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

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Galentine’s Day: Dr. Jane Frederick Talks Female Friendship and Support

In case you haven’t heard, Galentine’s Day takes place on February 13, the day before Valentine’s Day. The brainchild of Parks and Recreation fictional character Leslie Knope, Galentine’s Day has since taken on a life of its own.

Galentine’s Day is a celebration of female friendship and gal power. Girlfriends provide companionship, comfort, support and understanding through both our happy moments and darkest hours.

When you’re trying to conceive, female friendships can be more important than ever. But they can be complicated, too, especially if your closest friends are getting pregnant and having babies. But there are many reasons to find strong female lifelines as you navigate the frequently rocky waters of the fertility journey.

You need your friends to lean on
Of course, you should be able to rely on your spouse or partner for support. After all, you are going through treatment to make a baby together. Sometimes, though, another woman is the best person to lend an impartial ear when you need to vent or a shoulder to cry on when crying is the only thing you want to do.

You need a community of TTC sisters
There are many online resources where you can find support and understanding among other women who are trying to get pregnant. But if virtual friendships aren’t for you, there are also ways to find in person female infertility friendships. In Southern California and other metropolitan areas, there are numerous ways women experiencing infertility can meet each other. Some patients have gotten to know each other in their clinic’s reception area, and then formed an informal support network. Others have taken advantage of support groups organized by RESOLVE: The National Infertility Association or other nonprofits.

You need your friends for fun, and to remind you to take some “me” time
As you ride the emotional roller coaster ride of infertility, it can be difficult to remember to take time off to relax and “smell the roses.” We hope you have friends who can take you away from your challenges, and you can, in turn, reciprocate for them. During this time, you may feel like less of a woman because of your inability to conceive. So it’s a necessity to set aside time to do something indulgent–whatever that might mean for you.

P.S.: Don’t forget Valentine’s Day
We hope you and your partner take some time to reconnect on Valentine’s Day and use this time to do something special together, know that someday you will become parents and “couple” time won’t be as easy. Focus on what you love about your partner and what you’ve been through together. Try to make this day about romance and your love for each other.

But also don’t forget to thank your girlfriends the day before on Galentine’s Day. Make February 13 a special day for the women who have been with you every step of the way to overcome infertility. Candy, flowers, and a night out on the town with your GFs may be just what the doctor ordered!




Extra Research Meant Finding Dr. David Tourgeman!

Before moving to California, Maggie T. had undergone several surgeries in Colorado to repair a uterine septum preventing her from getting pregnant. It was a traumatic experience, with Maggie needing to find a second surgeon to correct the errors the first doctor made.

At the urging of her then boyfriend (now husband), Maggie quit her job and moved to California where she focused on getting herself into shape and finding an infertility physician.

She scoured the Internet and was impressed with Dr. David Tourgeman’s online reviews. But she didn’t stop her search there. She dug deeper to learn how his patients honestly felt about the care he administered.

Recalled Maggie, “By the time I had my initial consultation with Dr. Tourgeman, I’d been through the ringer with the first fertility practice. That doctor did not understand my infertility issues, and the staff did not support me emotionally. After several surgeries and one unsuccessful round of IVF, I wanted to make sure a new clinic and doctor would not repeat the same mistakes.”

The former program manager was direct with Dr. Tourgeman about her needs, and was pleasantly surprised to learn that HRC Fertility was committed to not only treating patients medically but also supporting them emotionally. “Deciding to become Dr. Tourgeman’s patient was one of my best decisions,” she said. “He read all my charts to understand what was wrong with me. He also adjusted my medications after assessing what my previous doctor had done. I feel all the new steps he took contributed to my success with IVF after one cycle. Above all, he was upfront and honest. I knew exactly what to expect.”

Maggie and her husband also appreciated how kind and courteous every staff member in the office was; everyone knew her name, from the nurses to the front desk employees. She never felt like a number or that the clinic could not make time for her individual needs.

Most importantly, Dr. Tourgeman saw her at every appointment and was with her every step of the way. “He completely changed my perspective. I felt jaded from my previous episode with the Colorado practice and was resigned to the possibility we might not be able to have kids.”

Though her focus is now her infant daughter, Maggie eventually would like to take what she has learned from her fertility journey and help other women who are confused and concerned when they can’t conceive.

