fertility Blog

When considering fertility, it’s important to understand the various health conditions that can have an impact on fertility. Endometriosis and polycystic ovary syndrome (PCOS) are two common conditions that can pose problems when trying to become pregnant. While both conditions can affect fertility and share some overlapping symptoms, they are different in their causes, symptoms, and treatments.

What is Endometriosis?

Endometriosis is a condition where tissue similar to the lining inside the uterus, known as the endometrium, starts to grow outside of the uterus. This can lead to inflammation, pain, and the formation of scar tissue within the pelvic region. The condition affects about 10% of reproductive-aged women globally. A person with endometriosis may experience:

• Very painful periods.
• Pain with sexual intercourse.
• Pain with bowel movements or urination, especially during your period.
• Periods that are extremely heavy or abnormally long, or spotting between periods.
• Pelvic pain that ranges from mild discomfort to severe cramps.
• Bloating, diarrhea, constipation, or nausea.
• Chronic fatigue.

Although the exact cause of endometriosis is unknown, we do know why the disorder causes these symptoms. During your menstrual cycle, the lining inside the uterus thickens to prepare for pregnancy. If a pregnancy does not occur, the endometrium breaks down and sheds, exiting the body through the vagina. Whenendometrial tissue grows outside of the uterus, there is no way for it to shedand exit the body. This causes the inflammation, scarring, and other symptoms seenin patients with endometriosis.

What is PCOS?

PCOS is a hormonal disorder common among women of reproductive age. It is characterized by long or irregular menstrual cycles and elevated levels of male hormones (androgens). The disorder affects approximately 8-13% of reproductive-aged women globally, with up to 70%remaining undiagnosed.

PCOS characterized by a combination of symptoms that can impact the menstrual cycle, fertility, hormones, appearance, and long-term health. These symptoms include:

• Irregular menstrual cycles or the absence of menstruation.
• Excess hair on the face, chest, abdomen, or upper thighs, known as hirsutism.
• Severe acne or acne that doesn't respond to usual treatments.
• Thinning hair or male-pattern baldness.
• Weight gain or difficulty losing weight.
• Darkening of the skin, particularly along neck creases, in the groin, and underneath breasts.
• Skin tags, which are small excess flaps of skin in the armpits or neck area.

The exact cause of PCOS is unknown, but several factors are thought to play a role in its development.

Insulin Resistance: Insulin resistance is common in people with PCOS. This can lead to higher insulin levels, which can increase androgen production and affect ovulation.

Hormonal Imbalance: Sex hormone imbalances are common with PCOS, including elevated levels of androgens. This can disrupt menstrual cycles and cause symptoms like acne and excess hair growth.

Low-grade Inflammation: People with PCOS may have a type of low-grade inflammation that prompts the ovaries to produce androgens.This can contribute to cardiovascular and metabolic issues.

Heredity: Having family members with PCOS increases a woman's risk of having the disorder.

Excess Gonadotropin Production: An imbalance in luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels can contribute to the development of PCOS, affecting ovarian function and hormone production.

The primary difference between endometriosis and PCOS lies in the causes of the disorders. Endometriosis involves the growth of uterine-like tissue outside of the uterus, causing physical symptoms mainly related to menstruation and fertility. In contrast, PCOS is characterized by hormonal imbalances affecting the ovaries, leading to symptoms related to menstrual irregularity, changes in physical appearance, and insulin resistance.

How Does Endometriosis Impact Fertility?

Women with endometriosis do experience infertility more often than women without endometriosis though it is important to know that women with endometriosis can and do get pregnant, even without assistance. The growth of endometrial type tissue outside of the uterus can significantly impact a woman's fertility in several ways:

Obstruction and Scarring: Endometriosis can cause scarring and adhesions on the ovaries and fallopian tubes. This can interfere with the release of eggs from the ovaries and their subsequent fertilization and journey to the uterus.

Inflammation: The presence of endometrial tissue outside the uterus creates an inflammatory response that can affect the quality of eggs, sperm, and even a fertilized embryo. This can cause complications with the fertilization process and embryo implantation.

Hormonal and Ovarian Function Disruption:Endometriosis can  affect ovarian reserve and the pool of eggs available for fertilization, either through damage to the ovaries or through surgery to remove endometriosis lesions. Many women with endometriosis have cysts inside of the ovaries we call endometriomas that can be seen on ultrasound.

Immune System Response: Some theories suggest that an abnormal immune response may be involved in endometriosis, which might affect fertility by targeting the embryo or disrupting the environment necessary for a successful pregnancy.

How Does PCOS Impact Fertility?

PCOS primarily affects fertility through hormonal imbalances and ovulatory dysfunction:

Irregular Ovulation: The hallmark of PCOS is irregular or absent ovulation, which directly impacts fertility since ovulation is necessary for conception. Women with PCOS may have fewer opportunities to conceive due to infrequent ovulation, making it difficult to become pregnant.

Hormonal Imbalances: Elevated levels of androgens(male hormones) and insulin resistance can disrupt not only the environment necessary for regular ovulation, but also the development of the uterine lining. This makes it difficult for an embryo to successfully implant in the uterus.

Ovarian Environment: The ovaries of people with PCOS often contain multiple immature follicles that do not grow to full maturity. This contributes to difficulties with poor egg quality and normal ovulation.

Metabolic Factors: Obesity and insulin resistance are common in PCOS, which can further exacerbate hormonal imbalances and inflammation. This affects an individual’s overall reproductive health and the ability to conceive.

What should I do if I think I have endometriosis or PCOS?

If you suspect you have PCOS or endometriosis, you should make an appointment with your primary care provider, gynecologist, or one of our reproductive specialists to discuss your concerns. Explain your symptoms openly and honestly, providing detailed information about your menstrual cycle, pain levels, and any other relevant symptoms.

Maintaining a journal to track your symptoms can also be helpful. Include the frequency and severity of any pain you are experiencing and record your menstrual cycles and any other relevant changes in your body. This information can help your healthcare provider make an accurate diagnosis and develop an effective treatment plan.

Once you have a diagnosis, your provider will review your treatment options with you. Treatment approaches may vary depending on the severity of your symptoms, your overall health, and your reproductive goals.

How Is Endometriosis Treated?

Living with endometriosis or PCOS can be challenging, but a range of treatments is available to manage symptoms and improve quality of life. The right treatment depends on several factors, including the severity of symptoms, the individual's health profile, and their family planning goals.

