Frequently Asked Questions
General Information about Empower Fertility
What makes Empower Fertility in Santa Barbara stand out from other fertility clinics?
At Empower, we stand out due to our innovative IVF technology, which ensures the latest advancements are utilized to enhance success rates. Our highly trained teams bring expertise and compassion to every step of the journey, providing personalized care tailored to each patient’s unique needs. The extra "spark" comes from our boutique office setting, where we prioritize a warm, welcoming environment that fosters comfort and trust. This combination of cutting-edge technology, expert staff, and individualized attention sets us apart, making your fertility journey as supportive and effective as possible.
How do I get started with Empower Fertility?
Simply click on any of the “Schedule Consultation” links on the main page, or give us a call at 805-455-6500 to get your initial visit set up.
How long should I expect to wait for an appointment?
We understand that time is crucial in your fertility journey. At Empower Fertility, we aim to provide timely care. While appointment availability can vary, we strive to offer appointments at the earliest convenience. Contact us, and our team will work to schedule your appointment promptly.
I'm concerned about the cost of fertility treatments. How can Empower Fertility help make it more affordable?
Empower Fertility offers various financial options and can guide you through potential insurance coverage. Our team will work with you to explore cost-effective solutions without compromising the quality of care you receive. We also work with Prosper fertility treatment financing to assist with finding flexible options for funding your care.
Effectiveness and Safety
Are your treatments effective, and what is the success rate?
IUI rates are highest in a select group of people that will respond to that therapy. In patients that are selected properly, success rates are 15-20% per cycle. IVF success rates after achieving a genetically normal embryo are 90% or better.
I'm concerned about the safety of fertility treatments. How does Empower Fertility ensure patient safety?
At Empower, we adhere to higher than industry standard safety protocols and continuously monitor your progress to ensure your well-being. Our team is committed to making your fertility journey as safe as possible while maintaining the highest success rates.
I've had previous unsuccessful fertility treatments. Can Empower Fertility still help me?
Absolutely. Our team specializes in complex cases and will work diligently to increase your chances of a successful outcome. Even if you’ve had prior unsuccessful treatments, our experienced team will conduct a thorough evaluation to develop a tailored approach.
Understanding Fertility
What is infertility?
Infertility is a common issue that affects around 15-20% of couples. In women under the age of 35, there’s a 20% chance of conceiving during each menstrual cycle. This means that 50% of couples trying to conceive will become pregnant within 3 months and 85% within a year. For women over the age of 35, these percentages are lower. Infertility is typically defined as the inability to conceive after one year of unprotected intercourse for women under 35 and after six months for women over 35.
What causes infertility and how is it treated?
The main causes of infertility include male factors, tubal or pelvic issues, ovulation problems, unexplained infertility, and other factors. Sometimes, unexplained infertility can be due to undiagnosed issues related to egg quality or immunologic issues affecting embryo implantation. Treatment varies depending on the cause, ranging from basic treatments like medication to induce ovulation to more advanced options like in vitro fertilization (IVF) or reproductive surgery.
How do I know if I ovulate?
Regular menstrual bleeding accompanied by certain symptoms, like cramping and breast tenderness, is a reliable indicator of ovulation. Hormone tests and monitoring basal body temperature can also help confirm ovulation. Irregular menstrual cycles may be a sign of ovulatory problems, which can be caused by various factors, including thyroid dysfunction or hormonal imbalances. Ovulation issues contribute to about 10-15% of infertility cases.
How do I know when I ovulate?
The timing of ovulation is crucial for conception. Ovulation typically occurs 13-14 days before the onset of menstruation. Charting basal body temperature can help pinpoint ovulation, but it’s not ideal for timing intercourse. Ovulation predictor kits are a practical option to predict ovulation, as they detect the LH surge that triggers ovulation.
How do I know if my tubes are blocked?
The most commonly used test for diagnosing tubal blockage is a hysterosalpingogram (HSG) or dye test, where a dye is injected through the cervix, and x-rays show if the dye spills into the pelvis. Tubal damage is often caused by previous pelvic infections, such as Chlamydia, as well as other factors like endometriosis or abdominal surgery. Laparoscopy is the preferred method for both diagnosing and treating tubal disease.
How do I know if I have enough eggs left to become pregnant?
