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  • Getting Intentional about Third-Party Reproduction

    When you decide to pursue third-party reproduction as an alternative to childlessness or adoption, you solidify your intentions to become a parent. As an intended parent in Texas Fertility Center’s donor services program, you can achieve your dream of growing or starting your family through the use of donor eggs, donor sperm, and/or gestational surrogacy.

     

    The dream team: intended parents, donors and fertility doctors

    The term ‘intended parent’ refers to the individual or couple who will take home and parent the baby. Intended parents have typically exhausted all other infertility treatment options.  Alternatively, they may be a same-sex couple who wishes to share a biological connection with their child. Fertility doctors and donors help make pregnancy conceivable for intended parents.

     

    Through third-party reproduction, known or anonymous donors supply eggs, sperm, or even embryos to a recipient couple. Gestational carriers step in when a woman is unable to carry her own baby due to a medical condition, when her uterus has been removed, or when it has been damaged to the point where it is not safe or possible for her to carry a pregnancy.

     

    Preparing to become an intended parent

     

    Conceiving a baby through the involvement of a third party will require mental preparedness. The staff at Texas Fertility Center can connect you with other parents who have walked this less-traveled path, and counselors that can support you throughout the grieving and acceptance process. Whether you use a known donor (a friend or relative) or an anonymous donor, there are many factors to consider before you proceed.

     

    If you are struggling emotionally as you consider the option of donor services, take heart. The physically and mentally exhausting steps you take to get pregnant will have lifelong rewards. More than 80 percent of people who partner with a fertility specialist, like those at Texas Fertility Center, will conceive a child. Five years from now, the candles on the birthday cake will burn just as brightly for the child conceived with the help of third-party reproduction.

     

    As Texas state law only affords statutory legal protection to married couples using gestational carriers, we are unable to offer gestational surrogacy to either same sex couples or to unmarried heterosexual couples.

     

    If you have questions about intended parents and third-party reproduction, contact Texas Fertility Center for answers, or check out our Intended Parent FAQ page. Our in-house donor egg program is led by caring professionals who strive not only for excellent pregnancy rates, but also for outstanding clinical and emotional outcomes as well.

     

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    Texas Fertility Center

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  • Gestational Surrogacy

    For women and couples who are unable to conceive due to an irregular or absent uterus – or if other fertility treatments have failed – gestational surrogacy may allow them to grow the family of their dreams. Gestational surrogacy (a.k.a. gestational carriage) is the scenario in which the woman carrying the pregnancy is not genetically related to the child and this is legal in the state of Texas. Traditional surrogacy, where the surrogate is genetically related to the child, by way of using her own eggs, is illegal in the state of Texas.

    In the process of gestational surrogacy, eggs are removed from the intended mother, fertilized with the intended father’s sperm, and then they are placed into the uterus of a gestational carrier. This individual then carries the pregnancy until delivery, when the baby or babies are reunited with the parents. Donor eggs or donor sperm can also be used to help create the pregnancy.

    Tens of thousands of children have been born as a result of gestational surrogacy – which is exciting to think about considering that the technology that enables us to perform gestational surrogacy has only been around for less than 30 years.

    It is becoming more common to discuss infertility issues more openly – including scenarios of gestational surrogacy. Some ‘famous’ people who have disclosed using a gestational surrogate recently include Elton John, Sarah Jessica Parker, and Nicole Kidman.

    It is still common, however, to have misconceptions about the process. Here are some of the more common myths about gestational surrogacy:

    Myth: You have to know the surrogate who will carry your pregnancy.

    Fact: If you are in need of a surrogate, your options could be either having someone in your life (i.e. sister or friend) in this role – or you could work with an agency that can provide a qualified surrogate for you.

    Myth: Most surrogates will not want to give up the baby.

    Fact: In most cases, surrogates already have children of their own. It is often the love for their own children that drives women to give other couples the same possibilities that they had in experiencing parenthood.

    Myth: Any woman can become a gestational surrogate.

    Fact: Even though most women could biologically carry a pregnancy for intended parents, there are a number of criteria that a gestational carrier must possess before being selected by a reputable agency or clinic. A woman has to have delivered a child in the past – and undergo extensive screening including bloodwork, ultrasound, physical, and psychological evaluation. It is imperative that the surrogate is a good fit for the intended parents and the process.

    As Texas state law only affords statutory legal protection to married couples using gestational carriers, we are unable to offer gestational surrogacy to either same sex couples or to unmarried heterosexual couples.