Endometriosis treatments aim to alleviate pain, reduce endometrial growth, and address fertility issues. Options include:

• ‍Pain Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help manage menstrual pain and discomfort associated with endometriosis.
• ‍Hormonal Therapies: Hormone-based treatments, such as birth control pills, gonadotropin-releasing hormone (GnRH)agonists, and progestins, can help control hormonal fluctuations and reduce the growth of endometrial type tissue.‍
• Surgical Options: For more severe cases or when fertility is a concern, surgical interventions like laparoscopy can remove endometrial growths. Surgery is often not recommended for the sole purpose of treating infertility, however, as there is not a lot of data to suggest that it necessarily improves your chances of getting pregnant. Sometimes it is necessary to obtain a diagnosis or to simply treat the pain often associated with endometriosis. Whether you need to have surgery would definitely be a conversation to have with your physician.  In extreme cases, a hysterectomy might be considered, though this is generally a last resort, especially for women who wish to have children.
• ‍Assisted Reproductive Technologies (ART): For women with endometriosis experiencing infertility (where the endometriosis has not caused a blockage of your fallopian tubes), treatments like combining fertility drugs with intrauterine insemination (IUI) or in vitro fertilization (IVF) may offer a chance to conceive. If your tubes are blocked, whether that is from endometriosis or other reasons, IVF would be your only option for treatment.

How Is PCOS Treated?

Managing PCOS involves addressing symptoms such as irregular periods, hirsutism, and infertility and minimizing the risk of long-term complications like type 2 diabetes and heart disease. Treatment strategies include:‍

• ‍Lifestyle Changes: Weight management through diet and exercise can significantly improve symptoms, reduce insulin resistance, and in some women restore regular menstrual cycles without the need for fertility treatments.‍
• Medications to Induce Ovulation: For women trying to conceive, medications like clomiphene citrate (Clomid) or letrozole (Femara) can stimulate ovulation.This is the treatment you most likely would start with, assuming other factors are normal (male factor/fallopian tubes).‍
• Insulin-Sensitizing Drugs: Metformin, used primarily to treat type 2 diabetes, can also help improve insulin resistance and ovulatory function in women with PCOS who don’t have diabetes.N ot every patient with PCOS will need to take metformin, but your doctor may recommend it if there is evidence that you do have insulin resistance.‍
• Hormonal Contraceptives: Birth control pills can regulate menstrual cycles, reduce androgen levels, and alleviate symptoms like acne and excess hair growth. You might be placed on the birth control pill for several months to try and regulate your cycles before starting fertility treatments. If you are not trying to get pregnant, being on hormonal contraceptives long term can help treat many of the symptoms you experience with PCOS.
• Androgen-Blocking Medications: Drugs such as spironolactone can reduce hirsutism and acne by blocking the effects of androgens. These medications are not ones that you can take while undergoing fertility treatment or during pregnancy.

It's important to work closely with your healthcare provider to create a personalized treatment plan. Factors such as symptom severity, age, overall health, and reproductive goals should guide treatment decisions.Regular follow-ups and adjustments to the treatment plan can help manage these conditions effectively over time.

Coping with PCOS or endometriosis can also be emotionally challenging. Seek support from friends, family, or support groups where you can connect with others who understand what you're going through. Additionally, consider consulting a mental health professional if you're struggling with anxiety, depression, or other emotional difficulties related to your condition.

The journey to parenthood can be complex for those with conditions like endometriosis or PCOS, but with the right treatment plan and support, you can manage symptoms and pursue your goals, including starting a family. At Advanced Fertility Care, we are committed to providing personalized, compassionate care to help our patients navigate their fertility journey, offering hope and expert guidance every step of the way. 

Our dedicated team of specialists is here to offer you personalized care, from diagnosis to treatment, helping you navigate your fertility journey with compassion and expertise. Whether you're just starting to explore fertility treatment options, or you've been on this path for awhile, reach out to us today– we're here to support you every step of the way.

Infertility can stem from any number of causes, including things like endometriosis, ovulation problems, sperm-related issues, or polycystic ovarian syndrome (PCOS). Luckily, there are many treatment paths available for your unique fertility journey.  

Clomid, or clomiphene citrate, is an oral medication often used to treat infertility. Let's look closer at Clomid, the treatment process, and whether it's right for you.

Understanding Clomid

Clomid stimulates ovulation by promoting follicle-stimulating hormone (FSH) secretion. FSH then stimulates the growth of egg follicles, which are fluid sacs in your ovaries with eggs in them. Assuming you naturally ovulate (which isn't always the case), you only ovulate one egg. The purpose of the Clomid is to get more than one follicle to grow. The whole goal of being on Clomid is to get 2-3 eggs to be released that month instead of just the one that is ordinarily ovulated. If you don't ovulate at all, clomid can help make you ovulate, which gives you a chance of getting pregnant that month. Clomid also leads to increased estrogen levels, which increases luteinizing hormone (LH) levels, stimulating egg release (ovulation). Clomid may also be given for a Clomid challenge test, which can diagnose age-related infertility, though this is not done as often as it was in the past.

Clomid is typically used in an intrauterine insemination (IUI) cycle but is also sometimes part of an in vitro fertilization (IVF) cycle. There's some evidence that Clomid may also promote sperm and testosterone production, so it could be used to treat male infertility in some cases. Clomid success rates vary from person to person, depending on the root cause of infertility.

The Process and Protocol

Seeing a fertility specialist can help you get to the bottom of what's causing your infertility. They'll discuss your medical history and perform any diagnostic testing that may be needed so they can devise a custom treatment plan.

A Clomid treatment plan may vary, depending on whether your menstrual cycles are regular or not. But typically, Clomid is taken for several days in a row, starting during your menstrual cycle. You may need to do several rounds of Clomid. However, if you still aren't getting pregnant after several cycles of taking Clomid, you may need to pursue additional treatment.

While you're taking Clomid, your fertility specialist may conduct ultrasounds to check on your follicle growth and development. They may also do blood tests to check your hormone levels to show whether the Clomid works. The tests also help determine the best time to have intercourse or undergo IUI. Ovulation usually happens around two weeks before your next menstrual cycle, so this may be when intercourse or IUI is recommended.

Potential Side Effects and Risks

Like any medication, Clomid can cause side effects. You may experience mood swings, hot flashes, discomfort around your ovaries, breast tenderness, headaches, or spotting. There's also an increased risk of multiple births with Clomid.

Ovarian hyperstimulation syndrome (OHSS) is another possible risk of taking Clomid, though this is actually quite rare when taking it orally. OHSS is when the ovaries become overstimulated from fertility medications, and they become swollen and painful. And you may experience symptoms like abdominal pain, nausea, and vomiting with OHSS. This condition, again, is rare with Clomid and usually lasts for less than a week.

