Male factor infertility

Some cancers and cancer treatments can have a range of effects on a person’s current and fertility. The impact can vary depending on a number of factors, such as the type of treatment used, the dose and duration of treatment, and the person's age and general health. In this guide, we’ll dive into some of the facts about cancer, cancer treatments, fertility, and donor eggs.

Why some cancer survivors need donor eggs

While some cancer patients are given the opportunity to freeze their eggs before undergoing cancer treatment, too often this doesn’t happen. Sometimes the drugs required in egg freezing could promote the growth of hormone-sensitive cancers. Other times, the patient may not have enough time to complete a stim cycle before needing to start cancer treatment. And in some particularly unfortunate cases, the patient may not be not informed of their fertility preservation options. 

Regardless of the reason, if a cancer survivor no longer has sufficient egg quantity or quality, turning to donor eggs is one potential path to parenthood. 

How cancer treatments may affect fertility

Chemotherapy, radiation therapy, and surgery are all types of cancer treatment that can potentially affect fertility. The effects of cancer treatment on fertility can vary widely from person to person. Some people may experience temporary or permanent fertility changes as a result of treatment, while others may experience no significant changes.

• Chemotherapy can cause primary ovarian insufficiency (POI), which is when the ovaries stop  releasing eggs and estrogen. Sometimes POI is temporary and your menstrual periods and fertility return after treatment. However, even if normal ovulation resumes, chemotherapy can lower the number of healthy eggs.
• Some cancer surgeries, especially those addressing gynecologic cancers, include the removal of one or both ovaries, the fallopian tubes, uterus, vagina, or cervix. This can make getting pregnant and carrying a healthy pregnancy more difficult. 
• Radiation therapy can also cause infertility. Patients who receive abdominal or directed pelvic radiation at high doses are at greater risk for infertility. Radiation therapy can also negatively impact the number and quality of eggs, leading to a reduced ovarian reserve. 

If you are considering cancer treatment and are concerned about its potential impact on your fertility, it is important to discuss your concerns with your healthcare team. They can provide you with information about the potential effects of cancer treatment on fertility and help you understand your options for preserving your fertility before treatment begins.

Can you become pregnant after chemotherapy?

Some types of chemotherapy can temporarily or permanently damage the ovaries, which can affect a person's fertility. Chemotherapy can also cause a temporary or permanent decrease in the production of eggs, which can also affect fertility. However, the effects of chemotherapy on fertility are not uniform. 

It is also important to note that fertility can be affected by other factors, such as the underlying health condition for which the chemotherapy is being used. For example, some health conditions, such as cancer, can affect fertility even without chemotherapy treatment.

Can you do IVF after cancer and chemotherapy?

It is often possible to undergo in vitro fertilization (IVF) after cancer treatment, including chemotherapy. However, the timing of IVF treatment may need to be adjusted based on the specific type of cancer and treatment.

Chemotherapy and other cancer treatments can damage the ovaries, which can affect fertility. It may take some time for the ovaries to recover after treatment, and the timing of IVF treatment may need to be adjusted accordingly.

It is also important to note that cancer treatment can affect your overall health, which can impact the IVF experience. Some people may want or need to wait until they have fully recovered from treatment before starting IVF, while others may need to modify their treatment plan to take into account any ongoing health issues.

If you are considering IVF after cancer treatment and are concerned about its potential impact on your fertility, it is important to discuss your concerns with a fertility specialist. 

Using donor eggs to get pregnant after cancer

IVF using donor eggs is a fertility treatment option often considered by female cancer survivors who have experienced fertility changes as a result of cancer treatment. Because cancer treatment, such as chemotherapy and radiation therapy, can damage the ovaries and affect a person's ability to produce healthy eggs, using donor eggs may be the best option for achieving pregnancy.

Donor egg IVF involves using eggs from a healthy donor to create embryos, which are then transferred to the uterus of the intended parent or a gestational carrier. This can allow cancer survivors who have experienced fertility changes as a result of treatment to have a child. 

Donor egg IVF is an increasingly common fertility treatment, and an option that may be considered if other fertility treatment options are not feasible or have not been successful. Using donor eggs can greatly increase the chances of a healthy pregnancy, especially for women over 35. 

Cofertility is a human-first fertility ecosystem rewriting the egg freezing and egg donation experience. Our Family by Co platform serves as a more transparent, ethical egg donor matching platform. We are obsessed with improving the family-building journey — today or in the future — and are in an endless pursuit to make these experiences more positive. Create a free account today!

If you are single with fertility issues or in a relationship where both of you are experiencing fertility issues, you have an option of conceiving using both donor egg and donor sperm. Below I will answer commonly asked questions about the selection process, how treatment works, and on odds of success. 

Why would someone need both egg and sperm donation?

Why would someone need both donor egg and donor sperm? It may be that a woman has reached an age where conception using her own eggs is no longer an option. Or perhaps she has medical reasons that prohibit the use of her own eggs. A sperm donor may be needed because she may not have a male partner or if she does, perhaps the male partner is experiencing fertility problems where the sperm is not viable. 

For some single women, they may decide to use a sperm donor because they do not have a partner and are ready to start a family. So their journey to parenthood begins with coming to terms with the idea of raising a child alone. But once on that journey, she may discover a fertility problem (age or otherwise) and now also has to accept the idea of not having a genetic connection to her child as well. But when the longing to be a parent outweighs the desire to reproduce, that is where double donation comes in. 

Some other scenarios include lesbian couples where both women have fertility issues and cannot use their own eggs, single males who cannot use their own sperm, or a gay male couples where both have fertility issues and neither can use their own sperm.

In vitro fertilization (IVF) with double gamete donation consists of a fertility treatment in which the eggs of a donor are fertilized with the sperm of a donor. The donors can be identified (meaning the donor is known to the parents in some capacity) or non-identified (the donor is not known at all). Donors need to be over the age of 21, and pass both medical and psychological evaluations. Currently, there is no cap on how much a donor can be paid. 

Donor eggs

Let’s begin with the egg donation process. Once an egg donor has been selected and has completed and passed all the required medical and psychological testing, she will begin the medical protocol to retrieve her eggs. She will begin by injecting herself with hormones for approximately two weeks. These hormones stimulate the ovaries to produce more follicles than she would otherwise produce. Depending on the protocol, she will be regularly monitored by a clinic close to home so doctors can monitor the stimulation.  A final, trigger shot is taken on a specific day and time and within a certain amount of hours, the eggs are extracted under sedation.  The other option is to use frozen eggs from an egg bank. 

Donor sperm

Donor sperm can also be either fresh or frozen. However, regardless of how it is donated, it will remain frozen in quarantine for six months before it can be used. Some states and clinics will offer a waiver to release the sperm after three months. The reason for quarantine is that some diseases, such as HIV or Hepatitis B can take up to six months to show positive.

Once the donated eggs are matured and ready to be fertilized, the donor sperm is thawed and tested. Once approved and ready, the mature eggs are fertilized with the donor sperm. Embryos are given three to five days to grow and are then transferred to the intended mother or gestational carrier.  Remaining embryos can be frozen for possible future use, donated to another person or couple or disposed of. 

Double-donor embryo IVF

Because a double donor embryo is created using two donors, treatment can be costly. It can also be the treatment path that takes the longest since you are needing to find both an egg and sperm donor and you need to ensure everyone’s calendars are in sync. A planned trip, holiday lab closures, and medical and legal professionals scheduling calendars can create time lags in the process. So be prepared to spend months or even a year before treatment (embryo transfer) can actually occur. 

However, medically, double donation is safe and can have very high success rates. For example, the 2020 CDC IVF success rates looked at 449 clinics across the United States. A frozen embryo transfer cycle using donor eggs resulted in a 44.5% singleton live birth rate. Whereas a fresh embryo transfer cycle using frozen donor eggs had a 44.1% singleton live birth rate and a fresh transfer from fresh donor eggs resulted in a 49.5% singleton live birth rate.

Although double donation can be costly and time consuming, chances of a successful transfer and birth can exponentially increase when gametes used to create the embryo come from young,  healthy donors.  

Families come in many forms and everyone’s path to parenthood is unique. No matter those differences, anyone striving to build a family should have equal access to resources on their journey. We’ve compiled the below list of resources that we hope will help you navigate any challenges when it comes to starting a family.

