General

For many patients, moving into the New Year means starting over with their insurance plans and finding new and innovative ways to pay for fertility treatment. Shady Grove Fertility offers a variety of programs that make affording treatment easier for our new and current patients.

One of the greatest resources for new patients considering fertility treatment is Shady Grove Fertility’s New Patient Center. This dedicated team can give patients a general idea of the cost of treatment and insurance coverage when scheduling new patient appointments, although ultimately the cost will depend on the treatment recommended by your physician after your first visit and initial work-up is complete. For current patients our dedicated team of financial counselors will work one-on-one with you to explore the best options for you based on your specific insurance coverage and financial situation.

Read the top 6 ways to afford treatment in 2013.

You might be surprised to learn about 90% of our patients with insurance have coverage for the initial consultation and diagnostic testing. Currently, Shady Grove Fertility accepts 33 different Insurance Plans. We find that 70% of patients will have some level of insurance coverage for the treatment they need. If you have insurance, you will likely have some form of coverage for your pre-screening, medications, and potentially treatments including IUI and IVF. Patients should expect some out-of-pocket expenses when utilizing their insurance plan including traditional deductibles, co-pays, and cycle deposits.

A Flexible Spending Account (FSA) is a special savings account provided by your employer that is funded with pre-tax money deducted from your paycheck. The funds can be used to pay for out-of-pocket medical expenses not paid for by insurance, such as deductibles, co-pays, and treatment not covered. Be aware that most FSAs are use-it-or-lose-it. Money that is left in the account at the end of the year won’t be refunded to you, so you want to be conservative when you choose how much to put in the account.

Last year, over 1,100 patients were approved and participated in the Shady Grove Fertility Shared Risk program. The Shared Risk 100% Refund for IVF & Donor Egg is an extremely popular program that takes the guesswork out of paying for treatment. Patients receive up to six (6) IVF cycles and subsequent frozen embryo transfers (FETs) for one flat fee with the added peace of mind that 100% of your money will be refunded if you decided not to proceed with treatment or if you do not take home a baby. This plan is ideal for patients planning to pay out of pocket, under the age of 39 or using donor egg treatment, and that are considered a good candidate for IVF. Click here to contact us about Shared Risk.

Shady Grove Fertility currently offers three discount programs for qualifying patients. The first is theMulti-Cycle Discount Program for IVF . This program is designed primarily for patients with no insurance coverage, and whose doctor recommends IVF treatment using their own eggs. This includes patients of any age and/or those not eligible for Shady Grove Fertility’s Shared Risk 100% Refund Program. By prepaying for multiple treatment cycles, this option provides up to a 40% discount off the cost of two fresh IVF cycles and subsequent FET (frozen embryo transfers) cycles. The Multi-Cycle Discount Program does not offer a refund of fees if a baby is not born, however, benefits include:

• Medical and laboratory fees for two (2) IVF Cycles
• Subsequent frozen embryo transfer cycles (FET)
• Cryopreservation & cryo storage fees for one (1) year
• Minimizes patient’s financial risk by fixing the cost of treatment and offering more than one chance at a successful pregnancy for a discounted rate

The second discount program we offer patients is the Shared Help Fertility Treatment Discount Program. This income based program, offers a discount off services and treatments to those patients whose household income is $95,000 or less and do not have insurance coverage for treatment.
Introduced in early fall 2012, the Military Discount Program was created for our members of the military that are currently on active duty or in the reserves. This discount program was designed to help make fertility testing and treatment more affordable by offering a 25% discount to active military who have no insurance coverage for fertility treatment. The Shared Help Discount Program and Military Discount Program are designed to work in conjunction and complement all of our financial programs.

