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Knowledge Center

Everything You Need to Know About Fertility Options…But Were Afraid to Ask!

In Vitro Fertilization (IVF) FAQ

Q: What is In Vitro Fertilization (IVF)?

A: In Vitro Fertilization (IVF) is a type of assisted reproductive procedure used for infertility treatment. To perform IVF, female eggs are fertilized with the male partners or (sperm donor) in the laboratory. The resulting embryos from this process are transferred into the female partner’s uterus (womb). Typically, the created embryo(s) are grown and cultured in the lab for 3-5 days.

Q: What are the Advantages of In Vitro Fertilization?
A: One of the great advantages of IVF is that it can treat many causes of infertility. These conditions include, tubal blockage, problems with ovulation, problems with the way the sperm and egg interact, poor sperm quality or quantity, older patients, endometriosis, and recurrent pregnancy or loss related to chromosomal abnormalities.

Another great advantage of IVF is that it can be used to make specific diagnoses. Since the embryo is created in the lab it gives physicians the ability to test the embryos for any genetic or chromosomal abnormalities. IVF therefore can be used to diagnose inheritable diseases. Some of the most common diseases tested are cystic fibrosis, sickle cell disease, and chromosomal abnormalities such as Down Syndrome and Turner Syndrome.

Finally, IVF has the highest success rate in achieving a pregnancy for couples. It also affords couples the option to store and freeze extra embryos that are created for future fertility.

Q: How long is an IVF Cycle?

A: An IVF cycle normally lasts about a month, very similar to a regular reproductive cycle. Day 1 starts at the first day of menstrual bleeding. Most egg collections occur around the 12-14th day of an IVF cycle. But it may vary individually, from patient to patient, and from cycle to cycle.
On the day of the egg collection, the egg is exposed to sperm (IVF) or a single sperm is injected into the egg (ICSI). The embryo transfer will be performed 3-5 days later. And pregnancy test will be performed two weeks after the egg collection. Some clinics utilize oral contraceptives to control the period to ensure the patients going through treatment are right on schedule.

Q: What is the difference between a day 3 and day 5 Embryo transfer?

A: Eggs that are fertilized successfully are transferred into culture media to promote the growth of the now newly formed embryo. Embryos are generally transferred on day 3 or 5 of embryo development. The day of transfer depends on embryo number, quality, patient characteristics, and laboratory practices. Patients should discuss thoroughly the benefits and disadvantages of day 3 or day 5 transfers.

Most embryo transfers at ARC are day number 5 (Blastocysts). Blastocysts have higher success and are more likely to implant. At ARC, your embryos are transferred at the blastocyst stage to lower multiple births specially if tested for aneuploidy with PGT-A.

Q: What if my eggs don’t fertilize?
A: The IVF process involves placing several thousand sperms around eggs in a dish to “fertilize.” When the normal functioning sperm is not enough to fertilize the egg, fertilization will usually occur after injecting a single sperm into each egg. This process is called “intracytoplasmic sperm injection” or “ICSI”.

Intrauterine Insemination (IUI) FAQ

Q: What is Intrauterine Insemination (IUI)?
A: IUI, also known as artificial insemination, is a simple, assisted reproductive technology in which semen is collected and the sperm are washed with a special solution and concentrated to collect the active, normal sperm. The sperm are then placed directly into the uterus using a thin flexible catheter increasing the chances that more sperm will encounter the egg as the sperm travels to meet the egg in the fallopian tubes. Medications such as GONAL-F, FOLLISTIM, OF CLOMID are used to encourage the development of numerous eggs. The success rate is higher in stimulated cycles than natural cycles because of the increase in egg number.
Q: Who should consider IUI?

A: An IUI procedure can be helpful in several situations including mild male factor infertility, cervical or cervical mucous concerns, unexplained infertility, mild endometriosis, individuals, or couples using donor sperm; and women with ovulation conditions who have responded well to fertility medications.

Q: How much does intrauterine insemination cost?
A: IUI normally costs significantly less than IVF or other fertility treatments. ARC has the most affordable cost for Intrauterine Insemination in the country.
Q: What is the difference between IUI & IVF?

A: The key difference between IUI and IVF is that IUI involves fertilization inside the uterus and with IVF, fertilization takes place outside of the body in the laboratory. During IVF, an individual takes fertility medication to stimulate then ovaries and then the mature eggs are retrieved during a minor surgical procedure. The eggs are the fertilized in the lab with prepared sperm. The resulting embryos can then be transferred to the uterus, or frozen for later use.

Q: What are the risks of IUI?

