1. It's just what it sounds like.

Polycystic Ovarian Syndrome (PCOS) is a condition where many cycsts – small, fluid- or air-filled sacs – form on a woman's ovaries. Women with PCOS produce more male sex hormones, called androgens. The overproduction of androgens interferes with the body's signals to develop and release eggs from the ovaries.
If your body isn't producing and releasing eggs regularly, your chances of getting pregnant are greatly reduced.

2. You probably know someone with PCOS.

PCOS is fairly common. Between five and 15 percent of women of childbearing age have PCOS, and most women with PCOS aren't even aware they have it until they experience infertility.

We're not sure what causes PCOS, but underlying factors may be genetic. PCOS tends to run in families, and can be passed down from either the mother's or father's side. Many women with PCOS are also insulin resistant, and are at risk for developing type 2 diabetes. Unhealthy diet and poor exercise habits can also play a role.

3. Hair growth may be a signal.

Because their bodies are producing more male hormones, people with PCOS tend to have irregular menstrual cycles, or may even stop menstruating altogether. They also tend to grow more facial and body hair in patterns and places similar to male hair growth, and may also have acne outbreaks in those areas. At the same time, those with PCOS may experience thinning hair on their scalp, similar to male pattern baldness.

Weight gain also appears to be a factor in PCOS. Women with PCOS may find it difficult to manage their weight. That said, not all PCOS patients are overweight.

The presence of these factors helps doctors determine whether or not someone has PCOS. While no single medical test exists to diagnose PCOS, a doctor can confirm the diagnosis with physical exam, pelvic exam, ultrasound, and/or blood test.

During the physical exam, the doctor will look for thinning hair, acne, oily skin, or other visible signals of a hormonal imbalance. If a pelvic exam reveals an enlarged clitoris or ovaries, that can be a sign that too much androgen is present. A blood test can confirm levels of androgens and other hormones, and help rule out thyroid issues. An ultrasound will help determine whether or not a patient's ovaries have a high number of cysts.

At New England Fertility, rigorous testing is an important part of our process, and will help us discover the underlying issues and develop the treatment approach best suited to your needs.

4. PCOS can be overcome.

The good news is that PCOS is manageable. The first step for some women may be to make lifestyle changes to address insulin resistance and better manage weight. Diabetes medication, such as Metformin, might be prescribed. Losing weight and managing insulin may be enough to stimulate ovulation without further intervention.

Another option is to stimulate ovulation using an oral medication such clomiphene (Clomid) or letrozole (Femara).

If oral medications are not successful, hormones knowns as gonadotropins can be injected. Gonadotropins also act to stimulate ovulation.

If medical intervention, such as ovarian stimulation with or without insemination, is unsuccessful, in vitro fertilization (IVF) may be an option.

5. Insurance coverage for treating PCOS varies.

Coverage varies from plan to plan, and we'll be glad to support you as you discuss options with your insurance carrier.

Sources:
womenshealth.gov/a-z-topics/polycystic-ovary-syndrome
nichd.nih.gov/health/topics/PCOS/conditioninfo/Pages/infertility.aspx

It is estimated that at least 20% of women now wait until after the age of 35 to have their first child. Because more women are waiting to start a family, age-related infertility has increased in recent years. A woman’s peak fertility occurs in her 20s. From age 30 to 35, women experience a gradual decline in fertility. After age 35, fertility begins to decline more quickly. Be age 40, pregnancy potential is reduced by up to 50 %.

Infertility is generally defined as the failure to conceive after a full year of unprotected intercourse. Women over 35, because they have less “time to waste,” should speak to their doctor after just six months of unsuccessfully trying to conceive.

There are many factors that may contribute to reduced fertility, including irregular ovulation and conditions such as endometriosis and polycystic ovarian syndrome (PCOS). But the most important factor affecting fertility in women over age 35 is a decrease in egg quality. This decrease in quality impairs fertilization and embryo development, and reduces the chances of achieving a healthy pregnancy.

The same factors that reduce egg quality also increase the risk of miscarriage and chromosomal abnormalities such as those that cause Down’s Syndrome. New research suggests that there are things you can do to improve egg quality, which will increase the ability to conceive and improve your chances for a healthy baby.

Nutrients for Women Over 35 Trying to Conceive

Coenzyme Q10 for Improved Quality

Ovulation is an energy-intense process. Mitochondria are the energy production factories int eh body’s cells, and the human egg contains more mitochondria than any other cell.

Coenzyme Q10 (CoQ10) plays a crucial role in energy production inside the mitochondria. As people age, cellular production of CoQ10 decreases, so an older woman’s eggs are less efficient at producing energy. This reduced energy production can lead to poorer fertilization and early embryo loss.

Emerging research shows that taking supplemental CoQ10 as a form of “mitochondrial energy nutrition” for the egg, can help improve egg quality and potentially lead to a better chance of achieving a healthy pregnancy.

CoQ10 is fat-soluble nutrient. This means that it has to be specially processed by the body for proper absorption, and it is best to take Co Q10 with a meal containing fat. Even so, most CoQ10 supplements are not very well absorbed, especially those in tablet form. Some also claim to be formulated for better absorption, but without any proof. Look for a Co Q10 supplement formulated with VESIsorb®, a colloidal delivery system that has been show to improve the absorption and bioavailability of supplemental CoQ10 by more than 600% compared with other Co Q10 supplements.

