Frequently Asked Questions
How do I know if it's time to see a fertility specialist?
Depending on your age and other medical factors, if you have been trying to get pregnant for six months to a year without success, it may be time for you and your partner to think about getting a complete fertility evaluation. Learn more about what to expect at your first visit.
Where should my male partner go for infertility testing?
About 40 percent of couples having difficulty conceiving is due to male conditions. Therefore, a semen analysis should be done very early in the evaluation. We can do this analysis at our on-site Reproductive Lab.
How do I collect a sperm sample at home?
If you are collecting the sample at home, please pick up a clean container at the lab.
- Clean the head of your penis with wet, soapy towelettes or cotton balls. If you are not circumcised, pull back your foreskin and cleanse.
- Rinse the cleansed area with a new towelette or cotton ball that is wet with plain water. Dry your penis thoroughly before you collect the sample.
- Remove the lid from the collection container. Make sure the container is clean and dry. The sample should be collected by masturbation into the container. Lubricants or condoms should not be used while collecting the sample. If a pubic hair or thread from your clothing falls into the container, do not take it out.
- Put the lid back on the container. Make sure it is closed tightly.
- Write the following: full name — date of birth — date and time of collection.
- Wrap the container in a dry towel and place it in a paper sack. Keep it at room temperature.
What are the options for treating infertility?
With new medical advances, there are many choices for both men and women trying to conceive. These options range from hormone treatments, ovulation induction and intrauterine insemination to more advanced treatments such as in vitro fertilization, surrogacy, egg/sperm donation and embryo donation. Deciding which option is best can feel a bit overwhelming at first, but we are here to help you every step of the way.
How does a woman's age affect her chance of delivering a baby?
A woman’s peak reproductive potential is usually before the age of 30, and it declines rapidly after she turns 40. The older the woman is, the more difficult it is for her to become pregnant and deliver. That’s why we tailor treatments to suit each patient’s unique situation.
What is the chance of multiple births while taking infertility medications?
When used under the care of fertility specialists, the chance of multiple births with medication assistance ranges from 6 to 40 percent. The chance depends on patient prognosis, as well as the treatment being used. Careful monitoring of the woman’s response to medications minimizes the potential.
Fertility Library
Adhesion Scar
Tissue occurring in the abdominal cavity, fallopian tubes, or inside the uterus. Adhesions can interfere with the transport of the egg and implantation of the embryo in the uterus.
Adrenal Androgens
Male hormones produced by the adrenal gland which, when found in excess, may lead to fertility problems in both men and women. Excess androgens in the woman may lead to the formation of male secondary sex characteristics and the suppression of LH and FSH production by the pituitary gland. Elevated levels of androgens may be found in women with polycystic ovaries, or with a tumor in the pituitary gland, adrenal gland or ovary. May also be associated with excess prolactin levels.
Amenorrhea
The absence of menstruation.
Androgens
Male sex hormones.
Anovulation
Failure of the ovaries to produce an egg.
Artificial Insemination (AI)
The depositing of sperm (donor or partner) in the vagina near the cervix or directly into the uterus, with the use of a syringe instead of sexual intercourse. This technique is used to overcome sexual performance problems, to circumvent sperm-mucus interaction problems, to maximize the potential for poor semen, and for using donor sperm.
Assisted Zona Hatching
A laboratory procedure that involves creating a small perforation in the shell (zona pellucida) of the human embryo to assist it with escape from its shell and increase its likelihood of implantation in the uterus.
Assisted Reproductive Technology (ART)
Medical techniques in which fertilization of a human egg by a sperm is attempted outside the human body in an embryology laboratory. These techniques employ fertility medications and sophisticated medical procedures. In vitro fertilization (IVF) is the most common.
Azoospermia
Semen containing no sperm, either because the testicles cannot make sperm or because of blockage in the reproductive tract.
Bacterial Vaginosis Infection
A vaginal infection that causes a burning sensation and a gray, malodorous discharge. May interfere with fertility.
Basal Body Temperature (BBT)
Your body temperature when taken at its lowest point, usually in the morning before getting out of bed. Charting BBT is used to predict ovulation.
Blastocyst Transfer
The process in which embryos are transferred at day five or six of development (blastocyst stage) instead of day three of development.
Cervical Mucus
A viscous fluid plugging the opening of the cervix. Most of the time this thick mucus plug prevents sperm and bacteria from entering the womb. However, at midcycle, under the influence of estrogen, the mucus becomes thin, watery, and stringy to allow sperm to pass into the womb.
Cervix
The lower segment of the uterus where the vagina and uterus join. The cervix remains closed during pregnancy and dilates during labor and delivery to allow the baby to be born.