Maximizing Success with Clomid

Clomid can help stimulate ovulation and increase the chances of pregnancy. Lifestyle changes, like eating a healthy diet and exercising, can help boost fertility. Avoiding smoking, minimizing alcohol use, and getting plenty of antioxidants and vitamin D can also be helpful for male infertility.

Whatever your situation, seeing a fertility specialist is essential to ensure you have the best possible chances of getting pregnant.

There is Hope for Those Dealing with Infertility

Clomid is one of many effective treatments for infertility. If you're struggling to get pregnant, don't hesitate to reach out to our professional, compassionate team of fertility specialists at Advanced Fertility Care. Contact us today with any questions or to schedule a consultation.

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Couples struggling with infertility may benefit from preimplantation genetic testing (PGT), which can increase the chances of having a successful pregnancy. Infertility clinics will perform PGT testing before implanting an embryo into the uterus for IVF. This article outlines what PGT is, discusses who could benefit from it, and explains the different types of PGT.

What is PGT? 

Preimplantation genetic testing (PGT) is an option for couples undergoing in vitro fertilization (IVF). This testing screens the embryos for potential genetic and chromosomal abnormalities before implanting them into the uterus. PGT plays a crucial role in selecting the embryos with the highest chance of success during fertility treatments, like IVF, for implantation. Only the unaffected embryos are transferred to the uterus for implantation to increase the success of implantation.

Is PGT for Me? Who Can It Help? 

There are many factors to consider when deciding to have PGT. Reasons to consider PGT include:

• Previous pregnancy with aneuploidy (chromosome abnormality)
• Two or more miscarriages
• Couples at risk of having a child affected with an inherited genetic disorder
• Previously failed embryo implantation
• Women who are diagnosed with unexplained infertility
• Women over the age of 35
• Numerous unsuccessful fertility treatments

It is best to consult with a fertility specialist to make the best-informed decision. A fertility specialist will go over your health history, individual fertility journey and will be able to answer any questions.

Understanding the Different Types of PGT 

There are three different types of PGT. Preimplantation genetic testing-monogenic (PGT-M) testing targets a single gene disorder. Preimplantation genetic-testing aneuploid (PGT-A) is a broader test that screens for one or more extra or missing chromosomes, known as aneuploidy. Fertility clinics may recommend preimplantation genetic testing-structural rearrangements (PGT-SR) for concerns of translocations. Translocations are when two chromosomes break off and switch places.

Fertility specialists recommend conducting PGT during the blastocyst phase of an embryo, which is an early developmental stage of an embryo. Embryologists can also complete this testing at the embryo's later stages if needed. When performing PGT, embryologists will biopsy about 5-10 cells from the trophectoderm layer or the outer layer of an embryo that turns into the placenta. These cells do not require a biopsy of the inner cell mass, which turns into the developing fetus.

PGT-A (Aneuploidy Screening)

The PGT-A screens embryos for whole chromosome abnormalities. An embryo should have 46 chromosomes, of which half come from the egg and the other half from the sperm. PGT-A screens for any missing or extra chromosomes that may lead to failure of the embryo to implant, a miscarriage, or cause significant health issues for the child after birth. This screening counts the 46 chromosomes in an embryo to determine if there are any extra or missing chromosomes, a condition clinically referred to as aneuploidy. PGT-A screening can reduce the risk of having a child with genetic or chromosome abnormality, like Down syndrome, by identifying abnormal embryos so that transfer to a uterus can be avoided It can also help identify embryos with the greatest chance to implant during IVF, resulting in pregnancy.

Because PGT-A can identify embryos with high probability of implantation some fertility specialists recommended transferring only one embryo to avoid complications that may arise in pregnant patients with multiple fetuses.

Screening all 46 chromosomes means that the embryo sex is also available. This can benefit situations where a genetic disease is inherited based on embryo sex. Chromosomal abnormality in a developing fetus can lead to an increased risk of stillbirth, shortened lifespan, or cause significant medical problems after the child is born and is the leading cause of pregnancy loss. Screening the embryos for chromosomal abnormalities can avoid some of these situations and decreases the risk of miscarriage.

Additional testing of PGT-A adds extra cost to IVF. Insurance may not help cover the cost of PGT-A testing with the fertility treatment. Genetic screening tests also require embryologists to remove 5-10 cells from the trophectoderm, which are the cells that become the placenta. Testing is usually performed during the blastocyst stage of an embryo to decrease the risk of damage. The inner cells of the embryo that develop into the fetus are not disturbed. The risk of damage to the embryo is very low when performed in labs that routinely perform PGT screening.

Testing can deliver a false negative or false positive result. Healthy embryos can remain unused or for an embryo transfer with chromosomal abnormalities to occur due to test results. The test uses cells from the placenta and not the fetus, so it is not considered a diagnostic test. However, early genetic screenings also test cells from the placenta. Testing on the DNA of the fetus is not available until 15 weeks of pregnancy through an amniocentesis.

PGT-M (Monogenetic/single gene disorders)

PGT-M tests for a specific genetic mutation associated with a known diagnosis or known predisposition within the family. PGT-M does not test for all single gene disorders at once and will not detect genetic alterations present for the first time in one family member due to a variant. This type of testing uses cytogenetic or molecular techniques for single-gene disorders, like Huntington's disease, cystic fibrosis, or Fragile X syndrome. This includes single-gene disorders that are autosomal dominant and recessive or X-linked. PGT-M testing can also test for hereditary cancer syndromes like breast and ovarian cancer and Lynch syndrome. Furthermore, PGT-M can assist in detecting embryos that are compatible with human leukocyte antigens. These embryos can then be gestated so that ill family members can receive bone marrow transplants or cord blood transfusions compatible with their immune systems.

PGT-M tests a few cells from the early embryo, usually in the blastocyst stage. Misdiagnosis is possible but rare. To confirm the results of PGT-M, fertility specialists may recommend chorionic villus sampling (CVS) or amniocentesis.

PGT-SR (Structural Rearrangements)

Embryos at risk for chromosome rearrangement, when pieces of chromosomes are missing, duplicated, or rearranged, may consider having PGT-SR testing. It is important to consider genetic counseling and preimplantation genetic screening with the discovery of structural rearrangement in either parent. An individual with a chromosomal rearrangement is at an increased risk of experiencing recurrent pregnancy loss or having a child with a chromosomal rearrangement. If someone has experienced two or more pregnancy losses, fertility specialists may recommend a karyotype screening to check for any possible chromosomal rearrangement before beginning IVF. Testing for PGT-SR can lower the chances of experiencing another pregnancy loss or giving birth to a baby with a chromosomal abnormality.

