We also care about not only your physical well being, but also your emotional health. In fact, these issues as important enough to us that one of our core team members is a psychologist. Julianne Zweifel is an expert in addressing the mental aspects of secondary (and primary) infertility and she can promote emotional well being in a way that few others have the training or experience to do. If you should feel you do not wish to talk a specialist, but are struggling emotionally, please at least let other team members know-the more we hear from you, the easier it is for us to help.  
Ovarian reserve testing. To determine the quantity and quality of your eggs, your doctor might test the concentration of follicle-stimulating hormone (FSH), estradiol (estrogen) and anti-mullerian hormone in your blood during the first few days of your menstrual cycle. Test results, often used together with an ultrasound of your ovaries, can help predict how your ovaries will respond to fertility medication.
Along with being physically demanding, fertility treatments can also spark a roller-coaster of emotions each month, including hope, anger, disappointment, sadness, and guilt. Just the sight of a pregnant woman can evoke strong negative and stressful feelings. During this time, those struggling with infertility may pull away from friends and family who remind them of their difficulty with reproduction; some of their closest relationships may suffer.

s ohledem na poslední informace ohledně šíření koronaviru 2019-nCoV jsme zavedli zvýšená hygienická opatření za účelem ochrany pacientů i personálu kliniky. Klinika i nadále poskytuje zdravotní péči v plném rozsahu, avšak u pacientů ze zasažených oblastí, případně pacientů, kteří tyto oblasti v poslední době navštívili, bude léčba odložena. V případě příznaků respiračních onemocnění žádáme pacienty, aby před příjezdem na kliniku kontaktovali svého lékaře, případně koordinátora a dohodli se na nejvhodnějším postupu.
Mild IVF[64] is a method where a small dose of ovarian stimulating drugs are used for a short duration during a woman's natural cycle aimed at producing 2–7 eggs and creating healthy embryos. This method appears to be an advance in the field to reduce complications and side-effects for women and it is aimed at quality, and not quantity of eggs and embryos. One study comparing a mild treatment (mild ovarian stimulation with GnRH antagonist co-treatment combined with single embryo transfer) to a standard treatment (stimulation with a GnRH agonist long-protocol and transfer of two embryos) came to the result that the proportions of cumulative pregnancies that resulted in term live birth after 1 year were 43.4% with mild treatment and 44.7% with standard treatment.[65] Mild IVF can be cheaper than conventional IVF and with a significantly reduced risk of multiple gestation and OHSS.[66]
Infertility can have a profound impact on one’s mental health. When men and women find out that they can’t conceive, they may experience the same painful emotions as anyone coping with grief or profound loss. Common reactions include shock, frustration, grief, anger, decreased self-esteem, anxiety, and depression, but feelings about infertility can vary greatly depending on the source of the problems. Men, in particular, find it far easier to deal with a partner’s infertility than with their own.
Ovarian hyperstimulation syndrome (OHSS) occurs in 10% of women going through IVF treatment. For most women, symptoms will be mild, and they will recover easily. For a small percentage, OHSS can be more serious and may require hospitalization. Less than 1% of women going through egg retrieval will experience blood clots or kidney failure due to OHSS.
For women, intake of antioxidants (such as N-acetyl-cysteine, melatonin, vitamin A, vitamin C, vitamin E, folic acid, myo-inositol, zinc or selenium) has not been associated with a significantly increased live birth rate or clinical pregnancy rate in IVF according to Cochrane reviews.[30] The review found that oral antioxidants given to men in couples with male factor or unexplained subfertility may improve live birth rates, but more evidence is needed.[30]
Gathering the eggs. Your doctor gives you an anesthetic and inserts an ultrasound probe through your vagina to look at your ovaries and identify the follicles. A thin needle is then inserted through the vaginal wall to remove the eggs from the follicles. Eight to 15 eggs are usually retrieved. You may have some cramping and spotting for a few days afterward, but most women feel better in a day or two.
Fertility was found to be a significant factor in a man's perception of his masculinity, driving many to keep the treatment a secret.[139] In cases where the men did share that he and his partner were undergoing IVF, they reported to have been teased, mainly by other men, although some viewed this as an affirmation of support and friendship. For others, this led to feeling socially isolated.[140] In comparison with women, men showed less deterioration in mental health in the years following a failed treatment.[141] However many men did feel guilt, disappointment and inadequacy, stating that they were simply trying to provide an 'emotional rock' for their partners.[140]
The eggs are then fertilized with sperm that has been optimized in the laboratory so that sperm with poor morphology or motility are discarded and the healthiest remain. Fertilization usually takes place through Intracytoplasmic Sperm Injection (ICSI). In this high-precision technique, the best single sperm are selected and individually microinjected into each egg.
First, you take medication that makes several of your eggs mature and ready for fertilization. Then the doctor takes the eggs out of your body and mixes them with sperm in a lab, to help the sperm fertilize the eggs. Then they put 1 or more fertilized eggs (embryos) directly into your uterus. Pregnancy happens if any of the embryos implant in the lining of your uterus.
Gonadotropins are another drug used to trigger ovulation. Gonadotropins are used if other drugs are not successful or if many eggs are needed for infertility treatments. Gonadotropins are given in a series of shots early in the menstrual cycle. Blood tests and ultrasound exams are used to track the development of the follicles. When test results show that the follicles have reached a certain size, another drug may be given to signal a follicle to release its matured egg.
Fertility has long been considered a “woman’s problem.” This is simply not true, and men are in fact, equally as infertile as women. Traditionally the metrics for male fertility have been mostly limited to sperm count, morphology, motility, and, occasionally, DNA fragmentation. For females, on the other hand, a vast array of tests are available. These include ultrasound, cervical position, basal body temperature, hysteroscopy, laparoscopy, cycle tracking and a diversity of hormonal tests.

Risk of ovarian hyperstimulation syndrome (OHSS). OHSS can happen when women respond too well to fertility drugs and produce too many eggs. About 10 to 20 percent of women who take gonadotropins develop a mild form of OHSS, a condition marked by weight gain and a full, bloated feeling. Some also have shortness of breath, dizziness, pelvic pain, nausea, and vomiting. If you have OHSS, your ovaries swell to several times the normal size and produce fluid that accumulates in your abdominal cavity. Normally this resolves itself with careful monitoring by a physician and bed rest. But in rare cases it's life threatening, and you may have to be hospitalized for more intensive monitoring or treatment.

Only 30 percent of patients who receive 100 mg of Clomiphene a day will produce more than three follicles. Patients that produce less than than three follicles have about half the chance of getting pregnant than those that produce greater than three follicles. Patients that receive fertility medications but do not do an insemination have only half the success rates compared to those who do.
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