Do I have to be referred by another doctor before the Fertility Center of Dallas will see me?
No. While many of our patients are referred by the patient’s own physician, anyone who thinks he or she have a fertility problem can call our offices to schedule an appointment.
Should I bring my medical records with me, or wait until after my first visit with the Fertility Center of Dallas?
It’s most beneficial to send your medical records to our offices before your first appointment so the doctors have time to review them, but bringing them with you will still be very helpful. Even if you don’t have them, a great deal can be accomplished in your first visit.
My previous OB/GYN already did some testing before referring me. Will the Fertility Center of Dallas pick up where my doctor left off?
All previous studies are important to your situation. Most of the time it will not be necessary to repeat tests, but occasionally tests will need to be repeated due to inconclusive results, or a similar but more specific test is needed.
How do I know if I need treatment for fertility problems?
If a couple has been trying unsuccessfully to achieve a pregnancy for 12 months and they are under 30 years of age, they should consult their OB/GYN or a fertility specialist. If older than 30, don’t delay past 6 months. If you know that you have a specific problem, such as not ovulating, blocked tubes, or a sperm problem, seek assistance as soon as you’re ready to start a family.
What caused my fertility problem?
Many things can decrease your chances of becoming pregnant — 40 percent of the time, it’s male-related; 40 percent of the time, it’s female-related; 15 percent of the time, it’s a combination of the two; and 5 percent of the time, it may be unexplained. Call our offices to make an appointment and discuss possible causes of your specific issues.
My husband doesn’t want to do the semen analysis — he thinks it’s a female issue.
The fertility disorder preventing pregnancy is a male factor 40 percent of the time, and 20 percent of the time a male and female problem is contributing to the lack of pregnancy. A comprehensive semen analysis is one of the most important tests to do and should be one of the first tests performed.
My husband has a child from a previous marriage. Is semen analysis still necessary?
Absolutely, a lot of change can happen even in a short period of time. It’s very important to be sure his semen is still normal.
When is the best time to take a prenatal vitamin supplement? Is over-the-counter OK?
Start taking prenatal vitamins when you start trying to conceive. Prescription vitamins have a higher amount of folic acid and are formulated for pregnancy — ask your OB/GYN for a preferred prescription. We’ll put you on prenatal vitamins if you aren’t already taking them.
Will I still have a period if I don’t ovulate?
Most patients who don’t ovulate will not have regular, predictable monthly periods, but you may have menstrual flow at unpredictable times. An ultrasound study can be done to determine if you’re ovulating.
Don’t all women ovulate on day 14 of the menstrual cycle? Why should I test with my ovulation kit as early as day 9?
The ideal ovulation cycle has 28 days with ovulation being day 14, however, not all women’s cycles are 28 days. Some women may ovulate earlier or later than day 14 — it’s critical to know precisely when ovulation occurs. Testing early may detect an early sign of ovulation.
When I’m using an ovulation predictor kit, when is the most fertile time for intercourse?
The brain detects the presence of a mature or ripe egg by the ovary’s production of estrogen. Once the brain has received the ovary’s message, it sends back a message to the ovary telling it to complete the maturing process and release the egg. Approximately 36 hours after the brain’s message (LH surge), ovulation takes place. The ovulation predictor kit detects the LH message 24 hours before ovulation. The most fertile times for intercourse are the day of LH surge and the day after (day of ovulation). While the sperm can live for several days, the egg lives for only 24 hours.
I’ve heard that intercourse every other day is the best way to become pregnant. Is this true?
No, the egg lives only 24 hours and you only ovulate once a cycle. The best way is to know when you ovulate in your cycle so that you have intercourse during your fertile time.
Why is it necessary to come in for more than one ultrasound in an evaluation period?
To determine how well the egg is developing during a cycle, several ultrasounds need to be performed. We may find that you ovulate earlier or later than you thought, detect abnormal ovulation patterns, or determine that you aren’t ovulating at all.
Can being overweight or underweight affect conception?
Yes, the closer you are to your ideal body weight, the more likely you are to ovulate on your own without having to take fertility drugs. However, there are always exceptions when both overweight and underweight patients may not have a problem with ovulation.
My friend started taking thyroid medication and got pregnant in one month. Should I try this?
