What is secondary infertility?
Secondary infertility is defined as the inability to conceive an additional (not necessarily second) child successfully and naturally. When a childless couple is unable to conceive, they tend to seek treatment. However, couples who already have children are much less likely to seek help because of the misconception that once you are fertile, you will always be fertile.
Why does secondary infertility happen?
Reasons for secondary infertility tend to be the same as primary infertility. Since the last pregnancy, the husband or wife may have gained some weight, had an infection, or started eating fewer healthy foods. These small variances in lifestyle can affect reproductive health. Additionally, if it has been a few years since the last child, the quality of eggs may have decreased, or the husband’s sperm may have undergone some changes. Abnormalities with sperm and ejaculate are frequently cited as causes of secondary infertility.
Indications for secondary infertility:
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A response to ovarian stimulation depends on a number of different factors, the most important include available eggs, appropriate hormone levels, proper administration of any medications and lifestyle/environmental factors.
In order to respond to ovarian stimulation, a woman must have eggs available to respond; this is sometimes referred to as ovarian reserve. If a woman has diminished ovarian reserve (identified by high blood levels of follicle stimulation hormone (FSH), low blood levels of Anti Müllerian Hormone (AMH) or a low antral follicle count on ultrasound), she may not have as robust (or any) response to stimulation. For these patients, an alternate stimulation protocol may be tried or donated eggs may be used (from a woman known or unknown to the patient).
It is possible that a woman does have the necessary eggs but lacks the appropriate pituitary hormones to respond. In this case, using a different medication- one which may contain both FSH and luteinizing hormone (LH) may allow for an optimal response.
Lifestyle factors can also affect a woman’s response to stimulation. Optimizing weight, diet and stress and cessation of use of tobacco, alcohol and recreational substances can also improve a response to ovarian stimulation.
Photo ID: For your safety, IVF Phoenix™ requires that all patients provide photo identification prior to undergoing any surgical procedure within our facilities.
Responsible Adult: It is our responsibility to insure that you get home safely after your procedure, post- anesthesia. Therefore, you must have a responsible adult, over the age of 18, with whom you have a relationship, accompany you to this surgical appointment. They must stay at the center during your procedure, and be available to take you home after you are discharged. If both you and your partner are having procedures on the same day, we require a 3rd party be available to drive the couple home. We prefer that this person also be available to make sure that you are doing well once you get settled in your home.
No Children: Children are not allowed in the practice on the day of your procedure. Please arrange for childcare prior to arrival. Unfortunately, children cannot be brought with you to your surgical procedure at any time or under any circumstances.
Preparing for My Surgical Procedure with Anesthesia
Diet: Conscious sedations is used in our surgical procedures. If you have never been sedated before, there are important things to remember. For your safety, one important rule is to ensure that you do not eat or drink anything after midnight the night before your procedure. If you have a specific medical condition or special situation, please discuss with your nurse before this time frame.
Appropriate Clothing: Patients should follow these guidelines:
- Wear comfortable clothes
- No jewelry
- No perfume
- Refrain from makeup
- No contact lenses
For most patients arriving to the practice for their egg retrieval, a semen sample will be required by the Embryology Team in order to fertilize the egg(s) after your procedure. Male partners are encouraged to collect their sample at home prior to arriving for the retrieval. Once you arrive, please inform the Reception Desk staff that you have your sample so they can notify the Embryology Team. If you are traveling more than one and a half hours to the practice, you may collect a sample in our offices after you arrive. The period of abstinence from ejaculation is 3 days and no more than 4 days, as sperm DNA fragmentation increases with longer abstinence.
Arrival and Departure for Surgical Procedures
Patients should arrive 90 minutes before your scheduled procedure, or as instructed by your nurse. After checking in at the Reception Desk, the clinical team will bring you and your partner back to the procedure area. Your nurse will check your photo ID, review your recent food and beverage consumption and have you change into a surgical gown. Next, you will meet your Nurse Anesthetist, who will start an IV (intravenous) in your arm for medication administration. The office will review your medical history before beginning your sedation medication. During your procedure, your partner or accompanying adult will wait in the Reception Area. Most of the procedures are completed within 30 minutes. Most of our patients take about 30-60 minutes to recover before they return home. We find that our patients recover best when they are in a familiar, comfortable place usually in their home. From start to finish, patients should expect to be at the practice for 2½ to 3 hours.