Patients not able to conceive using their own eggs may need to consider the use of a donor’s eggs.Donor egg treatment has traditionally been an expensive option that frequently required an extensive wait. Shady Grove Fertility has one of the largest Donor Egg databases making the process of selecting the right donor fast. With Shady Grove Fertility’s unique Shared Donor Egg Program, a recipient can choose to keep all of the eggs from a donor (1:1, unshared) or share the eggs anonymously with another recipient (1:2) or two other recipients (1:3). The chance of a successful delivery is nearly identical in all three programs (63% success rate). Currently 75% of donor egg patients utilize the Shared Donor Egg Program which can cut the cost of treatment by up to 50%. If you choose to pair the shared donor program with Shared Risk, you will have a 6 cycle 100% money-back guarantee for the same cost as one traditional donor egg cycle.

Shady Grove Fertility works exclusively with Fertility Finance, LLC which specializes in providing patient financing services for all fertility treatment options. Last year, several hundred patients received loans from Fertility Finance. These loans, on average, provided patients with $15,000 dollars to help them realize their dream of becoming a parent. Fertility Finance has an easy loan process and competitive rates making them a great resource for patients.

Shady Grove Fertility supports the Tinina Q. Cade Foundation; a non-profit organization whose mission is to promote awareness of infertility and serve the needs of couples struggling with infertility. Each year, the Cade Foundation provides grants of up to $10,000 to infertile families to assist them with the cost of infertility treatment or domestic adoption. The Cade Foundation also established theSavannah Grant, a family building grant that will provide support to Shady Grove Fertility patients pursuing IVF. This grant, specifically designated for a Shady Grove Fertility patient, is in honor of Savannah Caroline Pereira, a SGFC baby who tragically died in March 2010. All Shady Grove Fertility patients are eligible to receive the Savannah Grant. To apply for these grants, submit an application here. Application Deadline for this year is June 1, 2012.

Affording fertility treatment doesn’t have to be complicated, to speak with someone at Shady Grove Fertility to discuss your financial options, call 1.888.761.1967.

For more information or to schedule an appointment with one of our physicians, please speak with one of our friendly New Patient Liaisons by calling 888-761-1967.

Anne and Matt tried for months to have a baby, while Anne had always struggled with her weight; it turned out to be the one thing in the end that would play a big role in her ability to conceive. When she and Matt decided to have a baby, although she was able to conceive, her first pregnancy ended in miscarriage. Eventually able to conceive her first son, Parker, her pregnancy caused her to gain a significant amount of weight, her heaviest at around 248 pounds. This began an uphill battle of weight gain and loss and a diagnosis that would change their life forever. After seeking help from Shady Grove Fertility Center and taking control of her weight, Anne and Matt were finally able to make their dreams a reality.

A “Grave” Diagnosis

After Parker was born, Anne was able to lose the baby weight over time. When her son was a year old, she began losing even more weight, but not in the way that she expected. “I found that I was able to eat however and whatever I wanted and lose weight like I’d not been able to do before, I was down to 170 pounds,” says Anne it was very scary, she ended up having another miscarriage and problems with her heart. After dealing with a headache for 3 days, Anne went to the doctor to find out what was going on. “The doctor wasted no time in diagnosing me with Grave’s disease”, says Anne. Graves is an autoimmune disorder that affects the thyroid and the hormones that control metabolism. It’s not been confirmed, but pregnancy can trigger the disease. In 2010, Anne’s thyroid was removed and her endocrinologist began testing her medication dosage to determinewhat combination would work best to manage Anne’s disease. “This was a stressful time, I was dealing with the disease and a recently brokenankle all while trying to keep up with a rambunctious 18-month old. That is when I began eating to deal with my stress” Anne explains. Between the medications and emotional eating, Anne found her way back to 190 pounds, a weight that she was never happy with for herself.

Trying Again

Anne and Matt had wanted to try for another child, but this was delayed so due to the recovery from thyroid removal.In September 2010,they were finally able to start trying again.“After Parker, it took 10 months to conceive, so when we tried this time around we figured we’d just be patient,” says Anne her OB/GYN didn’t find any reason to worry, the Grave’s was managed and Anne and Matt were both healthy. They kept telling themselves “we know you can get pregnant”, she’d been pregnant three times after all. They tried using Clomid for two months, when her OB/GYN advised they move on to a specialist. At now 38 years old, Anne was taking the news pretty hard, thinking she was at the end of the road and they would never be able to have any more children. She felt she was getting too old for anything to work and wondered if their dreams of a second child were over.

