This Is Us - Kate and Toby IVF analysis by Dr. Morris S3 Ep. 2-5

Recap

Kate and Toby had a miscarriage and then experience secondary infertility. They decide to do IVF. For my full analysis, watch my complete review of Season 3 Episode 1



Episode 2

So Kate and Toby have started the medical treatment phase of IVF. Kate is taking fertility medication injections. In the Uber on the way to Kevin’s movie premier, Kate gets hot flashes. Is this accurate? Well possibly… There are a few type of IVF medication protocols. In the older protocol, called a Down Regulation protocol, women take a medication called Lupron to suppress the pituitary gland. The reduces the chance of premature ovulation or ovulation before the eggs can be retrieved. Most women will need to take this medication for a couple of weeks before starting the actual fertility drugs which stimulate the ovaries. During this time, the estrogen levels from the ovaries get very low and this will commonly result in hot flashes.



These days, many IVF experts will use a shorter protocol in which the medications to prevent ovulation are given at the same time as the fertility drugs instead of beforehand. As a result, there is no decrease in estrogen levels so this protocol does not result in hot flashes



The big drama in this episode is when Kate’s mom, Rebecca discovers that Kate and Toby are doing IVF. This occurs, when Miguel goes into the refrigerator and accidentally discovers Kate’s medications. For this, the show gets good marks. Many of these medications have to be kept in the refrigerator. I know many stories of patients trying to hide the medications when guests are over.



The show also hits the right mark when dealing with Kate’s concern about her family finding out. Many of my IVF patients, do not reveal to their families what they are going through until after the fact.



Skip ahead to Kevin’s movie premier. Toby, who usually gives Kate her injections, is nowhere to be found. Kate is freaking out because she has been told that the medications have to be given at an exact time. A newly convinced Rebecca ends up giving the injection to Kate. The reality is that is overly dramatic. With one exception, these medications do NOT have to be timed to the minute. Generally speaking, we talk about these medications being given in the morning or the evening. There is a few hour leeway.



The one exception to that is that injection that is given before the eggs are retrieved. This is known as the trigger injection. This injection has to be given at a precise time according to the doctors injections. We know that this wasn’t Kate’s trigger injection however, because if it was, then Kate would have had the egg retrieval two mornings after Kevin’s premier - which she did not.



So Rebecca ends up giving Kate her injection in the bathroom of the movie theater. Love this scene! Many patients have told me stories about the odd places that they have had to given injections. Movie theaters, restaurants, weddings they were standing up at and even in airports and airplanes during flights. Where was the oddest place you gave or received fertility injections? Let us know in the comments or on Twitter #InfertilityTV and #milehighclub 



I do have a bone to pick about the location of the injection on Kate’s body. Rebecca gives the injection in Kate’s thigh muscle. Almost all fertility medications these days are given with a tiny needle under the skin - typically in the abdomen. Plus, most women do these injections themselves. But I’’ let them slide on this one because I loved Rebecca’s turn around on this.



One thing I didn’t like. Kate was drinking alcohol at the movie premier. A number of studies have found that alcohol use is associated with decreased success rates with IVF. At IVF1, we recommend to our patients that both partners stop alcohol use a month before starting the IVF medications.



Finally, this episode brings up the issue of risks. Specifically, Rebecca asks “Have you guys really considered all of the risks?”. I think she is not just talking about IVF here but about the risks of pregnancy in general. The biggest risk that Kate face with IVF is simply that it won’t work. The other risks associated with IVF egg retrieval like all procedures include infection, bleeding, damage to nearby organs and most importantly for Kate, anesthesia risk.



However, there are many more risks to pregnancy. These risks are magnified in women who have a history of infertility and women who have a high BMI. If Kate gets pregnant it will be interesting to see whether she has problems with gestational diabetes or the high blood pressure problem known as pre-eclampsia.



Episode 3



In this episode, Kate finally gets to the point of having her IVF egg retrieval but not before getting into an argument with Randall in which he suggests that maybe she and Toby should be adopting instead of doing IVF. Kate hits him with my favorite line in Season 2. She states “How dare you throw adoption in my face right now, and how dare you make me defend wanting this.”



