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The ABCs of PGD, PGS and More

Here's a primer ...

by Leigh Ann Woodruff, April 29, 2012

Are you new to an infertility diagnosis or just starting your research on in vitro fertilization (IVF)? Many clinics are offering an array of genetic testing options than can help you have a successful IVF that results in a healthy baby, but the alphabet soup of terms surrounding preimplantaton genetic diagnosis and other genetic testing on embryos can be confusing. PGD, PGS, CCS — what's the difference? Here's our best guide to genetic testing ...

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Endometriosis Awareness: Five Things You Should Know

by Leigh Ann Woodruff, March 13, 2012

March is National Endometriosis Awareness Month, so it's time to increase your knowledge about a disease that can cause debilitating pain and is estimated to affect 6.3 million women in the United States.

"When the Endometriosis Association was founded in 1980, endometriosis was commonly thought of as a disease of the single, white career woman," says Carol Drury, Education Program Coordinator and Associate Director. "That is certainly not the case! We estimate that more than 89 million girls and women around the world — of all races, single and married, working inside or outside of the home — are currently affected by endo. Endo has been diagnosed in girls as young as 8 — prior to their first menses — and can also be found in women who are post-menopausal."

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IVF, Infertility and Valentine's Day

Five ways to put the spotlight back on you and your partner

Does Valentine's Day seem like another painful holiday to you this year? The pressure to make Valentine’s Day all about sex and romance can feel daunting, especially if you have your baby-making sex scheduled down to the minute, and all you can think about are basal body temperature charts, ovulation and the possibility of in vitro fertilization (IVF).And, of course, if you're taking fertility drugs, you could be dealing with bloating, hot flashes or mood swings, making sex seem remarkably unsexy.

The good news is there are ways to enjoy Valentine’s Day even if you are in the middle of your fertility treatments.

“The nice thing about Valentine’s Day is its focus on the couple,” says Leslee Murphy, an infertility therapist at Houston Fertility Counseling who also works on-site at Houston IVF. “A lot of the other holidays — Christmas, Easter, Mother’s Day — are more about the family and children, but Valentine’s Day is about you and your partner.”

So snuggle up with your sweetie and read through our list of Five Ways to Cope with Infertility This Valentine’s Day.

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Video: How Is Unexplained Infertility Diagnosed?

Dr. Daniel Williams, a fertility doctor with Houston Fertility Institute, explains how a diagnosis of unexplained infertility is determined.

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0:00:00.000,0:00:03.000 (text on screen): Fertility Authority. Your Most Trusted Source 0:00:03.000,0:00:05.000 Ask the Experts 0:00:05.000,0:00:10.000 How is unexplained infertility diagnosed? 0:00:10.000,0:00:15.000 Dr. Daniel Williams, Houston Infertility Institute: The definition of infertility is inability to conceive after six months of trying, 0:00:15.000,0:00:21.000 for women over 35, and after 12 months of trying for women under 35. 0:00:21.000,0:00:27.000 A workup is then initiated looking at the sperm, the egg 0:00:27.000,0:00:30.000 (which is ovulation and, of course, fallopian tubes, to see if they're open.) 0:00:30.000,0:00:35.000 If those are all normal, the couple is considered to have "unexplained infertility." 0:00:35.000,0:00:38.000 (text on screen): Fertility Authority. Your Most Trusted Source
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Video: How Do I Choose Between Several Egg Donors?

Mary Fusillo, Founder and Executive Director of The Donor Solution, explains what to consider when you're narrowing down the choice of which egg donor to use.