It's important to note that PGT-SR testing has certain limitations. For instance, this type of testing cannot distinguish between an embryo with a typical karyotype and one with a balanced form of familial chromosome rearrangement. Individuals who carry balanced chromosome rearrangement involving imprinted genes are susceptible to irregularities related to uniparental disomy. This occurs when the embryo receives both copies of a chromosome from one parent instead of inheriting one from each parent. Uniparental disomy cannot be excluded from all preimplantation genetic testing analysis methods. A fertility specialist may recommend CVS or amniocentesis to confirm PGT-SR results.

Helping With Your Fertility Journey

Preimplantation genetic testing can help increase the chances of successful implantation for IVF patients. There are various reasons it may be considered. If you have been struggling with infertility, discuss your situation with one of our fertility specialists at Advanced Fertility Care to determine if PGT is right for you.

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Infertility is a common problem for many people trying to get pregnant. Fortunately, many treatment options are available to help those struggling with infertility. Medications, such as letrozole, are often recommended as part of an infertility treatment plan. 

What is Letrozole?

Letrozole is an oral medication that influences reproductive hormone balance in the body. Letrozole is an aromatase inhibitor, which reduces the hormone estrogen. It's widely used in breast cancer treatment, but it's also an effective treatment for infertility since its hormonal effects stimulate ovulation. 

How Safe is Letrozole, and Does It Work? 

Letrozole has been used to treat infertility for over twenty years. Success rates will always vary from person to person. Still, many studies suggest that letrozole is especially helpful for women dealing with polycystic ovarian syndrome (PCOS) or ovulation problems, like anovulation. 

Luckily, letrozole is safe to take, but like any medication, it can have side effects. Some women may experience hot flashes, night sweats, headaches, tiredness, breast tenderness, dizziness, and spotting, to name a few. Letrozole's side effects are mainly related to how it affects estrogen levels.  

Medication Alternatives to Letrozole

Medications are often the first-line treatment for women going through ovulation problems. Fertility drugs like letrozole impact hormones that affect ovulation and reproduction. 

Clomiphene is one common alternative to letrozole. This oral drug works on the pituitary gland, promoting the release of hormones that encourage the growth of ovarian follicles containing eggs. Clomiphene may be more effective for women who don't have PCOS. 

Human chorionic gonadotropin (hCG) is an injectable medication that may also help the body develop multiple ovarian follicles during an in vitro fertilization (IVF) cycle. 

Letrozole and IVF

Letrozole can be a valuable part of IVF and IUI treatments since stimulating ovulation can help increase the chances of conception. 

Letrozole is also commonly used during an intrauterine insemination (IUI) cycle. Before IUI, you'll typically take either clomiphene or letrozole to stimulate your ovaries. Next, an injection of hCG is given, inducing ovulation. Then, sperm from a donor or a partner is collected, prepared, and placed into the uterus using a thin tube. An IVF cycle has several steps, including ovarian and pituitary suppression, ovarian stimulation, egg retrieval, egg fertilization in a lab, and the transfer of embryos into the uterus. Letrozole can be used in select patients as part of an IVF cycle to improve ovulation or impact the menstrual cycle to help make IVF as effective as possible.

Embracing Letrozole as an Effective Fertility Aid

Letrozole continues to be a safe and effective choice for many people struggling with infertility when used appropriately under the guidance of a fertility specialist. If you're coping with infertility, it's important to empower yourself with the knowledge to make the best decisions for your unique situation. 

Our caring team of fertility experts at Advanced Fertility Care is always here to answer any questions. We strive to provide compassionate, individualized care to support you in building a family. Contact us today to schedule a consultation.

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A testicular varicocele is a common but often unnoticed condition that can significantly impact male fertility. It is characterized by enlarged veins in the scrotum, similar to varicose veins in other parts of the body. This condition can cause discomfort, testicular shrinkage, and, most importantly, hinder the production of healthy sperm. 

This article explains what a testicular varicocele is, the symptoms, the connection to infertility, the available treatment options, and when to seek medical care.

What is Testicular Varicocele?

A varicocele refers to the swelling of the veins that transport oxygen-depleted blood away from the testicle, located within the scrotum. 

Under normal conditions, two arteries (one for each testicle) provide the testicles with oxygen-rich blood. Two testicular veins return the blood to the heart once depleted of oxygen. Along with these larger testicular veins, the scrotum contains many small veins forming the pampiniform plexus network. This network acts as a conduit between the testicle and the testicular vein. A varicocele happens when blood pools in the vessels of the pampiniform plexus, causing the vessels to dilate.

Cause and Risk Factors

The exact cause of varicoceles is unknown, but they are believed to occur when the valves within the veins prevent proper blood flow. This results in pooling, which causes the veins to dilate. Varicoceles often form during puberty and are more common on the left side, probably due to the position of the left testicular vein.

Symptoms and Diagnosis

Many men with varicoceles are asymptomatic and may discover the condition during a fertility evaluation or routine physical exam. Symptoms, if present, include a lump in the testicle, testicular discomfort, or swelling.

When to Seek Medical Attention

Given its potential impact on male fertility, those planning to father children, should seek medical evaluation if they notice any discomfort, lump, or swelling in the testicle.

What to Expect

Medical evaluation involves a physical examination where doctors can often feel a varicocele during a routine physical exam. However, smaller varicoceles might be detected only with an ultrasound, which can precisely determine the presence and size of a varicocele.

Testicular Varicocele and Infertility in Men

Varicoceles can lead to infertility by reducing the quality, quantity, and motility of sperm. They can also lead to testicular atrophy or shrinking. Approximately 10% to 20% of men have a varicocele, and among infertile men, this increases to 40%.

Treatment Options

Varicoceles treatment is unnecessary unless there is pain, testicular atrophy, or infertility. Treatment options include over-the-counter pain relievers, supportive underwear, or surgical intervention, which can often improve sperm numbers and function. Lifestyle modifications like wearing looser clothing, avoiding strenuous activities, or taking cold baths can also help.

Boost Your Fertility by Addressing Testicular Varicocele Issues Today!

Don't let testicular varicoceles hinder your journey to parenthood. Advanced Fertility Care's fertility specialists offer comprehensive fertility evaluations and personalized treatments tailored to your unique needs. Contact us today and take the first step toward parenthood.