I love this because it is something that infertility patients hear commonly. It's an absurd comment to make because it implies that women who have infertility have a greater responsibility to adopt children than anyone else does simply because they have a disease process which requires them to have medical treatment to be able conceive on their own



Now on to the egg retrieval. I should point out here that 90% of the time, the anesthesia that is given for an egg retrieval is administered through an IV in the arm and that’s all. In Kate’s case, however, she gets Intubated. This means that the anesthesiologist buts a tube down her windpipe. This allows a deeper level of anesthesia to be given and at the same time allows the anesthesiologist to help her breathe if any problems come up during the procedure.



This is an excellent idea for women who are very obese, like Kate and at higher risk from anesthesia.



Next we learn that Kate’s IVF specialist, Dr Jasper, was able to retrieve 8 eggs and tells Kate that’s a good number. But is it? At IVF1, the average number of eggs retrieved for a 36 years is 14 but obese women do not respond as well to fertility medications and commonly get less eggs so 8 is probably doing pretty good



Incidentally, it seems Kate was lucky to get her own doctor to do the egg retrieval. It’s Dr Jasper who comes into the recovery room after Kate wakes up from anesthesia to tell her the number of eggs. We know from episode 1 that Dr Jasper is part of a larger group. With large groups, the doctors will commonly take turns each day. So one doctor would do all of the egg retrievals for a given day whether its for her patients or another doctor in the group. However, when we see the picture of Kate and Toby’s embryo later it says the Doctor was Dr. Arroyo. Production error ir was Dr Jasper trying to take credit for Dr Arroyo’s work?



Episode 4 is all about Jack in Vietnam so lets skip to Episode 5



This is the embryology episode. We learn that out of the 8 eggs, there were only 3 that fertilized. This seems a little low. An average fertilization rate is 70 percent. However, we are never told how many of the eggs were actually mature, healthy eggs that had Toby’s sperm injected. If we assume 5 mature eggs, then having three out of five fertilize seems closer to an expected number.



One confusing thing happens here. Dr Jasper calls Kate and Toby, the day after the egg retrieval to tell them they have three fertilized eggs but the picture they post on their refrigerator of the “Three Amigos” is of embryos at the 4 cell cell stage which is 2 days after the egg retrieval which is possible but most IVF labs don’t check or photograph embryos at that stage.



From the three fertilized eggs, only one embryo develops and is available for transfer. Is this typical? Actually, yes. Most of the the embryos that a woman produces either on her own or with IVF are not viable embryos that do not have the ability to produce a live born baby. In many cases, embryos will stop dividing or even degenerate.



The one embryo remaining, to which Toby sings, “One Singular Sensation” is an 8 cell embryo which means that Kate’s embryo transfer occurred on the 3rd day after the egg retrieval.  The picture says its Day 9 which is impossible so this is likely just another tiny production error.



Finally, we learn that Kate had a positive pregnancy test. Before getting the official news from Dr. Jasper, Toby wisely tells Kate to avoid doing a home pregnancy test which is a great idea because as Kate says, these home tests are not accurate enough when done this early in pregnancy and could quite possibly cause “emotional chaos.



Yay! Kate is pregnant. Will she miscarry again? Will she experience pregnancy complications? Did the embryo split and produce twins? Or Triplets? And most importantly, will the medical information presented on the show be accurate? Tune in to This is Us and Click that notification bell so you dont miss any future episodes of Infertility TV.

Does men's underwear matter for fertility ? - Boxers vs briefs - Inferti...

Today in InfertilityTV we are going to discuss underwear. Specifically male underwear. Stay tuned for 60 seconds to get my fertility recommendations



The following statements are well agreed upon facts. The testicles are located outside the body in the scrotum. The temperature of the testicles is a couple of degrees lower than inside the abdomen. When the scrotum is exposed to heat over a period of time, this will have an adverse of effect on sperm production.



Based on these facts, several practical questions comes up. Will wearing tight underwear increase the scrotal temperature? Several studies have looked at this but the results have been inconsistent.



The next question that scientists have tried to answer is - does the type of underwear that a man wears influence sperm production? Several studies have also looked at this but again there are conflicting results. Some studies say yes but other studies say no. A recent study, one of the largest ever performed, found a 17% decrease in sperm numbers when men chose non boxer type of underwear.



Why all the uncertainty? Well. for one, like most lifestyle questions, it’s pretty difficult to rule out all other variables and to say with certainty that one factor, such as underwear choice, makes a difference. Second, there is a huge variation in the type of underwear that mean wear. It’s not just a difference between boxers and briefs but the length of the underwear and how tightly fitting it is. The material is also important, cotton, nylon, silk, polyester, flannel-- all may have a different impact. Finally, studies show that up to ⅓ of men will change their underwear to a different type before going to bed!