She made the emotional call to Shady Grove and scheduled to meet with Dr. Naveed Khan in theLeesburg, Virginia office. Although Anne was unhappy with her weight, Dr. Khan saw no reason why she and Matt shouldn’t be able to conceive. The couple was diagnosed with unexplained infertility; Dr Khan decided to start with a low tech treatment option called intrauterine insemination (IUI). The summer of 2011, they tried 3 rounds of IUI, none of which were successful.

Dr. Khan advised them to begin considering In Vitro Fertilization (IVF). Anne, at 39 years old, thought her dreams were over. “I thought I was done, I was beside myself, thinking it was just never going to work for us.” She was almost 40 years old, and Anne felt like she had run out of options. Dr. Khan and his team assured her that she would have a much higher chance of success with IVF and they would do everything they could to get them pregnant. “I knew that with IUI’s our chances weren’t very good at my age, but I felt like if that didn’t work, nothing would,” says Anne.

Taking Control

She found somewhere within her the strength to fight back. Determined to take control of something, she walked into Weight Watchers, “with infertility, there is so little in your control, my weight was the one thing I could control.” Over the next 4 months, Anne took control of her eating and lost 30 pounds. When she arrived for her egg retrieval, the anesthesiologist read her chart, “191 pounds”. Anne politely corrected him, “160 pounds now”. He was just shocked, “I must’ve taken those extra 30 pounds you lost” he joked. “This was one of her most redemptive moments in my journey. I had conquered something I had been struggling with for years; I felt like the weight had literally been lifted.” Anne explained.

The good feelings were short-lived, the night before her egg transfer, Anne’s son Parker had the flu, so she was up all night with him. She was worried and stressed, “it just felt that everything that could go wrong did go wrong on the day of my transfer. I felt everything but positive about the outcome.” A couple of weeks later, she went in for her pregnancy test. “ I had the worst cramps and felt bitter I knew my period would start any second”. Shirley, Anne’s nurse, told her not to count herself out just yet; those symptoms could very well mean something else.

Anne missed the call from Shirley later that day; she got the message but was in no state of mind to handle any bad news, so amazingly enough, she took a nap! She lay there, trying to psyche herself up to call her back and drifted off only to wake up to another message from Shirley. “Call me back Anne, this is good news!” At about 10-weeks pregnant, Anne says “to this day, I still can’t believe it!” Anne and Matt will welcome their second child in August 2013.

Staying Healthy

“Now that I have the mindset of healthy eating, it’s hard to go back to the old bad habits”, says Anne. Although she has been advised to stop Weight Watcher’s during her pregnancy, she is confident she now has the strength to get back to her pre-pregnancy weight once she has the baby. Looking back, Anne just believes that she did everything she could to achieve this pregnancy, “it never hurts to be healthier”. She does believe her thyroid medications play a big role in her weight management, but she is fully aware that she has to play her part in controlling her food choices as well. Anne says“I really think it made me feel better, if nothing else. I was depressed about infertility and eating to make me feel better and I am so happy to start a pregnancy at a healthy weight!”

At Shady Grove Fertility our patients come in all shapes and sizes. For the majority of patients weight may be a hurdle, but it is not insurmountable. We have resources to help every step of the way such as support groups and counselors available to meet the needs of your journey. Our doctors will work tirelessly to help you achieve your dreams of parenthood, but they may ask for your help along the way. Stay positive, stay hopeful, and trust that there isn’t much our doctors haven’t seen in their years of experience, we can help make dreams come true, no matter what stands in your way.

For more information or to schedule an appointment with one of our physicians, please speak with one of our friendly New Patient Liaisons by calling 888-761-1967.