DEHYDROEPIANDROSTERONE FOR IMPROVING OVARIAN RESERVE

Ovarian Reserve (OR) is the ability of a woman’s ovaries to produce high-quality eggs. OR naturally decreases as women age, and is often the reason that women over 35 have a harder time getting pregnant.

Dehydroepiandrosterone (DHEA) is a hormone produced in the adrenal glands. DHEA level typically peak at about 20 years of age, and decline rapidly after age 25. Research indicates that 75 mg of DHEA per day increases the number of eggs and embryos, improved embryo quality, and increases live birth rates in women undergoing in vitro fertilization (IVF). Because the effects of DHEA take some time, it is thought that DHEA should be supplemented for at least six weeks prior to starting an IVF cycle.

INOSITOL FOR WOMEN WITH POLYCYSTIC OVARIAN SYNDROME

While not specific to women over 35, Polycystic Ovarian Syndrome (PCOS) is a condition affecting as many as one out of fifteen women in the U.S. It is caused by hormonal imbalances that prevent ovulation and make getting pregnant more difficult for women of any age. This imbalance contributes to weight gain and other symptoms such as acne and excess facial hair. Most women with PCOS develop small cysts on their ovaries.

Inositol is a vitamin-like carbohydrate compound. Taking a certain form of inositol, myo-inositol, may help induce ovulation in women with PCOS by improving the way the body uses insulin.

VITAMIN D and Pregnancy

Achieving an optimal vitamin D level is important before and during pregnancy. A recent study showed that women who became pregnant through VIF had significantly higher vitamin D levels than women who didn’t get pregnant. Women with a normal vitamin D level were four times more likely to get pregnant than women who were vitamin D deficient.

Low vitamin D levels are common among pregnant women, and have been associated with complications of pregnancy. Typical prenatals provide only 400 IU of vitamin D, which is likely an inadequate amount for most women. Speak to your doctor about whether you should have your vitamin D level checked, and how much vitamin D you should take. Recent research has found that doses of 2,000 and 4,000 IU of vitamin D per day were safe for pregnant women and effective in achieving normal vitamin D levels.

DIET and LIFESTYLE CHOICES FOR MAXIMIZING FERTILITY

Diet and lifestyle choices can have a big impact on your fertility. A large study conducted by Harvard researchers showed that women who adhered to a combination of five or more lifestyle factors, including specific changes to their diets, were at a 69% lower risk of ovulatory disorder infertility than women who did not engage in any of these factors. The women with the highest fertility scores ate more monounsaturated fats rather than trans fats, more vegetable rather than animal sources of protein, more low-glycemic, high-fiber carbohydrates, more iron from vegetable foods and supplements, and surprisingly, more high-fat rather than low-far dairy. The women with better fertility also took a daily multivitamin, had a lower body mass index (BMI), and exercised more.

Other studies have associated a Mediterranean diet (rich in vegetables, vegetable-based oils, legumes, and fish) with increased chances of pregnancy. One study found that following a Mediterranean diet pattern increased the chances of pregnancy in couples undergoing IVF.

The following guidelines will help you prepare for a healthy pregnancy.

Limit foods containing trans fats, such as vegetable shortenings, some margarines, baked goods, pie crusts, frostings, and fried foods. Trans fats will be listed on the Nutrition Facts Panel, or in the ingredients list as “hydrogenated” or “Partially hydrogenated” vegetable oil.

Increase foods rich in monounsaturated fats, such as olive oil, avocados, nuts and seeds, and canola oil.

Replace a serving of meat each day with vegetarian sources of protein such as beans, lentils, legumes, quinoa, nuts, seeds, and nut butters.

Choose slowly digested carbohydrates that are rich in fiber, such as whole grains, vegetables, fruits, beans, lentils, and legumes.

Eat more vegetarian sources of iron, such as spinach, beans, legumes, raisins or raisin bran, prunes, and cashews.

Start taking a high-quality prenatal vitamin as soon as you begin trying to conceive. A good prenatal should provide a complete range of nutrients including extra folic acid, choline, and vitamin D. Folic acid and choline are important for the early development of a baby’s nervous system, which occurs during the first few weeks of pregnancy, often before a woman knows that she is pregnant. Maintenance of a normal vitamin D level is also important for fertility and healthy pregnancy.

Choose whole milk, full-fat yogurt, or a small bowl of ice cream each day while trying to conceive.

Achieve a healthy body weight. Being over or underweight can interrupt normal menstrual cycles and impair ovulation and thus fertility. Research indicates that it takes longer for overweight or obese women to conceive, and they are at a higher risk of miscarriage than normal-weight women. Fertility treatment is generally less successful in obese women. The best range for fertility seems to be a Body Mass Index (BMI) of 20 to 24.

Get active. Moderate physical activity is best while trying to get pregnant. A recent study found that for women who are overweight or obese, adding any type of physical activity improves fertility. For women who are underweight or normal weight, too much vigorous activity increased the time it took to conceive. When these women switched to moderate activity, their fertility improved.