Fertility potential decreases with age, and ovarian reserve decreases as well. The number of eggs in the ovaries can be assessed by measuring hormones like follicle-stimulating hormone (FSH) and Anti-Mullerian hormone (AMH). Elevated FSH or estradiol levels may indicate decreased ovarian reserve. A high FSH level can diminish the chances of conception, and very high FSH levels may necessitate donor eggs for treatment.
Male Fertility
How do I test my sperm?
Sperm analysis is used to assess several sperm parameters, including volume, count, motility (movement), and morphology (appearance). Abnormalities can affect fertilization chances, and severe abnormalities may require IVF and intracytoplasmic sperm injection (ICSI). To assess sperm quality, a sperm DNA fragmentation test can be performed to evaluate DNA breaks and immaturity, which can affect fertility potential.
How is male factor infertility treated?
The treatment of male factor infertility has made significant progress with the arrival of assisted reproduction techniques. Depending on the severity of the issue, treatment can range from simple techniques like sperm washing to more advanced options such as intracytoplasmic sperm injection (ICSI). ICSI is particularly effective for severe cases of male factor infertility and can help achieve fertilization.
Female Fertility and Conditions
What is polycystic ovary syndrome (PCOS)?
PCOS is a complex endocrine disorder characterized by irregular or absent ovulation, polycystic-appearing ovaries on ultrasound, and hormonal imbalances. It can lead to infertility and other health issues like insulin resistance and an increased risk of diabetes. Treatment typically involves fertility medications to induce ovulation, with options like letrozole (Femara), clomiphene citrate (Clomid), or injectable gonadotropins, depending on the patient’s response.
What is endometriosis?
Endometriosis is a condition where the lining of the uterus, known as the endometrium, is found in other areas of the body. These displaced endometrial tissues can cause pain and inflammation and can sometimes lead to fertility issues. The exact cause of endometriosis is not known, but it’s thought to be related to retrograde menstruation where menstrual tissue flows backward into the pelvic area. Endometriosis can be progressive and is stimulated by the hormone estrogen.
What are the symptoms of endometriosis?
Symptoms of endometriosis can vary but often include cyclic pelvic pain, which may start before menstruation and last more than 48 hours. Pain during intercourse, bowel movements, or urination is also common. It’s important to note that the severity of symptoms doesn’t always correlate with the stage of the disease.
How do I know if I have endometriosis?
The symptoms of cyclic pain may suggest endometriosis, but they are not specific to the condition, as many women experience pain during their menstrual cycle. An ultrasound can identify large ovarian cysts known as endometriomas, indicative of advanced disease, but it cannot detect early stages of endometriosis. The only definitive way to diagnose endometriosis is through laparoscopy, a surgical procedure where the surgeon visualizes and treats the disease.
How does endometriosis affect fertility?
Endometriosis can affect fertility in several ways. In early or mild stages, it can impact the immune system, creating an immune response in the endometrium that may prevent implantation. In advanced stages, pelvic adhesions can cause a mechanical blockade of the tubes (preventing sperm and egg from meeting) and endometriomas can cause a decrease in ovarian reserve.
What is the treatment for endometriosis?
The treatment of endometriosis focuses on managing pain and, when needed, improving fertility. Pain management typically begins with over-the-counter or prescription pain relievers. Birth control pills can be prescribed, along with pain medications if pregnancy is not desired. If these treatments are ineffective, laparoscopy can be used to diagnose and treat endometriosis surgically. In some cases, surgical removal of lesions is necessary. While surgery can be effective, it’s essential to remember that endometriosis is a progressive condition, and new lesions can develop after surgery. Medications like Lupron, danazol, or progesterone can be used to slow down disease progression, but they often have side effects.
Does endometriosis need to be treated?
The treatment of endometriosis is necessary if you are experiencing significant pain or if you are seeking to improve fertility. If pain is your primary concern, treatment is essential, regardless of the stage of the disease. When fertility is the main concern, surgical intervention should be considered as it can improve the chances of conception by restoring the integrity of the fallopian tubes and reducing inflammation.
Fertility Procedures and Treatments
What is Intrauterine Insemination (IUI)?
Intrauterine insemination (IUI) is a procedure in which a concentrated sample of motile sperm is injected into the uterus through a thin catheter at the time of ovulation. This treatment is used for cases of cervical issues, unexplained infertility, and mild male factor infertility. Proper timing of IUI is crucial, which can be achieved using ovulation predictor kits or HCG injections to trigger ovulation.