     

    If you have further questions about whether gestational surrogacy may be right for your particular case, please talk further with your nurse or doctor.  You can also find more information about Texas Fertility Center’s third party services at http://www.txfertility.com/06surrogacy.php

     

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    Natalie Burger, M.D.

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  • Dr. Burger Shares That “DHEA May Hold New Promise for Diminished Ovarian Reserve”

    We are really excited about our recent press release and what it may mean to our patients  “DHEA May Hold New Promise for Diminished Ovarian Reserve” — Natural Hormone Produced 6 Fold Increase in IVF Success Rate –! 

    “We are excited that a relatively inexpensive option such as DHEA has the potential to help our patients conceive,” Dr. Burger explained.   You can get the whole story here ~ http://www.txfertility.com/articles/2012/DHEA-Improves-Fertility.php

    In response to this exciting research, Dr. Natalie Burger spoke with Perry Watson of KLBJ Health News and you can see and listen to the interview here ~ http://www.txfertility.com/beyond-the-birds-and-bees-podcasts.php

    For more information about this and other research studies going on at Texas Fertility Center, please visit our website http://www.txfertility.com/08research.php

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    Texas Fertility Center

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  • Preserve and Repair with Fertility Surgery

    With the precision of an Olympian, you’ve synchronized lovemaking to coincide with ovulation. Still no plus sign on the pregnancy test after six to 12 months? It may be time to consult with Texas Fertility Center to explore either non-invasive or minimally invasive surgical options for overcoming infertility.

    While most couples will not need fertility surgery, some conditions require it.

    Who may need fertility surgery?

    1. Women with blocked, damaged or diseased fallopian tubes (see our blog on hydrosalpinx). A dysfunctional tube can prevent the egg and sperm from getting together, or the fertilized egg from making it to the uterus.

    2. Women with endometriosis, ovarian cysts, scar tissue in the pelvis, uterine polyps, or fibroid tumors.

    3. Men with varicoceles or blockages in the male reproductive tract (these surgeries are performed by a urologist).

    How are these conditions diagnosed?

    A pelvic ultrasound (sonogram) or an x-ray test called a hysterosalpingogram (HSG) will bring to light most anatomical problems that will need surgical intervention.

    3 common types of fertility surgery

    Fertility surgery can correct physical barriers to getting pregnant, and is usually covered by insurance. Three common approaches include:

    1. Minimally-invasive operative hysteroscopy (involving a surgical telescope inserted vaginally under light sedation).

    2. Minimally-invasive laparoscopic surgery (involving a surgical telescope inserted through several small abdominal incisions under general anesthesia). These procedures can also be performed with the use of a robot through similar incisions.

    3. Abdominal laparotomy (surgery involving a 2-3 inch bikini line or abdominal incision under general anesthesia)

    Patients undergoing hysteroscopy and/or laparoscopy go home a few hours after the procedure, while patients who have a laparotomy may stay overnight in the surgery center or hospital.

    Why two extra letters matter when choosing a fertility surgeon.

    Reproductive endocrinologists (REs) are physicians who completed an additional 2-3 year fellowship in the diagnosis and treatment of infertility, recurrent pregnancy loss, and reconstructive pelvic surgery after their OB/GYN residency. REs are trained to treat both men and women.

    The board certified REs at Texas Fertility Center prioritize two goals when performing delicate fertility surgery: repair the problem and conserve future fertility. Receiving care from surgeons who have advanced specialized training in microsurgical techniques and assisted reproductive technology can impact the immediate and long-term success of your fertility surgery.

    To find out more about surgical management of infertility, contact the specialists at Texas Fertility Center.

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    Texas Fertility Center

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  • Laparoscopy

    A laparoscopy is a minimally invasive, outpatient procedure, which allows a physician to perform complex procedures using only 2-3 small incisions in the belly button and the lower abdomen. During this procedure, the abdomen is inflated with gas (carbon dioxide). This creates more space in the abdominal area and allows your physician to evaluate the uterus, ovaries, and fallopian tubes more easily. As well, the appendix, liver, and gallbladder can also be seen.

    A laparoscopy can be beneficial in a variety of patients.

    Examples include patients with painful periods or intercourse, unexplained infertility, and patients with a history of prior pelvic infection or surgery. As well, patients with persistent ovarian cysts, blocked fallopian tubes, or tubal pregnancy may also be candidates for laparoscopy.