Clomiphene Citrate (Clomid, Serophene)
A fertility drug that stimulates ovulation through the release of hormones from the pituitary gland.
Cryopreservation
A laboratory technique in which sperm or embryos are frozen in liquid nitrogen and stored for future use.
Dysmenorrhea
Painful menstruation. This may be a sign of endometriosis.
Ectopic Pregnancy
A pregnancy outside of the uterus, usually in the fallopian tube.
Egg (Ovum)
The female reproductive cell that contains the woman’s genetic information.
Egg Donation
Human eggs contributed by young, fertile females to women who are incapable of producing viable eggs.
Egg Retrieval
A procedure used to obtain eggs from ovarian follicles for use in in vitro fertilization. The procedure may be performed during laparoscopy or by using a long needle and ultrasound to locate the follicle in the ovary.
Ejaculate
The semen and sperm expelled during ejaculation.
Embryo
A fertilized egg from conception to the eighth embryonic week.
Embryo Donation
The transfer of an embryo resulting from eggs or sperm that did not originate from the recipient or her partner.
Embryo Transfer
Placing an egg fertilized outside the womb into a woman’s uterus using a non-surgical, ultrasound-guided procedure.
Embryo Transfer Cycle
An ART cycle in which one or more embryos are transferred into the uterus.
Endocrinology
The discipline involving the study of hormones.
Endometriosis
A condition where endometrial tissue grows outside the uterine cavity. The tissue may attach itself to the reproductive organs or to other organs in the abdominal cavity. The condition can cause adhesions in the abdominal cavity and in the fallopian tubes. Endometriosis may also interfere with ovulation and with the implantation of the embryo.
Endometrium
The lining of the uterus that grows during a normal cycle and is expelled during the menstrual flow; the bed of tissue designed to nourish the implanted embryo.
Epididymis
A coiled, tubular organ attached to and lying on the testicle. Within this organ the developing sperm complete their maturation and develop their powerful swimming capabilities. The matured sperm leave the epididymis through the vas deferens.
Epididymal Sperm Aspiration
A procedure in which sperm are aspirated from the epididymis.
Estradiol
A form of estrogen, this hormone is produced by developing follicles in the ovary. Measuring levels helps determine progressive growth of the follicles during ovulation induction.
Estrogen
Female sex hormone.
Fallopian Tubes
Ducts through which eggs travel to the uterus once released from the follicle. Sperm normally meet the egg in the fallopian tube, the site at which fertilization usually occurs.
Fertility Specialist
A physician specializing in the diagnosis and treatment of infertility. The American Board of Obstetrics and Gynecology certifies a subspecialty for OB-GYNs who receive extra training in endocrinology (the study of hormones) and infertility.
Fertility Workup
The initial medical examinations and tests performed to diagnose or narrow down the cause of fertility problems.
Fertilization
The combining of the genetic material carried by sperm and egg to create an embryo. Normally occurs inside the fallopian tube but may also occur in a petri dish (in vitro).
Fetus
The developing human being from the end of the eighth week of pregnancy to birth.
Fibroid
A benign uterine growth than can affect fertility and can cause abnormal uterine bleeding.
Follicles
Fluid-filled sacs in the ovary which contain the eggs released at ovulation.
Follicle Stimulating Hormone (FSH)
A pituitary hormone that stimulates spermatogenesis and follicular development. In the man, FSH stimulates cells in the testicles and supports sperm production. In the woman, FSH stimulates the growth of the ovarian follicle.
Follicular Phase
The pre-ovulatory portion of a woman’s cycle during which a follicle grows and high levels of estrogen cause the lining of the uterus to proliferate.
Gamete
A reproductive cell – sperm in men; the egg in women.
Gestational Age
The age of an embryo or fetus calculated by adding 14 days (2 weeks) to the number of completed weeks since fertilization.
Gestational Carrier
A woman in whom a pregnancy resulted from fertilization with third-party sperm and egg. She carries the pregnancy with the intention or agreement that the offspring will be parented by one or both of the persons that produced the gametes.
Gonadotropins
Hormones which control reproductive function: Follicle Stimulating Hormone and Luteinizing Hormone.
Hatching
The process that precedes implantation by which an embryo at the blastocyst stage separates from the zona pellucida.
Hirsutism
The overabundance of body hair, such as a mustache or pubic hair growing upward toward the navel, found in women with excess androgens.
Human Chorionic Gonadotropin (HCG)
The hormone produced in early pregnancy which keeps the corpus luteum producing progesterone. Also used via injection to trigger ovulation after some fertility treatments and used in men to stimulate testosterone production.