What is clomiphene citrate (Clomid)?
Clomiphene citrate (Clomid) is a fertility medication that stimulates the production of follicle-stimulating hormone (FSH) and can help induce ovulation. It is sometimes used to treat women who do not ovulate. Clomid can also be used for ovulating women to increase the chances of conceiving, although its success rates are typically around 5-8% per cycle. However, whereas many practitioners often opt for Clomid, it is an older medication. At Empower, we use Femara (letrozole), as it offers significantly better pregnancy rates.
What is in vitro fertilization (IVF)?
IVF is a procedure where the ovaries are stimulated with fertility medications to produce multiple mature eggs. These eggs are then retrieved, fertilized in a laboratory with sperm, and the resulting embryos are transferred back into the uterus.
What is Intracytoplasmic Sperm Injection (ICSI)?
ICSI is a procedure that allows the treatment of the most severe male factor infertility cases. Using ultra-fine instruments, it is possible to select a single sperm and inject it into the egg to accomplish fertilization without damaging the egg. Before ICSI, there was no effective treatment for poor sperm other than using donor sperm. In the era of ICSI, male factor infertility cases have high success rates with IVF.
What is laparoscopy?
Laparoscopy is a surgical procedure that involves the insertion of a thin, telescope-like instrument into the abdominal cavity through a small incision near the belly button. This instrument, called a laparoscope, allows the surgeon to visualize and access the abdominal and pelvic organs, including the uterus, fallopian tubes, ovaries, bowel, liver, and gallbladder. Additional small incisions are made in the lower abdomen to manipulate pelvic organs. Laparoscopy is used to diagnose and treat various gynecologic and infertility issues, and it offers a quicker recovery time compared to open abdominal surgery.
What is hysteroscopy?
Hysteroscopy is a minimally invasive outpatient procedure that is useful for diagnosing and treating uterine abnormalities. Hysteroscopy can be performed with minimal anesthesia and generally has a quick recovery time. It involves the insertion of a small telescope-like instrument into the uterine cavity through the vaginal canal. This instrument allows for the visualization and treatment of conditions within the uterus, such as polyps, scar tissue, or fibroids.
What is a hydrosonogram or fluid ultrasound?
A sonohysterogram, also known as fluid ultrasound or hydrosonography, is a diagnostic procedure used to image the uterine cavity. It is performed in the office and does not require anesthesia. A thin catheter is inserted through the cervix into the uterus, and saline (salt water) is injected into the uterine cavity while transvaginal ultrasound is conducted. The fluid distends the uterus, allowing for the detection of conditions like polyps, adhesions, or small lesions that might be missed on other tests. The procedure may cause some cramping, but it is usually well-tolerated.
Do blocked tubes need to be removed in preparation for IVF?
Tubal damage can result from previous infections, endometriosis, or pelvic surgery. While most types of tubal damage do not require surgical intervention to improve IVF outcomes, there is an exception: hydrosalpinx. Hydrosalpinx refers to blocked fallopian tubes that become filled with fluid, which can have a toxic effect on embryos. This fluid can also block the uterus, affecting implantation. In cases of hydrosalpinx, the tubes are typically removed or ligated before undergoing IVF to optimize the chances of success.
Should I have surgery to reconnect my tubes (tubal reversal)?
Tubal reversal is an option for women who have undergone tubal ligation and want to restore their fertility. The procedure can often successfully reconnect the fallopian tubes. Following surgery, the tubes are open 70-80% of the time, and women have a 50-60% chance of conception during their reproductive lifetime. Tubal reversal is a suitable choice for younger women who desire more than one child after reversing the ligation. However, if you have had a tubal ligation and seek fertility assistance, IVF is also a viable option, with success rates up to 50-80%. In cases of tubal ligation, IVF can provide effective pregnancy rates, especially since these individuals were using contraception and may not have infertility issues.
Specialized Testing and Diagnostic Procedures
What is a post-coital test?
The post-coital test (PCT) evaluates the interaction between sperm and cervical mucus. It is performed by examining a sample of cervical mucus 6-18 hours after intercourse to assess the presence of motile sperm. A poor PCT may indicate issues like anti-sperm antibodies. IUI is recommended for the treatment of repeated poor PCT results.