    Prior to your laparoscopy, you will have a pre-operative appointment to discuss your surgery in detail with your physician and make sure that all of your questions are answered prior to your scheduled surgery.

    Laparoscopy is done under general anesthesia, typically in an outpatient surgery center. The recovery time for laparoscopy is usually 2-3 days — but can vary depending on the actual procedures performed.

    Your clinical nurse will follow up with you after surgery to check on you and to schedule your post-operative appointment. At your post-operative appointment, you will discuss the surgery findings and outcome with your physician. Your physician may also recommend a fertility treatment plan at this point.

    For more information on laparoscopy as well as other surgical options, please visit our website at http://www.txfertility.com/04surgical-treatment.php or call 512-451-0149.

     

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    Jamie Leonard, RN

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  • Surgical Evaluation of Infertility

    Female infertility can be caused by multiple factors. Among the most common are ovulation disorders, fallopian tube disease, endometriosis, and uterine defects. While problems with ovulation are managed primarily with medications, the remaining conditions are most commonly diagnosed and treated with surgical intervention. Sonogram imaging of the uterus and ovaries may show conditions such as ovarian cysts or uterine fibroids (benign muscle tumors) that can compromise fertility. Another common component of the fertility evaluation is the “dye test”, or hysterosalpingogram (HSG). This radiologic exam evaluates the uterine cavity and patency of the fallopian tubes. If either of these tests is abnormal, your doctor will likely recommend a surgical procedure for evaluation and treatment of the problem.

    The most common surgical treatments include laparoscopy and hysteroscopy. These are both minimally invasive outpatient procedures that involve insertion of a small telescope through either the belly button (laparoscopy) or cervix (hysteroscopy). These telescopes are attached to cameras which are then connected to computer monitors so that the pelvic structures can be easily visualized by the operating room personnel. The vast majority of pelvic and uterine abnormalities can be treated by your doctor with these procedures at the time of diagnosis. Endometriosis (abnormal uterine lining growing on structures outside of the uterus) may be present in the absence of any symptoms such as heavy, painful periods and even when the sonogram or HSG is normal. Laparoscopy is the only reliable method to make the diagnosis of this condition and is also the best way to treat the disease, usually with laser or resection. The recovery time for hysteroscopy is usually 24 hours and for laparoscopy 2 to 3 days before resuming normal activities.

    Occasionally, women will have a significant anatomic condition that requires a more invasive surgical approach. The most common problem is large or multiple uterine fibroids that extend deep into the uterine muscle. In this situation, an incision is made in the lower abdomen (“bikini cut”) and the fibroids removed and uterus repaired through this incision. This procedure is called a mini-laparotomy and typically requires an overnight stay in the surgical unit and several weeks of recovery.

    For many women, surgical management of infertility will result in the ability to conceive naturally or with minimal intervention. Reproductive endocrinologists receive an average of three years of additional training in these specific procedures compared to general gynecologists and are uniquely qualified to provide these fertility-enhancing treatments.

    For more information on the surgical management of infertility please visit http://www.txfertility.com/04surgical-treatment.php or call our office at 512-451-0149.

     

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    Lisa Hansard, M.D.

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  • Next Step: Surgery

    After completing your fertility evaluation, your physician may recommend surgery as a next step.

    Surgery can be an excellent way to diagnose and treat many gynecological problems such as: endometriosis, ovarian cysts, pelvic and/or intrauterine adhesions, uterine fibroids, endometrial polyps, fallopian tube disease and obstruction, and congenital abnormalities of the pelvic organs such as a uterine or vaginal septum. Our physicians want to make sure that your pelvic organs are as perfect as possible to ensure that you have the best chance to conceive.

     

    Many patients are nervous about having surgery and want to know what to expect.

    Our office has designated Surgery Coordinators who will help to facilitate the scheduling of surgery and walk you through the process every step of the way.  They will help to determine the best time and location to have your surgery.  Many surgeries are scheduled based upon where you are at in your cycle, so please make sure to know your last menstrual period when calling to schedule.

    Our Surgery Coordinators will also verify your insurance benefits, and they will obtain any authorizations required by your insurance for the procedure.  The coordinators will provide an estimate of the fees that will be due for the surgery.  These fees are collected at your pre-operative appointment.