 Here are my InfertilityTV recommendations for men

If you like boxer shorts, knock yourself out. No one has ever suggested any adverse effect from boxers

If you like briefs, keep wearing them. There isn’t sufficient evidence that this one factor, by itself, will make you less fertile. In fact, the largest study to look at actual fertility potential found no impact of underwear type.

Essential Oils - Should you avoid them while trying to conceive - TTC ?

Should essential oils be avoided when you are TTC? Some essential oils are endocrine disrupters that may affect normal development or cause endometriosis. Listen in as Dr Randy Morris MD-The BOARD CERTIFIED fertility expert explains on InfertilityTV



#essentialoils #ttc #endometriosis



One of the latest fads to sweep the internet are essential oils. If you are not familiar, these are liquids that are chemically extracted from various plants and then released into the air through a vaporizing device and then inhaled into the body. In this respect, they are similar to E-cigarettes.



Hang on for another 45 seconds to hear my very important recommendations about essential oils for couples trying to get pregnant.



The first thing to understand about essential oils is that there is nothing essential about them. Your body does not need these chemicals as opposed to things it does require such as essential amino acids.



While these oils were initially utilized to provide a pleasant scent, more recently they have been promoted as healing therapies and are promoted on the internet as a cure all for everything from allergies and asthma to cancer prevention. 



Although the names sound benign, these oils contain mixtures of dozen or hundreds of chemicals. These oils, and therefore the chemicals that make them up, are very concentrated and can have very real effects on the body.



Recently, scientists were investigating why some young men who were exposed to these oils grew breasts, a problem called gynecomastia.



They discovered that a number of the chemicals that are found in dozens of oils act as endocrine disrupters. This means that they interfere with the action of hormones in the body.



Hormones are involved in the process of reproduction and pregnancy. Studies of various environmental endocrine disrupters have found they can negatively affect the growth and development of eggs in the ovaries, interfere with normal hormone production and affect the development of a fetus in the uterus.

There is evidence that endocrine disrupters may lead to the development of endometriosis.



In men, it can interfere with normal sperm production.



Until we studies about the safety on these powerful chemical mixtures, it is my recommendation that both women and men avoid exposure to essential oils if they are now attempting to conceive or plan on trying to conceive in the near future.



Women who are pregnant or think they might be pregnant should also avoid them as well as women who are nursing.



Infertility TV is your weekly source for the best medical information if you have infertility, recurrent miscarriage or are just trying to conceive. (TTC). InfertilityTV covers infertility testing, fertility treatments such as Clomid, Follistim and Crinone and fertility treatments like IUI and IVF (in vitro fertilization)



One of the most popular playlists on InfertilityTV are the TTC tips which are great even you are not struggling with infertility



Dr Morris is a practicing IVF and infertility expert who sees patients at IVF! located in the Naperville Fertility Center.



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A new episode of Infertility TV is broadcast weekly every Thursday afternoon



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Infertility Treatment for Women - IVF -

Dr Randy Morris MD-The BOARD CERTIFIED fertility expert with weekly TTC tips on InfertilityTV



No discussion of infertility treatment for women would be complete without a discussion of IVF or in vitro fertilization. IVF is a totally unique and successful infertility treatment for women



First off, many people confuse #IVF with #IUI. IUI or intrauterine insemination is when sperm is injected into the uterus at the time of ovulation. IVF or in vitro fertilization is when eggs are removed from the ovaries and fertilized outside of the body. Later on, embryos are placed into the uterus. 



There are many different ways to do IVF. Today, we are going to discuss the most common method used by the most advanced IVF centers such as IVF1. 



In order to obtain many eggs, women are first given injectable fertility medications for 10 to 12 days. During this time, she will visit the IVF specialist’s office for every few days or so to have blood tests and ultrasounds.



The results of these tests are used by the doctor to make adjustments to the treatment and to determine the appropriate time to remove the eggs.



The eggs are removed in a process called an egg retrieval. This is done under anesthesia by passing a long needle into the ovaries under ultrasound guidance. It takes about 15-20 minutes.



The eggs are then fertilized by adding sperm and then allowed to grow in the IVF laboratory for several days. The embryos can then be placed into the uterus or frozen for future placement. This is known as an embryo transfer. 



The embryo transfer is an easy procedure which does not require anesthesia. In fact, at IVF, we set up a special ultrasound monitor for the patient and her partner so they can watch the transfer as it’s being done.