LGBTQ+ family-building resources

• The Gay Dad's Guide to Egg Donation was written by Dr. Saira Jhutty, and discusses the process of using donor eggs to build a family.
• Connecting Rainbows is a resource for people in the LGBTQ+ community who are building their families. They're particularly knowledgeable on the topic of second-parent adoption.
• Family Equality is the leading national nonprofit organization advancing equality for LGBTQ+ families.
• Gay Parent Magazine: Gay Parent features personal stories of lesbian, gay, bisexual, and transgender parents about their experiences with international and domestic adoption, foster care, donor insemination, using a surrogate and what it is like to raise their children.
• Parents, Families, and Friends of Lesbians, Gays, Bisexual and Transgender (PFLAG): PFLAG is devoted to educating and supporting everyone involved in the life of a sexual minority individual. There are local chapters all over the United States
• Men Having Babies (MHB) is a non-profit dedicated to providing gay men with educational and financial support to achieve parenthood.
• The National Center for Lesbian Rights works to ensure that LGBTQ+ parents and their children are fully recognized as families under the law, including low-income parents using low-cost assisted reproduction, both married and unmarried parents, families with more than two parents, adoptive parents, and parents conceiving using surrogacy.  
• Resolve vigilantly tracks state and federal legislation pertinent to LGBTQ+ family building across the United States, and works to support positive family building bills and to stop harmful legislation from being enacted. You can view the legislation they’re working on here. 
• Trans Fertility Co. was created by trans community members to make the world of fertility easier to understand and navigate.
• Fertility Within Reach has resources to support transgender youth and their families with fertility preservation support.
• Gay Parents To Be is an informational resource and a starting point for LGBTQ parenting.

Family-building resources for BIPOC women 

• BMMA (Black Mamas Matter Alliance) is a Black women-led cross-sectoral alliance. with resources covering a broad spectrum of maternal health issues and advocacy tools.
• Black Women and Infertility is an organization based in Boston that provides online support for Black women experiencing infertility.
• The Broken Brown Egg provides support and resources for people in the Black community experiencing infertility.
• Fertility for Colored Girls provides education, encouragement, and support to Black women and other women of color experiencing infertility and seeking to grow their families. They aim to empower Black women to take charge of their fertility and reproductive health, and provide grants to help ease the financial burden of fertility treatments or domestic adoption.
• The Infertilidad Latina Podcast is a space for women to listen and share stories about their infertility and IVF experiences.
• The Infertility and Me podcast is a Black woman-hosted show covering reproductive justice, pregnancy loss/miscarriage, and infertility.
• Moms in the Making have infertility support groups in Spanish.
• The Resilient Sisterhood Project’s mission is to educate and empower women of African descent regarding common yet rarely discussed diseases of the reproductive system that disproportionately affect them.
• This article discusses why infertility isn’t discussed enough in Latinx communities.
• This article discusses overcoming stigma in the Asian American community

Religious family-building resources

• The Jewish Fertility Foundation is a resource for members of the Jewish community to seek support for infertility. Part of their work includes destigmatizing infertility within the Jewish community and educating community leaders on how to support those with infertility.
• Resolve has resources regarding the intersection of infertility and religion for community leaders, as well as links to support groups for those of Islamic, Jewish, Christian, or Catholic faith. This can serve as a good starting point for conversations about religion and infertility.
• This article from MuslimGirl.com shares the experience of infertility for Muslim women.
• Catholic Mom is an infertility support group for Catholic families.
• ATime provides guidance and support for Jewish families facing infertility. In addition to having therapists, they have a 24-hour helpline. 
• Uprooted’s work allows those struggling to turn toward the Jewish community as they navigate their fertility journey, to break through feelings of isolation and shame, and to connect with others traversing the same path. 
• Amal Fertility is a Mississauga-based support group for Muslim women struggling with infertility.
• Hasidah offers peer support as well as financial aid for those seeking to build Jewish families.
• Stardust Jewish Fertility Foundation is a nonprofit that offers grant opportunities from $1K - $25K to Jewish singles of couples, regardless of sexual orientation or marital status.
• Jewish Family and Children’s Service of Greater Philadelphia (JFCS) provides grants to Jewish families living in the Philadelphia area facing infertility.

Military and veteran family-building resources

• Resolve has a list of affordable infertility treatment options for military personnel.
• Bob Woodruff Foundation provides up to $5,000 funding to veterans eligible for the BWF Veterans In Vitro InitiAtive (VIVA) Fund. 
• Read the Tricare white paper on why expanding service members’ access to infertility treatment is easy, affordable, and the right thing to do.
• The Military Family Building Coalition is a non-profit organization to support military members in building their families through ART, IVF and Adoption.

Cancer-survivor family-building resources

• The Alliance for Fertility Preservation is a 501c3 made up of a team of professionals who advance the field of fertility preservation for cancer patients.
• The Expect Miracles Foundation provides grants for cancer patients for family building (adoption, fertility storage, IVF, & surrogacy).
• The Banking on the Future grant is available to adolescent oncology patients through the age of 21.
• Team Maggie provides financial assistance to teens and young adults with cancer seeking fertility preservation. 
• Duke has a monthly support group for women facing fertility concerns due to cancer.

Resources for all

• Resolve is the largest and most well-respected infertility non-profit offering advocacy, support, and education for anyone facing infertility.
• The Starfish Fertility Foundation is a 501c3 nonprofit group committed to providing financial support for those struggling with infertility in the United States.
• The Gift of Parenthood provides grants that can be used to cover any expenses associated with assisted reproduction including egg donation.
• Baby Quest makes grants for family building ranging from $2,000 - $15,000 plus medications. 
• Ferring Pharmaceuticals Heart Beat Program provides select fertility medications at no cost to female patients with a cancer diagnosis.

Cofertility is a human-first fertility ecosystem rewriting the egg freezing and egg donation experience. Our Family by Co platform serves as a more transparent, ethical egg donor matching platform. We are obsessed with improving the family-building journey — today or in the future — and are in an endless pursuit to make these experiences more positive.

We know that after being bombarded with hoards of hormones, supplements, and the struggles of infertility, making changes to our diets is probably the LAST suggestion you want to hear. 

But especially if you’re about to do an IVF cycle, you’ll want to get your body in tip-top shape to prepare for a healthy pregnancy. But don’t freak out; we’ve got the lowdown on the nutrients you need to support your fertility mission, and where to find them.

Dara Godfrey, a registered dietician at Reproductive Medicine Associates of New York, notes that there’s no one-size-fits-all nutrition guide. We’re all different, but there are some foods that can help support the body to hopefully function more optimally. But before you make any significant changes to your diet, be sure to speak with your doctor and maybe a registered dietician, who can tailor an individualized diet for your body’s specific needs.

Five A+ foods for fertility

Godfrey’s top five foods that she recommends to support clients’ fertility goals include: 

• Green veggies
• Wild salmon
• Walnuts
• Black beans
• Eggs 

Fertility-friendly nutrients FTW

Here’s a breakdown of the seven nutrients Godfrey says your fertile body needs, and a wide variety of foods where you can find them:

1. Omega 3s are known to help with hormone regulation. To get those good juices flowing, look for high-fat fish like sardines, anchovies and wild salmon. You can also find Omega 3-enriched eggs (which also have protein bonus points). Godfrey mentions that recent research also suggests that Omega 3s can improve embryo quality, reduce inflammation and can even help with sperm quality. If you’re vegetarian, vegan, or just not that into fish, you can get Omega 3s from walnuts, flax seeds, and chia seeds.

2. Some recent research shows that Vitamin D can increase IVF success, as well as potentially help regulate blood sugar. Keep in mind that Vitamin D supplementation may be especially needed during the winter months, when we’re not getting as much sunlight. There aren’t too many foods that are naturally fortified with Vitamin D, but Godfrey suggests include wild salmon, sardines, eggs and milk (yep, those guys are gonna come up a lot). Our favorite Vitamin D supplement? Natalist's Vitamin D Gummies. Use code COFERTILITY20 at checkout for 20% off!

