As reproductive endocrinologists specializing in the body’s hormonal and reproductive functions, the doctors at Texas Fertility Center wish to clear up the misconception that treating hypogonadism (Low T) will automatically lead to improved fertility in men.

For couples trying to get pregnant in the setting of male factor infertility, it’s important to work with a fertility specialist and possibly even a urologist in order to monitor sperm counts, hormone levels, and the potential administration of medications. Some patches and gels often prescribed for low libido and fatigue may actually hinder your chances of conceiving by lowering sperm count.

Testosterone’s Role in Conceiving a Baby

• Testosterone is a male hormone (androgen) tasked with transforming a boy into a man during puberty: increasing muscle and penis size, lowering his voice and putting hair on his face and chest, and sex on his mind.

• Testosterone, made by the testicles, signals the brain to make the hormones necessary to drive sperm production; low testosterone can lead to inadequate sperm production, while excessive testosterone (from gels, patches, pills or injections) can also significantly reduce sperm production.

• For these reasons, just like in the famous children’s story – Goldilocks and the 3 bears – it is critically important to make sure that the testosterone level is “just right”!

Is It Low T or Something Else?

Loss of interest in sex, fatigue and erectile dysfunction may be attributed to a drop in testosterone, or it could be caused by other conditions, such as depression, diabetes, genetic disease, heart disease, high blood pressure or obesity.

Testosterone deficiency is blamed for a host of symptoms. The progressive decline in testosterone as men age can sometimes result in a low libido, and low sperm count. When you are trying to get pregnant, Low T can be devastating.

Contact a fertility specialist about blood testing to check your hormone levels, and semen analysis to check your sperm count.

 Want more info on Male Fertility? Visit www.txfertility.com

Are sperm banks as closely guarded and regulated as the institutions that store your money? They should be. Texas Fertility Center partners only with reputable sperm banks, and shares with you here the criteria that we look for when evaluating a sperm bank, as well as the benefits of using a commercial sperm bank.

Stringent Screening Procedures followed at US Sperm Banks

Because semen is capable of transmitting several different types of infections, donor sperm should be double-screened. Upon collection, a reputable sperm bank will run a full panel of tests, checking for infectious disease like HIV/AIDS, hepatitis, syphilis, gonorrhea, and chlamydia before freezing the semen. Then, after a six-month quarantine period, the sperm bank runs the tests again. Only after this follow-up screen is negative will the sperm bank release the stored frozen sperm for use.

The donor himself will undergo genetic, medical, and physiological screenings for inheritable disease like cystic fibrosis and mental illness. A multi-generational medical history will uncover potential problems in a sperm donor’s DNA.

One of the nation’s largest sperm banks, Fairfax Cryobank, only accepts 1 out of 200 applicants because of its tough standards.

Closely Guarded Privacy Policies

When you choose an anonymous sperm donor, you can effectively eliminate the possibility of any future contact with the donor. You will neither meet, nor know the identity of the donor; you will only have access to his health history, physical characteristics and personality traits that are listed online. Depending on the sperm bank that you choose, an ID Option may exist that would allow you to choose a donor open to a meeting after the child turns 18.

Exceeding Regulation Requirements

The U.S. Food and Drug Administration regulates the sperm bank industry to prevent the spread of infectious diseases. Texas Fertility Center chooses sperm banks that go above and beyond to seek accreditation by the American Association of Tissue Banks (AATB) and Better Business Bureau. Only a few states require sperm banks operating within their borders to obtain separate licensing–New York, Maryland and California. Cryopreservation, or sperm freezing, allows Texas Fertility Center to acquire sperm specimens from sperm banks operating in any U.S. state.

Texas Fertility Center can help you choose a reputable sperm bank. If you are interested in donor services to add to or start a family, contact the fertility specialists at Texas Fertility Center.

Infertility is of particular concern to reproductive endocrinologists specializing in female and male infertility. Texas Fertility Center’s founding partner, Dr. Thomas C. Vaughn, shares his tips for protecting and preserving fertility, and boosting sperm health in men.

Maintain a healthful lifestyle. It will come as no surprise that smoking cigarettes or marijuana; drinking to excess; and taking anabolic steroids or illegal substances affect fertility in men. Men produce sperm over a lifetime, with a 74-108 day process to create sperm ejaculated during sex. Curbing unhealthy habits now can have a positive impact on attempts to get pregnant by the end of the summer!

Keep it cool this summer. It’s impossible to avoid steamy summer temperatures around Austin and Round Rock, but easy to say no to saunas, hot tubs and steam rooms. Sperm are produced in the testicles, which naturally moderate temperature by moving closer to the body for warmth, and away to cool things off. Elevating scrotal temperature even a fraction of a degree can temporarily shut down the sperm factory.