If I live out-of-town or internationally, how often will I need to visit IVF Phoenix™? How long will I need to stay?
IVF Phoenix™ requires out of town egg donors or recipients to visit our clinic initially, then if coordinated efficiently and if there is good offsite monitoring, we can expect the patient, to be seen by us at the end of the stimulation cycle, or at the peak of estrogen administration for endometrial development. Unlike many other clinics, mock cycles are not necessarily required. Depending on your circumstances, you will most likely need to be here for five to nine days. This is something your donor egg/ART coordinator will help determine.
One option that some couples choose is to have the male partner visit IVF Phoenix™ for sperm collection prior to the couple’s visit for the woman’s cycle. This option requires the man to travel to IVF Phoenix™ one time, and the couple to travel to IVF Phoenix™ one time.
Yes, but you should refrain from high-impact exercise and opt for workouts such as walking, swimming, yoga, or cycling during IVF treatment. Leading up to the beginning of the IVF cycle you may exercise as you normally do, but as you get closer to the egg retrieval we will ask that exercise be modified for health and safety reasons.
We won’t know the exact date of egg retrieval until two days prior to the procedure. We typically estimate it about 12-15 days from the start of your superovulation medications.
My husband and I are so thankful for Dr. Couvaras and staff. We were struggling to have a family and stumbled across the IVF Phoenix website. We are from Canada and the staff was fantastic to deal with and very accommodating to work with. We always had support no matter what time of the day. We now have the most perfect beautiful little boy to complete our family!!! So grateful and blessed!!!
Dr. Courvaras is the best there is in the infertility world!! Our first baby is here because of him and his team. Our baby is 17 and will be graduating from high school in less than a month!! We have never forgotten him and the gift he helped us have!!
The staff and Dr. Couvaras were so kind and understanding. They called me by name as soon as I walked in. Dr. Couvaras was incredibly knowledgeable and knew from the first visit what was going on and after tests came back he was 100% right. He was informative, personable and took care of my health needs as a priority. I never felt left on the back burner. Innovative for sure because now I have 3 amazing children!
From the moment we met Dr. Couvaras, My husband and I felt totally comfortable, secure, and well informed. Additionally, the nurses and staff at IVF Phoenix provided prompt, efficient care with both expertise and patience. Whether ordering prescriptions, educating me on how to properly administer medications or explaining options and probable outcomes of specific treatment protocols, Dr. Couvaras, and his team were simply remarkable. I never felt alone, and appreciated the close guidance they provided throughout our entire treatment. I couldn’t be happier with the results! My husband and I are now 12 weeks pregnant, and are absolutely thrilled! I would recommend Ivf Phoenix to anyone who is interested in finding the cause of their infertility. We love and appreciate everyone at Ivf Phoenix, they are a 2nd family to us. We still can’t thank them enough for making our dreams come true!
This is hands down the BEST fertility clinic in all of Az. Dr. Couvaras and Rhoda are amazing!! Not only are they compassionate and helpful beyond expectations they really look at the whole body and systems and get to the root of the problem. If you are even thinking about fertility go see this place first!
IVF Bundled Packages
IVF WITH FRESH EMBRYO TRANSFER
IVF WITH FROZEN EMBRYO TRANSFER
IVF WITH BIOPSY & FROZEN EMBRYO TRANSFER
* Once you have completed your consultation with one of our providers, we would be happy to customized a multi-cycle package for you if you are considering embryo banking.
Confused about the next steps to successfully conceive and carrying to live birth?
Please note that the following listed insurance companies are those that we currently partner with. Please call your insurance provider and check to see if your treatment or procedure will be covered.
IVF Phoenix™ is proud to be a Center of Excellence with United Healthcare/Optum