3. Iron is important during pregnancy to deliver oxygen to the baby and to prevent anemia in the mother. While the supplements in prenatal vitamins are great, Godfrey says you can also find iron naturally in foods such as lean beef, shrimp, chicken, and fish. Animal-free sources of iron also include oatmeal, organic tofu, enriched whole grains (Godfrey loves cereals like All Bran or Shreddies), which are also high in fiber. Iron loves to hang out with Vitamin C, so if you’re having shrimp, chicken, fish or tofu, Godfrey suggests throwing in some red peppers. In the morning and for snacks, sprinkle strawberries on your iron-rich cereal.

4. Folate. The first trimester is the most important time to prevent neural tube defects, and folate and folic acid are shown to have a protective effect, which is the main reason doctors and dietitians recommend you take a prenatal vitamin. The food form of folic acid is folate and it’s super easy to find it in dark leafy greens like brussels sprouts, kale, asparagus, avocado, black beans, kidney beans, lentils, oranges and sunflower seeds.

5. Vitamin C, especially during food and cold season, is super important while trying to conceive. Most people think of citrus right off the bat, and yes, oranges and grapefruit are great, but Godfrey also suggests red peppers and broccoli. Other fruits include strawberries, papaya, kiwis, pineapple, mango and watermelon. Keep frozen fruits (ideally organic) in mind when they’re out of season. Apparently, according to Godfrey, they’re actually more concentrated in nutrients, since they’re picked and frozen at peak ripeness. Mind blown. 

6. Vitamin C’s best friend is calcium. If you want to make sure that you’re getting the most out of your Vitamin C, Godfrey suggests pairing it with a source of calcium. She suggests pairing strawberries with yogurt to help with each others’ absorption, or trying a stir-fry with red peppers and other veggies, paired with a sprinkling of Parmesan cheese on top. One important note on dairy: go for organic and keep in mind that men and women have opposite needs here in regards to fat content. Women need whole fat: “the fat in milk is where the female hormones like estrogen are found,” explains Godfrey. So when that fat is taken out, what’s left are the male hormones (like androgen) which aren’t helpful to a female body seeking to conceive. Contrastingly, men should avoid whole fat yogurt for the same reason: their fertility could be adversely affected by the higher concentration of the female hormones. If you’re dairy-free, you can get calcium from broccoli, bok choy, collard greens, kale, almonds, organic tofu, and black beans.

7. Hydrating with water is important year-round. In the winter months, it helps to clear your body of mucus, getting rid of viruses and airborne infections more rapidly. This may not sound like it relates to fertility, but as Godfrey points out, “if your immune system is strong, your body is working more efficiently.” And that’s always a good thing.

Men can use a boost, too

For men seeking to improve their fertility, Godfrey adds zinc and selenium to this list.

• Zinc is shown to increase testosterone levels, improve quality and quantity of sperm and help prevent sperm from clumping together. It can be found in seafood like oysters, crab and shrimp, as well as pork, beef, chicken and venison. Vegetarian sources include sesame seeds, raw pumpkin seeds and low-fat yogurt.
• Selenium is necessary for the creation of sperm, and is best sourced from Brazil nuts, liver, snapper, cod, halibut, tuna, salmon, sardines, shrimp, turkey and broccoli. 

We love the Natalist Male Prenatal, which is especially formulated for male fertility.  

Every time is snack time 

If you’re looking for healthy ways to get your snack on, Godfrey also serves up these easy, on-the-go ideas:

• Bag up a mix of walnuts, sunflower seeds, pumpkin seeds, and flax. Grab a cup of full-fat, organic yogurt and sprinkle your healthy mix on top.
• Ladle some black beans (or kidney beans, or chickpeas) into a glass jar as a wholesome, satisfying snack at your desk.
• Pack your commuter bag with an iron-enriched cereal and some strawberries and almonds.
• When you’re traveling, you can sometimes find ready-made hard-boiled eggs in airport cafes.

The bottom line on fertility foods

Beyond diet, Godfrey stresses that improving your body’s fertility has to include changes to your overall habits and environment. Bottom line: you can eat a perfect diet, but if you’re not taking care of yourself in other ways, the foods you eat can’t work as efficiently. It’s probably a good idea for you to start reducing your wine and coffee intake (we know, we know). Coffee wise, getting down to one or two cups (think 6oz, not a 20oz Venti!) per day will make the transition easier if and when you do get pregnant. Be sure you drink your morning joe after you’ve had breakfast and a glass of water. 

Godfrey is also pretty permissive when it comes to alcohol—within reason. Practitioners vary with their recommendations on this (so make sure to talk to yours), but evidence that Godfrey has seen at her clinic suggests that having three to four glasses of wine per week shouldn’t have an effect. The larger concern about booze are the habits that surround it. Avoid having drinks on an empty stomach, and remember to hydrate. Otherwise, Godfrey observes, “your inhibitions are lowered and you choose poor quality foods and larger volume.” (Hey, we’ve all been there). 

Finally, Godfrey assures us, you don’t have to deny yourself all your favorite things. “For me, there are no absolute ‘no’s,’ because that’s unhealthy, too!” Pass the nachos, please?

NOTE: Cofertility works hard to recommend products and services that align with our brand mission of improving the family-building process for all. We sometimes earn a sales commission or advertising fee when recommending various products and services to you. As an Amazon Associate, we earn from qualifying purchases. Always be sure to consult with a doctor if you have any concerns. Prices and terms listed on our website are subject to change.

Let’s face it—there are a lot of things that can go wrong with your (or your partner’s) sperm, and a ton of reasons why you might be looking for the best male fertility supplements. 

We’re taught as kids that “nobody’s perfect,” and this couldn’t be more true than when it comes to male factor infertility; it’s actually super common and affects a third of all fertility troubles, according to the National Institutes of Health. But when you’re faced with sperm issues (sperm count, sperm morphology, or low sperm motility) it doesn’t matter how common it is. It’s still overwhelming, and you want to do whatever you can to make them go away. We get it. And while they won’t necessarily magically rid you of your sperm issues overnight, thankfully, male fertility supplements can help. Here’s the lowdown on male fertility supplements.

What do male fertility supplements do?

It’s often recommended that a woman takes prenatal vitamins while she’s trying to conceive, but it takes two to tango. It’s important to give sperm just as much attention as eggs.

Here’s what male fertility supplements (claim to) do:

• Increase sperm count: Nutrient deficiencies can lead to decreased sperm concentration or count. Male fertility supplements claim to help men get the right nutrition they need to get that “strength in numbers” kind of sperm. The more sperm you’ve got, the higher the likelihood one will make it to an egg. 
• Preserve sperm quality: Regardless of sperm count, getting pregnant can often come down to sperm quality. This matters, for example, when doing IVF — in order to fertilize the egg in a lab, an embryologist will need to utilize high quality sperm (and thanks to ICSI and PICSI, this process has become easier). Male fertility supplements claim to provide the nutrients needed for healthy, quality sperm. 
• Protect sperm as they mature: While most men produce millions of sperm each day, getting those little guys to stick around and mature is another story. Making sure your sperm is mature and high quality at the time of conception is key here.
• Boost overall health: Aside from the more tangible/direct benefits upon your sperm, just getting your overall health in balance prior to conception is always a plus and may have ancillary fertility benefits. Increased energy and better sleep are two outcomes many male fertility supplements tout.

Because we know busy enough worrying about your sperm health, we’ve taken out some of the legwork for you and rounded up some of our favorite male fertility supplements below.

Best male fertility supplements

Beli

The lowdown

Beli contains vitamins specifically designated to improve sperm count, sperm growth, sperm quality, and sperm motility. Every single ingredient in Beli is thoughtfully included due to research indicating how that particular ingredient will improve a man’s sperm (you can check out that research for yourself here). 

What makes it unique

Rather than a one-and-done bottle (which, honestly, might not do you many favors), Beli explains that it takes about three months of taking the male fertility supplements to ensure your sperm matures and strengthens. For truly optimal results, you should start taking Beli at least six months before trying to conceive. It’s a marathon, not a sprint. If you’re serious about improving your sperm long-term and achieving pregnancy, Beli is an awesome option. 

Check out Beli here. 