Limit caffeine. Caffeine is a stimulant found in food and beverages such as coffee, tea, chocolate, soda, and “energy” drinks. Although research is inconclusive, some studies show that even 300 mg daily (the amount in a 16-ounce coffee at your local coffee shop) can decrease your chances of conception and increase the risk of miscarriage. It is best for women trying to conceive ti keep their caffeine intake at 200 mg per day or less.

There are several tests which can predict whether a woman has a faster biological clock, such as the anti-Müllerian hormone (AMH) test. This simple blood test helps to estimate what is called “ovarian reserve” because its level can reflect the size of the remaining egg supply in the ovary at a particular time.

“The test can’t tell you exactly how many eggs you have left – or the quality of those eggs – but it can tell you if there is an inadequate supply,” he says.

According to the American Society for Reproductive Medicine, AMH testing is especially useful for women who have a higher risk of reduced ovarian reserve including:

• Women who are over age 35 years;
• Women with a family history of early menopause;
• Women with only one ovary;
• Women with a history of ovarian surgery, chemotherapy or pelvic radiation therapy;
• Women with unexplained infertility; and
• Women who have shown poor response to ovarian stimulation.

“With the test results in hand, we can discuss their reproductive options and develop a plan. If a woman is not in a situation to get pregnant quickly, she may choose to have her eggs frozen for the future.”

Dr. Lavy advises women to seek the help of an infertility specialist if they have been trying to get pregnant for six months or more. They should also seek the care of a specialist if they have had more than one miscarriage or are considering their options for fertility preservation.

“Knowledge can be empowering,” Dr. Lavy adds. “We can help you make an informed decision.”

Strictly speaking, infertility is defined as the failure to conceive after a full year of unprotected intercourse. At that point, couples should seek professional assistance. And while the support of a fertility doctor may be crucial, there are also steps you can take on your own to help improve the chances of conception.

What are the Causes of Male Infertility?

When the semen analyses are abnormal, the urologist’s evaluation may reveal the source of the problem. The possible causes include:

Varicocele
A varicocele is a condition in which the veins surrounding the testicle become swollen and dilated. It is fairly common, affecting about one in every seven men. Men with a varicocele have about a 50% chance of having an abnormal sperm count. Treating the varicocele, which is usually done with a minor surgical procedure, will often correct the problem.

Infection
Infections of the prosate or epididymis (a duct behind the testicle) can have a major impact on a man’s fertility. Such an infection would usually be diagnosed by the finding of numerous white blood cells in the semen. If infection is suspected, the urologist may request a semen culture and may recommend treatment with an antibiotic.

Hormonal Problems
Sperm production is under the control of special hormones that come both from the pituitary gland (FSH, LH) and from the testicle (testosterone). If the blood levels of these hormones are abnormal, sperm production may be very low or even completely absent. This type of problem is diagnoses with simple blood and saliva tests and, if present, may be correctable with medication.

Genetic Abnormalities
We now realize that many cases of male infertility are caused by genetic abnormalities. These include cases in which whole chromosomes are broken or misshapen, where either a whole chromosome is missing or an extra one is present, or where individual genes on the Y chromosome are damaged.

Another type of genetic problem is known as sperm DNA fragmentation. IN this condition, the DNA strands, which contain the genetic information in the sperm head, are filled with many breaks and nicks. This is believed to be due, in many instances, to oxidative stress.

Oxidative Stress
Recent scientific evidence has revealed that a condition known as oxidative stress may in fact be a common factor in some of the causes of male and female infertility. Oxidative stress is caused by the presence of certain molecules known as reactive oxygen in the semen. These molecules, also known as oxidants, can damage the sperm cell membrane and DNA. Oxidants are normally kept under control by the presence of antioxidants in the semen.

When the amount of oxidants in the semen exceeds the amount of antioxidants, we say that oxidative stress is present. Oxidative stress has been clearly shown to reduce fertility. Some studies have shown that oxidative stress may be present even when a standard semen analysis appears normal.

Blockage of Sperm Flow
Sperm are produced in the testicles and then move into the epididymis, a small duct behind the testicle, where they become fully mature. After several days in the epididymis, the sperm swim up a tube called the vas deferens toward the ejaculatory duct. There are several conditions that can lead to a blockage of the path from testicle to ejaculatory duct. Such a blockage could cause the sperm count to be extremely low or even crate a condition known as azoospermia, in which no sperm are present in the ejaculate. Sometimes a blockage can be repaired. And if repair of the blockage is not possible, a pregnancy should be achievable through IVF.

Medications and Treatment Side Effects
Certain medications or medical treatments can interfere with sperm production. Radiation treatment for cancer can impair testicular function. Many chemotherapy drugs will have a permanent effect on production. Some drugs, such as testosterone replacement therapy, can have a temporary effect that should reverse when the medication is stopped.

When taking a medical history, the urologist will ask about any medications or illnesses that have occurred in the past.

IMPROVING MALE FERTILITY THROUGH DIET AND LIFESTYLE CHANGES

Whether your semen analyses are normal or not, there is a good evidence that diet and lifestyle can have a major impact on a man’s fertility.

