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How Weight Affects Fertility

Weight is a sensitive subject, especially for women. Aside from how weight affects physical appearance and self-esteem, an unhealthy weight can impact a woman’s fertility, how she responds to treatment, the course of her pregnancy and the health of her child. An unhealthy weight means being either overweight or underweight.

What is considered a healthy weight?

Clinicians use the Body Mass Index (BMI) to determine whether someone is underweight, overweight or “normal.” BMI is measured by dividing a person’s weight in kilograms by the square of the person’s height in meters. The normal range for a BMI is between 18.5 to 24.9, less than 19 is considered underweight, 25 to 29 is deemed overweight and greater than 30 is categorized as obese.

You can use this handy chart, developed by the National Institute of Health, to calculate your BMI and learn where you fall on the range: https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm

How Weight Affects Fertility
Many overweight and underweight women get pregnant without experiencing any problems trying to conceive. But getting pregnant is not so easy for approximately 12 percent of women with infertility who may weight too much or too little.

Overweight women tend to produce excessive estrogen, which acts like birth control, while underweight women produce too little. Additionally, an abnormal weight can cause irregular ovulation.

Underweight women may have ovulatory problems because of a poor diet with insufficient nutrients combined with excessive exercise. Frequently their periods completely cease, resulting in amenorrhea.

Being overweight is a common characteristic of Polycystic Ovary Syndrome (PCOS). PCOS sufferers are predisposed to insulin resistance, which causes the ovaries to make excessive testosterone. This, in turn, results in irregular or scanty ovulation.

Weight and IVF Treatment

Weight also plays a role in treatment success in several different ways. A recent study found obese women need an increased dosage of gonadotropins to successfully harvest their eggs. Overweight women also produce lower quality eggs; in fact, when they use donor eggs, their IVF success rates are similar to women with a normal BMI using their own eggs.

Weight and Pregnancy
The impact of weight continues into pregnancy. Overweight pregnant women are at a higher risk for developing complications, such as preeclampsia and gestational diabetes, as well as experiencing miscarriages and early term births. The babies of underweight women are more likely to be underweight themselves.

We advise women attempting pregnancy to prepare themselves by establishing healthy eating and exercise patterns so they will fall within the normal BMI range. Additionally, it’s a good idea to visit their primary care physician to see if they have any medical conditions that could affect weight, such as thyroid disease or diabetes.

Reaching the goal of a normal BMI will insure that weight won’t stand in your way of getting pregnant and delivering a healthy baby.




HRC Helps You Look into Your Fertility Crystal Ball

Want to look into the Fertility Crystal Ball?

Have you ever wanted to look into a crystal ball to get a sneak peek at your fertility future? Your local infertility doctor may not be clairvoyant, but he or she can assess your fertility potential, especially if having children is an important part of your future happiness and life goals.

The following are several tests that can help fertility providers determine the current status of your baby-making potential. They all are relatively inexpensive as well as easy to administer. The results can serve as a barometer of your ovarian reserve or egg supply.

Follicle Stimulating Hormone (FSH) Test
The follicle stimulating hormone (FSH) test measures the amount of FSH on day three of a woman’s menstrual cycle. FSH is produced by the pituitary gland in the brain. It stimulates the ovarian follicles, which is where eggs grow and are eventually released during ovulation. FSH also prompts the production of estrogen.

A normal FSH level is between 3-10 mIU/ml. As ovarian reserve decreases, the amount of FSH in the blood increases while estrogen (estradiol) levels decrease. This means the pituitary gland is working harder to produce more FSH in order to stimulate the ovaries.

Estradiol Level (E2)
By itself, a normal FSH level is not sufficient to describe your fertility health. We also want to measure estradiol (E2), a key form of estrogen produced by the ovaries, on day three of a cycle. Doctors evaluating your results will look for a high level of this hormone. It encourages the growth of the uterine lining and also stimulates the pituitary gland to release luteinizing hormone, which is essential for ovulation.

E2 and FSH have a complementary inverse relationship with each other. While the production of FSH causes the release of estrogen, estrogen inhibits the production of FSH.

Anti-Mullerian Hormone Test (AMH)
This test checks a woman’s ovarian reserve or egg supply by measuring the size of its pool of remaining microscopic or primordial follicles. Cells in the developing egg sacs or follicles secrete AMH. A low AMH level indicates a waning egg supply. It can be performed on any day of the menstrual cycle.