Natalist

The lowdown

In our opinion, Natalist makes one of the best male fertility supplements out there. Created just for men’s fertility, The Natalist Male Prenatal Daily Packets is a high-quality, antioxidant-rich multivitamin formulated for male fertility with key nutrients designed to support sperm health. The formula development was led by Dr. Andrew Sun, a Harvard-trained urologist and expert in the field of male fertility and Lauren Manaker, RD, an award-winning registered dietitian-nutritionist and specialist in male fertility.

Natalist is basically the gold standard of male fertility supplements, and they’ve really done their diligence to make sure they’ve included everything you need and none of the junk that you don’t. Plus, they come in convenient daily packets so you can take them on the go. Use code Cofertility20 for 20% off your purchase.

What makes it unique

In addition to being super super high quality, the wonderful thing about Natalist is that it’s on autopilot. Once you sign up, you get a new 30-day supply delivered monthly. Sometimes it’s hard to remember ordering new vitamins, but with Natalist, you basically set it and forget it. That said, if you’re just not feeling it, there’s no commitment. You can cancel at any time. 

Natalist is all about consistency, hence the subscription model. For truly optimal results, you should start taking Natalist’s Male Prenatals at least six months before trying to conceive. It’s a marathon, not a sprint, guys. If you’re serious about improving your sperm long-term and achieving pregnancy, this is an awesome option. 

To purchase Male Prenatal Daily Packets, click here. Be sure to use code COFERTILITY20 to get 20% off!

Conception Men Fertility Vitamins

The lowdown

These male fertility supplements focus primarily on zinc and lecithin, two ingredients that they claim to help boost sperm production and health. Conception Men is meant to be taken at a minimum of 12 weeks prior to trying to conceive, in order to achieve its full effect on sperm. As an added bonus, we’ve seen lots of positive customer reviews claiming that these pills also helped out their (or their male partner’s) sex drive. 

To purchase Conception Men Fertility Vitamins, click here.

What makes it unique

We love the do-good philosophy behind these male fertility supplements. When you take Conception Men, you aren’t just helping yourself out; with every purchase, Eu Natural, the supplement manufacturer, will provide one year of vitamins to children under five, new mothers, and pregnant women at risk for malnutrition. Win-win. 

Check out Conception Men Fertility Vitamins here.

Summing up the supplements

When deciding on the best male fertility supplements, it can feel super overwhelming to find the right fit for you. But you got this. Hopefully, these supplements set your swimmers well on their way to becoming Olympic-level in both skill and form. We’ll be here, playing Eye of the Tiger and cheering you on.

Between IUI vs. IVF vs. ICSI vs. PICSI...looking into fertility treatments can feel a lot like you're trying to make sense out of all those noodles floating around a bowl of alphabet soup.

At first glance, it seems like IUI vs. IVF are similar. They both have an I in them...so maybe they're related? And what's with ICSI and PICSI? Is that P just a typo? Don't worry, you don't need a crystal ball to figure all of this out. Consider this your secret decoder ring for all those fertility treatment acronyms.  

There are plenty of new terms to learn when you're starting the fertility journey—or at least terms to dig out of your brain from your high school science class days. But there are four major acronyms that tend to come up when you sit down with a fertility doc to talk options.

IUI

Short for: Intrauterine insemination (although it's also sometimes called artificial insemination)  

How it works:  

• IUI involves donated or a partner's sperm being placed in the uterus. Sperm are "washed" (essentially, sorted to weed out the strongest, best swimmers) and injected through a catheter up through the cervix directly into the uterus, at the time of ovulation. That's the end of expert intervention when it comes to IUI—the goal is for fertilization to occur in the body, up in the fallopian tube, in the same exact way it would if the sperm swam there on its own.  
• This procedure may be combined with medications to induce ovulation, such as Clomid or Letrozole, typically given for five days, or medication prescribed after the procedure, like progesterone (which can be used during IUI or IVF).

Who does it: Usually a reproductive endocrinologist, though it can also be performed by a general OB/GYN.

IVF

Short for: In vitro fertilization

How it works:

• IVF typically involves stimulating the ovaries with medications in order to boost the number of eggs you produce and mature them enough to the point of almost ovulating. However, donor eggs can also be used with IVF. If a donor egg is used, the mother-to-be will typically take medications meant to sync her cycle with that of her donor.  
• Next step? A mom-to-be or her donor has to undergo minor surgery to retrieve the eggs. "The eggs are collected using ultrasound guidance, using a syringe to withdraw the eggs from the ovaries," says Dr. Mary Jane Minkin, M.D., a clinical professor of obstetrics, gynecology and reproductive sciences at the Yale School of Medicine.  
• Eggs are later mixed with donor or a partner's sperm in a lab—this process is called insemination.
• If insemination is successful and the embryo continues to mature after a few days, the embryo (or sometimes more than one, depending on your situation) is transferred directly into the uterus by a specialist, again using a catheter. Some first undergo genetic testing to ensure the embryo is chromosomally normal and/or isn't a carrier for certain conditions. If all goes well, the embryo will implant in the uterus, getting you pregnant.

Who does it: The retrieval and embryo transfer portions of IVF are typically performed by a reproductive endocrinologist, while the insemination process is handled by a clinical embryologist in the fertility clinic lab.  

ICSI

Short for: Intra-cytoplasmic sperm injection (usually pronounced ick-see)  

How it works:  

• The ICSI procedure is a part of the IVF cycle that's often used in cases of male factor infertility, such as poor sperm count or quality, says Dr. Alyssa Dweck, M.D., an OB/GYN at CareMount Medical in Westchester County, NY.
• A male partner's sperm is usually collected into a collection cup, though it may be retrieved surgically by a urologist from a male partner's testes or epididymis (that's a tube in his testicles where sperm collects).
• It is then studied in a lab to determine which specific sperm cell (sometimes called the spermatazoa) is the best candidate for potentially inseminating the eggs retrieved during the IVF process. "This technique allows a single sperm to be injected directly into a mature egg," Dr. Dweck says, hopefully resulting in a fertilized egg.
• The fertilized egg develops into an embryo, which is then placed in the uterus via the IVF process. And you know where this is going now, right?

Who does it: The ICSI process is typically performed in a fertility clinic or center's lab by an embryologist.  

PICSI

Short for: Physiological intra-cytoplamsic sperm injection (usually pronounced pick-see)

How it works:  

• No, that P isn't a typo. PICSI is essentially ICSI with an extra step, says Dr. Jaime Knopman, M.D., a reproductive endocrinologist at New York fertility clinic Colorado Center for Reproductive Medicine (CCRM).
• This procedure involves adding a special enzyme to the sperm to enhance insemination chances, but it otherwise mirrors ICSI. After an embryo forms, it's transferred to the uterus, and all fingers crossed…pregnancy hopefully occurs.  

Who does it: Like ICSI, PICSI is typically performed by lab specialists called embryologists.  

Consider artificial insemination and fertilization costs

It all depends on the treatment type. Something like IUI can cost you around or just over $400. Where on the other hand, IVF can cost upwards of $8,000, not including the required medications or ICSI treatment that can range from an additional $1,000 - $2,500. Surrogacy can exceed $100,000. 

With all of these different methods of insemination and fertilization, these processes can’t be cheap, or can they? This lies in the hands of your health insurance coverage.

If you’re looking to become pregnant and require one of these methods, you may save yourself a decent chunk of change by opting for a plan that covers fertility treatments. While each plan will vary as to what degree of coverage is provided, don’t forget to read the fine print before choosing your insurance plan.

The insurance policy carrier will determine what all is included. For example, if the man is the carrier of the policy, the plan may include fertility treatment for him but not for the female partner including the main event of the actual insemination.

If your employer doesn’t offer insurance that covers fertility treatments, you should take the issue to HR or a higher power to see if it’s possible. If it’s a large organization that has other employees dealing with the same issues, it may be something they’d be willing to change.

You should also conduct some research around grants offered by non-profits. There are many that exist to help with the cost of insemination.

Out of pocket expenses

If you are unable to obtain a plan that fully covers the artificial insemination process from start to finish, you’ll likely find yourself fronting the artificial insemination cost which can be an accrual of numerous things.

Medications

These are required to ensure that the woman is ovulating one or more eggs at the right time. There will typically be medications prescribed at each cycle and also one used to induce ovulation (otherwise known as a “trigger shot”). These medications vary in cost. For IUI, a prescription could cost you as little as $10. For IVF, depending on your insurance coverage, you could rack up a cost of $5,000 or more.