Who Needs IVF?
In vitro fertilization (IVF) is recommended for various indications, including:
Decreased Ovarian Reserve: IVF can be an effective option for individuals with a diminished ovarian reserve, where the number and quality of eggs are reduced.
Blocked Fallopian Tubes: IVF is a valuable choice for individuals with blocked fallopian tubes, as it circumvents the need for open tubes, allowing for successful fertilization within the controlled environment of the laboratory.
Moderate or Severe Male Factor Infertility: When male infertility is a factor, IVF offers a solution by facilitating the direct injection of sperm into the egg through Intracytoplasmic Sperm Injection (ICSI), ensuring fertilization.
Unexplained Infertility: In cases where the cause of infertility remains unknown, IVF is a versatile approach. It allows for controlled conditions, eliminating potential obstacles to conception.
Endometriosis: Empower Fertility recognizes endometriosis as a common cause of infertility. In advanced cases of endometriosis, IVF is often a recommended treatment option. While women with mild endometriosis may also benefit from IVF, those with advanced stages may experience even higher success rates with this approach.
Maternal Age > 40: Maternal age, particularly when exceeding 40, is a relative indication for IVF. This is due to the rapid decline in ovarian reserve and egg quality associated with advancing age. IVF can provide a targeted and effective means of addressing these challenges.
Polycystic Ovary Syndrome (PCOS): Women with PCOS, a condition causing irregular ovulation or anovulation, can choose IVF at Empower Fertility. This option minimizes the risk of high-order multiple pregnancies (triplets or higher) because the number of embryos implanted can be carefully controlled during IVF compared to other treatments like Intrauterine Insemination (IUI).
At Empower Fertility, our approach to IVF is tailored to the specific needs and circumstances of each individual, offering hope and comprehensive solutions for diverse fertility challenges. Please consult our team to discuss your unique situation and explore the best path forward for your journey to parenthood.
Empower Lab and Technology
How does Empower Fertility ensure patient safety?
At Empower, we adhere to higher than industry standard safety protocols and continuously monitor your progress to ensure your well-being. Our lab uses advanced technologies like the Matcher system, a barcode-based electronic witnessing system that prevents misidentification of patients, gametes, and embryos. The lab is also monitored 24/7 with the Safepoint Alert Monitoring System, ensuring the safety of all reproductive tissues.
What makes Empower Lab unique?
Empower Lab takes pride in its state-of-the-art facilities and exceptional results. Our lab is equipped with IVFCRYO-One, an efficient auto-fill freezer unit with an alert notification system for maximum safety. The lab consistently delivers implantation rates above the national average and participates in the AAB proficiency testing program to maintain the highest standards. This commitment to excellence ensures our patients receive world-class care and the best chances for success.
What is Matcher, and how does it ensure safety at Empower Lab?
Matcher is a state-of-the-art, barcode-based electronic witnessing and traceability system used in our lab to prevent errors in patient identification. This advanced technology safeguards against the misidentification of patients, gametes, and embryos by requiring biometric checks at every step of the process. Matcher also provides full reporting and audit functions, ensuring accountability and transparency. By integrating Matcher into our workflow, Empower Lab upholds the highest standards of safety and accuracy, giving patients peace of mind throughout their fertility journey.
Pricing and Financing
How much does a fertility consultation cost, and what does it include?
During your fertility consultation, you will have an extensive discussion with a dedicated fertility specialist. Together, you will explore the essential aspects of fertility and formulate a personalized plan for your unique family-building journey.
Is financing available for fertility treatments?
Yes, Empower Fertility offers financing options through Prosper Healthcare to help make treatments more affordable. Prosper’s fertility financing product is patient-friendly and includes a simple application process. It offers instant decisions on loans for fertility procedures, covers all fertility treatments and medications, and has no prepayment penalties. Flexible payment options are available, even for individuals with challenged credit.
What are the costs associated with egg freezing?
The Egg Freezing process at Empower Fertility is designed for individuals interested in preserving their fertility. This process includes egg retrieval, freezing, and storage, ensuring your reproductive options are secure for the future.
Is there an annual storage fee for eggs, embryos, or sperm?
Yes, Empower Fertility provides annual storage services for eggs, embryos, and sperm, maintaining them securely in liquid nitrogen tanks on-site. These valuable reproductive assets are stored with the highest safety standards.