“It can be so frustrating when you can’t get pregnant,” added Maggie. “No one knows how to start the process of finding the right infertility doctor.” She advises couples to spend the necessary time to find the right doctor who will be an advocate and engaged in their care: “Don’t rely on one source to look for a doctor. Do a thorough Internet search and ask other people for referrals. The best doctor for you is not necessarily the one with the best success rates on paper, but is the provider who is going to listen and work on your behalf.”




Dr. Diana Chavkin: Oncofertility Gives Hope to Those Living with Cancer

Of the 700,000 cases of cancer diagnosed each year in the U.S., 10 percent are women of reproductive age. This means that there are more than 70,000 women diagnosed with cancer every year who may be considering having children. The most frequently diagnosed cancers in reproductive aged women are breast, uterine, cervical and ovarian. Because women are now waiting longer to have their first child, many receive this diagnosis before they have started their families. And because life-saving treatments may jeopardize a woman’s fertility, patients are faced with illness from cancer as well as the possibility of losing their ability to have children.

However, there is promising news for those confronted with a cancer diagnosis. First, doctors are detecting cancers earlier because of better screening techniques and more successful treatment. Second, improvements in treatment are giving patients better odds at long-term survival. Third, advances in reproductive medicine are providing patients more options to preserve their future fertility.

Gonadotoxic effects of cancer therapies
Breast cancer has one of the lowest cancer mortality rates and is the most common malignancy to affect women younger than 45. Unfortunately, the different cancer therapies used to save their lives may accelerate the loss of their fertility. Chemotherapy can cause egg depletion and may lead to ovarian failure. Radiation can affect ovarian function and impair hormone production. Women of all ages may be affected, but those exposed later in life will face the greatest impact. They may even experience early or premature menopause, depending on their age.

Not all chemotherapies have the same effect. Some are more toxic to ovarian function than others. Clinicians can use online resources to calculate the toxicity of chemotherapy (www.fertilehope.org/tool-bar/risk-calculator.cfm)

How does chemotherapy affect a woman’s menstrual cycle?
Chemotherapy and radiation can affect menses and, potentially, fertility. During cancer treatment, most women do not get a period. It may take six months to a year for a woman to start menstruating again after her treatment ends. The younger a woman is at the time of exposure, the higher the chance her periods will return. Women who are younger than 35 when exposed to chemotherapy have a 90 percent chance of recovery; those who are 40 have a 20 percent chance of resuming regular menses.

The return of menses does not mean the return of fertility, however. A fertility doctor will often perform hormonal blood tests and ultrasounds to assess the remaining fertility.

Women are told to avoid pregnancy while undergoing cancer treatment. Because a woman’s fertility declines with age and the risk of miscarriage increases, the delay is more significant for older reproductive aged women than for younger women.

Tamoxifen and breast cancer
Oncologists give tamoxifen to women with estrogen positive breast cancer for about five to 10 years. During this time, patients are instructed not to conceive. This extended period of time in which patients are told to avoid pregnancy may have the most significant impact on a woman’s fertility and her increased risk of miscarriage.

What can be done to limit the damage?
There are techniques surgeons and oncologists can use to minimize the harm to their patients’ fertility. These include:
– Offering less aggressive resection for uterine, ovarian and cervical cancers
– Planning radiation fields to shield the ovaries
– Moving ovaries out of the radiation field before treatment
– Using chemotherapy drugs less toxic to the ovaries, which the clinician must weigh against the effectiveness of the drugs
– Modifying doses
– Timing of treatment for breast cancer, such as delaying chemotherapy one month to allow for fertility preservation

In addition to delaying the administration of tamoxifen, doctors can schedule breaks in the middle of treatment so that pregnancy or fertility preservation can occur.

Using these techniques does not preclude patients from using fertility preservation options like egg, embryo or sperm freezing before treatment, which we strongly encourage and will discuss in the next blog.





Women Over 40 Make Great Moms

Are you 40 or older and think that the motherhood ship may have already sailed? Think again. At HRC, we know there are several options to help women of all ages fulfill their dreams.

Here are some important considerations:

You’re in good company
Statistically, more women over 40 are becoming mothers than ever before. In fact, over the last three decades, that number has quadrupled. Some are even saying that 40 is the new 30!