No, not unless you are someone who has a thyroid hormone deficiency. Blood tests to measure your thyroid function are part of our evaluation. If you are hypothyroid, taking thyroid will help in both achieving and keeping your pregnancy. It’s also very important for your baby’s development.
Does fertility treatment increase or decrease the risk of birth defects?
Any pregnancy has a 3 to 5 percent risk of birth defects. Fertility treatment neither decreases nor increases this risk.
I’ve been told my tubes are blocked; does the Fertility Center of Dallas treat this?
Yes, treatment can involve corrective surgery (usually a day surgery procedure) to open your blocked tubes or in vitro fertilization when the tubes are not repairable.
I have endometriosis. What are my chances of becoming pregnant?
The severity of the endometriosis is a critical factor in becoming pregnant. The more severe the endometriosis, the less likely you can conceive on your own. Surgical treatment to remove or destroy all visible endometriosis increases the pregnancy chances. If there is too much scarring around the tubes and ovaries, in vitro fertilization can often be successful.
Will Clomid increase my chance of getting pregnant? I want to try it first.
Clomid is very effective for patients who don’t ovulate, though it has recently been shown in studies to decrease pregnancy chances in patients that ovulate normally. It’s best to evaluate your body and determine what treatment is needed based on your individual situation.
The Fertility Center of Dallas recommended superovulation (injectable hormones). Why do I have to give the injections at home?
During a super-ovulation stimulation cycle, we must carefully monitor the response of your ovaries to the medication. Ultrasound studies are done to detect the number of developing eggs and their maturity. Estrogen (hormone produced by the ovaries) is measured in your blood to further determine the egg maturity. The results are made available to our fertility clinic in the afternoon, then they can best determine the dosage needed that evening to give you the best chance for success.
My partner and I have one child, but we haven’t been able to conceive again. Why?
Secondary fertility problems can be caused by a variety of conditions. It’s best to evaluate them just as with someone who has never conceived. Fortunately, most patients who have had a prior successful pregnancy will have a very good chance of being successful again.
Does the Fertility Center of Dallas see patients who have immune problems?
Yes, we learn more every day about the role that the immune system plays in pregnancy. New tests have been developed to identify immune disorders, and innovative treatment methods are appearing to increase the chances for a successful outcome.
Is it best to just do in vitro fertilization and skip all of the evaluation processes, or should I try other treatments?
Many times the problem can be found and corrected without resorting to in vitro fertilization. IVF is an expensive and time-consuming process that may not be suitable for everyone. If success can be achieved by a simpler, less expensive, and less invasive method, then that’s what you should try first.
Will any of my fertility evaluation and treatment be covered by my insurance?
Possibly, it depends on what your individual insurance plan states about fertility disorders. Some insurance carriers will provide coverage for evaluating why you’re not conceiving (diagnosis coverage only), while others may include some or all treatments. It’s very important to know exactly what your policy will cover. If you have a copy of your policy, look under infertility coverage to see what is included or excluded. We’ll try to obtain your coverage information prior to or at your first appointment.
Sometimes that information will not be available to us unless you bring in your policy, contact your human resources person at work, or directly contact your insurance company. Remember to get any information from your insurance company in writing. While you have insurance to assist you in paying for medical care, you’re still responsible for your costs. We’re happy to provide you with estimated costs for your evaluation and treatment before you start the process.
If I have insurance that states it pays for my fertility evaluation and treatment, why do I have to pay for special tests and treatments?
Read your policy carefully. Many times evaluation and treatments have limitations. For example, it may not cover intrauterine insemination, but does pay for ovulation drugs. There may be a lifetime dollar amount that applies to fertility treatments. Most insurance companies contract with a laboratory (ie. Quest, LabCorp) to provide lab testing. If your tests are available from these labs, then you won’t have to pay for those tests. There are special tests (immune studies, such as embryo toxicity assay and natural killer-cell phenotype, and comprehensive semen analysis with ultra-specific morphology) that are not available from these labs.
You will be expected to pay for these tests. You can file for these tests with your insurance company, however, they may reimburse you at a lesser amount or not at all. There are times during your treatment when blood tests results must be available to us on the same day they were drawn (i.e. estrogen levels during ovulation stimulation to determine your medication dose). The contracted laboratories with your insurance cannot provide this stat same day during both weekdays and weekends. You will be responsible for part or all of those charges depending on your policy coverage.