Penn Fertility Care | Questions and Answers | Penn Medicine

We are interested in IVF and the gestational carrier program, but have many questions. Can you help?

2013-06-03T08:13:00.000-04:00

Piero asks: Hi we are an Italian couple, I'm 45 and my wife is 39. We already have a 9-year-old daughter and we wish to have one more child, but due to asherman syndrome (endometrium adhesions that partially close the uterus cavity) my wife cannot carry the baby. We have good gametes from several test results and so we want to use our eggs and sperm, excluding any donors. We are interested in IVF and the gestational carrier program. Is there list of fees and costs? What is included and what is not (for ex. medicines, ultrasound, etc)? Our interest, obviously, is to keep down costs, still looking at quality of services and success rate, is there any chance? How many oocytes do you normally obtain with stimulation and how many embryos with IVF? Also, how many embryos do you transfer to the carrier per time? Waiting for your answer, ciao.

Samantha M. Pfeifer, MD responds: Success of IVF is dependent on the age of the woman. The number of eggs obtained depends on the woman's age and her ovarian reserve. We like to have more than 5 follicles present after stimulation to go through the egg retrieval process. The average 39 year old woman will get approximately 5-10 eggs, unless there is a decreased ovarian reserve. Our program follows the American Society for Reproductive Medicine Guidelines for the number of embryos to transfer - on average 2-4 in this age group depending on fertility/reproductive history, quality of embryos, and stage of embryos (example: day 3 or 5 after retrieval).

Financial costs vary depending on your insurance coverage. Some insurances cover diagnostic services, ultrasound and blood work, while others may cover diagnostic services and procedures. The same applies for medications. Some insurance benefits cover medications and others do not. The cost is determined by the medication and the dose that is prescribed. At Penn Fertility Care we have financial counselors that will meet with you to review your insurance benefits and answer any questions related to your financial concerns.

If you would like to schedule an appointment with a Penn Fertility Care specialist, please contact 1-800-789-PENN (7366) or request an appointment online.

How can you get pregnant with low FSH?

2012-04-11T09:38:00.001-04:00

Mary asks:How can you get pregnant with low FSH?

Penn Medicine responds:
We suspect you mean FSH (follicle stimulating hormone). Each person is different. To advise you properly, we would have to review your health history to get a complete picture of what is going on — i.e. other hormone values, weight loss, etc.

If you would like to have an evaluation, we would be happy to help. To schedule a consultation, please call 1-800-789-PENN (7366) or request an appointment online.

Are you a participating provider with United Healthcare?

2011-09-15T12:18:00.003-04:00

Tina asks: Are you a participating provider with United Healthcare?

Penn Fertility Care responds: Yes, we do participate with United Healthcare and a variety of other insurance programs. Learn more about financial options at Penn Fertility Care:

To schedule an appointment with a Penn Fertility Care specialist, please call 800-789-PENN (7366) or request an appointment online.

If I donate will I still be able to have my own child?

2011-09-15T12:17:00.005-04:00

Kriskat11 asks: If I donate will I still be able to have my own child?

Penn Fertility Care responds: Yes, even if you donate some of your eggs you can still have children of your own later in life. Penn Fertility Care has a donor egg program for those who are interested in donating. Learn more at pennmedicine.org/fertility/patient/clinical-services/donor-egg-program/.

To schedule an appointment with a Penn Fertility Care specialist, please call 800-789-PENN (7366) or request an appointment online.

At my age, is it possible to consider using an egg donor?

2011-09-15T12:12:00.005-04:00

Kelly asks: I will be 45 this year and would like to have a baby with my new husband. I have a 14 year old and he has 2 children. Because of my age I am considering using an egg donor. Is that possible at my age? Thank you.

Monica A. Mainigi, MD responds: Many women in their 40's have children using in vitro fertilization with an egg donor. Whether at 45 this is a reasonable option for you depends on your health, your ability to carry a preganacy, and your partner's semen analysis. A fertility specialist could help assess whether egg donation is a reasonable option for you and help you with the process of selecting an egg donor and the egg donation process.

To schedule an appointment with a Penn Fertility Care specialist, please call 800-789-PENN (7366) or request an appointment online.

Is there a waiting list for embryo donation?

2011-09-15T11:56:00.003-04:00

Deb asks: Is there a waiting list for embryo donation and if so how long?

Penn Fertility Care responds: Yes, currently there is a waiting list for the Donor Embryo Program at Penn Fertility Care. The list size varies so please contact us to determine if you are a candidate and what the current wait may be.