Bloodwork and check-ups

During the process of artificial insemination, it’s important that the woman is frequently monitored and evaluated. Not only will this require doctor appointments, but also blood work that can monitor hormone levels and the status of follicles throughout the process. While these costs vary, you might see costs of $500-$1,000 during each cycle.

Insemination

The event you’ve been working so hard for, the actual process of artificial insemination may cost around $150 to $400. However, sometimes an additional injection is suggested the day after the initial to improve success rates, so double that number if your doctor recommends this approach.

Additional fertilization costs

There is a chance you might need some additional assistance throughout the process, which may — you guessed it — make things more expensive. 

Embryo testing and freezing

Embryo testing for chromosomal abnormalities can cost $1,000 or more. Depending on timing or if you want to use them at a later date or after a lengthy transfer protocol, embryos will require freezing. This can cost a couple of hundred dollars. Freezing for a year will cost closer to $800. 

If you use a frozen embryo, the transfer will also come with a cost. The average cost to transfer a frozen embryo is $3,000-$5,000.

Egg donors and sperm donors

If you need an egg donor, you’re looking to endure a cost for just one cycle somewhere between $25,000 and $30,000. If you need a sperm donor, on the other hand, it’s significantly cheaper. On average, it can be about $15,000 per cycle. 

Gestational carriers

In the event that you need a gestational carrier, this will put you in the upper tier or near the top range of the total cost of insemination. This cost can range anywhere from $50,000 to $100,000. 

Total cost

Again, costs will vary depending on the treatment. It’s best to consult with your doctor to determine which route you should go and what additional costs may be required in your situation. Some fertility treatment costs can be offset by insurance and potential grants. 

To ensure you can afford IUI, IVF, or whatever fertility treatment you might need, it’s best to consult with your fertility doctor beforehand so you can determine how much you will have to pay in the end.

Summing it all up

Starting your fertility journey is a lot like learning a new language, and it can feel a little overwhelming at times. Don't be afraid to ask your fertility specialist to slow down, back up, and explain if you didn't understand the medical jargon they threw at you or simply spoke too fast.  

And hey, now that you've got the big four acronyms under your belt, you can start dropping some knowledge on those Facebook support groups like you're a pro…or at least understand what the heck they're all talking about.

So you’re thinking of lining up to get the COVID-19 vaccine but maybe you’re worried about your fertility. Leave it to the pandemic to open up a whole new world of questions!

Maybe you saw posts making the rounds on social media that make some pretty scary claims that the new COVID-19 vaccines will hurt your fertility, or maybe you’re simply uneasy after a year of health news that’s put everyone on edge. We get it. 2020 will go down in history as the year that made us all second guess, well…just about everything.

But we know you came here for answers, not more questions! So what do the doctors (and not your high school best friend who went to Google University Medical School) have to say about the coronavirus vaccine and your fertility?

Will getting the COVID-19 vaccine affect fertility?

According to Mary Jane Minkin, M.D., clinical professor of obstetrics and gynecology at Yale University, there are no definitive answers because the pharmaceutical companies didn’t purposely recruit pregnant women for their trials. And yet we know that health experts, including Dr. Anthony Fauci of the White House's coronavirus task force and World Health Organization Director-General Tedros Adhanom Ghebreyesus, all say COVID-19 vaccines are a must to end the pandemic.

So, what do you do next if you’re trying to take your fertility into account?

Well, for starters, Minkin says the lack of pregnant women in the clinical trials doesn’t necessarily mean that the vaccine poses a problem — for pregnant women or women who are trying to conceive. It simply means the researchers don’t have data on these particular folks. Right now, there is no known reason why a woman shouldn’t get the vaccine.

Currently, Minkin says most doctors are advocating women get the shot (or series of shots — depending on which vaccine you get), and some of the major medical organizations are pushing doctors to collaborate with patients to help them make the right decision.

Did you notice that we said *some*? The World Health Organization released a statement in late January advocating against the COVID-19 vaccine for most pregnant women unless the risks of getting the disease outweigh any potential vaccine side effects. That means they’re still advocating the vaccine for pregnant women who work in a healthcare setting or similar setting with high exposure risk, as well as for women with high risk pregnancies. 

The WHO is not advocating testing for pregnancy prior to vaccination, and its statement made special note that it does not recommend delaying pregnancy after getting the shot. 

So, what about the rest of the experts?

The CDC, American College of Obstetricians and Gynecologists (ACOG), and Society of Maternal Fetal Medicine are all advising doctors not to withhold the COVID-19 vaccine from patients who are planning to conceive, currently pregnant, or breastfeeding. Joining them is the American Society for Reproductive Medicine (ASRM), which came out with a statement on December 16, suggesting that both patients undergoing fertility treatment and pregnant patients should be encouraged to receive the vaccine — based on eligibility criteria.

The folks at ASRM say doctors and patients should work together to make that decision. You can expect your provider will consider these criteria in helping you choose:

• Local COVID-19 transmission and risk of picking up the virus in your area
• Personal risk of contracting COVID-19
• Risks of the vaccine and any side effects
• The lack of data out there about the vaccine during pregnancy

Honestly, like any medical decision, it comes down to individual women and their doctors to make the choices that are right for them.

Benefits of the COVID-19 vaccine

Doctors give multiple reasons for recommending the COVID-19 vaccine for both men and women on their fertility journey.

For women

If you’re fully vaccinated before conceiving, Minkin says “you'll have the benefit of immunity before conception.” That’s important. Data indicates pregnancy is associated with a higher risk of severe COVID-19 impact, and the American College of Obstetricians and Gynecologists is recommending pregnant women and lactating women have the vaccine made available to them to keep them safe.

The WHO, despite its cautions for pregnant women, is also advocating breastfeeding mothers get vaccinated — they say it’s both “biologically and clinically unlikely” to pose any risk to a breastfeeding child.  There’s currently no evidence (yes, we know we keep saying this) that contracting COVID-19 will affect your fertility, and experts like the WHO continue to say there’s no reason to put off pregnancy just because you’ve gotten a vaccine, but researchers are still monitoring this as more people contract the virus and more time passes. Vaccination is intended to prevent the virus as well as any potential side effects of getting sick.

For guys

Scientists are already seeing some cases where men who’ve experienced COVID-19 end up with impacted sperm production, which could impair their fertility. Preventing him from contracting the virus at all could prevent that from happening.

What if you’re already undergoing fertility treatment?

Many hopeful parents-to-be had to put fertility treatments on hold during the COVID-19 pandemic, but maybe that’s not you. You’ve been faithfully doing those injections, and your body is riding that gonadotropins rollercoaster.

Should you still get the vaccine? Minkin says this is another unknown simply because of a lack of data, but again this isn’t a sign that the vaccine is off the table.

The lack of data goes both ways, she says. There’s no evidence that being on hormones will affect how your body handles a vaccine AND there’s no known evidence that taking the vaccine can affect your treatments either.

Do we know anything about the COVID-19 vaccine?

We have thrown a lot of “we just don’t know” at you. So what the heck do we know?

Well, we know that the COVID-19 shot is an mRNA vaccine, rather than a live virus vaccine. That means:

• It doesn’t affect your genes. Any time scientists go poking around the human DNA strand, folks get nervous (and hey, we get it). But the one letter difference between RNA and DNA is a biggie — an mRNA or messenger ribonucleic acid vaccine never enters the nucleus of human cells. That means your basic DNA will not be changed if you choose to get the vaccine.
• The effect of mRNA vaccines on a fetus has been evaluated: And the folks at the Society for Maternal Fetal Medicine say there are no risks of an mRNA vaccine to fetal health.
• It’s similar to the make-up of vaccines for influenza, Zika, and rabies: According to the CDC, this is not the first time mRNA vaccines have been developed and used.
• It has undergone testing by the Food and Drug Administration: The FDA gave the Pfizer coronavirus vaccine a thumbs up for emergency use, but only after doing what they call a “benefit-risk assessment.” That means the experts at the FDA evaluated every bit of information from the company’s clinical trials. They’re expected to do the same for other pharma companies and their vaccine trials too.

When will we have some data?

