Our high pregnancy rates result from applying advanced fertility treatments in a caring and empathetic environment.

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04/21

2017

HRC’s Commitment to Preserving Fertility for Cancer Survivors

According to the American Cancer Society, an estimated 1,688,780 Americans will receive the dreaded cancer diagnosis in 2017.

In addition to understanding what this diagnosis will mean to their health and well-being, men and women of reproductive age faced with cancer also need to know the impact of cancer treatment on their ability to have children. Treatment can cure their cancer diagnosis, but might simultaneously dash their dreams of having a family.

Getting a cancer diagnosis is both terrifying and life-altering. First and foremost, people want to know how they can be treated and cured. Early detection, prompt care and advances in treatment have contributed to significant increases in remission and cure for many types of cancers. But often the treatment, depending on its type and duration, as well as the location of the cancer, will impair the reproductive organs and the sperm and eggs they create.

The American Society of Clinical Oncology and the American Society for Reproductive Medicine recommend, when possible, at-risk patients be referred to a fertility preservation specialist prior to starting cancer treatment. This does not always happen. Family physicians and oncologists need more education about how to counsel patients so they can get timely and accurate details.

At HRC Fertility, we are committed to helping those who want to preserve their fertility before undergoing treatment that might compromise it. Here are some of the ways they can do that.

Male options
For adult men, it seems relatively simple. They must produce a sperm sample to be frozen, stored and then thawed for when they are ready to have a child. It’s more complicated, however, for male children who have not yet reached puberty. Testicular tissue freezing and sperm aspiration are both experimental procedures. Only a small number of patients have used these techniques, so it’s too early to know if they will be effective.

Female options
The best option is to preserve fertility by freezing eggs (single women) or embryos (with a partner or sperm donor) prior to the initiation of chemotherapy or radiation. We can expedite egg retrieval and IVF treatment and suggest cancer patients undergo at least one cycle, no matter the type of cancer. The patient would, of course, want to get medical clearance from her doctor. If the cancer is not very aggressive, then the patient may be able to complete more cycles to store more eggs/embryos. We base medication dosage and length of treatment on their diagnosis and prognosis.

Ovarian tissue removal and freezing is experimental through a promising surgical procedure. It is being offered in a few locations in the United States, but is not widely used. Last December, a British woman gave birth using ovarian tissue frozen in childhood, so this advance looks promising.

If fertility cannot be preserved
If the unthinkable happens and there is not time to preserve your fertility, then there are options like sperm and egg donation, and surrogacy.

Light at the end of the tunnel
A cancer diagnosis is devastating. An infertility diagnosis is devastating. But we hope cancer patients can feel optimistic about their ability to preserve their fertility. Their desire for children does not need to be dashed with this frightening diagnosis.

Resources for fertility preservation
Live Strong
https://livestrong.org/we-can-help/livestrong-fertility

Fertile Action
http://fertileaction.org

References
Cancer.net
http://cancer.net/survivorship/life-after-cancer/having-baby-after-cancer-fertility-assistance-and-the-other-options

https://cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2017.html

http://savemyfertility.org/pocket-guides/fertility-preservation-women-diagnosed-cancer

https://cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fertility-and-sexual-side-effects/fertility-and-men-with-cancer/how-cancer-treatments-affect-fertility.html

http://telegraph.co.uk/news/2016/12/14/woman-gives-birth-baby-using-ovary-frozen-childhood-inworld/

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04/10

2017

#ListenUp for National Infertility Awareness Week

#ListenUp! In honor of National Infertility Awareness Week (NIAW), April 23-29, our infertility specialists are trying to make infertility treatment more accessible to new patients. Often, taking the first step to schedule an appointment with a physician is a difficult one. Patients don’t know what to anticipate during the initial meeting. They may be intimidated and confused.

Drs. Jane Frederick, Daniel Potter, Sanaz Ghazal and Mickey Coffler hope to break down some of those barriers by providing the following specials during NIAW. New patients can respond on the doctors’ individual Facebook pages.

* Dr. Jane Frederick and Dr. Daniel Potter: Raffles for a $500 gift certificate toward fertility treatment with the first 10 people responding getting a free “new patient” consultation voucher
* Dr. Sanaz Ghazal is offering a $500 gift certificate and five free “new patient” consult vouchers
* Dr. Mickey Coffler will be providing a $250 raffle

#ListenUp: So what happens during the initial consultation? Here’s what you should know about an initial consultation:

Your first impression
The initial consultation usually is the first meeting between you and the doctor (unless you met at one of our seminars) who will be your primary infertility specialist at HRC Fertility Orange County. Expect the appointment to last between 60-90 minutes. We encourage both partners to attend this meeting. You are in this together to make a baby!