To schedule an appointment with a Penn Fertility Care specialist, please call 800-789-PENN (7366) or request an appointment online.

Is there an age cap for donor egg receipients?

2011-09-15T11:46:00.005-04:00

Anna asks: Do you set an age cap for donor egg receipients? I have 3 biological children and another from embryo donation. However, I have suffered 7 miscarriages and want to use donor eggs.

Steven Sondheimer, MD responds: For most individuals, deciding to undergo fertility treatment is a difficult decision. This is especially true as one gets older. As each person is different, we meet with patients desiring fertility treatment and do a complete evaluation. This may include directing them to a counselor to help decide on a medical fertility treatment, meeting with a maternal fetal medicine specialist or meeting with a geneticist to help with the decision making process.

To schedule an appointment with a Penn Fertility Care specialist, please call 800-789-PENN (7366) or request an appointment online.

I have not received my information packet in the mail. Can you email me instead?

2011-07-25T09:49:00.016-04:00

Marvin asks: I called about your Donor Embryo Program and was supposed to receive a packet of information in the mail. It has been three weeks and I have not received anything yet. Is there an information packet that can be emailed to me instead?

Penn Fertility Care responds: We are researching your request and would like to reach out to you directly. Please give us a call at (215) 662-6100 as this public forum does not provide us with your email address and contact information. You may also generate a new request for information by calling 1-800-789-PENN (7366).

To schedule an appointment with a Penn Fertility Care specialist, please contact 1-800-789-PENN (7366) or request an appointment online.

Are there any fertility treatments available over-the-counter?

2011-07-18T09:36:00.004-04:00

Jennifer asks: I have been trying to get pregnant for almost a year now with no success. One person told me to start taking prenatal vitamins because it increases fertility in a woman, but I still have not become pregnant. I am afraid I am infertile. Are there any fertility treatments available over-the-counter? Is there anything I can do to become pregnant?

Samantha Butts, MD MSCE responds: I would advise that after one year of trying to become pregnant you should be seen by a doctor who specializes in the treatment of patients who are having difficulty achieving a pregnancy. In many cases, explanations can be found during a thorough evaluation of you and your partner that provide the doctor with options to treat you and increase your chances of becoming pregnant. Many options exist that help many couples achieve a pregnancy.

Prenatal vitamins do not increase the chances of becoming pregnant but you should still take them every day. They are important for the health of a baby and can prevent specific birth defects in babies.

If you would like to schedule an appointment with a Penn Fertility Care specialist, please contact 1-800-789-PENN (7366) or request an appointment online.

I am 20 years old, can I still be an egg donor?

2011-07-18T09:26:00.012-04:00

Tashianna asks: I am 20 years old, can I still be an egg donor?

Penn Fertility Care responds: To start the screening process to become an egg donor you must be 21-years-old.

If you would like to schedule an appointment with a Penn Fertility Care specialist, please contact 1-800-789-PENN (7366) or request an appointment online.

Is it possible for me to be a surrogate for my girlfriend?

2011-07-18T09:26:00.011-04:00

Skipper asks: Is it possible for me to be a surrogate for my girlfriend - meaning I carry her biological baby? Can I do this if I have never carried a child before?

Samantha Butts, MD MSCE responds: In order to determine if you could carry a child for your girlfriend, you would both have to be evaluated by a fertility specialist. At a meeting like this, the doctor would obtain a medical history on you both to understand what your reproductive needs are and will provide you with information about what treatment options are available and what they require from you both.

If you would like to schedule an appointment with a Penn Fertility Care specialist, please contact 1-800-789-PENN (7366) or request an appointment online.

What occurs at the first appointment at the fertility center? Does the couple attend the first appointment together?

2011-07-14T08:26:00.001-04:00

Selena asks: What occurs at the first appointment at the fertility center? Does the couple attend the first appointment together?

Samantha F. Butts, MD , MSCE responds: At the first visit, your doctor will ask you questions about your health, your general medical history and your history of any gynecologic problems. This information is important because it adds to an understanding of risk factors for infertility. If you have had important studies related to infertility treatments or testing from another doctor you should arrange to have those sent to the new doctor's office ahead of time (and call ahead of time to verify that they have been received) or bring the records with you. If your doctor does not get your records ahead of time, you should expect that he or she will have to dedicate time after the appointment to do a thorough review of these studies.

You may be examined during this visit and possibly be offered a pelvic ultrasound (typically done vaginally) to examine your uterus and ovaries. This is an important part of the evaluation.