Then comes the longest wait of your life. It takes a while for an embryo to implant into the uterus and a little time after that before a pregnancy test will be positive. 



So the final step is to keep your fingers crossed



Infertility TV is your weekly source for the best medical information if you have infertility, recurrent miscarriage or are just trying to conceive. (TTC). InfertilityTV covers infertility testing, fertility treatments such as Clomid, Follistim and Crinone and fertility treatments like IUI and IVF (in vitro fertilization)



One of the most popular playlists on InfertilityTV are the TTC tips which are great even you are not struggling with infertility



Dr Morris is a practicing IVF and infertility expert who sees patients at IVF! located in the Naperville Fertility Center.



Increase your "Infertelligence"  ™



Subscribe to Infertility TV now!!!

A new episode of Infertility TV is broadcast weekly every Thursday afternoon



or visit our website at IVF1.com



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Infertility Treatment for Women - Fertility Drugs - Infertility TV

This is part 3 in our series on Infertility Treatment for Women. This Episode covers Infertility Drugs. Dr Randy Morris MD-The BOARD CERTIFIED fertility expert with weekly TTC tips on InfertilityTV





Fertility drugs are the most commonly used #infertility treatment for women. Today, we are going to discuss how these medications are used.



Fertility medications are used for three purposes:

1) To get women who don’t ovulate on their own to ovulate

2) To increase the number of eggs released in women who do ovulate and

3) In preparation for IVF.



For inducing ovulation, oral medications are usually used first since they are less expensive, easier to use and don’t require as much monitoring.



#Clomid is the most commonly used medication. Typically, your doctor will start with a lower dose such as 1 or 2 pills a day for five days. After monitoring, if the doctor determines that you did not ovulate, then your dose can be increased by 1 pill per day. So if two pills a day for five days didn’t work then you go up to three pills a day and so on. You usually wouldn’t go higher than five days but in rare cases you might take the Clomid for 7 or 10 days.



Injectable medications are a more potent #infertilitytreatment for women. Typically, you will see a higher percentage of women who will ovulate and more will get pregnant. Commonly used brands of these medications are Follistim or Gonal F. 



Like the Clomid, if you are trying to induce ovulation, the doctor will usually start on a lower dose and increase only if necessary. The exact dose is going to be determined by a number of factors however such as your age, the results of hormone testing and the response you had to any previous treatments.



Because they are more potent, the injections require closer monitoring with blood tests and ultrasounds in the doctor’s office every few days.



When being used to get multiple eggs in women who already ovulate, or for IVF, the dose of medications may be higher than when it’s used to induce ovulation.



There are side effects and complications that occur with the use of fertility medications so make sure you have an experienced fertility specialist to oversee your treatment.



Infertility TV is your weekly source for the best medical information if you have infertility, recurrent miscarriage or are just trying to conceive. (TTC). InfertilityTV covers infertility testing, fertility treatments such as Clomid, Follistim and Crinone and fertility treatments like IUI and IVF (in vitro fertilization)



One of the most popular playlists on InfertilityTV are the TTC tips which are great even you are not struggling with infertility



Dr Morris is a practicing IVF and infertility expert who sees patients at IVF! located in the Naperville Fertility Center.



Increase your "Infertelligence"  ™



Subscribe to Infertility TV now!!!

A new episode of Infertility TV is broadcast weekly every Thursday afternoon



or visit our website at IVF1.com



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Do you want to become a patient at IVF1?

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Register online here:

https://patient.ivf1.com/PatientPortal/NewPatient



Or call:

630-357-6540

Infertility treatment for women - Surgery - InfertilityTV

What types of surgery can be used as infertility treatment for women? Find out on this week's episode of InfertilityTV with Dr Randy Morris MD-The BOARD CERTIFIED fertility expert with weekly TTC tips



Infertility treatment for women - Surgery



Surgery, as an infertility treatment for women is not nearly as common as in the past. There are still some cases in which surgery is a good treatment for women with infertility. Make sure you stay to the end for the complete story.



#Surgery for infertility can be divided into two main areas. Surgery inside the uterus and surgery outside of the uterus



#Hysteroscopy

Surgery inside the uterus is performed with a fiber-optic scope called a hysteroscope. The doctor looks inside of the uterus through the hysteroscope which is attached to a video camera with a monitor.