Smoking
Several studies have linked cigarette smoking to lower sperm count, motility, and morphology. Smoking also increases levels of oxidative stress in the semen and can lead to sperm DNA damage and genetically abnormal sperm. If you’ve tried to quit without success, seek help from your family doctor.

Alcohol and Drug Use
Excessive alcohol consumption has been shown to impair normal sperm. The evidence regarding moderate alcohol intake is less clear, but most experts agree it is best to avoid more than one drink per day.

Sexual Activity
The likelihood of a woman becoming pregnant is much higher when you have intercourse in the three days immediately leading up to and including ovulation. Some experts call these three days the fertile window. You can determine when the woman ovulates either by using basal temperature charts or with an over-the-counter ovulation predictor kit.

The frequency of intercourse during the fertile window generally doesn’t matter. Although earlier studies seemed to show that several days of abstinence might increase sperm counts, more recent findings indicate that more frequent intercourse may in fact be better.

Avoid the use of any artificial lubricants, which can be toxic to sperm.

Avoid Excessive Heat
It is well-known that the testicles should be cooler than the rest of the body for sperm production to be at its best. The harmful effect of a varicocele on sperm production is believed to result from the extra warming of the area caused by the dilated veins. While there is no scientific evidence to support the claim that boxer-style shorts are better than Jockey type, it is important to avoid other sources of heat exposure to the testicles such as hot tubs, laptop computers, high-temperature work area, or prolonged baths.

Proper Diet
Eating a healthful diet rich in fruits, vegetables, and whole grains can be beneficial for sperm function and male fertility. Drinking enough water to stay well-hydrated is also important.

Exercise
Moderate exercise may be beneficial. Aim for at least 30 minutes of moderate physical activity on most days of the week.

Caffeine
Try to limit coffee or other caffeine-containing beverages to one serving per day.

Environmental Hazards
If your work or hobby brings you in contact with environmental dangers such as pesticides, solvents, organic fumes, or radiation exposure, you may be unknowingly affecting your fertility by impairing sperm production.

Harmful Nutritional Supplements
Nutritional supplements that provide hormone-like substances such as DHEA or “andro” can actually impair fertility by stopping sperm production. If you are taking any of these types of supplements, or other products intended to build muscle mass, it’s probably best to stop immediately.

BENEFICIAL NUTRITIONAL SUPPLEMENTS

There is substantial scientific evidence to suggest that certain nutritional supplements may help improve male fertility. A recent Cochrane Review found that antioxidants increased pregnancy and birth rates, and improved sperm motility in sub-fertile males.

Vitamin C and Vitamin E
Vitamins C and E are essential antioxidants that protect the body’s cells from damage from oxidative stress and free radicals. Vitamin C is one of the most abundant antioxidants in the semen of fertile men, and it contributes to the maintenance of healthy sperm by protecting the sperm’s DNA from free radical damage.

Vitamin E is a fat-soluble vitamin that helps protect the sperm’s cell membrane from damage. Studies have shows that vitamin E improves sperm motility (movement). Vitamin C functions to regenerate vitamin E; thus, these vitamins may work together to improve sperm function. Vitamin C has been shown to increase sperm count, motility, and morphology. Men with low fertilization rates who took vitamin E supplements for three months showed a significant improvement in fertilization rate. Vitamin E supplementation in infertility men resulted in increased pregnancy rates.

Vitamin D
Vitamin D has several important roles in the body, including regulating the immune system, improving muscular function, and potentially offering protection from a variety of health conditions. Vitamin D is important for male reproduction and androgen (testosterone) status. In a recent study, men with normal vitamin D levels had better sperm motility than men who were vitamin D deficient.

Selenium
Selenium is a trace mineral that functions as an antioxidant. Selenium supplements have been shown to increase sperm motility, ad a combination of selenium and vitamin E has been shown to decrease damage from free radicals and improve sperm motility in infertile men.

Lycopene
Lycopene is a potent antioxidant and carotenoid (plant pigment) that is abundant in tomatoes. This phytonutrient is found in high levels in the testes, and research has shown that lycopene supplementation improved sperm parameters in infertile men.

L-Carnitine
L-Carnitine is an amino acid derivative produced y the body that functions to transport fat so it can be broken down for energy. L-carnitine is though to also have antioxidant properties. L-carnitine’s primary benefit is to provide energy for sperm, and therby increase sperm motility.

Zinc
Zinc is an essential trade mineral that plays a role in sperm formation, testosterone metabolism, and cell motility. Zinc supplementation has been shown to increase testosterone levels, sperm count, and sperm motility.

Folic Acid
Folic Acid is a B-vitamin that is necessary for DNA synthesis. Low levels of folic acid have been associated with a decreased sperm count and decreased sperm motility. In a recent study, the combination of zinc and folic acid results in a 75% increase in total normal sperm count in sub-fertile men.

CHOOSING A NUTRITIONAL SUPPLEMENT

A number of combination-type products are currently for sale on the internet and elsewhere that claim to promote male fertility. However, the lack of government oversight of the dietary supplement industry create significant concerns about the purity and content accuracy of these products. It’s best to choose a supplement that has been independently certified for content accuracy and purity (by NSF or USP). In particular, since it is extremely difficult to standardize the content and purity of plant extracts, supplements with any herbal content should be considered with care, and probably avoided completely if they have not been independently certified.