Eat fertility-friendly foods. A diet rich in antioxidants, particularly vitamins A and C, has been shown to improve sperm count and movement.* Try Austin’s farmers market foods like guavas, bell peppers, dark, leafy greens, cantaloupe and sweet potatoes this summer.

Practice safe sex. An estimated 2.8 million cases of chlamydia and 718,000 cases of gonorrhea occur annually in the United States, leading to infertility in many cases. Protect yourself and your partner from sexually transmitted diseases (STD) by using a condom and seeing a doctor for annual checkups.

See a fertility specialist. If you have been trying for more than a year to get pregnant, contact a reproductive endocrinologist (fertility specialist) for a semen analysis.

Men’s Health Week leads up to Father’s Day, a holiday that 1 in 7 American couples with infertility desperately hope to celebrate next year. Knowing the facts about male infertility risk factors, and partnering with a fertility specialist when you suspect there is a problem, will help increase your chances for getting pregnant.

For more information on Male fertility Visit www.txfertility.com or Check out the ASRM Fact Sheet on Optimizing  Male Fertility

A new blood test, anti-mullerian hormone or AMH gives women greater insight into the number of egg-containing follicles growing in your ovaries.

Texas Fertility Center research and its clinical application of anti-mullerian hormone (AMH) testing were recently featured on a KVUE segment with Jim Bergamo. The interview with Dr. Natalie Burger focused on diminished ovarian reserve (DOR), a condition all women go through as they near the end of their fertility. According to a 2008 Society for Assisted Reproductive Technology study, diminished ovarian reserve is one of the most common causes of infertility and is the fastest growing infertility problem.

Ovarian reserve is reflective of the number of eggs a woman has remaining in her ovaries. The greater her reserve, ie. the more eggs she has left, the more fertile she is. As women age, they lose eggs at a rapid rate, eventually running out of eggs which results in menopause. Diagnosing DOR is not always easy. Until recently, the most predictive factor was a woman’s age; however several other factors can cause ovarian reserve to diminish more rapidly than normal.

Now, partly due to research performed by the Texas Fertility Center, women can undergo simple testing that can tell them where they are in their reproductive lifespan. If their testing suggests DOR, they can then take proactive steps to start a family, optimizing the use of their remaining eggs.

 Do you know someone that needs fertility help? Let them know about free fertility testing in June!

What causes diminished ovarian reserve?

• Aging
• Genetics
• Autoimmune issues
• Idiopathic, (i.e. unexplained) reasons
• Radiation therapy
• Pelvic surgery

How do we predict future fertility?

The closest science can come to counting eggs contained in a woman’s ovaries involves measuring blood levels of specific hormones.
Traditionally, fertility specialists looked at follicle stimulating hormone (FSH) levels on day 2 or 3 of the menstrual cycle. FSH is the hormone that causes eggs to mature during a woman’s menstrual cycle. When a woman is young and her ovaries are full of eggs, her FSH level is low. As she ages or runs out of eggs due to other causes such as genetic factors, smoking, or ovarian surgery, FSH levels rise.

Recent TFC research – presented at the annual meeting of the American Society for Reproductive Medicine – demonstrated that AMH testing is also very predictive of fertility. A woman’s AMH level isn’t detectable until puberty. It then steadily diminishes with age, until it essentially disappears after menopause. To use a baseball analogy, the newer AMH test measures the eggs on the bench, but not yet up to bat. Unlike FSH levels, AMH levels remain constant throughout a woman’s menstrual cycle so fertility specialists can perform this test any day of the month.

A very low AMH level indicates that there are few remaining eggs.

A higher AMH level is a good predictor of future fertility, and a successful response to ovarian stimulation prior to in vitro fertilization (IVF) or intrauterine insemination (IUI).

According to Dr. Burger, determining the true normal range for AMH testing is an ongoing process, as this test is still relatively new. Research like that performed at TFC, however, will go a long way toward validating this test as an accurate predictor of female fertility.

Texas Fertility Center, one of the nation’s leading fertility practices, has performed ground breaking research on the value of AMH as a predictor of fertility. Based partially on our research, more and more fertility practitioners are incorporating AMH levels into their routine fertility evaluations.

To read Texas Fertility Center’s research on AMH testing  “Both AMH and Day 3 FSH Levels Predict IVF Stimulation Outcome Regardless of Patient Age; Day 3 Estradiol Levels Are Not Predictive“ Visit the TFC Research Library.

Have a friend the just “wants to know” about her fertility? Free fertility testing is available through the month of June to all new TFC patients.

Q: You were once chief resident, and likely had your pick of sub-specialties. Why did you choose reproductive endocrinology?