Now that vaccines are being administered, researchers are already kicking off studies to get more information about the effects of the vaccine on the body, and that includes fertility concerns. Here’s what’s on tap:

• Experts at the American Society for Reproductive Medicine have called on doctors to encourage more patients to participate in vaccine trials and post marketing surveillance.
• Scientists are already looking to see if the vaccine affects a man’s semen and for how long.
• Although pregnant women weren’t sought out for vaccine trials, there have been some reported pregnancies in women involved, and the pharmaceutical companies are tracking them. The Moderna trial, for example, ended up including 13 women who have gotten pregnant along the way — six who had the vaccine and seven who were in the placebo group.

What about THAT article?

But wait a second, what about that article you saw all over everyone’s Facebook feed claiming a link between the vaccine and fertility? The one warning you that the vaccine is “female sterilization”?

The article showed up as a screenshot on Facebook in early December, seemingly pulled from a blog called “Health and Money News.” In it, you’ll see claims that the COVID-19 vaccine is “training the female body to attack syncytin-1,” a spike protein that’s part of the building of placenta, which would result in “female sterilization.”

That sounds frightening, we know. But it’s also fake news.

Minkin sums the viral article up in one pretty clear word: “bogus.” As for all the details the article goes into about spike proteins and syncytin-1, the Yale professor says it’s got no “significant scientific validity.” There you have it.

Bottom line

As of right now, there just isn’t a lot of clinical data or guidance to be found. You’re caught between a rock and a hard place, and we know it’s scary!

If you’re on your fertility journey and considering whether or not you should get vaccinated against COVID-19, we suggest you ignore the bogus myths and go directly to your doctor’s office. They’ll be able to help you plan out the best path forward.

Maybe your doctor just informed you that your sperm count is low, which may contribute to fertility issues. Or maybe you just have a sneaking suspicion that low sperm count is at the root of your fertility challenges. If so, you’re probably thinking: Why me? What does “low sperm count” even mean? How can I fix it?

The first thing to know is that you’re not alone. In fact, up to 50% of fertility problems can be attributed at least in part to male factor infertility. Still, depending on the cause of the low sperm count, there may be several avenues on which you can proceed.

What is low sperm count?

When you have a semen analysis, there are several parameters that are assessed. Two of the main aspects doctors look at are sperm concentration, or how many sperm there are in each milliliter of the sample provided (normal concentration is greater than 15 million sperm per milliliter), and sperm motility, or what percentage of the sperm in the sample is in motion (normal motility is greater than 40%). Low sperm count would be defined as a semen analysis with results less than these normal values.

What causes low sperm count?

A number of things can cause low sperm count, including certain cancer treatments, hormonal disorders, history of groin or testicle surgery, reproductive tract infections (including sexually transmitted infections) and certain medications such as chronic opioids and testosterone supplementation.

Varicocele is the most common surgically correctable cause of low sperm count and male factor infertility. This is characterized by dilated veins in the scrotum. The majority of men with low sperm count, however, may have no identifiable cause, as frustrating as that may be.

How can I treat low sperm count?

If you have been told you have low sperm count with associated fertility issues, it’s a good idea to chat with a urologist who specializes in male infertility. They can perform a thorough evaluation to assess for possible causes and potentially recommend medical or surgical treatments.

But don’t freak out. There are actually a few things you can try on your own to treat low sperm count while waiting for your appointment or the results of your workup:

Avoiding some stuff

Plain and simple, cigarette or e-cigarette usage has a negative effect on sperm counts; regular cannabis use (more than once per week) and excessive alcohol intake similarly are associated with low sperm count. Anabolic steroids or supplemental testosterone use can affect the hormones in the body that stimulate the testicles to make sperm and thus can cause low sperm counts.

Keeping tabs on your diet and exercise

Obesity is associated with low sperm count. There is data to suggest that weight loss in obese men may improve semen quality. And further, obese men tend to have hormonal abnormalities, which can improve with weight loss.

Moderate- or high-intensity physical activity (activities that force you to breathe somewhat harder or much harder than normal) has a positive effect on semen parameters. But interestingly, elite physical activity — when a person performs exhaustive endurance exercises — may negatively affect semen parameters.

Lastly, adherence to a healthy diet, notably the Mediterranean diet, can improve semen count. Increasing intake of fruits, vegetables, fiber-rich foods, fish, seafood, poultry and limiting full-fat dairy, cheese, red meat, soy and sugar-sweetened foods can improve sperm quality.

Thinking hard about supplements

There’s a lot of mixed information out there about supplements and male fertility. We know that oxidative stress (when cells that use oxygen to function produce toxic end products, known as reactive oxygen species or free radicals) can play a role in male subfertility. While many antioxidants and dietary supplements may reduce oxidative stress, the data on improving semen parameters is limited and occasionally contradictory.

Further, many supplements that claim to improve male fertility have limited or no scientific support. However, there is data that Coenzyme Q10, L-carnitine, Folic acid, Zinc, Vitamin C and Vitamin E may improve certain semen parameters. Just make sure that you chat with your doctor before taking any supplement used for male fertility management.

Unexplained low sperm count can be super hard to process. Still, some lifestyle modifications can have a positive effect on semen parameters. “Sperm health is a measure of overall health,” Dr. Sarah Vij, the Director of the Center for Male Fertility at Cleveland Clinic explains. “Anything you can do to improve your overall health, eating right, staying active, avoiding cigarette smoking and limiting alcohol, can improve your fertility.”

Summing it all up

When it comes to sperm count, there isn't always a definitive answer, and more research is needed to truly understand all that's involved. The good news is, there are promising low-risk strategies to improve sperm count. Good luck!

If you’ve experienced pregnancy loss, there may be a hard-to-ignore question in the back of your mind: what, exactly, causes miscarriage?

You may know that it’s common—as many as 1 in 4 pregnancies end in miscarriage, and the real number is, unfortunately, even higher when you factor in unknown pregnancies—but as frequently as it happens, many prospective parents still don’t know what actually causes it.

That giant question mark can make the miscarriage experience even worse. Grieving over your pregnancy loss is hard enough, but when you don’t know where to place the blame, and wonder if it could happen to you again, you end up facing fear, anger, and frustration on top of grief.

When miscarriage happens, it’s crushing. But the thing to keep in mind is this: miscarriage is not your fault, and there’s nothing you could have done to prevent it or change it. The universe has a pretty messed up way of working, huh?

So...what are the causes of miscarriage, anyway? And why do they happen to so many women?

Here are some common reasons why miscarriage can occur, and what you should ask your doctor if it’s happened to you.

Possible miscarriage cause #1: abnormal chromosomes

Biology may be a science, but it kind of functions like a delicate musical instrument: one wrong note and the whole thing goes out of tune. Translated to genetics, this means that if one teensy piece of the babymaking chromosomal puzzle doesn’t fall perfectly into place, the embryo may not develop properly, potentially causing miscarriage.

According to OBGYN Mary Jane Minkin, M.D., clinical professor of obstetrics, gynecology and reproductive sciences at Yale University School of Medicine, an embryo that’s genetically abnormal is the most common cause of miscarriage. She says sometimes this abnormality occurs at the very start of the fertilization process and other times it happens a bit later.

Either way, you can’t control the genetic processing that happens when sperm meets egg (unless you did in vitro fertilization and your doctor tested the genes of your embryo before transferring it, which many do!).

You can, however, ask your doctor to do some detective work for you if you’ve had repeated miscarriages: placental and fetal tissue can be tested for chromosomal abnormalities, giving you a clearer picture of what’s going on in your body when a fertilized egg ends in miscarriage.

Possible miscarriage cause #2: advanced maternal age

You know what sucks? Because women are born with all the eggs they’ll ever have, those eggs age right along with us...and can increase your chances of those chromosomal abnormalities we mentioned.

In a 2019 study published in the British Medical Journal, the risk of miscarriage rose sharply in women over the age of 30, reaching as high as 53 percent by age 45.

Even men, who generate fresh sperm all the time, are subject to chromosomal aging, says Minkin: “Guys keep making new sperm, although there is data to show that older fathers do have more genetic issues, too.”

If you and your partner are concerned about your genetic health—whether it’s because of aging or not—you can ask your doctor for genetic screening, which may alert you to risk factors you otherwise wouldn't know about.