EVALUATING MALE FERTILITY:

The Semen Analysis
Couples having trouble conceiving often seek the advice of their family physician or the woman’s gynecologist. Usually, as part of the initial evaluation, that physician will suggest that the man undergo a semen analysis.

How many specimens are needed?
Considerable variation in semen quality can occur from day to day or week to week. For this reason, it’s usually best to do two separate specimens at least two weeks apart.

How should the specimens be collected?
Semen specimens should be obtained by masturbation, and collecting the specimen properly is very important. First, you should abstain from ejaculation for at least three days before each specimen. Second, be sure to use a sterile collection container. Your doctor’s office or the lab should provide this. Finally, it’s best to product the specimen at the lab so it can be tested immediately. If you must produce the specimen at home, be sure to et it to the lab within 30 minutes, and protect it form extreme heat or cold.

What do they test for?
The three most important measurements taken are the sperm count, motility, and morphology. The count simply means the number of sperm present. The motility means determining the percentage of sperm seen that are actively moving. The morphology is reported as the percentage of sperm that are shaped normally. Individual labs have slightly different standards of what is normal for each of these measurements.

What if the results are abnormal?
If the semen analyses are abnormal, the man should be evaluated by a physician, usually a urologist, who specializes in male infertility. This evaluation should start with a comprehensive history and physical examination and then may go on to include blood work, ultrasound testing, genetic testing, or specialized test on the semen.

What if the results are normal?
A normal result on two semen analyses usually means that the man has normal fertility potential. However, there are certain situations (see “Oxidative Stress” section) in which a man’s fertility may be low despite a normal semen analysis.

But as she grew, that spirited girl’s dream changed. Instead of being just a princess, she wanted to be a doctor or a lawyer or the CEO of a business kingdom. So she went to college and focused on her career—all the while still dreaming of the little princesses and princes she would cradle in her arms… someday.

Sounds like a fairytale, huh? Well, today many women are indeed choosing to have it all—a satisfying career and a family. But delaying marriage and then motherhood does present some obstacles to having a baby. But fear not! A relatively new process for egg freezing called “vitrification” is offering women the ability to essentially “stop the clock” until they are ready to realize their dream of growing a family.

USE IT (YOUR EGGS) OR LOOSE IT? NOT NECESSARILY SO.

Unlike the 1950s when many young women said “I do” just a year or two after graduating from high school, more and more women (and men) are choosing to walk down the aisle for the first time while pushing 30. According to U.S. census data, women are getting married at 27 and men at 29, on average.

Although this trend is great news for women as it relates to education and earning power, it’s not so good news for their proverbial biological clock.

According to Dr. Gad Lavy, a fellowship-trained Reproductive Endocrinologist and Practice Director at New England Fertility Institute, a woman’s eggs begin to diminish in quantity and quality as she ages. “A recent study found that women lost 90 percent of their eggs by the time they are 30 years old, and 97 percent are gone by the age of 40,” she says. “This means that as a woman ages, her odds of getting pregnant drop significantly.”

Dr. Lavy is among the growing number of infertility specialists offering the option of egg freezing, or cryopreservation, to women who are choosing to delay motherhood. It is also an option for adolescents who have been diagnosed with cancer or other serious diseases and must undergo fertility-threatening treatments.

“Today many women are choosing to focus on their careers before settling down and starting a family,” Dr. Lavy says. “I have seen patients who are in medical school or those who haven’t met their spouse yet. They know in their hearts they want to have baby in a few years—but not yet.

“If you are in your late 20s or early 30s and hoping to conceive in the next several years, egg freezing is something to seriously consider,” he says.

The reasons for becoming an egg donor are as unique as each woman who has even entertained the thought. The only thing that outnumbers the reasons for becoming an egg donor are the questions that go along with making such an important decision.

As a veteran egg donor, I remember mulling over many of the same reasons, and I’ve asked the same questions. What do egg donors need to know about donating? Here are a few of the most common questions:

How does it work?

Choosing the team you want to work with for egg donation is crucial. Egg donation requires a significant physical and emotional investment on the part of the donor, and you should be treated with care and respect. Look for a team that is responsive to your questions and checks in on your well-being. You should be treated with the same care and respect afforded a recipient. You are about to embark on an intense process, and you need to feel confident in the team you are trusting to guide you through.

The next step is to determine whether your health and overall wellbeing make you a good candidate to become an egg donor. Egg donors selected by New England Fertility are usually between the ages of 19 and 29, have no significant medical history or hereditary genetic diseases, and have a body mass index (BMI) of 28 or lower. Women interested in donating eggs undergo extensive screening, including blood/drug screening, as well as thorough physical and mental evaluations.

Once screening has determined you are healthy, you are available to be matched with a recipient. The team at New England Fertility works carefully to bring together just the right donor and just the right recipient. Once a match is made, the process of harvesting eggs begins in earnest.

First, your cycle and the recipient’s cycles will be synced up using birth control pills. Once cycles are in sync and timing is right, you’ll begin to inject yourself with hormones aimed at stimulating egg growth.