It is important to note that a high AMH value can be symptomatic of polycystic ovarian syndrome and is a measure of egg supply, but not necessarily egg quality.

Antral Follicle Count
Performed by vaginal ultrasound, this exam is used to count antral follicles, which are resting or primordial follicles that remain in the ovary waiting to be eventually released. It is also an indicator of how well a woman might respond to ovarian stimulation medications used during IVF.

Assessing Your Test Results
Many fertility physicians like to conduct all four tests to obtain the most likely scenario of fertility potential. No one test is sufficient.

Women are born with their lifetime supply of eggs. Though there is nothing they can do to increase or improve this supply, the can be proactive in becoming educated about their own reproductive health. Knowledge is power and these tests can provide you with a baseline of your ovarian reserve.

A fertility checkup may motivate you to either start trying to conceive earlier than you had originally planned or to freeze your eggs for use when the time is personally right for you, especially if your test results determine of a healthy reserve. Though they are not a guarantee of what the future holds, these assessment tests are a good start for taking charge of your fertility.





Guys: Are You Producing Enough Sperm?

Many reasons for a lower than normal sperm count

Infertility is an equal opportunity medical condition. This means there is a 40 to 50 percent chance that prospective dads who seek our help will have an infertility problem, with low sperm production being one of the main culprits.

Getting this diagnosis can be very shocking for men. After all, they probably have been producing what they think are normal and plentiful ejaculations. They may not realize that abundant semen does not indicate a normal sperm count.

The sperm production journey
First, let’s look at how sperm is made. It takes approximately 72 days for men to produce a new sperm supply. The production process begins in the brain with the pituitary gland. It releases hormones that jump start the development of sperm and testosterone inside the testicles that are protected within the cool confines of the scrotum. Sperm continue to mature as they move through the semniferous tubes of the testes to the prostate gland, where sperm mixes with seminal fluid to create semen.

What is a a low sperm count?
According to the World Health Organization (WHO), a man with few than 15 million sperm per milliliter of semen is considered to have oligospermia or low sperm concentration. If his ejaculate is absent of sperm, he has azoospermia.

Depending on the cause of their sperm shortage, many men with low sperm counts can conceive on their own or with minimal assistance and lifestyle changes. After all, it only takes one sperm to fertilize an egg. However, low sperm counts can be predictive of a medical problem or genetic condition and may warrant further evaluation.

Azoospermic men, who comprise approximately five percent of infertile males, will need medical intervention to achieve a pregnancy.

Why do some men have low sperm counts?
So how and why does sperm production go awry? The reasons are varied and complex, and include the following medical, environmental and lifestyle reasons.

* A varicocele, a collection of varicose veins in the scrotum that can interfere with blood flow, and inhibit temperature control of the testicles
* Antisperm antibodies that mistake a man’s own sperm for foreign bodies and attempt to eradicate them
* Infections, including sexually transmitted diseases
* Cancers and nonmalignant tumors, as well as medical conditions like diabetes and hypertension
* Undescended testicles, a congenital condition
* Chromosomal defects
* Blockage of the tubes that transport sperm
* Prior surgeries, such as vasectomies and prostate surgeries

* Some scientists are crediting overexposure to toxic industrial chemicals, metals, x-rays, and radiation to an increase in male fertility


* Steroid drugs, marijuana or cocaine
* Excessive alcohol or tobacco
* Being overweight
* Exposing testicles to heat or friction (saunas and biking)

Diagnosis and treatment
Generally speaking, a semen analysis that evaluates sperm count, as well as movement and shape, is the main diagnostic tool for male fertility. A thorough medical examination is helpful in pinpointing lifestyle or occupational hazards to sperm health. Because sperm production is continually occurring, men can make positive changes that can potentially improve their sperm numbers after two to three months.

When treatment is needed, we recommend intrauterine insemination and/or in vitro fertilization with intracytoplasmic sperm injection (ICSI), depending on the extent of the male fertility problem or other infertility diagnoses.

Though no man likes to hear that he has a low sperm count, there are many reasons for low sperm production as well as treatment options. Low sperm does not necessarily mean “no” sperm–and only one sperm is needed to make a baby.