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0:00:00.000,0:00:03.000 (text on screen): Fertility Authority. Your Most Trusted Source 0:00:03.000,0:00:05.000 Ask the Experts 0:00:05.000,0:00:10.000 How do I choose between several egg donors? 0:00:10.000,0:00:14.000 Mary Fusillo, RN, BSN, MS, The Donor Solution: Once you have your four or five; maybe even six donor candidates, 0:00:14.000,0:00:15.000 I would kind of rank them. 0:00:15.000,0:00:21.000 And a lot of couples like to each take their donors and each rank them secretly from each other, so, like, maybe the wife 0:00:21.000,0:00:28.000 likes number 125 and 327, and the husband likes two or three different ones. Then kind of compare and contrast their lists. 0:00:28.000,0:00:30.000 What is most important? 0:00:30.000,0:00:36.000 In the end, I do believe that it's very important for the wife to be the person that makes the final decision. 0:00:36.000,0:00:42.000 So many times, I have couples, and the woman comes to me and says, "Well, I really like this donor 0:00:42.000,0:00:50.000 but my husband really likes this one because, you know, she's very tall and he wants a team of basketball players." 0:00:50.000,0:00:53.000 Well, but let's look at her mother. Let's look at the other genetic traits. 0:00:53.000,0:00:58.000 I believe that women need to make the final decision on who's gonna be their stand-in. 0:00:58.000,0:01:04.000 Once they've narrowed it down, I think it's very important to talk to the agency, find out, hey, when are these donors available? 0:01:04.000,0:01:06.000 Which is going to be the most convenient for me? 0:01:06.000,0:01:12.000 And sometimes your first choice may end up being not the one that you really; is best for you. Maybe second or third choice. 0:01:12.000,0:01:17.000 And realizing that you could have two or three choices and they could all be equally good. 0:01:17.000,0:01:21.000 Once you've done that, then, it's more important to talk to the agency. 0:01:21.000,0:01:27.000 Make sure that you know exactly when the donor's going to be available, especially with young working women. 0:01:27.000,0:01:29.000 They have very tight schedules. 0:01:29.000,0:01:33.000 I ask people to be really realistic about their expectations for a donor. 0:01:33.000,0:01:38.000 So, someone who has a clinic that requires them to have a donor to be there for seven or 10 days 0:01:38.000,0:01:41.000 really needs to pick a donor that's local to that clinic. 0:01:41.000,0:01:46.000 If the clinic doesn't require that and they only need to come for an initial visit and a retrieval 0:01:46.000,0:01:53.000 and the monitoring can be done in the donor's hometown, then, you know, kind of, it's whoever you really are happy with. 0:01:53.000,0:01:59.000 Once you've gotten that, make sure that everyone knows the dates. Because invariably the recipient will say, 0:01:59.000,0:02:05.000 "Well, my husband and I are planning on going on this cruise before we have our baby, and it's scheduled for these weeks." 0:02:05.000,0:02:11.000 Well, those are the weeks that the donor has available, because she's going to be taking midterms or she's studying for the LSAT. 0:02:11.000,0:02:18.000 So, that part needs to be really put in writing: What are the dates that are definitely "cannot do it." What can we do? 0:02:18.000,0:02:22.000 After that, you make sure that the donor is accepted by your clinic. 0:02:22.000,0:02:29.000 We like to pre-screen our donors so that they have the ability to be immediately starting. 0:02:29.000,0:02:36.000 They're not waiting to have fertility testing and then you turn it over to the donor coordinator and are a backup to the couple. 0:02:36.000,0:02:39.000 (text on screen): Fertility Authority. Your Most Trusted Source
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What Traits Should I Consider When Choosing an Egg Donor?

What should you consider when choosing an egg donor - looks, academic background or other traits? Mary Fusillo, Founder and Executive Director of The Donor Solution provides some insight.

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0:00:00.000,0:00:03.000 (text on screen): Fertility Authority. Your Most Trusted Source 0:00:03.000,0:00:05.000 Ask the Experts 0:00:05.000,0:00:10.000 What traits should I consider when choosing an egg donor? 0:00:10.000,0:00:14.000 Mary Fusillo, RN, BSN, MS, The Donor Solution: A lot of times, when people initially start their search for an egg donor, 0:00:14.000,0:00:16.000 they're looking at what the donor looks like. 0:00:16.000,0:00:22.000 Because the websites are filled with pages and pages and pages of potential donors, 0:00:22.000,0:00:25.000 and so they tend to run through them looking for someone who looks like them. 0:00:25.000,0:00:30.000 I think that people get very disappointed: "I don't find anyone that looks like me." 0:00:30.000,0:00:35.000 But there's a big age difference. You know, the donor's going to be 23. The recipient could be 40. 0:00:35.000,0:00:38.000 And you look a lot different in that 17-year period. 0:00:38.000,0:00:41.000 So, that's one of the big issues is deciding what's most important. 0:00:41.000,0:00:45.000 When they're looking at academic background, it's very important to also realize 0:00:45.000,0:00:51.000 that not every donor had the same opportunities that the potential recipients had. 0:00:51.000,0:00:56.000 Your average egg donor, while she's very smart and she's very driven 0:00:56.000,0:01:02.000 (and that's a real good trait to have, because you want a driven egg donor who really wants to help you have a family), 0:01:02.000,0:01:07.000 you also have to realize not every single one comes from Yale or Harvard or Columbia. 0:01:07.000,0:01:11.000 Hopefully, you're gonna pick a donor who's very much like you. 0:01:11.000,0:01:17.000 Not only just in your ethic background, but maybe some of your looks, but your attitude about life. 0:01:17.000,0:01:23.000 Because then, when you see those traits in your child, they're not the donor's traits. They're your traits. 0:01:23.000,0:01:25.000 (text on screen): Fertility Authority. Your Most Trusted Source
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What Is the First Step In Choosing an Egg Donor?

You've decided to use egg donation to get pregnant, but don't know where to begin. Mary Fusillo, Founder and Executive Director of The Donor Solution gives advice on how to get started in choosing an egg donor.

