More Miscarriages

Couples who experience miscarriage are in a difficult position because they have had success conceiving and may not feel as if they are infertile. However recurrent pregnancy loss (two or more miscarriages) is often the result of an underlying issue. A fertility specialist will work with you to determine the cause of miscarriage and develop a plan to help you carry your pregnancy to term.

3. You Had Your First Child (or Children) Without Trouble, But Now You’re Having Problems

If you are having trouble getting pregnant again despite having a child or children without the assistance of fertility treatment or medication, you may have secondary infertility. Often couples wait a few years between children, and in some cases they experience decreased fertility due to age. As a woman ages, the quantity and quality of her eggs decrease making it harder to conceive. Other times, new conditions have developed preventing conception. If you have been trying for 6 months and are over the age of 35, we recommend seeing a specialist, even if you already have a child or children.

4. Your Periods are Irregular, Frequent, or Absent

If your menstrual cycle is less than 21 days or longer than 35 days, or consistently irregular, you may have an ovulatory disorder. Ovulatory disorders are one of the leading factors of female infertility but can often be easily treated through medication.

5. It’s Been Over a Year (or Less in Some Cases) and You Haven’t Been Able to Get Pregnant

Whether or not you have been actively trying to conceive, if you have been having regular intercourse without contraception for a year or longer (or even sooner based on age), it is time to speak with a fertility specialist, as that is classified as infertility. And this doesn’t just apply to the female partner—nearly half of infertility is at least in part male factor—so it is important for both partners to be evaluated.

According to Stephen Greenhouse, M.D., of our Fair Oaks, VA office, a women in her early 30s has a 15 to 20 percent chance of pregnancy per month when she initially starts to try. About 60 percent of couples will get pregnant within the first 4 to 5 months of trying; thereafter, the pregnancy rate begins to decrease each month. After trying for 1 year, the chances of pregnancy declines to 1 to 2 percent per month (Zinaman, 1996). This is the reason that we recommend beginning an evaluation after trying for 1 year if under 35 and after 6 months if 35 or older.

Here are the recommended guidelines. Infertility is present based on the following definition. When a woman is:

• Under 35 with regular cycles and no pregnancy after 1 year
• 35 to 39 with regular cycles and no pregnancy after 6 months
• 40 or over with regular cycles and no pregnancy after 3 months

Other conditions that may warrant an early evaluation include:

• History of pelvic surgery (such as the removal of an ovarian cyst, ablation of endometriosis, ectopic pregnancy, tubal surgery, or ruptured appendix)
• Severely painful periods
• Other female infertility diagnosis 

Medical Contribution by: Stephen Greenhouse, M.D.

Shady Grove Fertility reminds you, there are now treatments available to help nearly everyone take home a baby. If you’ve been wondering “should I see a fertility specialist” or if you’d like to learn more please speak with one of our New Patient Liaisons at 877-971-7755.

References:

Zinaman MJ, Clegg ED, Brown CC, O’Connor J, Selevan SG. Estimates of human fertility and pregnancy loss. Fertil Steril. 1996; 65(3). 503-509.

National Infertility Awareness Week® (NIAW) took place last week (April 24-30, 2016), a yearly initiative founded by RESOLVE: The National Infertility Association, to encourage people to act as their own infertility advocates and to educate legislators and the public about how infertility impacts one in eight couples within our community.

SGF and Resolve

Since establishing a partnership with RESOLVE, Shady Grove Fertility has helped to increase infertility awareness and raised more than $20,000 through annual events such as support groups, educational content, and public awareness initiatives to ensure that family building options are available to everyone.

#StartAsking

To promote this year’s NIAW theme, #StartAsking, Shady Grove Fertility provided those who are trying to conceive with various outlets for their questions including Q&As on Glow, a popular fertility app, with SGF reproductive endocrinologist Shruti Malik, M.D., and SGF’s first ever Facebook Live featuring Frank E. Chang, M.D.