Educational Resources
Why consult a reproductive endocrinology specialist?
Reproductive endocrinologists offer a comprehensive range of fertility care services, treatments, and diagnostic procedures. These include fertility evaluations, ovulation induction, intrauterine insemination (IUI), in vitro fertilization (IVF), preimplantation genetic testing (PGT), fertility preservation, oncofertility, third-party reproduction, and specialized family-building services for LGBTQ+ individuals and couples. Consulting a specialist ensures you receive expert care tailored to your unique needs.
What training and education do reproductive endocrinologists have?
Reproductive endocrinologists undergo extensive education and training, including:
A four-year undergraduate degree in a science-based field, such as biology or pre-med.
Four years of medical school leading to a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree.
A four-year residency in Obstetrics and Gynecology.
A three-year fellowship in Reproductive Endocrinology and Infertility.
Board certification in Reproductive Endocrinology and Infertility.
They may also receive subspecialty training in areas such as assisted reproductive technology, male infertility, and third-party reproduction. Additionally, mid-level providers like nurse practitioners and physician associates play a vital role in fertility care.
What are common diagnostic procedures for infertility?
Reproductive endocrinologists use several diagnostic tools to identify the causes of infertility, including:
Hormonal Testing: Measuring levels of reproductive hormones like FSH, LH, estradiol, and testosterone.
Ovarian Reserve Testing: Assessing egg quantity and quality through blood tests and ultrasound imaging.
Hysterosalpingography (HSG): An imaging test to evaluate fallopian tubes and the uterine cavity.
Laparoscopy: A minimally invasive surgical procedure to diagnose and treat pelvic abnormalities or endometriosis.
Why is board certification important when choosing a reproductive endocrinology and infertility (REI) specialist?
Board certification signifies that a reproductive endocrinologist has undergone rigorous training and demonstrated expertise in the field of fertility care. It requires completion of a fellowship in Reproductive Endocrinology and Infertility, passing comprehensive exams, and maintaining the highest standards of clinical practice. Choosing a board-certified REI specialist ensures you are working with a physician who is highly qualified, experienced, and up-to-date on the latest advancements in fertility treatments, giving you confidence in the quality of care you will receive.
What is the difference between an OB-GYN and a reproductive endocrinologist (REI)?
While both OB-GYNs and REI specialists are trained in obstetrics and gynecology, REIs have additional training in diagnosing and treating infertility and hormonal disorders. After completing a four-year OB-GYN residency, reproductive endocrinologists undergo a three-year fellowship focused on fertility and endocrinology. This specialized training allows REIs to provide advanced fertility treatments like IVF, IUI, and PGT, as well as manage complex reproductive health issues such as endometriosis, PCOS, and recurrent pregnancy loss.
How can preimplantation genetic testing (PGT) benefit my fertility journey?
Preimplantation genetic testing (PGT) is a technique used to screen embryos for genetic and chromosomal abnormalities before implantation during an IVF cycle. This ensures only healthy embryos are transferred, increasing the chances of a successful pregnancy and reducing the risk of miscarriage or genetic disorders. PGT is particularly beneficial for patients with a history of recurrent pregnancy loss, advanced maternal age, or known genetic conditions.
What is the role of lifestyle in fertility?
Lifestyle factors, such as diet, exercise, stress levels, and substance use, can significantly impact fertility in both men and women. Maintaining a healthy weight, managing stress, and avoiding smoking or excessive alcohol consumption can improve overall reproductive health. At Empower Fertility, we provide guidance on lifestyle changes that may enhance your fertility and complement medical treatments.
How does age affect fertility?
Age is one of the most important factors influencing fertility. In women, fertility begins to decline after age 30 and more significantly after age 35, due to a decrease in both the quantity and quality of eggs. In men, age-related fertility decline is less pronounced but can still affect sperm quality. Understanding how age impacts fertility can help patients make informed decisions about family planning and treatment options.
What is the success rate of fertility treatments for individuals with unexplained infertility?
Unexplained infertility accounts for 10-20% of infertility cases and occurs when no specific cause can be identified after standard testing. Despite the lack of a clear diagnosis, treatments like IUI and IVF are highly effective for individuals with unexplained infertility. IVF success rates in these cases often match or exceed those for other causes of infertility, offering hope for those facing this challenge.