Your doctor will also order lab tests for you, many of which will look at hormone levels that are important for understanding your fertility. Some of these tests can be done at anytime, but some can only be done at certain time during your menstrual cycle so be prepared to possibly need to get your blood drawn more than once during this process. You will most likely have some additional studies ordered (x-ray or ultrasound) that are designed to look at your uterus, fallopian tubes and ovaries.

If you have a male partner (as opposed to needing/requesting sperm from a sperm bank for instance) he will be asked to collect a sample of sperm to perform a semen analysis. Specific instructions will be provided for this process.

Finally, your doctor will want to know if your routine medical care is up to date. You should have seen your gynecologist and your primary care doctor (and of course any specialists you see) within the last year and gotten a clean bill of health from them. It is very difficult to move forward with infertility treatments if you have medical problems that are not controlled or monitored - we worry that these problems could become worse in pregnancy and jeopardize your health and the health of your baby.

Don’t be surprised if it takes between 4 to 6 weeks for a complete evaluation. Some of the results can take more than a week to come back. We typically recommend that you schedule a follow-up appointment at least one month after your initial visit to review all your test results and make treatment recommendations. Also, your doctor may ask you to repeat some tests that have already been performed, especially if the initial result was not normal.

If you would like to schedule an appointment with a Penn Fertility Care specialist, please contact 1-800-789-PENN (7366) or request an appointment online.

I was wondering how much a tubal reversal will set a family back?

2011-07-14T08:24:00.001-04:00

Wendy asks: I was wondering how much a tubal reversal will set a family back?

Penn Fertility Care responds: The cost of a tubal reversal procedure varies according to practice location, hospital, and health insurance coverage. An option that is, on average, less expensive is in vitro fertilization (IVF). IVF involves stimulating your ovaries with medication and using a needled to obtain the eggs from your ovaries. These can be fertilized with your husband’s sperm in the laboratory (in vitro) and the resulting embryo(s) can be transferred back into your uterus: bypassing your tubes altogether. The best option is to schedule a consultation with a specialist in reproductive endocrinology who can discuss both IVF and tubal reversal.

If you would like to schedule an appointment with Penn Fertility Care, call 800-789-PENN (7366) or request an appointment online.

Will you take a patient at age 43? Also, Where can my male partner go to receive tests?

2011-07-14T08:20:00.002-04:00

Lynn67 asks: I am 43 years old and was diagnosed with infertility in 1995 due to crushed/twisted fallopian tubes. I went through IVF in 1996 but it did not result in pregnancy. I would like to try again but would also like my partner’s sperm to be tested for count and mobility. Will you take a patient at my age? Also, where would my partner have to go to receive his test?

Steven Sondheimer, MD responds: I think you should arrange a meeting with an infertility specialist. I would be glad to meet with you and your partner to review your history and records.

Each person and couple is different and I cannot give you specific answers without all the information. Your partner should schedule a semen analysis and the two of you should schedule a consultation. Obtain as much of your records before hand so that the visit can be most productive. Also write down questions even before you arrive.

In general, as a women gets older the interventions we use to help make pregnancy possible such as IVF are less likely to be successful. If blocked fallopian tubes are your cause of infertility we can evaluate the number of eggs remaining in your ovary and give you a better idea of the chances of success with your eggs and IVF.

If you would like to schedule an appointment with a Penn Fertility Care specialist, please contact 1-800-789-PENN (7366) or request an appointment online.

Does Penn reimburse the cost of IVF if it is not successful?

2011-06-23T13:39:00.001-04:00

Boss asks: Does Penn reimburse the cost of IVF if it is not successful?

Penn Fertility Care responds: Penn Fertility Care does not reimburse for unsuccessful IVF cycles. However, we do have a partnership with Advanced Reproductive Care (ARC). ARC provides affordable and convenient financing as well as a Refund Guarantee program. For more information you can contact one of our Financial Counselors or visit ARC’s website.

If you would like to schedule an appointment with a Penn Fertility Care specialist, please contact 1-800-789-PENN (7366) or request an appointment online.

I had a tubal ligation in 2003 and got married. I can’t afford to get my tubes untied. What is my best plan for me and my husband to have a baby?

2011-06-06T14:05:00.001-04:00

Lisa asks: I had a tubal ligation in 2003 and got married. I can’t afford to get my tubes untied. What is my best plan for me and my husband to have a baby?