A: IUI is a low-risk procedure, but there are some concerns to be aware of. These can include:

    • Infection
    • Becoming pregnant with twins/multiples

Our experienced and board-certified reproductive endocrinologist closely monitors your cycles with blood work and ultrasounds. Monitoring your cycles requires extensive training and experience to avoid multiple pregnancies (triplets, etc.)

Preimplantation Genetic Testing/Diagnosis (PGS/PGD) FAQ

Q: What is preimplantation genetic testing (PGT)?
A: Preimplantation genetic testing (PGT) is a procedure used to identify genetic abnormalities in embryos created with in vitro fertilization (IVF). PGT is performed before embryos are transferred to the uterus. The goal of PGT is to significantly reduce the chances of transferring an embryo with a specific genetic condition or chromosomal abnormality and limit the number of embryos transferred and lower multiple gestation.
Q: Are there different types of genetic testing?

A: Yes. There are three types of PGT:

Preimplantation genetic testing for aneuploidy (PGT-A): This type of PGT screens embryos for certain types of chromosome abnormalities. Human embryos should have 23 pairs of chromosomes in each cell.  One chromosome in each pair is contributed by the egg, and the other is contributed by the sperm.  It is common for embryos to have random chromosome abnormalities such as a missing or extra chromosome (aneuploidy).  These chromosome abnormalities happen by chance and are not typically inherited from a parent or donor.  Embryos with aneuploidy are more likely to result in miscarriage or a failed IVF cycle. Less commonly, aneuploidy may result in the birth of a baby with a chromosome condition such as Down syndrome or Turner syndrome.

Preimplantation genetic testing for monogenic disorders (PGT-M): This type of PGT is performed when a patient has an increased risk for a specific genetic condition to occur in his or her embryos.  PGT-M is appropriate when an individual is affected with a genetic condition that could be passed on to his or her children, for women who are carriers for an X-linked condition, or when an individual and their partner or donor are both carriers for the same autosomal recessive condition.

Preimplantation genetic testing for structural rearrangements (PGT-SR): This type of PGT is performed when a patient or their partner has a rearrangement of their own chromosomes such as a translocation or inversion.  A person with a translocation or inversion is at increased risk to produce embryos with missing or extra pieces of chromosomes.  Embryos with missing or extra pieces of chromosomes are more likely to result in miscarriage or a child with serious health issues.

Q: Who should have PGT performed for their embryo(s)?
A: PGT-A can be performed for any IVF cycle, but the decision to have this testing is complex and should be made after careful discussion with our trained and expert staff. PGT-A is mostly considered for patients who have had recurrent pregnancy losses (miscarriages), multiple failed IVF cycles, older patients, gender selection, and for personal reasons.

By contrast, PGT-M and PGT-SR are only performed when the patient, their partner and/or their donor have abnormal genetic test results that put the embryos at increased risk for a genetic disorder. PGT-M is an option for patients with an increased risk for a single gene disorder in their embryos, such as sickle cell anemia. PGT-SR is an option for patients who have a chromosome translocation or inversion. These two procedures allow patients the opportunity to reduce the risk of having an affected child prior to becoming pregnant.

Q: How is PGT performed?
A: All three types of PGT are performed in a similar fashion. The patient goes through their IVF cycle and egg retrieval as recommended by their physician. Their embryo(s) are monitored in our laboratory until day 5 or 6 when they are referred to as blastocysts. At that time, a small number of cells are biopsied (removed) from each embryo and shipped to an outside laboratory for PGT. The cells are taken from a part of the blastocyst called the trophectoderm, which will eventually form the placenta. These cells are expected to be representative of the rest of the embryo; however, this may not always be the case due to circumstances such as mosaicism (see question 13). The embryo(s) must be frozen while PGT is performed. An embryo with normal PGT results would be selected, thawed, and transferred to the uterus at a later date.
Q: Are there risks to the embryo(s) from the PGT process?
A: Yes, there is a small percentage of risk in performing this process. When cells are removed from each embryo for PGT (the biopsy process), has a small chance of damaging the embryo. Additionally, since the embryo(s) must be frozen while PGT is performed, they must also undergo a thawing procedure prior to transfer. ARC has 98% survival rate of embryos that were biopsied and later thawed. Selecting an embryo with the correct number of chromosomes can increase pregnancy rates, lower miscarriage rates and can allow for single embryo transfer to limit multiple pregnancy.