Do needles make you nervous, and does the thought of injecting yourself make you particularly squeamish? Don’t worry – you’ll be coached through the process to start, and the needles are very small and most donors don’t find them too troublesome. A little ice on the injection spot usually relieves any discomfort.

During the injection process, you’ll be carefully monitored to be sure your egg follicles are growing appropriately, and you are tolerating the process well.
Like many donors, I experienced the PMS-like symptoms during this part of the process: bloating, tenderness and general moodiness. My symptoms were a bit more intense than my average cycle, but manageable. As the process went on, my symptoms became more intense, more like the very early stages of pregnancy. Because I anticipated this, I wasn’t too alarmed and I was able to tolerate it well.

Once follicles are mature, you’ll be readied for the retrieval process. Eggs are retrieved vaginally. You’ll be comfortably sedated, and the doctor will pass a needle through the vaginal wall to carefully remove around a 10 – 15 eggs.

My own retrieval procedure lasted only around 30 minutes, but I remained under observation for a couple of hours as I recovered from anesthesia. A close friend drove me home from the clinic (a must!) and stayed with me the rest of the day to make sure I rested comfortably.

I was able to resume most of my usual activities the next day, and I was back to 100 percent within a week.

What are the risks?

There’s no question that egg donation is an intense process, but as medical procedures go, it’s very low risk.

Perhaps the biggest risk is a condition known as Ovarian Hyper-Stimulation Syndrome (OHSS). OHSS results in enlarged ovaries, which could lead to blood clots and other complications. OHSS occurs about 5 percent of all cases of ovarian stimulation for egg retrieval. Careful monitoring throughout the process and follow up after will help detect signs of OHSS.

Fortunately, like the vast majority of egg donors, I did not experience any OHSS symptoms, nor difficulties due to the anesthesia used during the retrieval. I tolerated the anesthesia well, and my recovery was smooth. If you have difficulty with anesthesia, your results may be different.

Long-term, it is not believed that egg donation has any significant impact on the health or reproductive ability of the donor. At this point, I have no concerns about my future ability to conceive and carry my own children.

How will I feel after?

Every egg donor will feel a little differently. For me, the feeling I experienced most was a sense of accomplishment. I wanted to donate my eggs because I felt a strong desire to help another person become a parent. While I donated anonymously, the recipients of my eggs did request the team at New England Fertility let me know that they were able to conceive, and they have finally started the family that they long dreamed of.

I’m considering donating again, and helping another family get its start.

What’s next?

If you are considering becoming an egg donor, I recommend that you to contact New England Fertility. They can answer your specific questions, and guide you through the process of deciding if becoming a donor is right for you. If you do decide to become a donor, you’ll be in good, caring hands with this team.lity. They can answer your specific questions, and guide you through the process of deciding if becoming a donor is right for you. If you do decide to become a donor, you’ll be in good, caring hands with this team.

How? That's the number of children who have been welcomed into loving families through our work here at New England Fertility. It's wonderful – and a little overwhelming! – to consider the possibilities.

Those 10,000 children mean 10,000 first birthdays, first steps and first days of school. They mean thousands of family holidays, millions of kisses and hugs and bedtime stories, and countless memories.

Since 1991, as these children and families have grown, our practice has grown, too. We've added capabilities, refined techniques, expanded to new locations.

We offer comprehensive fertility treatment options, starting with infertility testing and diagnosis. We spend considerable effort diagnosing the causes of infertility, because a clear diagnosis allows us to develop and recommend treatment plans that are best suited to your particular situation – offering the greatest likelihood of conception.

Treatment plans may include in vitro fertilization (IVF), intrauterine insemination (IUI), preimplantation genetic testing, gender selection, egg freezing, medical fertility preservation or reproductive surgery.

We are also proud to have worked with many LGBT patients and we warmly welcome all same-sex male, bisexual, transgender and lesbian individuals/couples to our practice. Connecticut, where we are based, offers a favorable legal environment for surrogacy, opening up this option to same-sex male couples and any prospective parent who is unable to carry a pregnancy to term.

Our proximity to New York City means we are within easy reach of patients all over the country, and all over the world. Our reputation for compassion and clinical excellence coupled with Connecticut's supportive environment for fertility treatment options and surrogacy make New England Fertility a wonderful place for prospective parents from all over the world to take their first steps on the journey toward making a family.

Where are you on the journey toward making your family? Perhaps you have already held your little one in your arms, and you'd like to share your story with others. Maybe you are still dreaming of that day. Wherever you are, we'd like to help you on your journey.

We'd like to be part of bringing 10,000 more sweet little people into the world. We'd like to imagine 10,000 more first birthdays, first steps, first days of school. We'd like to unleash upon the world millions more hugs and kisses and smiles, and countless wonderful memories. We'd love for yours to be among them.

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“The relationship between stress and infertility is complex,” says Dr. Gad Lavy, a Reproductive Endocrinology and Infertility Specialist at New England Fertility Institute. “Psychological stress does not appear to cause infertility, but infertility is certainly a major cause of psychological stress for our patients.”