By Kimberly Wong, RD, LDN
Pulling Down The Moon

Stress. There’s work stress, family stress, fertility stress…but now oxidative stress?

Oxidative stress is natural body process that is essential to physiological function. As we breathe, our cells produce energy, and our body uses oxygen in the process. As a result of these normal metabolic actions, Reactive Oxygen Species (also called free radicals) are produced. In layman’s terms, we can understand ROS’s as highly-reactive molecules that have lost an electron during a chemical reaction and roam around “stealing” electrons from other molecules. While this doesn’t sound particularly scary, this chain reaction actually causes a tremendous amount of trouble on a chemical level. Enter antioxidants.

Antioxidants are chemical compounds that happily give electrons to free radicals in order to keep chemical peace. Antioxidants are present inside the body and also come from food. Antioxidant vitamins include Vitamin E, A and C, alpha-lipoic acid (ALA) and other compounds found in fruits and vegetables. As long as our body’s antioxidant capacity is adequate to manage ROS production, all is well. But when the balance tips, and ROS production outstrips our antioxidant ability, free radicals begin to wreak havoc on DNA, cell membranes and tissues. This condition is called Oxidative Stress (OS). Oxidative Stress can cause damage to our cell membranes, alter protein and DNA and cause cell death. OS is implicated in chronic diseases like cancer and heart disease…and now fertility.

So, what about oxidative damage does a girlfriend need to know?

In general, our body knows what to do with free radicals. The body has abundant antioxidant systems that involve antioxidant substances like vitamins C and E, and their cofactors, selenium, zinc, and copper, which swoop through the body and dispose, scavenge, and/or suppress the formation of ROS. Yet it’s a delicate balance that our modern lifestyle with its pollution, over-processed/nutrient-bare foods and stressful pace is likely to upset.

“Oxidative Stress is increasingly recognized as a very important participant in many health disorders, including male and female infertility,” says Dr. Robert Stillman of Shady Grove Fertility. “Our understanding of oxidative stress and of Reactive Oxygen Species – and their reduction – can improve the overall quality of health of our patients – and their fertility”

In terms of fertility, when the bad stuff (ROS) begins to outpace the good stuff (our antioxidant defenses), our fertility may begin to suffer. Because sperm are basically “DNA torpedoes” with one simple mission (swim fast and fertilize egg), they don’t have extensive antioxidant defense systems and are vulnerable to ROS. In addition, they have a high polyunsaturated fat content, which makes them susceptible to lipid peroxidation (read: damage) in the cell membrane. Various environmental and life-style behaviors can tip the balance of OS for sperm, including STDs, automobile pollution, smoking and potentially diet. OS in sperm has been associated with deceased sperm motility, sperm number, and sperm-oocyte fusion (Desai 2009)

In women, the female ovary is the source of both oocytes (eggs) and the hormones that regulate reproduction. As such, the environment around the ovaries is of particular importance to optimal fertility. The ovaries are also “power houses,” and contain more mitochondria (cellular power plants) than any other cells, including muscles (Bentov 2010). For this reason, oocytes use lots of energy and oxygen, especially as they are maturing in preparation for ovulation, r oxidative stress.

Oxidative stress has been implicated in every stretch of the conception-to-birth cycle imaginable, including endometriosis and miscarriage, yet no direct research has been conducted on the effect of OS on female fertility. However, studies have shown that women with unexplained infertility show increased free radicals in the peritoneal fluid (the fluid around the egg) and, conversely, lower levels of peritoneal free radicals are associated with successful IVF procedures (Ruder 2008).

