What makes Empower Fertility in Santa Barbara stand out from other fertility clinics?
Are your treatments effective, and what is the success rate?
If you pass the prescreen, you’ll be encouraged to finalize your full application. We recommend doing this promptly once you gain access, as it typically requires at least 45 minutes. This comprehensive step involves responding to medical and family history questions and uploading relevant photos.
How do I get started with Empower Fertility?
Candidates schedule an in-person appointment at an Empower Fertility office location for a comprehensive evaluation. This includes blood tests for genetic screening, infectious diseases, toxicology screening, and hormonal levels, as well as a transvaginal ultrasound to assess ovarian health.
I'm concerned about the cost of fertility treatments. How can Empower Fertility help make it more affordable?
How long should I expect to wait for an appointment?
I've had previous unsuccessful fertility treatments. Can Empower Fertility still help me?
I'm concerned about the safety of fertility treatments. How does Empower Fertility ensure patient safety?
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 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 test my sperm?
Sperm analysis is used to assess sperm parameters, including volume, count, motility, and
morphology. A normal sample should have specific values for each parameter. 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 do I know if I ovulate?
Ovulation issues contribute to about 10-15% of infertility cases. 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.
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 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.
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 clomiphene citrate
(Clomid) or injectable gonadotropins, depending on the patient’s response.
What is a Luteal Phase Defect?
A luteal phase defect (LPD) occurs when the second half of the menstrual cycle, the luteal
phase, is shorter than the normal 14 days. LPD can be diagnosed through endometrial biopsy
or hormonal assessments, and treatment may involve medications like clomiphene citrate,
progesterone supplementation, or HCG injections. LPD is a potential factor in infertility, as it can
affect the uterus’s readiness for implantation.
What is the role of cervical mucus?
Cervical mucus plays a crucial role in fertility. It typically prevents bacteria from entering the
uterus and facilitates the passage of sperm during ovulation. Abnormal cervical mucus can
prevent sperm from reaching the egg, and in some cases, women can develop antibodies
against their partner’s sperm. These issues can be diagnosed through a post-coital test and
may require intrauterine insemination (IUI) or IVF for treatment.
What is a post coital test?
The post-coital test (PCT) evaluates the interaction between sperm and cervical mucus. It’s
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.
How is male factor infertility treated?
The treatment of male factor infertility has made significant progress with the advent 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.
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 commonly 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.
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 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, inflammation,
and 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 stages, it can impact the immune
system. In advanced stages, there’s a mechanical blockade and a decrease in egg reserve. In
severe cases, pelvic adhesions and scarring can block the fallopian tubes, preventing eggs from
reaching sperm and the uterus. Endometriomas can compromise the quality and quantity of
eggs. Even mild endometriosis can negatively affect fertility by creating an abnormal immune
response in the endometrium that may prevent implantation.
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.
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 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. Different fluids may be used to distend the uterine cavity during the
procedure. Hysteroscopy can be performed with minimal anesthesia and generally has a quick
recovery time. It is useful for diagnosing and treating uterine abnormalities.
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 without 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.
Who Needs IVF?
At Empower Fertility, in vitro fertilization (IVF) is recommended for various indications, ensuring
personalized care for those seeking fertility solutions. These indications include:
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. This is particularly crucial,
as the availability of viable eggs significantly influences the chances of success.
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.