Facing infertility can cause a profound emotional strain that most couples don’t expect. Studies have shown that up to 40% of women meet diagnostic criteria for anxiety or depression at the time of their initial visit with a fertility specialist, and many women go on to report their experience with infertility and its treatments as the most stressful event of their lives.

“Infertility can be very isolating,” Dr. Lavy says. “Many women have a hard time talking with their family members, friends, or even their partners about such personal issues, and often end up suffering in silence as a result.”

Social pressures commonly add to the emotional burden of infertility. Reminders of infertility are everywhere—a baby photo on a social media site, a birth announcement in the mail, a holiday dinner with nephews and nieces… These everyday encounters may lead to social withdrawal in some women, while others experience symptoms such as irritability, insomnia, weight changes, or difficulty concentrating.

Dr. Lavy believes encouraging stress reduction and healthy coping techniques is an essential part of his role as a fertility specialist. “Stress is the #1 reason people abandon fertility care—not treatment failure, not financial concerns—simply overwhelming emotional stress.” Although studies have shown that stress reduction doesn’t directly lead to higher pregnancy rates, Dr. Lavy explains that it does ultimately help more couples to reach their goal of becoming pregnant: “It helps them to keep trying.”

Women and men undergoing fertility treatments can effectively reduce their stress in a number of different ways. Acupuncture, yoga, art, music, sports, dance, and exercise are all commonly used, and couples are also encouraged to stay engaged with their social support networks. Meeting with counselors or local support groups can also be beneficial, particularly for combatting feelings of isolation and hopelessness that may occur. Resolve has a number of online resources that many couples find helpful, including a directory of local infertility support groups.

“The journey to parenthood can be challenging, but it helps to know that you are not alone,” Dr. Lavy offers.

Until recently, the only method for preserving eggs for fertilization at a later date was a slow-freeze method. But unlike sperm, which has been successfully frozen and used for many years, eggs contain a lot of water, which makes freezing more difficult. With slow-freezing, ice crystals can form within the egg, and these ice crystals can destroy the cell’s structure.

“With vitrification, the egg freezes so quickly that ice crystals don’t have time to form,” Dr. Lavy says. “When the woman is ready to try pregnancy, the thawed eggs can be fertilized using ICSI, a technique that injects one sperm directly into one egg.”

In 2012, the American Society for Reproductive Medicine declared egg freezing no longer experimental because eggs frozen with vitrification are similar to fresh eggs in terms of their ability to lead to pregnancy.

“Worldwide, the number of babies born from frozen eggs is growing, and we are seeing good results,” Dr. Lavy says.

Your nutritional choices before, during, and after pregnancy have a major impact on the long-term health of both you and your baby. Prepare for a healthy pregnancy by eating a balanced diet, taking a high-quality prenatal supplement, and maintaining an overall healthy lifestyle including regular physical activity.

BEFORE YOU GET PREGNANT
It’s never too soon to begin preparing for your baby. As soon as you are actively trying to get pregnant, start taking a prenatal supplement that provides a complete range of nutrients including extra folic acid, choline, and vitamin D. Folic acid and choline are important for the early development of a baby’s nervous system, which occurs in the first few weeks of pregnancy, often before a woman knows that she is pregnant. Maintenance of a normal vitamin D level is also important for a healthy pregnancy.

For women over 35, taking a supplement containing coenzyme Q10 (CoQ10) may be beneficial for healthy ovarian function. Research indicates that CoQ10 may support mitochondrial energy production in the ovary for improved egg quality in women age 35 and older.

EATING RIGHT DURING PREGNANCY
In addition to taking a high-quality prenatal multivitamin and mineral supplement, mothers-to-be need to east a variety of healthful foods every day.

A balanced diet to support your healthy pregnancy consists of colorful fruits and vegetables, whole grains (whole grain bread and pasta, brown rice, quinoa, couscous), lean protein (milk beans, tofu, and lean meats and poultry), and healthful fats (olive oil, walnuts, almonds, avocados).

AN OVERALL HEALTHY LIFESTYLE DURING PREGNANCY AND BEYOND
A lifestyle that includes healthy eating habits, regular physical activity, and refraining from smoking, excessive alcohol consumption, and substance abuse will support the lifelong health of your entire family. Remember, when a child reaches adulthood, they tend to eat what their parents at, and follow the lifestyle patters they learned early in life. So making good choices now can influence your child to lead a health lifestyle into adulthood.

Most women can be moderately physically active throughout their pregnancy. In fact, a fit woman may experience an easier labor and faster recovery due to her strength and endurance. Talk to your doctor to see if you need to make any modifications to your exercise program.

KEY NUTRIENTS FOR PREGNANCY
There are many different prenatal supplements on the market. It is important to find one that is easy for you to swallow, and that you tolerate well. A high-quality prenatal should generally contain the following nutrients.

Vitamin D
Optimal vitamin D levels are important for a healthy pregnancy

Low vitamin D blood levels are common among pregnant women and have been associated with numerous complications of pregnancy. Low intake of vitamin D during pregnancy has also been associated with low infant birth weights and increased risk of childhood asthma. Typical prenatals provide 400 IUI of vitamin D, which recent research suggests is inadequate. For example, one study showed that even with 800 IUI of vitamin D per day, most pregnant women and their infants did not achieve a normal vitamin D level.