The types of problems that can be fixed with a hysteroscope includes growths like fibroids or polyps, scar tissue and abnormalities in how the uterus developed. Once common example of this is something called a uterine septum in which tissue divides the uterus down the middle so that the uterus is split into two smaller halves.



Hysteroscopy is a non-invasive surgery. It does not usually require an overnight stay in the hospital and most women will be able to return to their normal activities by the next day.



#Laparoscopy

Sometimes problems can occur outside the uterus which can interfere with fertility. The most common problems are endometriosis, scar tissue and blocked fallopian tubes. Surgery for these problems can also be treated with a fiber-optic scope called a laparoscope.



Instead of going through the vagina, this scope is inserted through the belly button through a 1 cm incision. Additional instruments can be placed through additional incisions near the pubic hair line.



Depending on how much is being done, some women might end up staying in the hospital overnight but most of the time they can go home right after the surgery. The amount of time they will need for recovery is also going to vary on how long the surgery took and how much was done. Most women will need at least a few days before returning to normal activities and some might require a week or more.





Infertility TV is your weekly source for the best medical information if you have infertility, recurrent miscarriage or are just trying to conceive. (TTC). InfertilityTV covers infertility testing, fertility treatments such as Clomid, Follistim and Crinone and fertility treatments like IUI and IVF (in vitro fertilization)



One of the most popular playlists on InfertilityTV are the TTC tips which are great even you are not struggling with infertility



Dr Morris is a practicing IVF and infertility expert who sees patients at IVF! located in the Naperville Fertility Center.



Increase your "Infertelligence"  ™



Subscribe to Infertility TV now!!!

A new episode of Infertility TV is broadcast weekly every Thursday afternoon



or visit our website at IVF1.com



*******************************************

Do you want to become a patient at IVF1?

*******************************************



Register online here:

https://patient.ivf1.com/PatientPortal/NewPatient



Or call:

630-357-6540

Infertility treatment for women - IUI - 7 facts you should know

There are many infertility treatments for women. Is IUI the right infertility treatment for you? Dr Randy Morris MD-The BOARD CERTIFIED fertility expert with weekly TTC tips on InfertilityTV



#IUI #infertility #infertilitytreatment



Infertility treatment for women is a big topic to cover. I am going to break it down into some broad categories to make it easier to understand. In today’s episode, I am going to explain IUI.



 IUI is also called intrauterine insemination or sometimes artificial insemination. It’s the process of putting sperm directly into the uterus.Why would this help you get pregnant?



When you have intercourse, sperm are deposited into the vagina. Most of them promptly die. Some leak out of the vagina. Most of the sperm that aren’t killed, get trapped in the sticky mucous of the cervical canal. The end results is that very few sperm make it into the fallopian tubes where fertilization happens.



With IUI, you put the sperm directly into the uterus. That way you get a lot more sperm into the tubes and the chance for pregnancy is higher. This is true even when a man has a normal amount of moving sperm on his semen analysis.



Of course, in order for IUI to work, a woman must ovulate and have at least one fallopian tube that is open.



Fertility medications are often used with IUI to further increase the chance for pregnancy.



Men who have really low sperm numbers, such as less than a million or two are not the best candidates for IUI and should instead consider IVF.



IUI does not increase the chance for a multiple pregnancy but the use of fertility medications will increase that risk.



Compared to other fertility treatments, IUI is pretty reasonable priced. Usually, it somewhere in the few hundred dollar range for each month.







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A new episode of Infertility TV is broadcast weekly every Thursday afternoon



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IVF Procedure - How Long Does It Take? | InfertilityTV

How long does it take to complete the IVF procedure? Find out from Dr Randy Morris MD-The BOARD CERTIFIED IVF expert with weekly TTC tips on InfertilityTV



#IVFProcedure #IVF #invitro



The IVF procedure - how long does it take? The answer is anywhere from a few weeks to a few months depending on what type of IVF procedure you do and what protocol you use.



To figure out the length of time that IVF will take, you first need to know what type of IVF medication protocol you are going to use. There are two main types: The long protocol and the short protocol.



The long protocol uses a medication called Lupron to stop you from ovulating during the treatment. Most women will need to be on Lupron for two to three weeks BEFORE they then start the fertility medication to stimulate the ovaries.



The short protocol uses a different type of medication to prevent ovulation. Two common brands are called Ganirelix and Cetrotide. The medications are given DURING the time that the fertility drugs are being given.