A: We perform rotations as interns, so I spent time with reproductive endocrinologists during my residency. I saw my first ultrasounds during that time, and experienced moments when couples saw or heard the baby’s heartbeat. That joy peaked my interest

I love the amazing things we as fertility specialists can do for people. For example, preimplantation genetic diagnosis (PGD) can eliminate the threat of genetic diseases such as cystic fibrosis (CF). Finally, I’m drawn to the cutting edge technology that drives reproductive endocrinology. Fertility is an exciting field, and one that is constantly changing. I’ve practiced medicine for more than a decade, and there is always something new on the horizon.

Q: What do you like best about San Antonio, your new hometown?
A: Well, as the mom of twin 10-month-old daughters and lead physician at one of San Antonio’s newest fertility clinics, I haven’t had much time to explore! Everyone tells me I will love it, and I already have discovered that family-friendly San Antonio is a big city with a small-town feel.

Q: You have twins, so I’m sure you have fielded this question: Have you experienced fertility first-hand?
A: I’m not shy about telling people that it took me three years to get pregnant. We progressed from ovulation induction with Clomid, to IUI, and then three cycles of in-vitro fertilization (IVF). After lots of fertility treatment, it took IVF to get the job done.

Q: What do you want people to know when they begin fertility treatment?
A: First, most of the time I find something treatable. In fact, most couples will get pregnant within the first few months of fertility treatment. I don’t always know immediately what the fix is, but if you can stick with a fertility regimen, you will almost certainly create the family you want.

Q: What do you like to do in your spare time?
A: Did I mention the twins? When I have the time, though, I am an avid sports fan, and enjoy working out and lifting weights.

Fertility specialists and all those affected by the disease of infertility will converge on Capitol Hill in Washington D.C. this month as part of the National Infertility Association (RESOLVE) Advocacy Day (resolve.org/advocacyday) on May 8. Texas Fertility Center has a long history of participating in advocacy efforts, both at the state and national level.

In May 2011, March, 2012, and March, 2013, Dr. Kaylen Silverberg represented TFC and couples and individuals undergoing fertility treatment by advocating in Washington for the Family Act. At the time, it was new legislation calling for a tax credit for out-of-pocket costs of fertility treatment. The bill (S 965/HR 3522) died in the 112^th Congress, but the bill is being reintroduced in the 113^th Congress.

*It took nine years to get the Family and Medical Leave Act passed, so TFC will continue to push for the Family Act until it becomes law!

Ask for Infertility Coverage

Dr. Silverberg continues to communicate with Texas State Senators John Cornyn and Ted Cruz, as well as Representatives Michael McCaul, Lamar Smith, and John Carter about the challenges of providing infertility treatment without funding and research support that would help millions of Americans start a family. We want to hear from you, too, about how the Family Act could help you better afford treatment.

Texas Fertility Center is committed to raising awareness and educating our elected officials about the physical and financial burden of infertility. Join us in speaking up for infertility coverage.

Your 3 Infertility Advocacy Action Items

1. Post on the TFC Facebook page, and let us know your thoughts on the cost of IVF and fertility treatment.
2. Contact your Texas representatives and weigh in on the Family Act. They can’t represent you if they don’t know how you feel about the issues!
3. Tell your friends and family to support the Family Act of 2011.

The TFC physicians and support staff care about your struggle with infertility, and join in the ongoing fight to increase awareness, advance medical research and make fertility treatment accessible and affordable for more Americans.

A new way to view Mother’s Day

Here are a few spectacular women that gave selflessly to society, without giving birth. Texas Fertility Center salutes these mothers of movements that changed the world:

1. Anna Jarvis Considered the mother of Mother’s Day, Anna was the 9^th of 11 children but never had children. In honor of her late mother and a graveside promise, she devoted years to letter-writing campaigns and advocacy efforts that finally resulted in a proclamation in 1914 making the second Sunday in May Mother’s Day.
2. Mother Theresa At 17, she left her family to travel to Ireland and then India, eventually devoting her life to the poor. She received the Nobel Peace Prize in 1979. When the Pope gifted her his ceremonial limousine, she raffled it off to build a leper colony.
3. Mary Eliza Mahoney The first black professional nurse in America pursued her dream when she was just 18. She was a leader and one of the first black members of what would become the American Nurses Association (ANA), an activist in the suffrage movement and director of the Howard Orphan Asylum in New York.
4.  Jane Addams The 8th of nine children, Jane Addams was a feminist and activist in Chicago whose father was a friend of Abraham Lincoln’s. In 1889, she founded a community center called Hull-House that offered preschool programs, education, arts and vocational training to the immigrant community in Chicago.

As you focus on getting pregnant and infertility treatment, don’t overlook the woman you were born to be: What are your hopes and dreams for making the world a better place?