Initial paperwork
Please try to complete the financial, administrative and medical history paperwork we send in the initial consultation packet. This includes other important documents to help us more effectively plan your care.

Become informed about your health insurance
It’s always a good idea to know what your insurance plan will pay for the diagnosis and treatment of infertility. We have experienced financial counselors who will work with you to figure out what will be covered as well as other options you can take to afford treatment.

Bring your medical records
If you have had previous diagnostic tests or treatment performed by an obstetrician/gynecologist or a reproductive endocrinologist, please arrange for the release of those records. You can either bring these records to the initial consultation or, better yet, have them sent before your appointment. You can save previous time and money with the receipt of these important documents. We do not want to repeat any unnecessary tests or procedures.

Reviewing your medical history

Your past records and the completed medical history forms will alert us to any health concerns or issues you and your partner might have. During the consultation, we will ask both partners about past medical problems, surgeries, and prescription medications they are using. With the female partner, we will discuss her OB history, previous infertility workups and treatments, and if her mother or sisters have had trouble conceiving.

We also want to know if the father-to-be has already fathered a child/gotten a woman pregnant and lifestyle factors that may affect his sperm. If he has already completed his semen analysis, the doctor will also go over those results as well.

Explaining and scheduling diagnostic testing
We will explain what each test entails and what the results will mean. For women, we will schedule blood work on day three of your menstrual cycle to evaluate your hormone levels and other key indicators of fertility, as well as an ultrasound to visualize your ovaries and pelvic cavity, and a hysterosalpingogram, a specialized x-ray to assess the anatomy of your fallopian tubes and uterus.

The male partner has it relatively simple. He must produce a semen sample to be evaluated.

Developing a roadmap to success
Our goal is to get you pregnant! The initial consultation is the first step in outlining your treatment options. Unless otherwise medically indicated, we proceed from low-tech (medication and/or intrauterine insemination) options to more complex, such as assisted reproductive technologies, including in vitro fertilization. We also discuss success rates based on age and diagnosis. We want you to feel comfortable with your treatment course.

We hope you leave the consultation with a positive viewpoint and a feeling that you are on the way to making your dreams come true.

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04/06

2017

A Cross-Country Move Joins Couple with HRC’s Dr. Jeffrey Nelson

As a same sex couple, Elena and Erin knew they would need intrauterine insemination (IUI) to create their family. But they were not anticipating fertility problems when they embarked on their baby plans at a North Carolina clinic.

“Generally people think it’s easy to get pregnant because you have doctors and technology,” Elena said. “But after four failed IUIs, we learned nothing was a certainty.” Around the same time, Erin, an active duty Marine for 19 years, had received orders to move to California.

The couple, who married in April 2015, were separated for four months before reuniting in 29 Palms, Calif., and began their search for a new fertility clinic. Friends referred them to HRC Fertility and they also researched online reviews about the practice. They liked what they read and felt confident HRC Fertility would be right for them–even though Dr. Jeffrey Nelson’s office would necessitate a five-hour round trip drive.

Erin felt the same way, and added, “We knew IVF was the next step for us. Knowing others who had been treated successfully by him was reassuring. We took a leap of faith and it worked out marvelously.”

Elena became pregnant in July 2016 during her second IVF treatment. Though her first cycle failed, Dr. Nelson was able to identify through genetic testing a clotting problem that had caused a miscarriage after the couple’s initial IVF attempt.

“It was incredible to have Erin by my side while undergoing IVF,” Elena reminisced. “Dr. Nelson conducted all of our exams; at the other clinics, the nurses saw us. Everyone greeted us by our first names and knew our story. That made us feel special, even though it is a busy practice with many patients.”

Erin and Elena really appreciated the team approach at HRC, where the financial, administrative, nursing and laboratory staff worked in a coordinated fashion to ensure the best type of care. As Elena described, “The financial counselors made sure I understood our financial responsibilities. The nurses always quickly communicated with us when we had questions. The coordination was flawless.”

When Elena was three months pregnant, Erin deployed to Kuwait, where she was stationed when Cassidy Elizabeth was born in early March. Fortunately, technology allowed her to witness the birth and continuously keep in touch with her wife and baby. Erin, who is due home in a few months, remembered that “though it’s hard to be so far away, I was able to zoom in on the baby with my WiFi camera. Considering I’m thousands of miles away, that kind of access is pretty amazing. Knowing that there is an end in sight has also helped.

The couple advise others to be patient and to know their emotional boundaries to best manage expectations. “It’s not unusual to need several cycles of treatment before you get pregnant. You ask ‘why me’ when it seems others are conceiving so easily, so having an understanding of what you can tolerate is important.”