Most women will need to take fertility drugs for 10 to 12 days. At IVF1, we have seen some women who only needed 8 days and others who needed 16 days but most are somewhere between those extremes.



The egg retrieval is performed two days after the last dose of fertility medication.



So if you are doing the long protocol, you are up to 4-5 weeks. If you are using the short protocol, you are at about two weeks.



The next thing to figure out is whether you are doing a fresh transfer or a frozen transfer.



A fresh transfer is going to be performed three to five days after the egg retrieval. However, most of the really good IVF programs these days are no longer doing fresh transfers. At IVF1, we freeze all of the embryos and then put the embryos in the uterus at a later time.



Check out this video for more info on fresh versus frozen transfer.



Frozen embryos transfer will definitely add some time to the process. First, it will take about a week and a half for you to get your period after the egg retrieval. At that point, you will need to prepare the uterus for the transfer. How long this part takes will again be dependent on the protocol your doctor puts you on.



If you are using Lupron again, figure another 4-5 weeks. If not figure about two weeks.



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Subscribe to Infertility TV now!!!

A new episode of Infertility TV is broadcast weekly every Thursday afternoon



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*******************************************



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This Is Us | Real Infertility / IVF Doctor Analysis

Are you a #ThisIsUs fan? We are! Season 3 Blockbuster: #katepearson has #PCOS! Toby has low sperm counts! They need #IVF! #DrMorris gives an in depth analysis of Episode 1. See what they got right! See what they got wrong. How did you feel as #infertility patients? Let us know in the comments #invitrofertilization #Polycysticovarysyndrome  #RandyMorrisMD CAUTION: Spoilers!

Fertility Diet: 7 science based food tips for TTC

Which fertility diet tips actually work? Which fertility diet prevents endometriosis? Or helps with sperm counts?  Dr Randy Morris MD-The BOARD CERTIFIED fertility expert with weekly TTC tips on InfertilityTV



#fertilitydiet

Fertility diets - Are they fact or fiction? In today's episode, we will discuss whether fruits, vegetables, fast food, seafood, trans fats and carbs can help or hurt your fertility. Stay tuned to the end for my specific diet recommendations.  (more below)



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First, don’t get confused. There are many different types of diets for a variety of medical problems. A diet to lower cholesterol, for example, won’t necessarily help with your fertility.

Second, if you are overweight, ANY type of diet that will allow you to lose weight will improve your fertility. Let’s get into some specifics. 



Fruits and vegetables -- A new study found that women who eat fast food and little or no fruit take longer to become pregnant. For women who had with the lowest intake of fruit, the risk of infertility increased from 8% to 12%, and in those who ate fast food four or more times a week, the risk of infertility doubled from 8% to 16%.



Fast foods included burgers, pizza, fried chicken and chips that were bought from take-away or fast food outlets. These findings were true regardless of female weight (BMI   ).



The LIFE (Longitudinal Investigation of Fertility and the Environment) study of 501 couples planning pregnancy shows that couples consuming two or more servings of seafood every week enjoyed more sex and got pregnant faster than those eating seafood less often. After 1 year, 92% of couples with a seafood-rich diet had conceived compared with 79% of couples with diets that contained less fish and shellfish.



Another study found that a diet high in trans fats were 48% more likely to develop endometriosis than those with the lowest consumption. However women eating a diet rich in omega-3 fatty acids, found in oily fish, seemed to protect against the disease as these women had a 22% reduced risk of developing endometriosis



A survey of women with and without ovulation problems found that women with ovulation problems were more likely to eat low fat dairy products, refined carbs, get their protein from animal products and consume trans fats. So if you have an ovulation problem avoid these things.



A typical Mediterranean diet contains a high amount of vegetables, fruits, olive oil, beans and cereal grains, moderate amounts of fish, dairy products, and wine, and only a small amount of red meat and poultry. A study from Greece of nearly 250 women found that those women who adhered most closely to this diet had 66% higher pregnancy rates during IVF.



Men who follow Alternative Healthy Eating Index (AHEI guidelines) (a diet rich in vegetables, fruits, whole grains, and low-fat dairy products and a relatively low intake of refined grains, saturated fatty acids, and added sugars) showed significantly better results for concentration, total sperm count, and percentage of normal semen morphology compared with men who didn't follow such a diet. 