Possible miscarriage cause #3: infertility or hormonal issues

This is going to sound like a chicken vs. egg scenario, but hear us out: infertility issues may actually cause...more infertility issues? Basically, your miscarriage rate can be higher if you’ve struggled to conceive in the past, possibly because there’s something up with your hormones at the root of your infertility challenges.

“Occasionally, a woman might not be ovulating well enough, [meaning] she is ovulating enough to produce the egg, but not enough to make the progesterone needed from the ovary to maintain the pregnancy,” explains Minkin. This might apply to you if you experience anovulatory cycles, irregular cycles, or if you have polycystic ovarian syndrome (PCOS).

Possible miscarriage cause #4: infection or chronic illness

No, we’re not talking about colds or stomach bugs here—we’re talking about more severe infections, like sexually transmitted diseases (STDs), cytomegalovirus (CMV), and pelvic inflammatory disease. We’re also talking about chronic conditions, many of which come with the one-two punch of increasing your risk of miscarriage and infertility issues.

Kecia Gaither, M.D., double board-certified physician in OB/GYN and maternal fetal medicine and director of perinatal services at NYC Health + Hospitals/Lincoln, says maternal illnesses like diabetes, thyroid disorders, autoimmune disorders such as lupus, and blood clotting disorders can contribute to the overall causes of miscarriage, too.

Possible miscarriage cause #5: reproductive or anatomical issues

There are a bunch of congenital abnormalities in the reproductive system that can a) make it harder for you to conceive and b) make it harder for a fertilized embryo to thrive after conception.

Some of these abnormalities include:

• a misshapen uterus (like a double- or half-uterus)
• uterine fibroids
• a uterus with a septum
• blocked or damaged fallopian tubes
• endometriosis scarring

You may know about these anomalies already if you’ve got ‘em; they may have affected your menstruation or caused other symptoms. Either way, many of them can be treated if they’re contributing to infertility, so talk to your doctor.

Possible miscarriage cause #6: substance abuse

According to Dr. Gaither, frequent drug and alcohol use may also increase your chance of miscarriage. No, we don’t mean the celebratory glass of champagne you had on your birthday before you knew you were pregnant. It’s the consistent consumption of alcohol—especially as you move past week five of pregnancy—that’s affiliated with miscarriage. (And any amount of drug use, at any point during pregnancy, is potentially a problem.)

Addiction is a debilitating mental health condition; if you’re struggling, consider seeking help—especially if you’re trying to have a baby.

What to ask your doctor

If this is your first miscarriage, it may not be necessary to ask your doctor anything just yet; Dr. Minkin says miscarriage is common enough that it doesn’t always mean there are overarching fertility issues that need to be addressed. On the other hand, if you’ve been trying to conceive for a while, have a known fertility issue, or received any kind of fertility treatment, you may want to investigate any underlying issues as soon as possible rather than wait.

It’s best to talk to your doctor about a miscarriage so they are aware it happened and can make a decision, based on your overall health, about how to proceed. If your doctor feels more evaluation is needed to determine what caused your miscarriage, Dr. Gaither says there are a few things your doctor can do in terms of getting your fertility prospects checked out. These may include:

• Having miscarriage tissue genetically evaluated
• Having diagnostic tests to look for uterine or cervical anomalies
• Managing any other medical conditions that could be contributing to your inability to maintain a pregnancy

If you’re grieving a pregnancy loss, we know this information is probably pretty overwhelming. You may not be eager to dig into the reason behind your miscarriage at this point — and that’s understandable. You should take the time you need to consider your options and move forward when you feel ready.

But you should also know that miscarriage doesn’t mean you can’t ever get pregnant. Many women go on to have healthy pregnancies after experiencing loss, sometimes naturally and sometimes with assistance from a fertility specialist. We’re rooting for you.

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Read more in Does Using Donor Eggs Decrease the Risk for Miscarriage?

Zika has been in the news a lot since it first came to public consciousness in 2016. And while it's definitely a very scary virus, there's some confusing information out there about how people get it and what the risks are to those of us living in the US and trying to get pregnant. We did some research to make sure you have all the facts before you plan your next vacay while you're TTC.

What is Zika?

Broadly speaking, Zika is a mosquito-borne virus, but there are other ways it can be transmitted: through sex with an infected person, or if a pregnant woman passes it on to her developing fetus. Symptoms in adults are similar to getting the flu: fever, rash, headache, joint pain, muscle aches and red eyes. However, many people won't show any symptoms at all, and those that do might not feel badly enough to go to the doctor.  

For most adults, the symptoms will pass without issue within a week. But the biggest danger is that Zika can get passed to a fetus if a person with Zika becomes pregnant, because the symptoms for a baby are far more severe, including a birth defect called microcephaly and other scary brain defects.  

I'm not pregnant (yet). Why should I worry about Zika?

Not to freak you out, but, "the fear is that Zika can stay in your system for several months," says Dr. Jamie Knopman, a reproductive endocrinologist at New York fertility clinic Colorado Center for Reproductive Medicine (CCRM). "So, let's say you went on a great trip and then got pregnant after you got back, it could still be living inside of you."

And remember, Zika can also be sexually transmitted. So if your partner traveled to an area with a Zika risk and caught the virus, it could continue to live in his or her system and then get passed on to you (and your future pregnancy) even months after.

So, if you're already trying to get pregnant, or you're thinking about starting to try, here is some info you'll need to make sure you conceive as safely as possible.

Where can I contract Zika?

The Centers for Disease Control (CDC) states on their website that there were no local mosquito-borne Zika cases reported in the US in 2018. That means there is no known risk of getting Zika from a mosquito bite in the States. But, if you have plans to travel out of the country while you're TTC, be sure to search for your dream destinations on the CDC's website to ensure you're playing it safe.

What precautions should I take when I travel?

The cold, hard truth: "don't go to places that may have Zika," says Dr. Knopman.

But if you must travel to one of these areas, you've got to protect yourself from bug bites. Wear an EPA-approved bug spray at all times, protect your skin with long-sleeve shirts and full-length pants, ideally treated with permethrin (an insecticide that keeps working, even after washing), and keep bugs at bay when you're indoors with screens on windows and doors and mosquito nets over your bed. Don't hate us for killing your travel vibe; we're just the messenger!

But wait, there's more. after you or your partner return from your trip, you need to continue to be cautious, pushing your TTC timeline even further into the future, including:

• Continuing to fend off those mosquitos: For at least 3 weeks, the CDC recommends you keep taking all the same precautions to avoid bug bites. Sounds crazy, but better to be safe than sorry.
• Months of no unprotected sex or fertility treatments: if your partner traveled without you, doctors advise you avoid conception for at least 3 months after your partner returns from that trip. If you traveled with your partner, or if you traveled alone, the recommendation is to avoid pregnancy for at least 2 months. These periods apply even if you have no symptoms of having contracted Zika, and they're extended if one or both of you has caught the virus: you'll need to wait until 2-3 months from the date your symptoms first appeared or the date of your Zika diagnosis.

So, yeah...it's complicated. Really, if you're hoping to conceive any time within the next year, it's probably best to take Dr. Knopman's advice and avoid traveling to anywhere on the CDC's list of Zika risk areas. Even if you don't end up getting Zika, you're still going to be playing a waiting game to ensure the healthiest pregnancy possible.

So your doctor wants you (or your partner) to undergo a semen analysis for infertility, huh? If you've never given a sperm sample before, you're probably imagining all kinds of embarrassing and/or awkward scenarios. Will a random stranger accidentally burst in at a critical moment? Will you be able to "make the magic happen" under pressure? Will it be exactly like that scene at the sperm bank in Road Trip? (Spoiler alert: no, it's nothing like that.)

Chances are, if you're facing infertility and your doc has asked for a semen analysis, he or she's got a pretty good reason—there's a lot that can be learned from that precious cup of bodily fluids, so it's definitely worth going through the process even if you don't totally love the idea. But relax: a semen analysis is not as bad as you think. Here's everything you need to know.  

Why do I have to do a semen analysis?