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Embryologists and fertility doctors need an objective assessment guide to help them decide on the best embryos, the ones most likely to result in a pregnancy and a healthy baby, to transfer during the process of in vitro fertilization (IVF).

The number and quality of embryos a fertility doctor transfers influence the procedure's success rate. Transferring low-quality embryos may cause uterine implantation failure and ultimately hinder pregnancy.

This article discusses embryo grading, its criteria, the various grading systems available, and the role of embryo grading in IVF success rates.

What is Embryo Grading?

Embryo grading is a scoring system used by embryologists or fertility doctors to determine the quality of embryos before their use in treatment. Embryo grading provides the clinic with a priority guide as to which embryos to transfer.

During IVF, eggs are artificially inseminated inside the laboratory. After successful fertilization, the fertilized egg divides and grows to become an embryo. Before the embryos are utilized, the embryologist conducts a quality assessment using an embryo grading system. This grading system allows the embryologist to determine which embryos should be used for treatment and which should not be.

Is Embryo Grading Beneficial?

A study published in the US National Library of Medicine revealed that embryos with a higher grade had better clinical pregnancy and live birth rates compared to those with a poor grade.

Apart from an embryo grade, factors such as the genetic makeup of the embryo, laboratory conditions, experience, and skill of the fertility expert can influence the overall success of an IVF treatment. Genetics is the gold standard for embryo choice and truly drives success.

Notwithstanding, embryo grading still plays a role. Selecting only good-quality embryos provides the best opportunity that an embryo will be able to endure various types of possible treatments (e.g., PGT biopsy, cryopreservation, and thawing).

"Preimplantation genetic testing (PGT) is a more objective test while embryo grading comes from an embryologist’s subjective opinion," according to an Advanced Fertility Care embryologist. In recent times, PGT has taken over because we know that it is far more important than my subjective opinion," the embryologist further explained.

Criteria for Embryo Grading

A few hours after fertilization, the fertilized egg or zygote starts dividing to form a mass of cells that develops gradually into an embryo. The embryo cell number progressively increases within the first few days. 

The embryo cell number should be 2-4 cells after 48 hours and up to 7-10 cells by 72 hours.  Embryos are most commonly cultured to the blastocyst stage, which occurs between the 5th and 7th day of culture.

Grading Systems

There are different embryo grading systems, each focusing on specific characteristics of the dividing cells or blastocysts.

The IVF embryo grading system focuses on the following features:

• degree of fragmentation and symmetry
• the expansion rate and hatching of the blastocysts
• inner cell mass
• trophectoderm (a group of specialized tissues that differentiate and form the outer cell layer of a developing embryo.)

Generally, embryologists use the grading system based on the blastocyst expansion, inner cell mass, and trophectoderm for day five embryo grading. While day three embryo grading is typically based on the degree of fragmentation and symmetry.

Here are the common embryo grading systems most fertility clinics use to assess embryo quality before its transfer into the uterus for implantation.

Embryo Grading Based on Blastocyst Expansion and Hatching

Fertility specialists use the expansion rate of the dividing cells to score the embryo. It is also a numeric scoring system, and each embryo receives a score from 1-6.

The following is the numeric scoring system and its description using the blastocyst expansion and hatching feature:

• 1: Blastocyst development and stage status
• 2: Blastocoel cavity occupying more than half the volume of the embryo
• 3: Full blastocyst with cavity completely filling the embryo
• 4: Expanded blastocyst with cavity larger than the embryo and thinning of the zona pellucida
• 5: Hatching out of the zona pellucida
• 6: Hatched out of the zona pellucida

Embryo Grading Based on Inner Cell Mass

The inner cell mass is the group of cells in the developing embryo that transforms to produce the cellular structures that form a fetus.

Embryo grading using the inner cell mass is an alphabetical scoring system and includes the following:

• A: Many cells, tightly packed
• B: Several cells, loosely grouped
• C: Very few cells

In this system, the quality of the inner cell mass reflects the quality of the embryo.

Embryo Grading Based on the Trophectoderm

A trophectoderm is a group of cells that are the first to differentiate and form the outer cell layer of a developing embryo.

Embryo grading using the trophectoderm entails:

• A: Many cells forming a cohesive layer
• B: Few cells forming a loose epithelium
• C: Very few large cells

In this system, the embryologist uses the quality of the trophectoderm to assess the quality of the embryo.

Significance of Grades in Predicting IVF Success

Our embryologist also noted that: "just because an embryo looks good doesn't mean it's genetically normal, and just because it is a grade B doesn't mean it isn't normal. Today we use embryo grades as a way to demonstrate why an embryo was chosen to biopsy and/or freeze. The reason we do this is that poor quality embryos can't survive a biopsy and they also cannot survive the freeze and thaw process either."

Embryos with good grades have the potential to increase the chances of achieving pregnancy during an IVF treatment. In contrast, poor-quality embryos may fail to implant into the uterus, inevitably limiting IVF success.

Therefore, embryo grading provides fertility experts with the tool to make objective clinical decisions on the embryos to transfer.

Understanding Your Embryo Grade Results

Embryo grading will begin on day five. The embryos will be graded each day between day 5 and day 7. Any embryos deemed to be good quality will be utilized in treatment that day.  

Any embryos that are not chosen are allowed to continue to develop until day 7. The IVF lab routinely expects that approximately 50% of the embryos in culture will make good-quality embryos for use.

Interpreting Your Embryo Grading Report

Embryologists typically assign alphanumeric scores, such as 1AA, 2BA,3BC, etc., to embryos to indicate the quality level.

The following are possible embryo grade scores according to their exhibited degree of blastocyst expansion, inner cell mass, and trophectoderm grades:

• High-quality embryos: ≥3AA
• Poor quality embryos : 1–6BC, 1–6CB, 1–6CC

Of note, these embryo grades alone do not indicate failed IVF treatment. Other factors, such as an embryo's genetic makeup, medical history, or age, among other things, also affect your chances of achieving IVF success and pregnancy.

Do You Need Help with IVF Treatment?

Embryo grading is one of many tools that provides crucial information to fertility doctors to enable them to select suitable embryos for transfer. Transferring poor-quality embryos can reduce the success rate of IVF treatment.

If you intend to go for IVF treatment, consult an experienced fertility doctor and learn more about their embryo grading process.

Our team at Advanced Fertility Care has proven experience with IVF, and we use standardized embryo grading methods to assess quality before embryo transfer.

If you want to learn more about our process and IVF treatment, contact us or schedule an appointment with our team today. We look forward to supporting you in starting or building your family using IVF. We serve in different areas.