So to put this all together. My recommendations for a fertility diet. It seems reasonable to eat some fruits and vegetables every day. Seafood at least twice a week. Stay away from fast foods and foods that are high in trans fats. If you have an ovulation problem, try to switch from low fat dairy to high fat dairy. Get more of your protein from plants sources that from animal sources. Swap out your current vegetable oil for Extra Virgin Olive Oil. The Mediterranean diet takes most of these recommendations into account already. If you follow that diet closely you should maximize your fertility.





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A new episode of Infertility TV is broadcast weekly every Thursday afternoon



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Music: Divider - Chris Zabriski

IVF Expert Randy Morris Performing IVF with low sperm counts

Randy Morris, an IVF expert, discusses how to do IVF with low sperm counts



According to Randy Morris M.D. if a man has very low sperm counts, then standard IVF may not work due to failed or poor fertilization.



Dr. Morris states that the technique known as ICSI or intracytoplasmic sperm injection can overcome these problems and result in normal fertilization and pregnancy.



#RandyMorris

##IVF

Randy Morris Endometriosis Surgery

Randy Morris is an IVF and Infertility Expert at IVF1 in Naperville, Illinois.

Endometriosis is a common problem which can cause both infertility and pain.

Dr. Randy Morris grades endometriosis based on how much of it is present in the body. Learn about the staging from Randy Morris M.D.

Also discussed in this video is the impact of surgery on the ovaries which can compromise ovarian reserve.


#RandyMorris
#DrRandyMorris
#Naperville

Randy Morris Naperville Restaurant Fire

Randy Morris tells the story of how a special air filtration system protected his IVF lab from a  Naperville Restaurant Fire

Fertility pills to get pregnant - TTC - InfertilityTV

Which fertility pills to get pregnant work? More importantly, which ones don't work or are dangerous? Dr Randy Morris MD-The BOARD CERTIFIED fertility expert with weekly #TTC tips on #InfertilityTV
Fertility pills to get pregnant
The are several different #fertilitypills you can use to get pregnant. I’ll discuss the ones that work first but stick around to the end to hear about the ones that don’t work or are dangerous.
#Clomid, or clomiphene citrate, is probably the most widely used fertility pill in the world. Clomid is used to help women who don’t ovulate but also for women who already ovulate to produce more eggs at one time.
A typical course of Clomid goes for five days. Monitoring for ovulation is important. With clomid you can use a home ovulation predictor test or be monitored in the doctor’s office with blood tests and ultrasound.
Like all fertility treatments, the success rate with Clomid decreases as women get older. Plus, out of every hundred pregnancies on Clomid, about 15-20 will be twins. Triplets and more are pretty rare.
Clomid will not work for everybody. If clomid is going to work for you, you will usually get pregnant in the first four months. So if you are not pregnant by then, think about moving on to something else.
#Letrozole, also known as #Femara, is another fertility pill. Like Clomid, letrozole is also given over five days. Its most common use is to induce ovulation in women with PCOS. In fact, well done studies have shown that for PCOS patients, letrozole is better than Clomid. More women will successfully ovulate and more will get pregnant.
You may hear about women using letrozole for other reasons. But there is no good evidence that it works any better than Clomid in other instances.
The risk for multiples with letrozole is about the same as it is with Clomid.
#Metformin or #Glucophage is a pill that was originally used to treat people with Type 2 diabetes. Metformin helps treat a problem called insulin resistance. Insulin resistance in women can interfere with ovulation. The two groups of women are most likely to have ovulation problems due to insulin resistance are women with PCOS and very overweight women with a BMI over 30.
If your doctor wants to start you on metformin, here are some quick tips. The optimal dose of metformin is 2000 mg a day. But don’t start at that dose. Metformin can cause side effects such as bloating, cramping and diarrhea. Start on 500 mg or one pill a day and work your way up gradually. Also, there are long acting versions of metformin. These will have the letters XR or ER which stand for extended release. We recommend extended release to make your life a little easier and further lower side effects.
The biggest benefits to metformin are that it does not increase your risk for multiple pregnancy and even if you don’t get pregnant, it will lower your chance for getting Type 2 diabetes
Which pills don’t improve fertility?
First, although prenatal vitamins are recommended before you conceive, they don’t actually do anything to help with fertility. You should absolutely take them, however, because they will reduce the chances for birth defect and help with fetal brain, eye and heart development
Supplements such as #CoQ10 and #DHEA are often sold on the internet as fertility pills but there is little evidence for any benefit for fertility
Herbal supplements should also be avoided. A review of scientific evidence failed to find a benefit of herbal supplements. People using herbal supplements, especially women trying to conceive, should be aware of the possible risks associated with lead exposure from herbal supplements.
Exposure of a fetus to high lead concentrations in the uterus could result in neurological defects, lower birth weight, premature birth, and an increase in birth defects. Adverse effects may even occur at lower levels than previously thought. All patients should consult their physician before beginning any such treatment.
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HSG blocked fallopian tubes - What now?