Recent studies tested 2000 and 4000 IUI of vitamin D per day in pregnant women. The researchers found these doses were safe and effective in achieving normal vitamin D levels. Pregnancy complications such as preterm labor and infection were lower in women with higher vitamin D levels at delivery. Look for a prenatal with 2000 to 4000 IUI vitamin D3, the preferred from of vitamin D, per daily dose.

Folic Acid
Folic acid is critical during the first trimester to reduce the risk of neural tube birth defects.

Choline
Choline is important to promote your baby’s brain development.

Vitamin B6
Vitamin B6 (pyridoxine) may help reduce nausea during pregnancy.

Iodine
Iodine promotes normal thyroid function and nerve and brain development.

Iron
Increased iron is recommended to meet your increased needs during pregnancy.

Biotin
Biotin is broken down more rapidly during pregnancy.

DHA
DHA (docosahexaenoic acid) is beneficial for your baby’s brain and visual development)

UNIQUE NUTRIENT NEEDS FOR LACTATION
Breastfeeding is one of the best things you can do to support your baby’s health, and good nutrition plays a key role in your baby’s growth and development. Moms who breastfeed have unique nutrient needs — different from during pregnancy or any other time in a woman’s life. Taking a nutritional supplement specifically formulated for breastfeeding moms, along with a balanced diet, will provide the essential vitamins and minerals needed during this time.

Vitamins A and C
While you are breastfeeding, you need slightly more vitamins A and C than most prenatal supplements provide. Higher amounts of these vitamins are needed for yor breast milk to meet your baby’s nutritional requirements. Look for a lactations supplement that contains the Recommended Daily Allowance for vitamin A (4000 IUI) and vitamin C (120 mg)

Choline
Your requirement for choline, a nutrient that supports your baby’s growth and brain development, is higher during lactation than at any other time during your life. This nutrient is often left out of prenatal supplements because it is bulky; however, it is estimated that only 10% of American meet their daily choline needs. Foods rich in choline include egg yolks, Brussels sprouts and broccoli, milk and some meats. Look for a lactation supplement with 200 -300 mg of choline to help meet the recommended amount for breastfeeding mothers (550 mcg)

DHA
DHA is beneficial for your baby’s brain and visual development. The omega-3 fatty acid DHA is important during pregnancy and lactation because of its role in infant brain and eye development. The amount of DHA in your breast milk is directly related to the amount of DHA in your diet (from fatty fish such as wild caught salmon) and your supplements, so it is important to get enough while you are breastfeeding. Look for a lactation supplement with 300 mg DHA.

Vitamin D
Vitamin D is important for your baby’s overall growth and development. The American Academy of Pediatrics recommends that breastfed infants receive 400 IU vitamin D drops each day to prevent vitamin D deficiency and rickets. This is because most women don’t have enough Vitamin D in their breast milk. It is important that babies get enough, but not too much, of this important nutrient. Early research suggests that if mothers take very high doses of vitamin D, there may be enough in breast milk. However, it is not yet clear exactly how much vitamin D is needed. Until the exact amount is known, a lactations supplement should contain about 1000 IUI of vitamin D3 to support your nutrient needs without providing too much to your baby. Talk to your pediatrician if you have questions about vitamin D for you and your baby.

Folic Acid
Although you needed more folic acid in early pregnancy to support your baby’s growth and neural tube development, your folic acid needs are lower during lactation. There is some controversy about supplementing with high doses of folic acid for long periods of time, so it makes sense to take higher doses only before and ruing pregnancy, when it is really needed. Look for a lactation supplement with 400-600 mcg of folic acid.

Iron
Your iron needs are much lower while breastfeeding than during pregnancy. If you are breastfeeding exclusively, you likely will not have your period for 4 to 6 months after giving birth. Without menstrual blood loss each month, your iron needs decrease. If you are anemic after giving birth, however, you may need additional iron supplementation. Look for a lactation supplement with 9 mg of iron, the Recommended Daily Allowance during breastfeeding.

MORE INFORMATION ABOUT VITAMIN D AND PREGNANCY
Recent studies indicate that low vitamin D levels are common among pregnant women in the US and in the UK, even among those taking a standard prenatal multivitamin, which usually contains 400 IUI. Low vitamin D levels during pregnancy can affect the well-being of the mother as well as the newborn. Adequate vitamin D during pregnancy is important for skeletal development, as well as general growth and development of the fetus. Because a newborn’s vitamin D level depends on the mother’s vitamin D status, deficiency during pregnancy can lead to rickets (bone softening and weakening) in the child. A recent study confirmed that a mother-to-be’s vitamin D level was related to her child’s bone health. Children whose mothers had insufficient vitamin D levels during pregnancy were more likely to have reduced bone mass at age nine. Low vitamin D levels during pregnancy have been associated with an increased risk of numerous complications, including gestational diabetes (high blood sugar during pregnancy), preeclampsia (pregnancy-induced high blood pressure) and bacterial vaginosis (an infection caused by an overgrowth of bacteria in the vagina ). One study found that mothers-to-be with vitamin D deficiency were almost four times more likely to require a Cesarean section.