Why is Early Male Evaluation Important?

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The realm of male fertility often remains shrouded in silence and stigma, despite its significance in the journey to parenthood for many couples. Recognizing and addressing male infertility through comprehensive evaluations is a crucial step in demystifying this issue, providing clear pathways to treatment, and, most importantly, offering hope and support to those affected.

Beyond the Basics: Understanding Male Infertility

Infertility is not just a woman's issue; it is a couple's challenge. Statistics reveal that in up to 50% of cases, male factors contribute to the couple's infertility. This highlights the necessity for thorough male fertility evaluations. Such assessments are pivotal not only in identifying potential fertility obstacles but also in debunking the myth that infertility is predominantly a female concern. By broadening the focus to include male reproductive health, we can foster a more inclusive and supportive environment for all individuals facing infertility.

The Process of Male Fertility Evaluation

Male fertility evaluations are important for identifying potential fertility issues, ruling out medical conditions, planning appropriate treatment, and providing emotional support for couples struggling with infertility.

Early evaluation answers some crucial questions:

• Is the male a factor in the couple's infertility?
• Can the male benefit from treatment? (About 20% respond to treatment)  
• Are assisted reproductive technologies (ART) indicated?

The journey begins with a comprehensive evaluation designed to pinpoint the underlying causes of infertility. This process includes:

• Medical History and Physical Examination: A detailed discussion of the individual's medical history, including any underlying health conditions, surgeries, or medications that could affect fertility. The physical examination can reveal varicoceles (enlarged veins in the scrotum) or other physical abnormalities that may impact sperm production or delivery.
• Semen Analysis: The cornerstone of male fertility testing, semen analysis measures several key parameters, including sperm count, motility (movement), and morphology (shape). This test provides invaluable insights into the male partner's fertility status.
• Advanced Testing: For some, further testing may be necessary. This can include hormonal evaluations, genetic testing to identify chromosomal anomalies or specific genetic conditions, and additional assessments like testicular biopsies or imaging studies.

Deciphering the Results: From Diagnosis to Action

The results of these evaluations can lead to a diagnosis that not only sheds light on fertility challenges but also opens the door to tailored treatment options. Whether the solution lies in lifestyle adjustments, medication, surgical interventions, or assisted reproductive technologies (ART) such as IVF or ICSI, the path to parenthood becomes clearer.

The Psychological Aspect: Addressing Emotional Well-being

An often-overlooked component of male fertility evaluations is the psychological impact. The process can stir a range of emotions, from anxiety and frustration to hope. Acknowledging and addressing these feelings is essential. Many fertility clinics and centers offer counseling services to support individuals and couples through their journey, emphasizing the importance of mental and emotional health in the context of fertility treatments.

Navigating Treatment Options: A Guided Path to Parenthood

A male fertility evaluation can help to determine the appropriate treatment for infertility. Treatment options may include lifestyle changes, medication, surgery, or assisted reproductive technologies such as intrauterine insemination (IUI), in vitro fertilization (IVF), or intractyoplasmic sperm injection (ICSI). Understanding the underlying cause will help determine the best path forward and will guide your individual treatment plan.

The Bigger Picture: Fertility as a Shared Journey

Male fertility evaluations play a critical role in transforming the journey to parenthood from a solitary struggle into a shared experience. By actively participating in the evaluation process, men can take control of their reproductive health, contributing to a more balanced and inclusive approach to infertility.

Male fertility evaluations are a crucial step in breaking down barriers, addressing misconceptions, and opening the door to effective treatments. By prioritizing comprehensive assessments, we can support couples in their quest for parenthood, ensuring they have access to the care, information, and emotional support they need to navigate this complex journey.

‍Connect with our team today to start your journey to parenthood.

Many couples struggling with infertility are having a hard time getting pregnant because of an egg quality issue they can't seem to overcome. Egg donation is one way to help these couples fulfill their dream of having a baby of their own. Many egg donors consider the positive emotional impact of egg donation a valued addition to their compensation, citing the knowledge that they've helped someone have a family as highly rewarding.

For any couple or individual who cannot use their own eggs, an egg donor can help make the dream of a baby come true.

What is an Egg Donor?

An egg donor is a young person, usually between the ages of 19 and 30, who donates their healthy eggs to an individual or couple known as the intended parents for them to use in an in vitro fertilization (IVF) cycle in the hopes of having a baby. The intended parent will carry the pregnancy that results from the donor eggs or they will have a gestational carrier (surrogate) carry the pregnancy. Donors typically receive financial compensation for their egg donation, with the amounts varying by area, clinic, and individual legal agreements.

Egg Donation FAQ

If you're considering becoming an egg donor for couple fighting with infertility, you probably have multiple questions on how to donate eggs. Read on to learn about the process through these frequently asked questions (FAQ).

Question #1: How Do I Become an Egg Donor?

The requirements will vary depending on the clinic or agency you apply to. In general, to become an egg donor, you'll need first to complete a family medical history form. This will be a thorough questionnaire on your and your family's medical history. Most clinics or agencies will also want a recent photograph submitted. A reproductive specialist will review your information, and if approved, you'll be contacted to set up a consultation.

At Advanced Fertility Care (AFC), to qualify as an egg donor, we are looking for young women between the ages of 19 and 30 who reside within the Phoenix metropolitan region and have dependable transportation to our office. Additionally, candidates must be non-smokers, abstain from psychoactive or recreational drugs, have no past issues with substance abuse, and have not been diagnosed with Chlamydia or Gonorrhea in the past 12 months. Furthermore, responsibility, ability to follow instructions, and meeting height and weight requirements are also important factors considered during the screening process.

You'll receive in-depth explanations of the egg donation process, including required medications and lab testing. You may be required to meet with a psychologist to discuss the psychological aspects of being an egg donor. You'll receive instruction on properly administering the required medications, some of which may include self-injection.

Question #2: Is Egg Donation Safe?

There are risks associated with any medical procedure, but there are currently no documented long-term risks involved in egg donation. There is a potential for side effects from the medication used to stimulate egg production and from the retrieval process itself, but the risks associated are low. Before a person can begin the egg donation process, they receive consultations with qualified doctors who provide specific information on the possible risks.

Question #3: What is the Time Commitment for Donating Eggs?

After acceptance as an egg donor, the process doesn't usually begin until you're matched with a recipient. Once that happens, the time requirements will usually involve up to six or more clinic visits over a two-week period. This may vary between individual clinics. The fertility clinic you choose will cover the time commitment in your pre-donor consultation. You'll need to arrange time off from work or school on the day of the actual retrieval because you'll require sedation for the procedure.