In-House Egg Donation FAQ

Q: How does our egg donation program work?
A: Our egg donation program locates and screens egg donors who can provide healthy eggs for women who are unable to conceive due to advanced ovarian age, elevated FSH, multiple failed IVF attempts, premature ovarian failure, and same-sex male couples. Deciding to be a recipient of egg donation is an extremely rewarding and effective method of conception that allows you to be fully involved in the development of a child from the moment of his or her conception.
Q: What are the advantages of utilizing our Egg Donation program?
A: Egg donation has many advantages over other alternative methods of conception and adoption including:

  • As a recipient of egg donation, you will be giving yourself the opportunity to experience all the wonders of motherhood from the very beginning that will allow you to create a lasting bond with your child.
  • You and your spouse can carefully choose the characteristics of the donor, which may allow you to find an egg donor whose attributes are very similar to yours.
  • You will be giving the fetus an environment that you know and trust for its growth and nurture – your own body!
  • It is the closest method available to natural childbearing.
  • Very high success rate.
  • Egg donation often results in multiple embryos that can be used in the future if you decide to have another child, which makes the entire process a lot shorter and easier for you and your family.
Q; Can we have any contact with our anonymous donor?
A: No. The anonymous donor signs a contract protecting her anonymity, and you cannot contact her. Conversely, she also has no way of contacting you, either. Many couples have a fear of the donor coming to their door looking for a baby. Not only does the donor know nothing about you at all, she also is not told whether or not you achieve a pregnancy.
Q: How long will this cycle take?

A: This is the million-dollar question. Under normal circumstances if everything goes perfectly, we say it’s about six to eight weeks from contract signing to embryo transfer.

Q: Does the success rate differ by age?
A: In general, the uterus does not age in the same manner as the ovary. The success rate is similar for women in their third, fourth and fifth decade of life – assuming that the patient is in good health and otherwise a suitable candidate for this treatment.

Surrogacy FAQ

Q: What is Surrogacy?
A: Surrogacy is defined as an arrangement whereby a woman agrees to carry a pregnancy for a same-sex or heterosexual couple. With the advent of current reproductive technologies, it is now possible for couples that cannot have a child on their own to utilize the services of a gestational surrogate. A gestational surrogate is a person that carries a pregnancy for another couple.
Q: Are there different types of surrogacies?
A: Yes! There are three types of surrogates:

IVF Surrogacy (gestational carrier)

A woman carries a pregnancy created by the egg and sperm of the genetic couple. The carrier is not genetically related to the child.

Natural Surrogacy (traditional/straight surrogate)

American Reproductive Centers does NOT participate in this type of surrogacy due to California State laws. This is just for information purposes. A woman is inseminated with sperm from the male partners of an infertile couple. The child that results is genetically related to the surrogate and to the male partner but not to the commissioning female partner.

Donor Egg/Gestational Surrogacy

The surrogate agrees to carry the embryos made from the sperm of the intended father and the eggs from a third-party donor. This is commonly used by same-sex male couples to have children.

Q: Why consider surrogacy as a fertility option?
A: Families, couples, and individuals may choose to pursue surrogacy for several reasons.

If you are a woman, you may use a surrogate mother because:

  • You have uterine issues. The uterus is an incredible organ, but some women have medical roadblocks that prevent them from carrying a baby to full term.
  • You have a pre-existing health condition. Beyond uterine issues, other medical conditions can make carrying a baby extremely dangerous – if not life-threatening. Those living with heart and kidney issues, for example, may find surrogacy to be the safest option.
  • You have had a hysterectomy. Women who have had cervical or another type of cancer requiring a hysterectomy cannot conceive and carry a child naturally.
  • Your previous pregnancies were traumatic. Women who have been pregnant before and experienced serious problems throughout might choose surrogacy to protect themselves and their babies.

Surrogacy is also a popular alternative family planning journey for other couples and individuals, including:

  • People that cannot adopt a child because of their marital status or age.
  • LGBTQ+ couples that cannot have a child because of logistical reasons. In these instances, surrogacy has several benefits. For example, a gay man can be the biological father of his child.
Q: What are the benefits of surrogacy?

A: There are many benefits awarded to families that have been created in this very special way. These include the following: 

  • Surrogacy offers the potential for one or two of the intended parents to be related to their child biologically.
  • Surrogacy gives parents the opportunity to raise their child from birth.
  • The intended parents can be involved in the pregnancy and, in some cases, be present for exciting milestones throughout the journey.
  • The intended parents can, if everyone agrees, form a meaningful relationship with the surrogate mother and her family.
  • People that peruse surrogacy may face fewer limitations than those that choose adoption.
  • The intended parents can rest a little easier when using a surrogate, as the surrogate has undergone extensive medical testing, and many have carried babies to full term in the past. This increases the likelihood of success.
Q: How do I start my surrogacy journey?

