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

11/17

2017

Dr. Sanaz Ghazal Discusses the “Waiting Game”

Posted by admin | Filed under Getting Pregnant, Infertility

Whether you’re undergoing intrauterine (IUI) or in vitro fertilization (IVF), an infertility treatment cycle consists of many steps. Everyone involved in the process — doctors, nurses, embryologists and patients — does their part to ensure the cycle will be as successful as possible. Then the waiting begins, euphemistically known in the “trying to conceive” world as the tortuous two-week wait.

At HRC Fertility, we try to support our patients and their partners as much as possible during this emotionally turbulent time. The emotional roller coaster doesn’t necessarily end with the announcement of the first test results and often continues throughout the several months before we discharge patients to their obstetricians.

For most infertility patients, a pregnancy test is not as simple as seeing two lines on a home pregnancy test (HPT). They will undergo several blood hormone tests as well as ultrasounds to confirm the health of their pregnancy.

Initial beta hCG blood test
We will administer the initial blood test, known as a beta hCG, 12-14 days after an IUI or embryo transfer. It will assess the presence of human chorionic gonadotropin (hCG), which is produced by placental cells that nourish the fertilized egg after it becomes attached to the uterine wall.

It takes about two weeks for the test to determine if the embryo is creating a sufficient amount of new hCG versus the hCG that can linger in our body after it is administered as the ovulation trigger shot. Because of this, we need to wait an adequate amount of time to ensure patients do not get a false positive.

Even though those weeks may seem like an eternity, blood tests can detect the presence of hCG earlier than commercially sold urine tests, which require you to wait until you have missed a period in order to obtain an accurate outcome. We advise patients to be patient and avoid taking a home pregnancy test.

Congratulations, you are pregnant!
When the day finally arrives to learn your test results, you will likely be on pins and needles. A positive result is considered above 25mIU/ml.

As your pregnancy progresses, hCG levels typically double every 72 hours, confirmed by blood tests over the next several days.

Your hCG levels will reach their peak in the first eight to 11 weeks of pregnancy. Repeat blood tests should be performed by the same laboratory so results are consistent. After several hCG beta blood tests with increasing levels of between 1000-2000 mIU/ml, we will order one or two ultrasounds to look for the presence of an amniotic sac and a heartbeat. Around 8 to 10 weeks, we will feel confident to discharge you to the care of your OBGYN for further prenatal care.

This transition period can be equally stressful, especially for those who have experienced previous IVF failures or miscarriages.

If your results are negative
Though we were hoping to tell you good news, this, unfortunately, is not always the case. Before you start a cycle or at the embryo transfer, we try to be candid about your prognosis. If we find that you’re not pregnant, we will do our best to communicate this news to you in the most sensitive way possible, as well as be available to answer your questions. We will schedule you for a follow-up appointment where we can discuss what we learned from this cycle and how we suggest you move forward. Though delivering bad news is never easy, we are committed to supporting you every step of the way.

Additionally, you could experience a chemical pregnancy, where beta hCG levels at first rise appropriately, but we cannot confirm the pregnancy at the ultrasound. This is devastating news, though hopefully we can glean some information about what caused the implantation failure, whether it’s a chromosomal abnormality or issues with the uterine lining, which can be used to fine-tune your next cycle.

We will also observe your results for indications of an ectopic or molar pregnancy.

Knowing what to expect in the testing process can be very empowering. Though we cannot guarantee a positive outcome for every treatment cycle, we can assure you that we will provide all the information and support you need to survive the two-week wait, the results of your pregnancy tests and your transition to an OBGYN.

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10/03

2017

Infertility: The Waiting Game

Posted by admin | Filed under Getting Pregnant

Tick-tock. Waiting may be the most nerve-wracking part of the infertility journey.

Whether you are undergoing intrauterine insemination (IUI) or in vitro fertilization (IVF), an infertility treatment cycle consists of many steps. Everyone involved in the process–doctors, nurses, embryologists and patients–does their part to ensure the cycle will be as successful as possible. Then the waiting begins, euphemistically known in the “trying to conceive” world as the tortuous two-week wait.

At HRC Fertility we try to support our patients and their partners as much as possible during this emotionally turbulent time. The emotional roller coaster does not necessarily end with the announcement of the first test results, and, in fact, often continues throughout the several months before we discharge patients to their obstetricians.

For most infertility patients, a pregnancy test is not as simple as seeing two lines on a home pregnancy test (HPT). They will undergo several blood hormone tests as well as ultrasounds to confirm the health of their pregnancy.

Initial beta hCG blood test
We will administer the initial blood test, known as a beta hCG, 12-14 days after an IUI or embryo transfer. It will assess the presence of human chorionic gonadotropin (hCG), which is produced by placental cells that nourish the fertilized egg after it becomes attached to the uterine wall.

It takes about two weeks for the test to determine if the embryo is creating a sufficient amount of new hCG versus the hCG that can linger in your body after it was administered as the ovulation trigger shot. Because of this, we need to wait an adequate amount of time to ensure patients do not get a false positive.

Even though those weeks may seem like an eternity, blood tests can detect the presence of hCG earlier than commercially sold urine tests, which require you to wait until you’ve missed a period in order to obtain an accurate outcome. We advise patients to be patient and avoid taking a home pregnancy test.

Congratulations, you’re pregnant!
When the day finally arrives to learn your test results, you probably will be on pins and needles. A positive result is considered above 25mlIU/ml.