Question #4: As an Egg Donor, Will My Identity Remain Anonymous?

Donors generally fall into two categories: known to the recipients or unknown (anonymous.) Whether your identity as an egg donor is revealed to the intended parent(s) will depend on the clinic's policy or the agency involved. With recent advances in genetic and DNA testing, and its widespread use, it is no longer possible to assure our egg donors that you will remain anonymous, even if you yourself don't do one of these DNA tests. The American Society for Reproductive Medicine recommends a discussion of the considerations for egg donation with a mental health professional before treatment begins.

Question #5: Can I Donate My Eggs More Than Once?

There are no strict rules governing how many times a person can donate eggs, but programs and state laws often limit the number of repeat donations. On average, this limit is a maximum of six times. The reason for this limit is to curtail the number of children possibly created from a single donor. Since these children will be genetic half-siblings, the limit on donations is to decrease the already small chance they could meet as adults and develop a relationship. This hypothetical situation would raise health concerns for their potential offspring.

Question #6: Will I Be Compensated for My Egg Donation?

Egg donors are typically compensated for their donation, and medical expenses are at no cost. The amount of compensation varies widely, depending on the clinic or agency used. Payment is usually not made until the completion of a donation cycle. You can request a copy of the results of pre-donation medical screening tests for your own records or give it to your primary care physician for his/her records.

At AFC, egg donors' compensation starts at $5,000. Donors who participate multiple times can earn up to $30,000 by donating eggs up to six times.

Question #7: What Are My Legal Responsibilities to Any Child Born?

When you sign the documents agreeing to donate your eggs, you give up all rights and responsibilities associated with or connected to the eggs retrieved from you. You have no legal responsibilities for or rights to any child born because of the use of your donated eggs.

Question #8: Does Egg Donation Cause Early Menopause?

No, there's no evidence that donating eggs or using the medications required for egg donation triggers premature menopause. Human ovaries contain a large number of eggs at the time of puberty — between 400,000 and 500,000. Only 400 to 500 of these actually develop to the point of ovulation. That leaves, at the least, over 399,000 "spare" eggs.

In a natural cycle, you only ovulate one egg but there are other eggs that could potentially have been ovulated that month if they had been given a chance. In any egg donation cycle, the eggs we obtain are eggs that would have "died" that month anyway, so we are not depleting your egg supply but rather rescuing eggs that would have been lost.

Question #9: Does Egg Donation Cause Infertility?

Egg donation has been possible for over 25 years. Studies over the years have shown no increase in infertility among those who donate eggs over those who don't. During a person's normal monthly cycle, only one egg is released during ovulation. The rest that matures during that cycle becomes non-viable and no longer available for fertilization. The egg retrieval process simply removes the eggs that would not be utilized during that month's cycle.

Ready to Be an Egg Donor?

If you're ready to give the gift of parenthood to someone else, apply to become an egg donor today.

Reach out to our team at Advanced Fertility Care if you have any questions about egg donation.

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What Is ICSI?

Intracytoplasmic sperm injection (ICSI) is a laboratory technique that offers a pathway to a successful pregnancy for couples with little hope of reproducing naturally or with IVF alone due to significant sperm issues. ICSI is the most used method that is a critical part of assisted reproductive technology. Its use accounts for 70% to 80% of the IVF procedures performed. 

For sperm to fertilize an egg, the sperm's head must attach to the outside of the egg. It then must break through to the inside, where fertilization takes place. If the egg's outer layer has become hardened or thickened, or if the sperm is abnormal and cannot swim effectively, it will be difficult for the sperm to penetrate it. 

Standard IVF vs. ICSI

In an IVF procedure, an egg is fertilized in a laboratory dish. Healthy sperm collected from the patient's partner or a selected donor is added to the dish to surround the egg. The sperm will naturally fertilize the egg by attaching itself to its outer membrane and breaking through into the egg. The fertilized egg (embryo) is transplanted into the uterus when it reaches a certain stage of development approximately five to six days after fertilization. If it implants into the lining of the uterus successfully, a pregnancy results. 

There are times, however, when surrounding the egg with sperm in the dish may not result in fertilization. Based on the circumstances or results of a prior semen analysis, doctors may opt for ICSI to help improve fertilization success. This procedure can frequently solve the issue of male factor infertility or poor fertilization in IVF cycles. ICSI is essentially an extension of IVF that works to control some of the variables that affect fertilization and increases the chances of an embryo resulting in pregnancy. 

How Is ICSI Performed?

ICSI is performed in conjunction with in vitro fertilization (IVF). Patients will undergo egg retrieval, and the egg will be injected with a single sperm in the lab through the process of ICSI with the hope of growing into a healthy embryo to be transferred to the carrying uterus.

Steps for Egg Retrieval

To prepare for egg retrieval, patients administer hormonal injections to stimulate the ovaries to produce multiple eggs for an average of 10 days, followed by an injection of human chorionic gonadotropin (hCG) or leuprolide acetate to assist in the eggs' final maturation.

When the eggs are ready for actual retrieval, a transvaginal ultrasound guides a thin needle through the vaginal wall into the ovary, then suction draws out and collects the eggs. This is performed under anesthesia and is a relatively short procedure lasting 10-20 minutes.

Unless frozen sperm is used, it is collected on the same day that egg retrieval occurs. The person supplying the sperm must collect ejaculate into a lab-provided container and deliver it to the lab within 30 minutes. The semen is analyzed for volume, mobility, and quality.

The ICSI Procedure

The ICSI procedure is performed with these steps:

1.    The embryologist holds the mature egg in a lab dish using a small glass tube equipped with a suction bulb.

2.    Using a thin needle, a single sperm is immobilized and picked up.

3.    The needle is inserted into the egg.

4.    The sperm is injected directly into the egg.

5.    The needle is withdrawn.

Now the waiting begins.

After the ICSI Procedure

Following the completion of the procedure, the embryology team monitors the embryos' progress to look for signs of successful fertilization. Cell division should begin within one day if the fertilized embryo is healthy. In many cases, the embryos are grown for five to six days, and at this point, if the patient elects to have preimplantation genetic testing performed (PGT) this is when the surviving embryos are biopsied (cells removed and sent for additional testing) and then frozen. 

If a fresh embryo transfer is performed, the developing embryo will need to grow appropriately for at least three to six days. When it is ready to transfer, a long, thin tube (catheter) is inserted through the vagina into the uterus under ultrasound guidance to inject the embryo into the uterus. The embryo must implant in the uterine lining for pregnancy to occur. If PGT testing is being performed, a frozen embryo transfer will be performed at a later date.