A: Our team of surrogacy experts can guide you through every step of the process, offering expert advice on all things medical and legal. Our services are client-tailored, and we can facilitate and oversee surrogacy agreements that use an egg donor, sperm donor, or IVF technologies to help you build the family you’ve always wanted. 

We don’t discriminate against different ages, genders, backgrounds, sexual orientations, or marital status. We believe that a world-class surrogacy experience can be life-changing, and whoever you are, we are ready to make your family dreams a reality!

Male & Female Fertility Evaluation FAQ

Q: What does infertility mean? Can I ever have children?
A: Infertility and being sterile are different. Infertility—or, more accurately, subfertility—is diagnosed if a couple is unable to conceive a child after having well-timed, unprotected intercourse over the course of a 12-month time period if younger than age 35, but only a 6-month time if over 36. It does not mean you may never get pregnant. Sterility is diagnosed after a thorough medical examination indicates the patient has no uterus, no ovaries, no egg production or no sperm production.
Q: How do we evaluate infertility in women & men?
A: Fertility testing for women includes bloodwork, ultrasound, hysterosalpingogram (HSG), and/or a saline sonogram to evaluate hormone levels, ovarian function, and the uterine cavity. These tests will help us determine egg quality and quantity, as well as to detect uterine abnormalities. If you are determined to be infertile after our evaluation, we can recommend options available to you through our centers.

Most men will initially be diagnosed with a potential male factor fertility issue based on the results of an ejaculated sperm specimen or Semen Evaluation. The components of a Sperm Analysis include:

  • Volume
  • Sperm Count
  • Sperm Motility
  • Sperm Morphology
Q: How do you determine what tests to run?

Our fertility testing programs begin by going over the medical history of both partners. This, coupled with a physical exam of both partners helps us to determine what fertility tests to run. 

A: The physical exam is both a gynecological exam, a pelvic ultrasound, and a hormone screening for women and a semen analysis on the man. In some cases, a woman also experiences an evaluation of tubal patency. This is used to determine if the fallopian tubes are blocked or not.

Q: How is infertility treated?

A: The most common treatments for infertility are Intrauterine Insemination (IUI) and In Vitro Fertilization. Your ARC specialist will determine and recommend the most effective treatment plan for you.

Q: When should I consider fertility preservation?

A: There is never a wrong time to consider fertility preservation and many reasons to discuss preservation with us. If you are facing a medical condition that may impact your ability to conceive, or if you are not ready to start a family until later in life, it is important to speak with a provider at ARC to see if egg freezing is a good option for you!

Egg Freezing FAQ

Q: What is Egg Freezing?

A: Egg freezing also known as Oocyte Cryopreservation is a method that helps women freeze and store their eggs (oocytes).  Women now have the option to stop the “biological clock” from ticking.  This treatment option essentially keeps the eggs suspended and prevents the eggs from aging and thereby giving women the ability to delay childbearing. 

Currently American Reproductive Centers utilizes the latest methods in egg freezing.  In the past previous technologies have made success with egg freezing relatively rare.  With the technology that we utilize pregnancy rates are much improved.

Q: What is the best age to freeze my eggs?

A: Ideally, as soon as possible for the best chance of achieving a healthy pregnancy down the road. The reason is, as a woman ages, the number of she owns gets fewer and fewer. Eggs age just like our bodies do. Even if the egg number stays the same as five years ago, their “quality” declines.

Q: Who should consider egg freezing?

A: Egg freezing can be beneficial for a number of reasons for women wishing to preserve their fertility for the future including: 

  • Women who want or need to delay childbearing in order to pursue educational, career or other personal goals.
  • Women diagnosed with cancer.
  • Women with objections to storing frozen embryos for religious and/or moral reasons.
Q: How does egg freezing work?

A: Although sperm and embryos have proved easy to freeze, the egg is the largest cell in the human body and contains a large amount of water. When frozen, ice crystals form that can destroy the cell. Our process includes dehydrating the egg and replacing the water with an “anti-freeze” prior to freezing to prevent ice crystal formation. Because the shell of the egg hardens when frozen, sperm must be injected with a needle to fertilize the egg using a standard technique known as ICSI (Intracytoplasmic Sperm Injection). Eggs are frozen using a flash-freezing process known as vitrification.

Q: Is egg freezing expensive?
The costs for egg freezing are much less expensive than a complete IVF cycle. In general, it costs $5,000 to undergo an egg freezing cycle. The egg thaw, fertilization, and embryo transfer procedure costs approximately $5,000 and is payable at the time of cycle start. All of these costs will be set and guaranteed at the time of the initial egg freezing cycle.