    A pre-operative appointment will be scheduled with your physician prior to your surgery.  This will give you an opportunity to discuss the procedure in detail with your physician as well as have any questions you may have answered prior to the procedure.  Recovery time is dependent upon what surgical procedure(s) you have performed, and your physician will also discuss this with you.

    After surgery, you will receive a phone call from our clinical nurses to check in with you on your recovery.  The clinical nurse will also answer any questions that you may have, and she will schedule a post operative appointment for you.  During this appointment, your physician will discuss the surgical findings as well as the plan for you moving forward.  The post-operative appointment usually occurs about one to two weeks after the surgery takes place.

    Many times you can proceed with treatment during the menstrual cycle following surgery.  It is dependent upon the type of procedure(s) performed and the findings at the time of surgery – your physician or nurse can advise you if this is a possibility.

    If you have any questions regarding surgery or how to schedule, you can reach our Surgery Coordinators at 512-451-0149 ext 7419 (Sharon) or ext 7431 (Cyndi).

    Please check out our website at http://www.txfertility.com/04surgical-treatment.php for more information.

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    Jamie Leonard, RN

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  • Hydrosalpinx and Infertility

    What is a hydrosalpinx?

    Though it sounds like an exotic Egyptian relic, a hydrosalpinx is a swollen and blocked fallopian tube. Because the end of the fallopian tube is closed off by scar tissue, fluid abnormally collects, causing further swelling and dilation of the fallopian tube.

    Hydrosalpinges usually occur as a result of previous pelvic infection. Sexually transmitted diseases, such as gonorrhea or chlamydia, are the most common culprits. However, damage can also be caused by abdominal infections — such as a ruptured appendix.

    So, why is this a problem?

    First of all, if the fallopian tube is completely blocked, there is no way for egg and sperm to meet.

    Even if there is a partial fallopian tube blockage, the cilia (tiny finger-like projections inside the fallopian tube) often don’t work normally.  In women with hydrosalpinges, the cilia do not move properly and either cannot get the egg and sperm together – or are not able to direct the fertilized egg toward the uterus.  As well, the fluid collection can contain bacteria and other elements that are toxic to the fertilized egg.  Ectopic pregnancies are much more common in women with abnormally functioning fallopian tubes.

    In most cases, a fertility specialist will recommend removing the abnormal fallopian tube(s) via a procedure called a laparoscopy. In isolated cases, repair of a damaged fallopian tube may be considered.  After surgery, pregnancy may be achieved if ovulation occurs on the side of a normal, remaining fallopian tube – or with IVF if both fallopian tubes are damaged. For more info on tubal abnormalities, please visit http://www.txfertility.com/03tubal-abnormalities.php

    And for further information regarding surgical management of infertility, please visit our website at http://www.txfertility.com/04surgical-treatment.php  or call us at 512-451-0149

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    Kellye Cruz, RN

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  • Why TFC? Advocacy and Legislative Lobbying, Charitable Foundation

    When a patient of mine recently moved to California, she asked me to refer her to a specialist who could continue her care.  Drs. Vaughn, Hansard, Burger, and I have each noticed that when we provide our patients with a couple of names, they frequently ask us why we chose those particular specialists over many others in the same area.  This made us realize that many couples with infertility in Central Texas may be thinking the same thing about TFC – why should they come see us?  WHY TFC?  In an attempt to answer this question, we wrote an article that you can find on the home page of our website at www.txfertility.com.  I have taken the liberty of breaking this article down into smaller blog entries so that patients can read it at their leisure.  In this ninth and final blog in this series, I will tell you a little about our advocacy and lobbying roles, as well as the charitable foundation that we have recently established.  We believe that each of these issues, as well as those I have outlined over the past several weeks, make us very different from every other fertility practice in the Central Texas area.

    Advocacy and Legislative Lobbying

     Expanding coverage for fertility patients involves several things – not the least of which is convincing our legislators that infertility is a disease.  In the pursuit of this effort, both Dr. Vaughn and Dr. Silverberg have testified repeatedly over the years before the Texas state legislature.  Our efforts were rewarded when the legislature passed laws permitting and protecting the use of donor sperm, donor eggs, and donor embryos for the citizens of Texas.  Since that time, we have continued to mount an aggressive effort designed to further expand coverage.  Our most recent focus has been in Washington DC, where we have actively lobbied for the Fertility Family Act of 2011, which has now been introduced into both houses of Congress for consideration.  This act calls for a $13,360 lifetime tax credit for couples who are pursuing fertility treatment – analogous to the credit that couples who pursue adoption currently receive.  We have met with our Congressmen, their staffs, and lobbyists who work on behalf of the American Society for Reproductive Medicine to educate them about the importance of this legislation and solicit their support.  Dr. Silverberg also serves as an advisor to Congressmen Michael McCaul, Lamar Smith, and John Carter about issues related to healthcare in general.  In this capacity, he works to keep them aware of how new legislation such as the Affordable Care Act affect the quality and cost of medical care that the citizens of Central Texas receive.  Only TFC physicians have worked to develop these important relationships and spend our time actively working on these issues.