• Glow Q&A: When to See a Specialist
• Watch Facebook Live: How to Get Started with Fertility Treatment

NIAW is a significant event to raise the profile of infertility awareness, but it is only one of the many ways throughout the year in which Shady Grove Fertility spreads infertility awareness and supports the infertility community. On May 11, 2016, Shady Grove Fertility physicians and staff will let their voices be heard at Advocacy Day, a RESOLVE event in which the community speaks with members of Congress to promote increased access to family building options and financial relief.

• Learn More About Advocacy Day 

 Be Your Own Advocate

With one in eight couples experiencing infertility, it is important for the community to come together and present a unified front, spreading awareness and letting couples know when it’s time to see a fertility specialist—given the importance of early intervention and how predominantly maternal age affects pregnancy outcomes. Shady Grove Fertility physicians typically recommend for a couple in which the woman is younger than 35, has normal cycles, and no risk factors for infertility, a year of trying to get pregnant without success is enough to warrant special attention. However, there are most definitely cases in which the 1-year standard isn’t the best course of action. Generally, when the woman is 35-40, a fertility consultation (to make sure there are no infertility-causing conditions besides age) should be considered after 6 months of unprotected intercourse, or after 3 months for women who are older than 40.

In addition to age, other factors have such an  impact on a woman’s fertility that a baseline fertility workup is necessary, including:

• history of irregular menstrual periods or absence of periods
• previous abdominal or gynecological surgery, pelvic inflammatory disease (PID), or other sexually transmitted infection
• known structural abnormalities of the uterus or other reproductive organs
• endocrine (hormonal) disorders such as thyroid disease
• pituitary tumors or hyperprolactinemia

To learn more about infertility awareness or if you like to schedule an appointment, please call our New Patient Center at 1-877-971-7755 or click here.

Infertility treatment can be challenging for anyone going through it. The process is great but the reward is greater. We asked our Shady Grove Fertility Facebook community for tips they would share with anyone beginning the infertility journey. The numerous responses were incredibly insightful, helpful, and encouraging! Women who have personally struggled with infertility shared their knowledge and strength on how to positively get through treatment and most importantly, to never give up. Read 25 patient tips.

25 Patient Tips:

1. Be honest with your partner and share your thoughts with him or her! Together you can accomplish amazing things.
2. Never. Give. Up.
3. Remember, you are strong!
4. Find someone to talk to. It doesn’t necessarily have to be a therapist but someone who will just listen! For instance, I talked to my acupuncturist while she just sat and listened and I can’t tell you how refreshing it was to have someone just listen and not give me horrible advice like “just relax.” Not to mention that I didn’t feel judged when I talked to her. Oh and my second piece of advice is try acupuncture.
5. Your dreams are alive and always growing as long as you have faith. Think of each new step as being one step closer to happiness and no matter how hard the next one is – it’s always one worth taking.
6. Have open communication with your partner about your feelings through all the ups and downs of the process. And have a sense of humor about some of it, too.
7. Take breaks when you get overwhelmed – it’s better to make life altering decisions with a clear mind.
8. “Life is too short to be upset and offended. Don’t allow circumstances control your joy” I read this while going through infertility and love it.
9.  Trust yourself and don’t listen to negative stories. You will make the right decisions for you and your spouse/partner.
10. Believe.
11. You don’t need to keep this journey a secret! You’d be surprised how many people you know are on this path as well.
12. Don’t give up on your dreams. One step at a time and yours dreams will come true.
13. 1 – Call Shady Grove Fertility
    2 – See #1
14. Support each other and communicate your needs calmly and clearly. Don’t take your frustrations out on each other or assume your spouse knows what you want or need on this journey.
15. “The moment you are ready to quit is usually the moment right before the miracle happens” is so true! I was ready to quit before our final cycle but thank goodness I didn’t cause now I’m 15 weeks pregnant.
16. I definitely felt alone. I didn’t know anyone else who was struggling. Now, through sharing our story, a lot of women have shared their stories with me and I am able to walk beside them as they walk this road. I try to use my experiences and trials to help others through theirs.
17. “The brightest skies are always foreshadowed by dark clouds.”
18. I try to stay busy during the 2 week wait but I like to err on the side of caution, while still enjoying life.
19. Understand that while there are many common threads, every infertility journey is unique. Try not to compare yourself to others and do what feels right for you. Also, if you ever, at any time don’t understand something, don’t hesitate to ask.
20. When I was going through treatments, I tried new things to keep my mind from stressing too much-like a cake decorating class. I then had the added benefit of eating my results.
21. Letting go of control can be hard for many. Give in to the process.
22. Our faith is what has kept us going through all of this – it’s nothing short of a miracle that we’ve gotten as far as we have.
23. I give myself 24 hours to feel sorry for myself after bad news, and then move on. I refuse to let this consume my life. And if I can’t have kids naturally, I will adopt, so no matter what, I will be a mother!
24. I also didn’t keep anything about it a secret. If anyone was willing to listen, I’d talk about it. I think it was therapeutic for me. Although you have to be ready for the comments that aren’t what you want to hear, and people who don’t understand. Sometimes explaining it to people really changed their point of view as well. So many women feel so alone during such a sensitive and emotional time.
25. It only takes 1, try to stay positive.