Elective Single Embryo Transfer (Fresh & Frozen) FAQ

Q: What is Embryo Transfer?
A:  Embryo Transfer is the process of inserting an embryo into the uterus using a catheter. The embryo maybe the product of a fresh IVF cycle or a thawed embryo. It may or may not be tested for extra or missing chromosomes.
Q: How does the frozen embryo transfer process differ from IVF with fresh embryos?
A: The only differences between using fresh and frozen embryos in a cycle of IVF is that the female patient will not have to go through ovarian stimulation at the beginning of the frozen embryo transfer process, and that the male patient will not need to deliver his sperm. The male patient (or indeed, sperm donor) has already played his part and his genetic material is not needed again. This is also true of the female patient (or egg donor), but she will still need to go through hormone treatment to encourage thickening of the endometrial lining. This is the part of the cycle that prepares the womb for embryo implantation. The frozen embryo is thawed carefully and, when ready, transferred. The rest of the cycle is the same as when fresh embryos are used, and rates of success remain stable, regardless of whether a fresh or frozen embryo is transferred.

When PGT-A is performed , all embryos must be frozen at the blastocyst stage after biopsy. ARC does not perform biopsy on cleavage stage embryos but rather on blastocysts.

Q: Who can opt for frozen embryo transfers?

A: ARC works with women between the ages of 18 and 54, offering the fertility treatment that is most appropriate for each patient’s individual circumstances. In general, younger women have higher quality eggs, though of course this is not true in every case. Those who have suffered through multiple miscarriages, endometriosis, or early miscarriage may have different success rates to those who have other infertility issues, and this may be down to the quality of the eggs. However, the earlier a patient visits our center and begins the fertility treatment, the higher the likelihood that her eggs will result in embryos and ultimately result in pregnancy. Any of ARC’s female patients who go through ovarian stimulation are welcome to opt to freeze resulting embryos for future use.

Q: What is ARC’s Embryo Transfer Procedure?
A: The embryo transfer procedure is the procedure that places the embryo(s) into the patient’s uterus (womb). Embryo transfer is done by placing the best embryo(s) into a thin plastic catheter; this catheter is then passed through the vagina and cervix into the uterine cavity (womb). Once in the appropriate location inside the uterus the embryos are injected inside. Our physicians will utilize an ultrasound to visualize the tip of the catheter and ensure its proper placement.

ARC highly promotes elective single embryo transfers.

The embryos chosen for transfer are evaluated by the embryologist and physician to determine the best quality embryos. The number of embryos transferred depends on the patient’s age, history, embryo quality, risk assessment, risk tolerance, and other diagnostic and clinical indicators.

Q: Do frozen or fresh embryo transfers have better success rates?
A: There has been a lot of debate surrounding the successes of frozen and fresh embryo transfers, and the benefits that surround these options. Many fertility specialists and treatment providers indicate that frozen embryo transfers provide a higher pregnancy success rate than using fresh embryos during assisted reproductive technology. Whenever PGT-A or PGT-M is performed embryos must be frozen, the transfer of normal yields a high success rate.

However, success rates aren’t the only determining factor. Depending on your situation, going fresh over frozen for your embryo transfer may better suit your needs. Let’s explore what to consider when selecting between fresh and frozen embryo transfers during your ARC journey!

Robotic/Advanced Endoscopic Surgery FAQ

Q: What is robotic-assisted surgery?

A: Robotic surgery requires only a minimal incision and places a higher level of precision in the hands of a skilled surgeon. Incredibly accurate 3-dimensional planning facilitates optimal surgical accuracy, often resulting in reduced pain, faster recovery, and improved outcomes.

Q: What are the benefits of robotic-assisted endoscopic surgery?
A: Because robotic-assisted surgery is conducted by making tiny incisions and making smaller surgical movements, patient benefits are incomparable to traditional surgical methods.

  • Tiny incisions and smaller surgical movements mean less pain
  • Shortened hospital stays and mostly outpatient surgeries with same-day discharge.
  • Faster road to recovery
  • Fewer complications like blood loss and infection
Q: Is robotic-assisted surgery more expensive?

A: Robotic-assisted surgery is typically no more expensive than traditional surgery. And, depending on the specific procedure being performed, it can be far less costly.

Dr. Abdallah is the only Board Certified Reproductive Endocrinologist who uses Robotics.


Dr. Maher Abdallah and American Reproductive Centers in the News!

American Reproductive Centers

Where Success is Measured in Heartbeats!

Two Locations:

1199 N. Indian Canyon Dr.
Palm Springs, CA 92262

255 Terracina Blvd. – Suite 202
Redlands, CA 92373

We are happy to schedule a consultation and answer all your questions!