    Charitable Foundation 

    With the establishment of the Fertility Foundation of Texas, a new charitable foundation conceived by TFC, we will soon be able to enlist the assistance of individuals and companies throughout Central Texas to help us raise awareness about infertility as a curable disease.  The foundation has three main purposes: to raise awareness about infertility, to provide funding to patients who cannot otherwise afford fertility treatment, and to fund research related to the diagnosis and/or treatment of infertility.  Over the years we have been approached by many grateful patients who have wanted to be able to help other, less fortunate couples reach their dreams.  This foundation provides a mechanism through which patients, forward thinking companies, and philanthropic entities in our area can help those who continue to struggle with infertility.

     

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    Kaylen Silverberg, M.D.

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  • Why TFC? Medical Staff Leadership, Consulting with Industry

    When a patient of mine recently moved to California, she asked me to refer her to a specialist who could continue her care.  Drs. Vaughn, Hansard, Burger, and I have each noticed that when we provide our patients with a couple of names, they frequently ask us why we chose those particular specialists over many others in the same area.  This made us realize that many couples with infertility in Central Texas may be thinking the same thing about TFC – why should they come see us?  WHY TFC?  In an attempt to answer this question, we wrote an article that you can find on the home page of our website at www.txfertility.com.  I have taken the liberty of breaking this article down into smaller blog entries so that patients can read it at their leisure.  In this eighth blog, I will tell you a little about our roles on the medical staffs at local hospitals and surgery centers, as well as the significant consulting we do with both medical and non-medical companies, several things that make us very different from other doctors who practice infertility.

    Medical Staff Leadership

     Rather than merely serving on the medical staffs in our community, the TFC physicians have assumed positions of leadership.  Dr. Vaughn served as the Chief of Staff at Seton Medical Center, and Drs. Vaughn, Silverberg, and Hansard have all served on the Medical Executive Committees and/or Governing Boards at Bailey Square Surgery Center and the North Austin Surgery Center.  Our physicians have also served on numerous committees in the Travis County Medical Society, the Texas Medical Association, and TEXPAC.  We have also held leadership positions in the American Society for Reproductive Medicine (ASRM), the Society for Assisted Reproductive Technology (SART), the Society for Reproductive Endocrinology and Infertility (SREI), and the Pacific Coast Reproductive Society (PCRS).

     Consulting with Industry

     The field of Reproductive Endocrinology/Infertility is a small one, with fewer than 1000 Board Certified physicians in the United States.  As such, relationships are very important – not only with our patients, but also with our colleagues and with pharmaceutical and surgical equipment manufacturers.  TFC physicians have very close relationships with each of the leading pharmaceutical manufacturers in our field.  They recognize our practice for excellence in research, which is why they ask us to participate in every major infertility research study.  In addition to participating in research, our physicians are thought leaders in our field.  We consult regularly with the leading companies in the pharmaceutical, surgical, and biotechnology industries and serve on many Medical Advisory Boards in order to help identify new technologies and treatments that may serve to benefit our patients.  We also consult with several Fortune 500 companies and insurance companies in order to help broaden coverage of infertility for infertility patients at large.  Our recommendations and treatment protocols have actually been demonstrated to reduce the cost of fertility coverage for large employers.  One, Southwest Airlines, was so pleased by our efforts that they co-authored and helped us publish a large study in Fertility and Sterility showing how covering infertility diagnosis and treatment has actually helped them save hundreds of thousands of dollars per year.  Other nationwide employers are using the Southwest plan that we developed as a model for their own employee benefit programs.  Only TFC can claim these accomplishments.

     

    Stay tuned for this weekly series on Why TFC? Or if you prefer to read the article in its entirety, please visit

    http://www.txfertility.com/why-texas-fertility-center.php

     

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    Kaylen Silverberg, M.D.

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