Every Day is Mother’s Day for this Dr. Boostanfar Patient

This month Allyson, mom to three-month-old Sean, celebrated her first Mother’s Day. At 51, she is savoring her new status and knows she is lucky to be cuddling her precious baby.

Allyson used the donor egg program at HRC Fertility after undergoing one cycle of IVF with her own eggs. When she married a few years ago, she and her husband understood she probably would have challenges because of her age, so she was not surprised this option would be necessary.

She found an anonymous donor and was referred to Dr. Boostanfar’s Encino office. After several diagnostic tests were completed, Allyson was able to start IVF treatment.

The rest of the process moved along very quickly. Said Allyson: “The communication was great, especially about all the medications and injections. With the frequent office visits, I got to know the staff. I felt it was important to have a close relationship with the providers since this was such an important process.”

Fortunately, Allyson received the happy news that she was pregnant after her second cycle.

Though the businesswoman isn’t getting her usual good night’s sleep, she is figuring out how to make motherhood work and relishing her new role. She advises other “older” moms to not let age limit their life.

“All the staff at HRC Fertility were judgment-free about my age, which I really appreciated, recalled Allyson. “They honored my wanting to fulfill my dreams. I felt I was in a safe place and would refer other women to seek treatment at Dr. Boostanfar’s office.”

Though the official Mother’s Day has passed, every day feels like Mother’s Day to Allyson, who is only feeling joy about a dream that finally has been realized.




Celebrities and Surrogacy

You’ve probably seen their stories reported in popular magazines and websites. When celebrities choose to publicize their surrogacy journeys, people listen. This spreads awareness and gives the public a greater understanding of the challenges of family building for both same sex and heterosexual celebrities who want to have babies–just like the rest of us!

Turning to Surrogacy
Regardless of their fame, prospective parents may need to use the services of a surrogate mother, also known as a gestational carrier, for a variety of medical and social reasons.

Intended mothers may have been born without a uterus, have a uterine structural abnormality, or needed a hysterectomy due to cancer, all of which make it impossible for them to carry a pregnancy. Some may have medical problems that would make pregnancy dangerous. Surrogacy also may be needed for women who have experienced numerous failed IVF cycles. They can produce healthy, normal-looking embryos, but implantation does not occur, even with IVF.

Of course, same sex individuals and single men who want to have biological children need two, “third parties,” an egg donor and a surrogate mother.

Here are four examples of celebrities who have shone a light on surrogacy:

GloZell Green
GloZell is viral social media superstar known for her signature green lipstick, vivacious personality and hilarious YouTube videos. When she wanted to have a baby in her late 30s, her doctor discovered she had endometriosis and a thin uterine lining. He suggested she use a surrogate mother to carry her baby.

GloZell and her husband Kevin Simon are now the proud parents of a little girl, O’Zell, born last August with the help of HRC Fertility’s Dr. Bradford Kolb. In her unique style, GloZell chronicled her surrogacy journey and, in the process, has educated millions of people about infertility and surrogacy.

Elton John and David Furnish
This megastar and his producer/director husband are one of the most famous gay couples who used surrogacy to build their family. Elton and David are British citizens and commercial surrogacy is not legally recognized in the United Kingdom. They used the same surrogate mother for the birth of their sons.

When fashion designers Dolce and Gabbana created a firestorm by calling IVF and surrogacy “unnatural,” Elton John came to the defense of the millions of parents and babies who have used these miraculous technologies.

Nicole Kidman
Nicole Kidman and Keith Urban needed the help of a surrogate mother for their second daughter. After Ms. Kidman’s struggle to conceive baby number two, she was very open about talking about secondary infertility and the struggle of undergoing treatment and miscarriage, as well as showing her admiration for her surrogate mother.

Ricky Martin
Ricky Martin is not only a gay dad via surrogacy but was a single man who wanted to become a father when his twins Matteo and Valentino were conceived via surrogacy. He is well-known as a “choice dad” who made a conscious choice to become a father.

Ricky’s surrogacy experience is an example of how the desire for parenthood is a universal goal for both men and women, with or without a partner. Thank you to these celebrities and others who have brought awareness to this unique, but increasingly popular, family-building option.

HRC Fertility has an active third party parenting program because California has very favorable surrogacy law, which attract intended parents from all over the world. To learn more, click here: http://www.havingbabies.com/infertility-treatment/third-party-reproduction/