Who May Benefit from ICSI?

Male factor infertility is one of the causative factors in over one-third of male infertility cases. It usually results from complications in the sperm's production or delivery. In such a case, ICSI would be high on the list of options to overcome infertility. A man who has undergone a vasectomy reversal would also be a candidate for this procedure, even if the sperm is healthy otherwise. Other examples of infertility that may be helped through the ICSI procedure include:

•      Abnormal sperm motility. This references the sperm's ability to move effectively. 

•      Low sperm count. The male partner doesn't produce enough sperm for a successful attempt using artificial insemination or IVF.

•      Infertility that cannot be explained.

•      The semen lacks sperm because of a blockage in the reproductive tract of the male.

•      The sperm is unable to attach to an egg.

•      Traditional IVF has been unsuccessful, even with fit sperm.

•      The eggs used were matured in vitro.

•      The eggs were frozen before use.

Even when it isn't specifically indicated, some physicians may choose to use ICSI when appropriate. 

What Are the Risks of ICSI?

Compared to conventional IVF, some studies of the ICSI procedure suggest a possible connection between ICSI and an increased risk for intellectual delays, autism, chromosomal abnormalities, and birth defects such as Beckwith-Wiedemann syndrome, hypospadias, Angelman syndrome, and sex chromosome abnormalities. These are rare, occurring in less than 1% of babies conceived through ICSI with IVF. Other possible risks include:

•      Ovarian hyperstimulation syndrome in response to excessive fertility drugs 

•      Multiple births, either twins or triplets

•      Increased risk of premature labor and low birth weight

•      Slight increase in risk compared with IVF

•      The need for a cesarean section for delivery is slightly increased

ICSI Success 

On average, fertilization occurs through ICSI in 70% to 85% of cases. The rate of live births reflects the number of healthy children born following an IVF/ICSI cycle. These success rates are classified based on maternal age and will often vary due to additional factors affecting the eggs and sperm.

Take the First Step

If you'd like to learn more about IVF, ICSI, or other fertility treatments that may be a solution for you, contact the infertility specialists at Advanced Fertility Care to set up a consultation.

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Infertility is a disheartening experience for those who want to build a family. And since infertility is a common health issue affecting all genders, you likely know someone dealing with it. After all, as many as 15% of couples, and about one in five women between ages 15-49, cannot conceive after a year of trying. 

A variety of factors can cause infertility. But whatever its cause, infertility is a difficult journey. On top of that, no two fertility stories are alike. If someone you care about struggles with infertility, you may wonder how you can best support them. In this article, we'll look at ways to be there for a friend or family member struggling with infertility.

6 Ways to Support a Loved One Struggling with Infertility

Naturally, you want to be there for the people you love. Yet, infertility can be a sensitive topic, and you may be afraid to do or say the wrong things. 

Fortunately, there are some simple ways to be a safe space for your loved one as they cope with infertility.

1. Offer a Listening Ear

One of the best things you can do is just be there for your friend. Everyone needs to feel supported, heard, and validated, especially during a difficult time. 

Living with infertility can feel like a lonely path. Your friend may not know who they can talk to, even if they're in a relationship. This is because everyone experiences infertility differently; their partner is likely dealing with their own complex emotions. 

It helps to have an outside person to lean on. You can support your loved one just by letting them know you're always available if they need to talk. Some people may not want to discuss their infertility, while others do. Therefore, it's important not to pry or assume anything. Still, just knowing you're there for them can mean a lot to your friend.  

2. Don't Give Unsolicited Advice

It may be tempting to offer your own opinions and advice — but it's unhelpful in supporting your loved one. 

For example, your gut reaction might be to say things like, "you can try again next month," "maybe you should adopt," or "why don't you try IVF?" However, statements like these can feel like you're minimizing the situation or judging your friend's choices. 

Not only that, but not everyone wants to pursue fertility treatments or adoption. So instead of offering up advice, try saying things like, "I'm sorry you're going through this," "how can I help?" or "I wish I could fix it...I'm here if you need to talk." 

This way, you can provide a supportive, non-judgmental space for the person you care about. 

3. Be Mindful 

It's essential to lead with compassion and mindfulness when supporting a friend with infertility. Understand that it may be difficult for them to attend certain events, like baby showers, while they struggle to start a family themselves. Be mindful of this and let your loved one know it's okay if they don't want to attend such events. 

On the other hand, don't feel like you can't invite them to your baby shower or kid's birthday party. It may mean a lot just to be invited, even if they don't feel up to attending. Besides, your family is a huge part of your life — it would probably feel more uncomfortable if you refrain from talking about them in front of your friend. 

What matters the most is your consideration of your friend's feelings. For instance, if you're about to announce your pregnancy, you might tell your friend in private first. This way, they'll have time to quietly process any emotions. 

4. Educate Yourself on Infertility

Infertility looks different for everyone, and well-meaning friends and family often have many questions. It can be exhausting for your friend to answer these similar questions repeatedly when they're struggling with infertility. 

Educating yourself about infertility and fertility treatments is a great way to be supportive. Instead of asking for details from your friend, you can find tons of valuable information online. 

This way, you're prepared to have a meaningful heart-to-heart about any treatments your friend is undergoing. Then, they can talk freely with you on level ground rather than having to explain their medical choices. 

5. Don't Minimize What They're Going Through

Infertility can be profoundly heartbreaking on multiple levels. It's also a significant health issue, even if it's not life-threatening. Avoid comparing infertility to other medical conditions or minimizing your friend's experience. 

Statements like "at least you don't have cancer" or "at least you can sleep in" don't help your friend feel supported. Instead, let them know you understand how difficult it is to struggle with infertility.

6. Find Concrete Ways to Help Out

There are many ways to be supportive besides talking it out. For example, you could help your friend with things like watching their other children while they attend fertility appointments. Or help them find a support group in the area. 

Going through fertility treatments can be physically and emotionally draining. Offering to clean your friend's house after treatment could mean a lot to them! Sending cards, flowers, or home-cooked meals are all thoughtful ways to show your support. 

The bottom line is that there are many simple ways to show heartfelt care to a loved one struggling with infertility. Most importantly, you approach them from a place of love and understanding.

At Advanced Fertility Care, we strive to help couples and individuals achieve their family-building goals through cutting-edge technology and patient-centered care at different locations. We're always here to answer any questions about infertility or fertility treatments that you may have. Contact us today to learn more.

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