According to a 2016 National Vital Statistics Report (Centers for Disease Control), the birth rate for women 40-44 increased two percent from 2013 to 2014. For those 45-49, it stayed the same, while women over 50 had 743 births in 2014, a 66 percent increase from 2013. The trend seems to be pointing upward when it comes to the age at which women are giving birth.

You can get pregnant naturally
Fertility decreases significantly as women age, but this doesn’t mean women over 40 can’t get pregnant naturally. It will likely take them longer to achieve pregnancy because the quantity and quality of their eggs have declined, and they are also at a higher risk of miscarriage because of chromosomal abnormalities. However, we caution couples to not wait too long before seeking the help of an infertility doctor. If you’ve tried without success for three months or more, and as you age through your 40s, please contact us.

There are medical interventions when you need help
There are many tools in our reproductive arsenal to help women over 40 achieve a successful pregnancy when assistance is required. You can decide to use either your eggs or those of an egg donor with in vitro fertilization (IVF). Some couples try an initial cycle with the prospective mom’s eggs. If this doesn’t work and they decide to use a donated egg, their chances of success is the same as that of a younger woman who provided the genetic material.

You are older but wiser
By the time you decide to become a mother in your 40s, you may already have accomplished many of your professional and personal goals. Throughout your life, you likely also learned from your mistakes and then applied the knowledge moving forward. Those experiences will help you become a better parent, and scientific research proves it.

A recent Danish study of 5000 mothers, published in the European Journal of Developmental Psychology, found older mothers to be calmer without needing to yell as much or impose harsh discipline with their children. The kids, in turn, exhibited fewer behavioral and social problems and better emotional well-being.

Pregnancy at an older age can make you wiser
2016 research from the Keck School of Medicine at the University of Southern California concluded that women who had their last babies after age 35 tended to function better cognitively after menopause than women who had their children earlier in life. Scientists hypothesized this might be due to the surge in estrogen and progesterone, the pregnancy-related hormones.

Risks of older motherhood
In addition to infertility, there are increased risks for miscarriage, chromosomal abnormalities, and developing medical conditions like gestational diabetes and hypertension during pregnancy. Women also are more at risk of having a C-section as well as a preterm or low birth weight baby.

You can have a healthy pregnancy
Even with all the potential unpredictability of a later-in-life pregnancy, women over 40 can have a healthy pregnancy and childbirth with proper prenatal care and monitoring by an obstetrician. Chances are women who conceive later in life are very prepared and ready to undergo the challenges and joys of becoming a mother over 40.




Dr. Daniel Potter: HRC’s 2018 Resolutions to Patients

The way to new year 2018

At the end of each year, many (MANY) people start planning their resolutions for the coming year: lose weight; stop smoking; become more organized; read more; and well, the list goes on.

Those trying to have a baby, however, may be focused on only one New Year’s goal: to become a parent or expand their family as they have always envisioned. At HRC Fertility, our New Year’s resolution is to help you achieve your resolution. We aim to provide our patients with a pathway to parenthood in the most efficient, cost-effective and successful way possible.

At HRC Fertility, we vow to:
1) Effectively diagnose your infertility problems so we know the best route forward
2) Compassionately communicate so that you understand the treatment plan and have realistic expectations about the potential outcome
3) Educate you about your responsibilities as a patient, especially regarding medication and cycle monitoring
4) Answer every question and address any concerns
5) Provide medical treatment options reflecting the latest advances in treatment and medical practices
6) Treat you as we would want to be treated: as a person with hopes and dreams that we want to fulfill
7) Hold your hand and provide a shoulder to cry on when the roller coaster of the infertility experience becomes too much to bear
8) Share your joy and celebrate your accomplishments when the time comes for you to leave our practice

If your goal is to have a baby in 2018, please contact us if you:
1) Have been unsuccessfully trying to conceive for too long. That means a year or more if you’re a woman 35 years old or younger; six months if you’re older than 36; or three months or longer if you’re 40 or older
2) Are aware of a fertility diagnosis such as endometriosis, polycystic ovary syndrome or low sperm count
3) Are frustrated with the course of treatment or care at your current fertility provider
4) Have been treated by your gynecologist but know it’s time to move on to more advanced therapies, such as in vitro fertilization
5) Are a woman or man contemplating single or “choice” parenthood
6) Are part of a same-sex couple who knows you’ll need help getting pregnant

Happy New Year and a joyous 2018 from HRC Fertility!