The most obvious reason is because you're dealing with infertility issues—male factor infertility is found in 40% of couples struggling to conceive, so a semen sample is the best way to determine if something's up with the quality of your sperm. But Dr. Mark Trolice, reproductive endocrinologist at Fertility CARE: The IVF Center in Orlando, Florida, says there are some other possible reasons for needing to give a semen sample, like if:

• You're trying to become a sperm donor
• You want to freeze your sperm for future insemination or conception
• You're going to be away during a planned fertility treatment cycle (like if your wife is undergoing in vitro fertilization while you're deployed with the military)
• You've had a vasectomy but want to make sure there's no remaining sperm in your ejaculate

Will it be like in the movies?

Well...yes and no. Basically, you do have to set up shop in a private room at the fertility clinic and manually stimulate yourself until your efforts are, you know, fruitful. Clinic staff will give you a sterile collection cup to fill up with ejaculated sperm. Remember, they see this kind of thing every day—there's no need to be embarrassed or ashamed about what you're doing.

Now, as far as successfully setting off the fireworks show, there's a certain amount of flexibility in how you go about it. Dr. Trolice says that usually your partner can go into the room with you to help out or make things less awkward, and of course there are always helpful materials available if you need them.  

If you're still totally stressed out about the idea of a) manual stimulation or b) ejaculating in a semi-public place, there may be some options to get around those obstacles, too. In some cases, a couple can use a special condom during intercourse at home to collect semen (but it can't just be any old condom, because regular ones might contain lubricants or other residues that can kill sperm).  

If you go this route—or just want to collect your sample at home through masturbation—you'll need to be able to rush your semen down to the clinic within 30-45 minutes, says Dr. Trolice. Any longer than that and you risk affecting the sample; if it gets too cold, for example, the motility of your sperm could slow down and skew your results.

What am I going to learn from this?

According to Dr. Trolice, there are four things your doctor will be looking for in your sample:

1. Volume, or the amount of fluid you produced. Typically, about 1 ½ to 2 milliliters or more of semen will give you an adequate total number of sperm.
2. Density, or the amount of sperm per milliliter of semen.  
3. Motility, or how many sperm are moving around, and forward, in the sample (and how well they're moving forward).
4. Morphology, or the size and shape of your sperm (the Mayo Clinic says you want sperm with an oval head and straight tail, i.e. sperm that can successfully penetrate an egg).

In 2010, the World Health Organization (WHO) released a new set of guidelines for a normal sperm analysis; in order to be considered fertile, semen should have at least 15 million sperm per milliliter, a motility of 40% or more, and a morphology of 4% or more. Dr. Trolice warns patients to take these guidelines with a grain of salt, though.  

"It's important to know that just because your numbers are below the cutoff, that doesn't mean you can't father a child or will definitely need to do IVF," he says. In some cases, a patient might be referred to a urologist or possibly considered for hormone therapy or surgery if the problem can be corrected.

Your feelings about it are totally normal

Look, we know you probably don't want to do a semen analysis, but if you're struggling with the possibility that you could have male factor infertility or worried that you'll receive abnormal test results, know that those feelings are 100% normal—and it's okay to find someone to talk to about it. Until then, remember that this kind of thing happens all the time...and is pretty much always less eventful than it was for Seann William Scott.  

So, you're ready to start fertility treatment. Or at least, you think you're ready...but there's one question that you just can't get past. Is IUI or IVF actually going to work?  

You've probably read up on your clinic's success rates. It may even be why you picked them. But what do those numbers actually mean for you and your chances of getting pregnant?  

Success rates

What they are

We're going to take a quick trip back to elementary school math class for this one. IVF success rates are calculated by the federal Centers for Disease Control (CDC), using information provided by individual fertility treatment providers around the United States. The Feds take the number of assisted reproductive technology (ART) cycles performed each calendar year at every reporting clinic, then divide them by the number of resulting births to get a success rate. Rates can be broken down even further by a host of factors, including:

• Clinic
• The use of fresh eggs vs. frozen eggs
• The use of a woman's own eggs vs. donor eggs
• Fertility diagnosis
• A woman's age
• How many embryos are typically transferred
• How many embryos typically implant
• How many live births result
• Singleton, twin, and triplet births

The result is intended to give you a sense of your chances of having a baby at that clinic, with your specific fertility concern and that specific method. Makes sense, right?

What they're not

While success rates are an important factor in determining if you should proceed with treatment at a particular clinic, they're not the be-all-end-all, says Dr. Jaime Knopman, M.D., a reproductive endocrinologist at New York fertility clinic Colorado Center for Reproductive Medicine (CCRM). She advises to take the following into account:

• More data is better: When asking for a clinic's statistics, Dr. Knopman says you'll want to see how successful the clinic has been over time, not just in one year. "You want to see numbers in the thousands," she says of number of treatments the clinic has provided. "You want to see long-term data."  
• Live birth vs. pregnancy: Unfortunately not every pregnancy results in a birth due to miscarriage and stillbirth. Make sure the number your clinic is giving is not just their success rates in achieving pregnancy but their rate for producing bouncing, cuddly babies. After all, that's the goal, right?  
• Nothing is set in stone: Remember that success rates are not a guarantee that your treatment will (or won't) be successful. Everyone's fertility journey is different, and we humans can't be captured in a mathematical equation.  

Donor egg IVF success rates

According to the Society for Assisted Reproductive Technology (SART), donor egg IVF success rates depend more on the age of the donor, not the mother (recipient). During 2010, CDC data shows an average birth rate per embryo transfer of 55% for all egg donor programs.

At Cofertility, the average number of mature eggs a family receives and fertilizes is 12. Some intended parents want to do two egg retrievals with the donor which is definitely possible. We also ask each of our donors whether they are open to a second cycle as part of the initial application — many report that they are!

You can see how many eggs are retrieved in the first cycle and go from there. If, for any reason, the eggs retrieved in that round do not lead to a live birth, our baby guarantee will kick in and we’ll re-match you at no additional match deposit or Cofertility coordination fee. If you are considering working with an egg donor to grow your family, our donors are ambitious, kind, and eager to help — find your match today.

Wait, what about IUI?

The CDC tracks data on the IVF process, but what about IUI success rates? Because IUI does not involve the the manipulation of eggs, it's not considered an ART procedure. That means success rates are not tracked by the CDC. That doesn't mean you can't ask your OB/GYN or fertility clinic to supply individual data on how their rates of IUI match up with the delivery of babies. There are also national figures to keep in mind:  

• The American Pregnancy Association estimates IUI has an average success rate of 20% per cycle (but they don't account for fertility diagnosis, age, etc).  
• The CDC estimates the chance of having a term, normal birth weight and singleton live birth using fresh embryos and non-donor eggs is 21% per ART cycle for women younger than 35, progressively dropping as a woman ages.  

But will IUI or IVF work for me?

Ah, the magic question. If only we had a crystal ball to tell if fertility treatment will work for us and which one is going to work the best.  

You can probably guess that the answer is going to be extremely personal, and your best bet is to have a candid heart-to-heart with your doctor. You've probably heard more than a few (hundred) times that a woman's age has a major impact on fertility.  

It's true, Dr. Knopman says. "The sooner you do it, the better you're going to do," she says of fertility treatment. That said, there is good news—fertility doesn't suddenly shut down overnight, and you do have time to make the important decisions, and go for treatment.  

Dr. Knopman offers up a breakdown of age to keep in mind when it comes to fertility (take a deep breath):

• 32: This is what Dr. Knopman calls "the first inflection point," or the age at which fertility slowly starts to decline. Notice we said, slowly? You'll get three years before your fertility is likely to begin to change again.
• 35: Often dubbed the beginning of "advanced maternal age" by doctors (which sounds crazy, but hear us out), 35 marks another inflection point. "The rate of decline gets faster," Dr. Knopman notes. But this doesn't mean your fertility journey automatically ends on your 35th birthday.  
• 37-38: Two to three years after 35, the decline rate will again pick up.  
• 40: This is a general age when fertility gets more complicated. "That's when you're losing [egg] quality," according to Knopman. But as with all the other ages on this timeline, the numbers are just general guesstimates, not an indication of what your body will necessarily do.  

If you have the means, tracking your own mother's fertility journey may help you get an idea if your body will follow this path too, Knopman notes. Family history can sometimes (though not always) be an indicator of fertility.  

Bottom line

Picking a clinic with good success rates is a big part of the fertility equation, but it's not the only one. Don't be afraid to get personal and talk to your doctor about your own unique concerns!