Scott E. Edwards, MD responds: The two options available are in vitro fertilization (IVF) and a tubal reversal procedure. IVF involves stimulating your ovaries with medication and using a needled to obtain the eggs from your ovaries. These can be fertilized with your husband’s sperm in the laboratory (in vitro) and the resulting embryo(s) can be transferred back into your uterus: bypassing your tubes altogether. The cost of both procedures will vary according to insurance coverage, although on average IVF may be less expensive since it doesn’t require hospitalization and as much care in the operating room. However, costs will vary according to practice location, hospital, and health insurance coverage. Both procedures have a good chance for success but, of course, will vary according to a person’s age and particular health issues. The best option is to schedule a consultation with a specialist in reproductive endocrinology who can discuss both IVF and tubal reversal.

If you would like to schedule an appointment with Penn Fertility Care, call 800-789-PENN (7366) or request an appointment online.

How often can I donate eggs?

2011-06-01T14:47:00.001-04:00

Jen asks: How often can I donate eggs?

Anuja Dokras, MD, PhD responds: The American Society for Reproductive Medicine states that there are no clearly documented long term risks associated with oocyte donation; therefore, there are no definite data on which to base absolute recommendations. However, due to potential health risks it seems prudent to consider limiting the number of stimulated cycles in a given donor to approximately six. Donors should wait a minimum of two months between cycles.

If you would like to schedule an appointment with a Penn Fertility Care specialist, please contact 1-800-789-PENN (7366) or request an appointment online.

I have one child and would like another but I am having trouble. What could we be doing wrong?

2011-05-24T08:44:00.004-04:00

Angie asks: I've had one child and that was 3 yrs ago. Now we would like another but have been unsuccessful. I don't think it has to do with my weight because 4 yrs ago I weighed 230 lbs and now I weigh 185 lbs. What could we be doing wrong?

Clarisa R. Gracia, MD, MSCE responds: There are a variety of reasons why you might be having trouble getting pregnant. If your menstrual cycles are irregular, you could have an ovulation problem (not be releasing an egg). There could be a blockage in your fallopian tubes, or your husband may have a low sperm count. Other factors may also be playing a role such as your age. I recommend that you see a physician who treats women for infertility to find out what might be going wrong. Best of luck!

If you would like to schedule an appointment with a Penn Fertility Care specialist, please contact 1-800-789-PENN (7366) or request an appointment online.

IVF did not work for us. What services can Penn Fertility Care offer to give us hope of becoming parents?

2011-05-17T08:47:00.002-04:00

Ana asks: I just turned 36 and my husband is 39. We have been trying to get pregnant for past 10 years; two years ago our third IVF attempt failed. None of our embryos lived more than a week (each retrieval we had several spares) and our doctor at another fertility clinic was unable to give us any explanation as to why it did not work for us, why embryos stopped growing, or what to do next. He suggested trying donors. Do you have any advice? What services can Penn Fertility Care offer to give us hope of becoming parents?

Kurt Barnhart, MD, MSCE responds: Penn Fertility care provides a full range of services for couples trying to become parents. We offer comprehensive evaluation of men and women as well as treatment options ranging from ovulation induction, intrauterine insemination, IVF, ICSI, egg donation, embryo donation and pre-implantation genetics. To best determine the specific treatment to help your situation a full consultation is recommended. We look forward to assisting you in your desire to be a parent.

If you would like to schedule an appointment with a Penn Fertility Care specialist, please contact 1-800-789-PENN (7366) or request an appointment online.

Do you offer cryopreservation of embryos?

2011-05-17T08:45:00.001-04:00

Andrea asks: Do you offer cryopreservation of embryos?

Clarisa Gracia, MD, MSCE responds: Penn Fertility Care does offer embryo cryopreservation. We also offer a full range of services for couples trying to become parents. If you would like to learn more about our program you please feel free to schedule a consult with one of our physicians.

If you would like to schedule an appointment with a Penn Fertility Care specialist, please contact 1-800-789-PENN (7366) or request an appointment online.

A urologist prescribed my partner clomid. Is it time for us to see a fertility specialist or should we wait to see if the clomid works?

2011-05-17T08:42:00.002-04:00

Monk asks: My cycle is irregular, but that issue is being helped by medroxyprogesterone. All of my hormone levels are fine. My significant other has had a semen analysis and blood work. The blood work revealed low testosterone levels and the semen analysis revealed low motility. The urologist prescribed him clomid. I have been seeing my gynecologist and he has been to the urologist. Is it time for us to see a fertility specialist or should we wait to see if the clomid works?

Monica A. Mainigi, MD responds: It sounds as if your doctor(s) have already identified possible causes of your infertility and started treatment, which is great. Treatment with clomid may improve your husband’s testosterone and in turn, improve his semen parameters. He should have another semen analysis after 3 months of treatment to determine if the treatment is working and if his motility has returned to normal. If his count or motility is still low, a fertility specialist can discuss other treatments that may increase you chance of pregnancy.