In addition to their new roles as parents, the couple is also preparing for another cross-country move to Virginia after Erin’s return. Everyone at HRC wishes them the best of luck!

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03/23

2017

Choice Mom Chooses HRC Fertility for Her Path to Parenthood

When she was just 24, Jennifer Biffer underwent a hysterectomy because of severe endometriosis. This turning point made the talented interior designer realize she would never be able to have children in the “traditional” way.

Jennifer was able to become a devoted stepmother and later, when her stepdaughter got married, a grandmother. But her desire to have her own baby never went away.

Unfortunately, Jennifer’s husband didn’t want to start the parenthood journey a second time so Jennifer decided to become a choice mom and go it alone. She began the process at a Colorado clinic with the assistance of a boyfriend who agreed to become a sperm donor. Because of her age and prior hysterectomy, Jennifer also needed an egg donor and a surrogate mother.

When her boyfriend backed out, Jennifer started looking for another doctor. A girlfriend recommended HRC’s Dr. Robert Boostanfar.

“I immediately connected with Dr. B and felt one thousand times more comfortable with HRC than my first fertility clinic,” recalled Jennifer. “After my initial consultation ended, he gave me a hug and told me he would help me have a baby!”

The process moved quickly after that. With the help of a surrogacy consultant, three months later Jennifer had found an egg donor, a sperm donor and a surrogate mother. By January, her surrogate had a fresh embryo transfer with one embryo. The blastocyst embryo split, which resulted in the pregnancy of Jennifer’s identical twin boys.

Wyatt Gabriel and Aiden Royce were born eight weeks premature in August 2016, and both spent time in the NICU. As a single mom, Jennifer has experienced a roller coaster ride with doctor and therapy appointments. Though they have had some physical challenges because of their prematurity, the beautiful, healthy boys are starting to hit their milestones and are doing great.

Jennifer added, “My experience at HRC was incredible. Every staff member was so kind, always making me feel like I was the mom even though it was a surrogate pregnancy.”

Jennifer advises other women who need egg donors to focus on the health and fertility of the women who donate their eggs versus requirements like SAT scores. “At the end of the day, genetics can be a complete crap shoot, so it’s not worth it to get caught up in less relevant details.”

Jennifer found infertility to be as stressful, emotionally and financially, as undergoing the deaths of loved ones or a divorce. To cope, she attended a support group in New York for women using egg donors. Hearing everyone else’s stories was helpful, but she hopes the stigma surrounding egg donation can be lessened.

Jennifer’s final message? “Throughout my journey, I learned that parenting has nothing to do with how you became a parent. Many women who use egg donors to build their family wonder if they will feel like a ‘real mother.’ But once the babies arrive, they are yours in both heart and soul.”

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03/15

2017

HRC Fertility Free Seminar a Game-Changer

Margot had a gut instinct that she might have polycystic ovary syndrome, or PCOS. Though she is thin, Margot experienced irregular periods and suffered from bouts of acne. However, every doctor insisted Margot was fine, even though she and her husband had been trying unsuccessfully to get pregnant for just over one year. Luckily, Margot persisted in discovering the truth behind her inability to conceive and is now the mother of a 20-month-old toddler, Asher.

A registered nurse, Margot and her husband both wanted to start a family soon after they were married in 2013. Unfortunately, Margot’s search for a gynecologist who could confirm her diagnosis proved fruitless until she attended one of HRC Fertility’s free seminars in Fullerton. As part of the event, Margot was offered a free consultation with an infertility specialist. She and her husband scheduled an appointment with Dr. John Norian at HRC’s Rancho Cucamonga office.

“Within the first five minutes of meeting him, Dr. Norian was convinced I had PCOS,” recalls Margot. “An ultrasound confirmed my ovaries were polycystic. Dr. Norian reviewed all of our treatment options, including intrauterine insemination (IUI) and in vitro fertilization (IVF). However, my husband was unsure about IVF. Fortunately, Dr. Norian was very accommodating and didn’t want us to feel any pressure about how to proceed.”

The couple decided to undergo several rounds of treatment with the medication Letrozole. Though the first cycle didn’t work, Dr. Norian carefully monitored Margot with ultrasounds and the couple achieved success on their second cycle. Margot learned she was pregnant on her 33rd birthday!

She says, “We were fortunate that HRC had an incredibly encouraging and supportive staff. Infertility presents you with such a roller coaster of emotions and it was wonderful to have a great group of nurses and an outstanding doctor who understood our journey.”

Margot recommends that others follow their intuition and find a specialist who has expertise in infertility, adding, “It will save you a lot of pain and heartache if you do. Even if you have to go without your partner, it will give you peace of mind.”

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