Human Menopausal Gonadotropin (HMG)
A combination of hormones FSH and LH, which is extracted from the urine of post-menopausal women. Used to induce ovulation in several fertility treatments.
Hypothalamus
A part of the brain, the hormonal regulation center, located adjacent to and above the pituitary gland.
Hysterosalpingogram (HSG)
An X-ray of the pelvic organs in which a radio-opaque dye is injected through the cervix into the uterus and fallopian tubes. This test checks for malformations of the uterus and blockage of the fallopian tubes.
Hysteroscopy
An examination that involves inserting a narrow scope through the cervical opening to examine the cervical canal, uterine cavity and the areas where the fallopian tubes open into the uterus. Minor surgical repairs can be executed during the procedure.
Implantation (Embryo)
The embedding of the embryo into tissue so it can establish contact with the mother’s blood supply for nourishment. Implantation usually occurs in the lining of the uterus.
Impotence
The inability of the man to have an erection and to ejaculate.
Infertility
The inability to conceive after a year of unprotected intercourse or the inability to carry a pregnancy to term.
Intrauterine Insemination
A technique in which a small, soft tube is used to place sperm into the uterine cavity.
Intracytoplasmic Sperm Injection (ICSI)
A micromanipulation procedure where a single sperm is injected into the egg to enable fertilization. This procedure assists couples where the male has very low sperm counts or non-motile sperm.
In Vitro Fertilization
An assisted reproductive technology which involves the process of combining the egg and sperm outside the human body to optimize chances for fertilization, after which the resulting embryo is transferred to the uterus.
Laparoscopy
A surgical procedure usually performed on an outpatient basis, during which a small scope is inserted into the abdomen for visualization of the female reproductive organs. Used to diagnose and treat a number of fertility problems including endometriosis, abdominal adhesions, and polycystic ovaries. Also used in egg retrieval for in vitro fertilization.
Luteinizing Hormone (LH)
A pituitary hormone that stimulates the ovary and testicle. In the man, LH is necessary for spermatogenesis and for the production of testosterone. In the woman, LH is necessary for the production of estrogen. When estrogen reaches a critical peak, the pituitary releases a surge of LH (the LH spike), which releases the egg from the follicle.
Luteinizing Hormone Surge (LH SURGE)
The release of luteinizing hormone (LH) that causes release of a mature egg from the follicle. Ovulation test kits detect the sudden increase of LH, signaling that ovulation is about to occur (usually within 24-36 hours).
Menstruation
The cyclical shedding of the uterine lining in response to stimulation from estrogen and progesterone.
Miscarriage
Spontaneous loss of an embryo or fetus from the womb.
Oligomenorrhea
Infrequent menstrual periods.
Oligospermia, Oligozoospermia
A sperm count below 20 million; a low sperm count; a sperm count low enough to cause a fertility problem.
Ovarian Cyst
A fluid-filled sac inside the ovary. An ovarian cyst may be found in conjunction with ovulation disorders, tumors of the ovary, and endometriosis.
Ovarian Failure
The failure of the ovary to respond to FSH stimulation from the pituitary because of damage to or malformation of the ovary. Diagnosed by elevated FSH in the blood.
Ovarian Reserve Screening
This screening to determine a woman’s reproductive potential employs a variety of non-invasive testing: ultrasound for the measurement of antral follicular count (AFC); blood work for the measurement of anti-mullarian hormone (AMH) or day 3 follicle-stimulating hormone (FSH) levels; and the Clomiphene Citrate Challenge Test (CCCT).
Ovulation
The release of the egg (ovum) from the ovarian follicle.
Ovulation Induction
Medical treatment performed to initiate ovulation.
Ovulatory Failure (Anovulation)
Failure of the ovaries to produce an egg.
Ovum (Egg)
The egg; the female reproductive cell that contains the woman’s genetic information.
Patent
The condition of being open, as with tubes that form part of the reproductive organs.
Pelvic Inflammatory Disease (PID)
An infection of the pelvic organs that causes severe illness, high fever, and extreme pain. PID may lead to tubal blockage and pelvic adhesions.
Pituitary Gland
The master gland; the gland that is stimulated by the hypothalamus and controls all hormonal functions. Located at the base of the brain just below the hypothalamus, this gland controls many major hormonal factories throughout the body including the gonads, the adrenal glands, and the thyroid gland.
Polycystic Ovarian Syndrome
A condition found in women who don’t ovulate; characterized by excessive production of androgens (male sex hormones) and the presence of cysts in the ovaries. Though PCOS can be without symptoms, some include excessive weight gain, acne and excessive hair growth.