Even if his semen analysis returns to normal on clomid, with your irregular cycles it is difficult to know if you are ovulating (releasing an egg) every month. Even if you do ovulate, with irregular cycles it can be difficult to time intercourse to maximize your chance of pregnancy. A fertility specialist can help determine if/when you ovulate and if not, discuss what options are available.

If you would like to schedule an appointment with a Penn Fertility Care specialist, please contact 1-800-789-PENN (7366) or request an appointment online.

Can my husband's anti-seizure meds affect our fertility?

2011-05-12T08:51:00.002-04:00

J asks: Can my husband's anti-seizure meds affect our fertility? It took us over 2 years to get pregnant (resulted in a miscarriage at 19 weeks). We have been trying for the past 6 months and still not pregnant. We are both 32 years old and all other test results are normal.

Samantha Butts, MD, MSCE responds: If your husband has a normal semen analysis (normal concentration of sperm, normal amount moving and normal shapes of the sperm) it is unlikely that his anti-seizure medication is a problem. If the medicine were effecting his fertility in a substantive way, this would be detected on the semen analysis.

That being said, there is clinical evidence that some medications used to treat epilepsy (such as valproic acid, oxcarbazepine, and carbamazepine) might negatively impact hormonal levels in a way that increases sperm morphologic defects. Again, in anyone with a normal semen analysis, I would find it difficult to explain a couple's infertility by exposure to anti-seizure medications.

If you would like to schedule an appointment with a Penn Fertility Care specialist, please contact 1-800-789-PENN (7366) or request an appointment online.

I had a miscarriage and haven't been able to get pregnant since. When should I see a Reproductive Endocrinologist?

2011-05-11T08:10:00.002-04:00

Hemi ask: I have been pregnant 3 times (2 were terminations and 1 was a 2 trimester miscarriage). I was 15 years old with the first pregnancy and 20 years old with the second. It took almost 3 years of unprotected sex to get pregnant the 3rd time. It's been 6 months since my miscarriage and I still have not been able to get pregnant again. I have very regular cycles (every 27-28 days). When should I see a Reproductive Endocrinologist?

Scott Edwards, MD responds: In general, an evaluation should be undertaken after 12 months of unprotected intercourse in women under the age of 35. Because fertility begins to decline after the age of 35, it is reasonable to begin an evaluation after 6 months of unsuccessful attempts. However, given that it took you 3 years in the past it would be reasonable to undergo an evaluation at this time. An initial evaluation would include an evaluation of the uterine cavity and fallopian tubes, a semen analysis, and usually some measure of the health of the eggs within the ovaries.

If you would like to schedule an appointment with a Penn Fertility Care specialist, please contact 1-800-789-PENN (7366) or request an appointment online.

I have been having a hard time conceiving and I don’t know why I’m not able to have a baby. Can you help?

2011-05-05T11:37:00.001-04:00

Rasheeda asks: I have been having a hard time conceiving and I don’t know why I’m not able to have a baby. Can you help?

Penn Fertility Care responds: There are multiple reasons why you may be having trouble getting pregnant. It is recommended that women under age 35 who have been unable to conceive after a year of trying to get pregnant or women age 35 and over who have been unable to conceive after six months of trying to get pregnant, see a fertility specialist for a fertility evaluation to help determine the cause of infertility. In addition the male partner needs to be evaluated as well since approximately 40 percent of fertility issues stem from the male. We would be happy to meet with you for a fertility consultation.

If you would like to schedule an appointment with a Penn Fertility Care specialist, please contact 1-800-789-PENN (7366) or request an appointment online.

I had a tubal ligation and I regret this decision. Am I able to have the procedure reversed?

2011-05-05T11:34:00.001-04:00

Tina asks: I had a tubal ligation and I regret this decision. Am I able to have the procedure reversed?

Penn Fertility Care responds: Yes, we do perform this type of reversal surgery at Penn Fertility care, however; it is not always successful as tubal ligation is meant to be permanent.

One option to consider is in vitro fertilization. It does not involve major surgery and has a success rate of up to 50 percent per cycle for women less than 35 years of age.

We suggest obtaining records of your tubal ligation and setting up a consultation with a fertility specialist. Bring your records with you to your consultation so you and the specialist can discuss the issue at hand.

If you would like to schedule an appointment with a Penn Fertility Care specialist, please contact 1-800-789-PENN (7366) or request an appointment online.