The good news is that there are simple strategies for coping with oxidative stress. Here’s the “need to know:”

• Increase your dietary antioxidant consumption. A diet that is wholesome and rich in fruits, vegetables, tea, and healthy fats will improve our body’s defenses against oxidative stress. Be aware that many sources of healthy fats in the diet (fatty fish, flax seed) should be consumed intelligently to avoid excess intake of environmental toxins (fish) and phytoestrogens (flax).
• Avoid high intensity/high impact exercise. The huge aerobic and mechanical demands of strenuous exercise can actually increase oxidative damage to cells in the body. On the flip side, moderate intensity/low impact exercise increases our body’s defenses against oxidative stress.
• Consider an antioxidant supplement or insure your prenatal vitamins have adequate anti-oxidant levels.
• Quit smoking and avoid exposure to second-hand smoke.
• Limit alcohol consumption to < 3 servings per week. Choose red wine for its antioxidant benefits.
• Learn to relax, practice yoga or meditate. Life stresses may elevate levels of ROS in the body.
• Oxidative stress may also be higher where inflammation is present, so ensuring good digestion and gut health may reduce circulating levels of ROS. If you’re experiencing diarrhea, bloating, constipation, cramping or other digestive symptoms, it may be worthwhile to meet with a nutrition specialist to determine if food sensitivity or other digestive disorder is present.
• Where possible, use organic cleaning products.

Now, with a firm basis in OS and its effect on fertility, a gal is ready to face the fertility journey. Always at your availability is the advice of a Pulling Down the Moon nutrition expert in this field, who can help you optimize your dietary intake. Our ART Recovery/Prep Nutrition program is specifically designed to reduce inflammation and oxidative stress as well as provide optimal nutrition for fertility. For more information please visit www.pullingdownthemoon.com or call 301-610-7755.

The single most common misperception among women is that they can achieve a pregnancy at any age. It is not true. A woman’s fertility naturally decreases with age and fertility treatment results follow the same lines, down over time, beginning in the early 20’s and dropping more rapidly after 35.

Certainly there is a biological clock,” says Dr. Rachana Garde of Shady Grove Fertility Center’s Woodbridge and Annadale office, “but I don’t think all young women should feel compelled to have their fertility tested.”

Fertility specialists like Dr. Garde recommend the following general timetable as a guide to when it’s time for testing:

• Women younger than age 35 who have been unable to conceive within a year
• Women older than 35 who haven’t conceived within six months
• Women in their 40’s who are just starting out toward conception

The powerful impact of natural aging on a woman’s fertility is more than just a myth. If a woman has no physical obstacles to conception like hormonal or structural conditions, if she’s in at least relatively good health overall, and if there are no male factor fertility issues her level of fertility will decline from a general peak in the early 20’s to a pronounced downward turn around age 40.

Dr. Garde assures, “Still, most people don’t have fertility issues, so testing of everyone without cause for concern would be wasteful.”

Read more about when you should seek fertility treatment.

More Than Time

In addition to the impact of time, Dr. Garde emphasizes that other factors can compound fertility problems, and many can be discussed with their OB/Gyn or with one of Shady Grove Fertility’s physicians during an initial consultation.

“All current or past medical conditions should be discussed in case any might impact fertility. Irregular cycles are definitely a topic to bring up to your OB/Gyn or fertility doctor.”

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Problems with ovulation are a common cause of fertility problems. Women who ovulate regularly usually have menstrual cycles that range from 24 to 34 days. Women who have irregular cycles may ovulate infrequently or not ovulate at all, and only have a period every few months if at all.

Lifestyle activities can also stand in the way of getting pregnant. “We know that cigarette smoking affects egg quality,” Dr. Garde says, “so no matter the woman’s age, we recommend that they quit. Heavy drinking, too, can play a part in a woman’s reproductive capacity, as well as contact with certain environmental toxins such as pesticides, chemicals that can be found in paint or household cleaners and metals such as lead and mercury.”

Body Mass Index (BMI), a calculation of body fat based on height and weight, correlates with some ovulation disorders, so food intake and exercise can have a bearing on fertility. The BMI for achieving pregnancy is between 19 and 25. This is also not age-dependent, although it’s normal for women to generally increase their body weight as they get older. View our Webcast on Weight, BMI & Infertility

Your Diagnosis May Vary

Variations in diagnostic tests for fertility are based more on individual differences than on age. Dr. Garde explains that the baseline measures of fertility are mostly the same for everyone, regardless of their age.