As your pregnancy progresses, hCG levels typically double every 72 hours, confirmed by blood tests over the next several days. Your hCG levels will reach their peak in the first eight to 11 weeks of pregnancy. Repeat blood tests should be performed by the same laboratory so results are consistent. After several positive hCG beta blood tests with increasing levels of between 1000-2000 mIU/ml, we will order one or two ultrasounds to look for the presence of an amniotic sac and a heartbeat. After eight to 10 weeks, we will feel confident to discharge you to the care of your obstetrician for further prenatal care.

This transition period can be equally stressful as the two-week wait, especially for those who have experienced previous IVF failures or miscarriages.

If your results are negative
Though we were hoping to tell you good news, this, unfortunately, is not always the case. Before you start a cycle or at the the embryo transfer, we try to be candid about your prognosis. If we find that you’re not pregnant, we’ll do our best to communicate this news to you in the most sensitive way possible, as well as be available to answer your questions. We will schedule you for a follow up appointment where we can discuss what we learned from this cycle and how we suggest you move forward. Though delivering bad news is never easy, we are committed to supporting you every step of the way.

Additionally, you could experience a chemical pregnancy, where beta hCG levels at first rise appropriately, but we cannot confirm the pregnancy at the ultrasound. This is devastating news, though hopefully we can glean some information about what caused the implantation failure, whether it’s a chromosomal abnormality or issues with the uterine lining, which can be used to fine-tune your next cycle.

We will also observe your results for indications of an ectopic or molar pregnancy.

Knowing what to expect in the testing process can be very empowering Though we cannot guarantee a positive outcome for every treatment cycle, we can assure you that we will provide all the information and support you need to survive the two-week wait, the results of your pregnancy tests and your transition to an OBGYN.

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08/04

2017

Dr. Bradford Kolb and HRC End Couple’s Cycle of Heartbreak

Posted by admin | Filed under Age Factors, Getting Pregnant

Mary and James had been trying to conceive for eight years before being referred by their OBGYN to HRC and Dr. Bradford Kolb. The couple had seen other infertility specialists, including one overseas, and had undergone unsuccessful IUI and IVF cycles plus a heartbreaking ectopic pregnancy.

By the time they first saw Dr. Kolb in fall 2015, they were considering surrogacy. “We thought our age was a factor, “recalled 42-year-old Mary. “But Dr. Kolb reviewed our records and ran some tests. He convinced us that everything looked good and was confident we could get pregnant with IVF.”

The couple really liked how Dr. Kolb took the time to listen and was hands on, which was a pleasant departure from their previous physicians. One doctor would only see them a few minutes before handing them off to the staff. They also liked that Dr. Kolb was receptive to Chinese acupuncture, which made them feel less stressful and more relaxed.

At HRC Fertility, Mary and James underwent two cycles of IVF and had their embryos genetically tested. The remaining viable one became their son, who was born in June. They thank their lucky stars for this gift.

Mary advises other couples to do their homework to see if prospective clinics are a good fit for their needs and personality. They also encourage others to have a game plan, as they did. Mary explained, “We felt stressed during our previous IVF cycles. During our last one at HRC, we felt comforted knowing we had a backup plan if it didn’t work. That really helped to reduce our stress levels.

Even though they weathered much disappointment with other fertility providers, Mary and James are grateful for having found Dr. Kolb, knowing he was the difference in helping them create their family.

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08/01

2017

Dr. David Tourgeman Helps Couple Achieve “Plan A”

Posted by admin | Filed under Getting Pregnant, Infertility, IVF

Jill and her husband had been trying to start a family for several years when she sought help from her gynecologist because of abnormal menstrual bleeding. Her doctor suspected she had PCOS, but also diagnosed her with complex hyperplasia with atypia, which usually is found in childless women undergoing menopause. At 31, Jill learned she needed to be treated for this precancerous condition before she could start fertility treatment.

Once she was given the go ahead, Jill began treatment in 2016. Her doctor referred her to Dr. David Tourgeman along with other fertility specialists. “We really wanted to ‘click’ with our doctor,” recalled Jill. “Once I talked to Dr. Tourgeman, I knew he was the right choice for us.”

Because of her history, Dr. Tourgeman recommended the couple start IVF immediately. Unfortunately, their first two cycles were not successful, including a frozen embryo transfer that ended in miscarriage. But their third time with a fresh transfer was the charm and Jill became pregnant with twins. Zoe and Liam were born healthy and full term at 38 weeks.

Jill and her husband appreciated the support Dr. Tourgeman and his staff gave the couple both before and after they conceived. Said Jill, “I liked how he adjusted the medication protocol after each cycle. He was open to all of my suggestions, and his nurses were always very responsive. After we got pregnant, he was still supportive and interested in how we were doing. I’ve heard that not all fertility doctors are like that.”

Jill also took advantage of a fertility acupuncturist and other HRC services, including a medication administration service, that helped her have an easier, more relaxed experience.

“Infertility is not a fun journey, but it’s worth everything in the end. At first, you feel ashamed and wonder why you can’t get pregnant. Once you start being open about your infertility, however, you are amazed at how many people are having the exact same struggles as you, and you don’t feel so alone. We always felt our path was to try plan A, but if it didn’t work, we would move on to Plan B.”

As the parents of newborn twins, Jill and her husband are basking in the delights of their Plan A.

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04/10

2017

#ListenUp for National Infertility Awareness Week

Posted by admin | Filed under Blog, Getting Pregnant, Infertility, IVF

#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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