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0:00:00.000,0:00:03.000 (text on screen): Fertility Authority. Your Most Trusted Source 0:00:03.000,0:00:05.000 Ask the Experts 0:00:05.000,0:00:10.000 What is the first step in choosing an egg donor? 0:00:10.000,0:00:12.000 Mary Fusillo, RN, BSN, MS, The Donor Solution: The very first things couples need to think about, 0:00:12.000,0:00:21.000 or even a single woman or a same-sex couple needs to think about when looking at egg donors is, "Am I really ready to make this step?" 0:00:21.000,0:00:26.000 It's a big commitment and it's a lot of time, effort, money. And if you're kind of wishy-washy 0:00:26.000,0:00:30.000 ("Am I ready to do this? Am I ready to give up on my own fertility or not?") is the first step. 0:00:30.000,0:00:37.000 After that, you have to go, "Where do I want to focus? Do I want to find someone who looks just like me? 0:00:37.000,0:00:43.000 Do I want to find someone who has my personality traits? Or am I really looking for a family health history?" 0:00:43.000,0:00:49.000 So, being able to be honest with yourself and go, "Yes, it's very, very important to me that the donor looks very much like me," 0:00:49.000,0:00:56.000 or that the donor has a very high academic standards, came from a very well-educated family, or, 0:00:56.000,0:00:59.000 "I just want a healthy baby; I'm only looking at health criteria." 0:00:59.000,0:01:01.000 So, that's the very first step. 0:01:01.000,0:01:04.000 (text on screen): Fertility Authority. Your Most Trusted Source
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What Are Options for Getting Pregnant with Unexplained Infertility?

Fertility treatment for patients with unexplained infertility may include fertility drugs with IUI or IVF, according to Dr. Daniel Williams of Houston Fertility Institute.

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0:00:00.000,0:00:03.000 (text on screen): Fertility Authority. Your Most Trusted Source 0:00:03.000,0:00:05.000 Ask the Experts 0:00:05.000,0:00:10.000 What are options for getting pregnant with unexplained infertility? 0:00:10.000,0:00:13.000 Dr. Daniel Williams, Houston Infertility Institute: If we haven't found a cause for infertility, 0:00:13.000,0:00:16.000 we really can't treat something specifically. 0:00:16.000,0:00:25.000 Therefore, our treatment goal is simply to accelerate the time to pregnancy. That is, get the couple pregnant as quickly as possible. 0:00:25.000,0:00:30.000 So, there are two main principles we utilize to achieve that goal. 0:00:30.000,0:00:37.000 One is, we increase the number of eggs. And that makes sense because humans on their own make one egg a month. 0:00:37.000,0:00:43.000 If we give fertility medicines that increase the number of eggs made in that month, 0:00:43.000,0:00:45.000 it increases the chances for conception in that month. 0:00:45.000,0:00:51.000 The second thing that we do is we actually want to get the sperm and egg closer together. 0:00:51.000,0:01:00.000 And by doing that, it actually gives you higher rates above timed intercourse, or regular intercourse, 0:01:00.000,0:01:04.000 because we try to get millions of moving sperm into the uterus 0:01:04.000,0:01:08.000 or upper female reproductive tract by use of intrauterine insemination. 0:01:08.000,0:01:17.000 Or, we can actually go so far as to stimulate the ovaries, take the eggs out of the ovaries, and then fertilize the eggs in the lab; 0:01:17.000,0:01:23.000 let them grow into embryos and then put the embryos back into the uterus, which is called in vitro fertilization. 0:01:23.000,0:01:27.000 So, those are our two methods of getting the sperm and egg closer together. 0:01:27.000,0:01:36.000 Most studies have shown that use of either of the principles; say, doing fertility medicines alone for unexplained infertility, 0:01:36.000,0:01:43.000 or doing intrauterine insemination alone for unexplained infertility, do not significantly increase pregnancy rates above baseline. 0:01:43.000,0:01:49.000 So, that's usually not going to increase their chances for conception in that month. 0:01:49.000,0:01:55.000 There are two factors that couples consider when determining which treatment option they wish to choose. 0:01:55.000,0:01:58.000 One is cost. The other is success rates. 0:01:58.000,0:02:04.000 IVF has the highest success rates of all treatments. Of course, it has the highest cost as well. 0:02:04.000,0:02:12.000 But if you actually factor in doing multiple treatment cycles of a treatment that gives you a lower success rate, 0:02:12.000,0:02:18.000 it ends up being more cost-effective to move more quickly to in vitro fertilization. 0:02:18.000,0:02:21.000 And more recent studies have actually confirmed that. 0:02:21.000,0:02:26.000 We would not recommend more than three cycles of any given treatment. 0:02:26.000,0:02:33.000 In other words, most patients who are going to be pregnant with a given treatment have done so within three treatment cycles. 0:02:33.000,0:02:42.000 Usually, in actual practice, most patients do one or two cycles of a lesser treatment before moving directly to in vitro fertilization. 0:02:42.000,0:02:44.000 (text on screen): Fertility Authority. Your Most Trusted Source
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