If you have questions about fertility or are ready to schedule an appointment at Shady Grove Fertility, please speak with one of our New Patient Liaisons at 877-971-7755.

Editors Note: This post was originally published in April 2014 and has been updated for accuracy and comprehensiveness as of April 2016.

Isaac E. Sasson, M.D. discusses achieving a healthy pregnancy after an eating disorder with U.S. News & World Report in The Lasting Toll of an Eating Disorder: Fertility Issues.

For millions of Americans struggling to overcome eating disorders, it can take years of work to get their minds and bodies back to a healthy state. Once the psychological healing is complete, women who recover from eating disorders such as anorexia or bulimia may face additional effects to their fertility. Last week U.S. News & World Report reached out to Dr. Isaac Sasson from Shady Grove Fertility’s Philadelphia area offices to discuss The Lasting Toll of an Eating Disorder: Fertility Issues. In the article, Dr. Sasson describes the potential effects eating disorders can have on a woman’s fertility and how they can often be completely reversed. He was sure to point out that many women  go on and have healthy pregnancies following an eating disorder.

How do eating disorders affect a woman’s ability to get pregnant?

Some studies estimate the consequences of eating disorders contribute to approximately 18 percent of patients at fertility centers around the country. Fortunately, reproductive endocrinologists like Dr. Sasson can often treat any lingering issues. “It makes sense that women with eating disorders like anorexia can have trouble getting pregnant. Their periods are usually irregular—if not absent—which often means they’re not ovulating, or releasing an egg, each month. It’s all a defense mechanism on the part of the brain, which reverts back to a prepubertal hormonal state,” states Dr. Sasson.

Recovery, both of the mind and the body, is crucial to restoring the brain’s communication to the ovaries to release the hormones necessary for ovulation. According to Dr. Sasson, “The overwhelming majority of women, when they resolve the eating disorder piece, their periods will become regular again and they should not have trouble getting pregnant.” For those women who still struggle with ovulation issues, there are common oral fertility drugs like clomiphene citrate (Clomid or Serophene) that a physician can prescribe to stimulate the hormones to produce ovulation.

It can be a long journey back to a healthy life after suffering from an eating disorder. However, as the article points out, there are tremendous resources available from organizations like the National Eating Disorder Association and numerous books on the topic authored by survivors themselves. Shady Grove Fertility offers holistic support from our renowned professional counseling team who work in close concert with our medical team with to provide guidance to women who are ready to begin their families.

• U.S. News: The Lasting Toll of an Eating Disorder: Fertility Issues

To learn more about becoming pregnant and having a healthy pregnancy after overcoming an eating disorder, or to schedule an appointment with Dr. Sasson or any of our 34 reproductive endocrinologists, call 1-877-971-7755 or click to schedule an appointment.