Texas Fertility Center actively works for positive change in our community, and also encourages you to recognize the women in your life that have shaped and influenced you.

Your fertility doctor may someday prescribe a vaginal ring to deliver progesterone to you during a cycle of IVF. Good news for women who prefer to avoid a needle stick! Widely used for contraception, vaginal rings may in the future also provide an alternative to daily administration of progesterone gel or progesterone injections during the luteal phase after embryo transfer.

Texas Fertility Center and Dr. Kaylen Silverberg recently spearheaded a research study that found pregnancy rates using the vaginal ring were not significantly different than those achieved with progesterone vaginal gel. The participants in the study were evaluated by both cause and duration of infertility, and the goal of the study was to compare the effectiveness of two different delivery methods for progesterone – vaginal gel and the vaginal ring.

What does the vaginal ring study mean for you, a woman undergoing fertility treatment?

Texas Fertility Center concluded that the progesterone vaginal ring is effective for luteal phase supplementation in IVF, regardless of duration or cause of infertility.

Why do you need progesterone during the luteal phase?

Progesterone, a hormone naturally produced to nourish and prepare the uterine lining to cradle a growing baby, also helps to sustain a pregnancy. During the IVF retrieval, the cells that make progesterone are removed from the ovaries along with the eggs. Fertility specialists therefore routinely prescribe progesterone after an IVF cycle to supplement the significantly reduced amount of progesterone that is produced by your ovaries after retrieval.

How does a vaginal ring work?

You insert the flexible, silicone vaginal ring once a week into (you guessed it) the vagina. The main ingredient – natural micronized progesterone – is then released slowly exactly where you need it most.

If you are starting a cycle of IVF, talk with your TFC doctor about luteal phase progesterone support, and the benefits of using a vaginal ring versus daily gel or intramuscular injections.

One of our fertility specialists, Dr. Kaylen Silverberg, says: “Even if you understand the IVF rates and how to read them, it’s hard to apply this information to grade clinics.”

If you are considering IVF, it’s important to know how IVF success rates are calculated, and how to read the data.

TFC Top 5 Tips to Evaluate IVF Success Rates

1. Ask about live birth rates. Our fertility clinic has welcomed over 12,000 babies into the world. We strike a balance of recommending the fertility treatment most likely to lead to a pregnancy, and respecting the wishes of couples that want to pursue IVF despite obstacles.
2. Don’t settle for average. A leading fertility clinic, like Texas Fertility Center, will report above average statistics year after year.
3. Is the fertility clinic experienced in IVF? The number of IVF cycles performed in a year should average out to at least 2 per week (or 120 total).
4. Compare apples to apples. Evaluate the statistics that apply to you: age group and anticipated type of IVF cycle (donor egg, fresh or frozen transfer).
5. Choose an IVF clinic that prioritizes your hopes and dreams over success rates. It’s possible to stack the deck in IVF success rates by only accepting patients with a good chance for an optimal outcome. TFC takes on difficult cases because we have the expertise and experience to beat the odds.

IVF fertility treatment requires you to make a significant physical, financial and emotional investment. You might consider traveling to an out-of-town fertility clinic for better IVF success rates.

Contact Texas Fertility Center at our Austin, Round Rock or San Antonio clinics to learn more about our IVF protocols and IVF success rates.

Our TFC fertility nurses, reproductive endocrinologists and office team feel your pain, but may not have experienced infertility firsthand. We tend to focus on high IVF success rates, the promise of restored fertility and positive outcomes. That’s why we hold our annual IVF Baby Reunion, after all. It reminds us that new families are born out of the sacrifices.

How Did You Survive Infertility?

We’ll ask our friends on Facebook and followers on Twitter to share some words of encouragement for current TFC patients, as well as the greater Austin and San Antonio infertility community.

Watch for updates on our social media sites and blog feeds. Meanwhile, we’ll get the conversation started.

Encouraging Words from the Texas Fertility Center Staff:

• “Take care of yourself! It’s important to focus on wellness during infertility treatment, so I like to encourage couples to plan a regular date night, load up on whole foods, exercise and get enough sleep.”
• “Subscribe to Pinterest and its Motivational Monday quotes.”
• “Fertility envy is real and unavoidable. Don’t feel guilty about insulating yourself from baby showers and children’s birthday parties. However, it’s also important to recognize the efforts of family and friends that try to soften the news when they get pregnant.”
• “Start a journal, and look back along the journey to applaud your own strength and courage! Remember—infertility is a disease, not a character flaw. You are making every effort to overcome.”

April 21-27 marks Infertility Awareness Week, and Texas Fertility Center will do its part to communicate a message of hope. You will survive infertility, and we will provide support and medical empowerment throughout this trying time. If you haven’t already partnered with a fertility specialist, contact us here.