“We look at reproductive hormone status, whether or not the woman’s tubes are open, and semen analysis for the male partner. There may be additional ovarian reserve tests, such as a clomiphene challenge test, for older women, but again, we’re guided in our diagnostic path by the individual’s responses to tests and to their medical history more so than their age.”

Solutions May Be The Same

Contrary to what the media may have you believe, not every woman who seeks fertility assistance in her 30’s will undergo IVF. Here, too, all other fertility factors are taken into consideration. Many will benefit from intrauterine insemination (IUI) and some will need IVF with donor egg.

Similarly, not all women in their 20’s will respond successfully to IUI. So it’s a generalization to say that as a woman gets older, her need for assisted reproductive technology will become more complex and expensive.

“If a woman has any concerns or worries about getting pregnant,” Dr. Garde reasons, “she should bring it up to her gynecologist, regardless of her age. If her questions go unanswered, or if she simply wants to be sure she’s benefiting from the most recent reproductive knowledge, she can come to Shady Grove Fertility for a consultation.”

Dr. Garde added, “There is no additional cost to see a specialist versus an OB/Gyn, and often, because the practice focus is only on infertility, the diagnosis process may be more rapid. We do whatever is best for each patient. That’s what we’re here for.”

To Schedule an Appointment with Dr. Garde, or any other Shady Grove Fertility physician, please call 1-888-761-1967.

If you’re trying to get pregnant and it’s taking longer than you thought, you might be worrying about infertility. Is there something preventing you from getting pregnant, in your physiology or your lifestyle? The only way to find out for sure is to have a complete infertility evaluation performed. Dr. Jason Bromer of Shady Grove Fertility’s Frederick office says there are some common symptoms of infertility that couples should not ignore.

Women who have irregular periods or who don’t get a period at all many have a sense that their ability to get pregnant might be affected. Menstruation is tied to ovulation, the process whereby the ovary releases a mature egg every month to be fertilized. If you don’t ovulate or you only ovulate sometimes, it will be very difficult or even impossible to get pregnant.
“An irregular or nonexistent period almost always means there is an underlying ovulation disorder. This is a really common cause of infertility in women,” says Dr. Bromer. “The good news is that, in most cases, all we have to do is get you to ovulate, and you can get pregnant.” The process of getting the woman’s body to start ovulating again is called ovulation induction and can be as simple as taking an oral medication.
“We will always do a full evaluation of a woman who has irregular menses to make sure nothing else is wrong,” says Dr. Bromer, “but if ovulation is the only problem, we can start with very simple and low tech treatments and her chances for pregnancy are very good.”

A woman’s age affects the quality of her eggs. As she gets older, the quality of her eggs declines and her chances for pregnancy decrease. At the same time, the chances of miscarriage and of genetic abnormalities begin to increase.
“A lot of women think that at the age of 35, their fertility just falls off a cliff,” says Dr. Bromer. “The reality is that it starts to decline in their 30s, but the decline accelerates more rapidly over 35. This means that every year over the age of 35 matters more and more. For example, there isn’t a great difference between being 25 and being 27 in terms of getting pregnant, but there is a big difference between being 35 and being 36. And your chances are better at 36 than they are at 37, and so on.”
One common misunderstanding is that fertility treatment can reverse this decline, allowing older women the same chances to get pregnant as younger women. Dr. Bromer says that sadly, for women using their own eggs, this is not the case. “Age is the one problem that we really cannot fix,” he says. “The effectiveness of fertility treatments also goes down as a woman’s age goes up.”
He adds, “What this means for treatment is that we will be more aggressive. We might move to IVF sooner because we want a treatment that will work faster. We might also suggest moving from IVF to donor eggs sooner or, in some cases, just going directly to donor eggs.”
The great thing about using donor eggs is that the chances of success depend on the age of the donor, not on the age of the recipient. At Shady Grove Fertility, all our donors are healthy women between the ages of 21 and 32, so the success rates are very high.