Preimplantation Genetic Diagnosis (PGD)
Screening of cells from preimplantation embryos, before embryo transfer, for the detection of specific genetic diseases. This screening is recommended for patients wishing to diagnose their embryos for an inherited genetic disease.
Preimplantation
Genetic Screening of cells from preimplantation embryos, before embryo transfer, for the detection of chromosomal abnormalities. This screening is recommended for patients who have experienced multiple miscarriages or repeated unexplained IVF embryo implantation failures.
Premature Ovarian Failure
A condition where the ovary runs out of follicles before the normal age associated with menopause.
Progesterone
The hormone produced by the corpus luteum during the second half of a woman’s cycle. It thickens the lining of the uterus to prepare it to accept implantation of a fertilized egg.
Secondary Infertility
The inability of a couple that has successfully achieved pregnancy to achieve another. This strict medical definition includes couples for whom the pregnancy did not go to term.
Semen
The fluid portion of the ejaculate consisting of secretions from the seminal vesicles, prostate gland, and several other glands in the male reproductive tract. The semen provides nourishment and protection for the sperm and a medium in which the sperm can travel to the woman’s vagina. Semen may also refer to the entire ejaculate, including the sperm.
Semen Analysis
A laboratory test used to assess semen quality: sperm quantity, concentration, morphology (form), and motility (movement). In addition, it measures semen (fluid) volume and whether or not white blood cells are present, indicating an infection.
Sonogram (Ultrasound)
Use of high-frequency sound waves for creating an image of internal organs. Used to detect and count follicle growth (and disappearance), to examine fallopian tubes and the uterus and to detect and monitor pregnancy.
Sperm
The microscopic cell that carries the male’s genetic information to the female’s egg; the male reproductive cell.
Sperm Count
The number of sperm in ejaculate. Also called sperm concentration and given as the number of sperm per milliliter.
Sperm Donation
Human sperm contributed by young, fertile males to patients who do not have adequate sperm quality and numbers.
Sperm Morphology
A semen analysis factor that indicates the number or percentage of sperm in the sample that appear to have been formed normally. Abnormal morphology includes sperm with kinked, doubled, or coiled tails.
Sperm Motility
The ability of sperm to swim. Poor motility means the sperm have a difficult time swimming toward their goal – the egg.
Sperm Penetration
The ability of the sperm to penetrate the egg so it can deposit the genetic material during fertilization.
Sperm Washing
A process which isolates the strongest, most active sperm from the dead sperm and the seminal fluid.
Spermatogenesis
Sperm production in the testicles.
Sterility
An irreversible condition that prevents conception.
Superovulation
Stimulation of multiple ovulation with fertility drugs; also known as controlled ovarian hyperstimulation (COH).
Testicular Failure, Primary
A congenital, developmental, or genetic error resulting in a testicular malformation that prevents sperm production.
Testicular Failure, Secondary
Acquired testicular damage – for example, from drugs, prolonged exposure to toxic substances, or a varicocoele.
Testicular Function
The ability of the testicles to produce sperm and testosterone.
Testicular Sperm Aspiration (TESA)
A procedure in which sperm are aspirated directly from the testicle.
Testosterone
The male hormone responsible for the formation of secondary sex characteristics and for supporting the sex drive. Testosterone is also necessary for spermatogenesis.
Turner's Syndrome
The most common genetic defect contributing to female fertility problems. The ovaries fail to form and appear as slender threads of atrophic ovarian tissue, referred to as streak ovaries.
Ultrasound
Use of high-frequency sound waves for creating an image of internal organs. Used to detect and count follicle growth (and disappearance), to examine fallopian tubes and the uterus and to detect and monitor pregnancy.
Uterus
The hollow, muscular organ that houses and nourishes the fetus during pregnancy.
Vagina
The canal leading from the cervix to the outside of the woman’s body; the birth passage.
Varicocoele
A dilation of the veins that carry blood out of the scrotum. The resulting swollen vessels surrounding the testicles create a pool of stagnant blood, which elevates the scrotal temperature. A major cause of male infertility.
Vas Deferens
One of the tubes through which the sperm move from the testicles (epididymis) toward the seminal vesicles and prostate gland. These tubes are severed during a vasectomy performed for birth control.
Zona pellucida
The strong membrane that forms around an egg as it develops in the ovary. The membrane remains in place during the egg’s travel through the fallopian tube. To fertilize the egg, a sperm must penetrate the thinning zona pellucida. If fertilization takes place, the zona pellucida disappears to permit implantation in the uterus.
Zygote
A fertilized egg that has not yet divided.