Some women have heard the guidelines about when to seek help from a fertility specialist. Women under the age of 35 are often told to try on their own for a year while women over 35 are asked to try naturally for just six months. The catch with these time frames is that they only consider the time you have been having unprotected intercourse not the amount of time you have “been actively trying to conceive.”
“The definition of infertility is one year of unprotected intercourse without a pregnancy,” says Dr. Bromer. “It doesn’t matter if you’ve been actively trying at the right time of the month. After a year, 85% of couples will be pregnant. The rest need to be evaluated.”
Dr. Bromer adds, “If you meet the criteria for infertility – one year of unprotected sex without pregnancy – all it means is that an evaluation is warranted. It doesn’t necessarily mean you need fertility treatment, but you should definitely have a complete infertility workup and find out what’s going on.”

Sexually Transmitted Diseases (STDs), even those that are successfully treated, can affect a woman’s fertility. STDs, especially chlamydia and gonorrhea, can cause inflammation and scar tissue that damage the fallopian tubes. Any damage to the fallopian tubes can prevent pregnancy or make it much more difficult. It also increases the risk of ectopic pregnancy, which is a pregnancy where a fertilized egg is stuck in the fallopian tube and must be removed.
“A history of STDs doesn’t necessarily mean that you will have infertility, but it’s worth getting checked out,” says Dr. Bromer. “We have simple tests that can evaluate the health of the fallopian tubes. Once we have the results, we will know whether the patient needs treatment or we can take a wait and see approach.”

We all know you’re not supposed to smoke when you’re pregnant, but it turns out that smoking, including regular exposure to second-hand smoke, also makes it much harder to get pregnant. Smoking affects the quality of a woman’s eggs. It affects the ability of the fallopian tubes to transport the egg and sperm, which makes getting pregnant harder and increases the risk of an ectopic pregnancy. Smoking by men affects their production of sperm and can cause erectile dysfunction. “Even with fertility treatment,” says Dr. Bromer, “pregnancy rates go down dramatically if the patient smokes.”
In fact, studies of patients undergoing IVF treatment have found that female smokers need higher doses of hormones to stimulate their ovaries, have fewer eggs obtained, more canceled cycles, lower implantation rates, and undergo more cycles with failed fertilization than nonsmokers. For this reason, Shady Grove Fertility won’t start treatment with a patient who smokes. “We don’t think it’s appropriate for patients who smoke to go through the effort and expense of fertility treatment. It’s like fighting with one hand tied behind your back,” says Dr. Bromer.
Quitting smoking is difficult, but it does make a difference. Experts believe that if you stop smoking, even just 2 months before you start fertility treatment, it significantly improves your chances of getting pregnant. “When we see patients who are smokers, we strongly encourage them to stop smoking, and we provide them with resources they can consult for help.”

Pain, above and beyond the normal cramps associated with your period, can be a sign of a condition called endometriosis. In this condition, the uterine lining, called endometrium attaches and grows outside the uterus in the abdominal cavity. This endometrial tissue bleeds and causes inflammation and scarring. That scar tissue can block the fallopian tubes or interfere with their function. Endometriosis can also cause cysts in the ovaries that affect their ability to release eggs.
“If you have painful periods and you’re trying to conceive, you should be evaluated for endometriosis,” says Dr. Bromer. “How much endometriosis affects your ability to get pregnant depends on the health of your fallopian tubes and ovaries. With an infertility workup, we can assess the situation and decide whether treatment is necessary and what treatment might be best. With the right treatment, women with endometriosis have a good chance of getting pregnant.”
If you recognize one of these symptoms in yourself, it’s best to talk to your doctor about it right away. There are ways to treat almost every problem associated with fertility, so none of these symptoms have to be a roadblock to your success.
For more information or to schedule an appointment with one of our physicians, please speak with one of our friendly New Patient Liaisons by calling 888-761-1967.