If your HSG showed blocked fallopian tubes could you still be able to get pregnant without IVF or surgery?  Learn how from Dr Randy Morris MD-The BOARD CERTIFIED fertility expert with weekly TTC tips on InfertilityTV

You’ve just had an #HSG and your doctor told you that you have #blockedfallopiantubes and you can’t get pregnant on your own. What do you do now? First, don’t panic! There may be a number of options for you.

First step, get more information.  How many tubes are blocked?

If only one tube is blocked, it is still possible to get pregnant on your own without any treatment. Although the chance for pregnancy is a little lower than for women with two open tubes, it is not 50% lower.

If both tubes are blocked, then the location of the blockage is important. There are two common locations for blockage.

-- Proximal blockage is where the tube is attached to the uterus.

-- Distal blockage is at the far end, near the ovary.

Proximal blockage may not even be a real blockage. Sometimes, during an HSG, the muscle around the tube may contract, pinching off the tube. This may look like a blockage but it isn't real. A repeat HSG will often be normal.

At IVF1, we can also put a catheter into the tube so the spasm doesn’t impact the dye flow.

***A real blockage can sometimes be fixed - without surgery.***

This technique uses a wire which is pushed through the tube to clear the blockage from the tube. This technique has allowed many women to avoid having the more expensive #IVF treatment.

Distal blockage cannot be fixed without surgery. Surgically opening the end of a tube is possible but the pregnancy rates are low and there is a higher risk for a tubal pregnancy to occur afterward.

If all else fails, patients with tubal blockage generally will do well with IVF.

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Music: Divider - Chris Zabriskie (CC BY 3.0)

First Time IVF Success - More Tips From The Expert

First time IVF success - More tips from Dr Randy Morris MD-The BOARD CERTIFIED #fertility expert with weekly TTC tips on InfertilityTV #IVFSuccess Tip #1 - Frozen Embryo Transfer #FET In the last several years, the technology for freezing #embryos has improved dramatically. Survival rates upon thawing have never been higher and pregnancy rates with frozen embryos have skyrocketed. We now have proof that the chance for first time #IVF success with a frozen embryo is higher than with a fresh embryo. Why is this true? With these new freezing methods, the embryos are essentially the same whether fresh or frozen. The difference is in the uterus. When you stimulate the ovaries in a fresh cycle, changes in the uterus may interfere with implantation. These changes are more easily controlled on a frozen embryo transfer cycle. IVF Success Tip #2 Diet It is really difficult to do studies on the impact of diet on IVF success. The proof that diet or dietary changes has an impact is not strong but these are easy, common sense things to do. A 2018 study found that patients who adhered most closely to a Mediterranean Diet had higher #pregnancy and delivery rates compared to patients who did not follow that diet. What is a Mediterranean Diet? Concentrate on these items: -- Fruits and vegetables - for every meal -- Whole grains- daily for example wheat, corn,oats, barley and quinoa. -- Eggs, cheese and yogurt - daily -- Change your oil to Extra Virgin Olive Oil for cooking and instead of salad dressing -- Fish and seafood - at least two times per week -- Avoid red meat and sweets IVF success Tip #3 Evaluate for Chronic #Endometritis There are three ways to evaluate the uterine cavity. -- #HSG --Saline ultrasound and -- #Hysteroscopy. Only hysteroscopy allows you to look for inflammation of the uterine lining. This is known as chronic endometritis. Chronic endometritis has been associated with IVF implantation failure. Diagnosing and treating it before embryo transfer can increase your chances for a successful first IVF attempt. This is not just shameless promotion for InfertilityTV. All of our recommendations in the 100 or so episodes of InfertilityTV are based on actual scientific evidence. Patients who follow our advice are going to be more successful so Subscribe right now! #RandyMorris #DrRandyMorris #RandyMorrisMD Increase your "Infertelligence" TM Subscribe to Infertility TV now!!! A new episode of #InfertilityTV is broadcast weekly every Thursday afternoon or visit our website at IVF1.com ******************************************* Do you want to become a patient at IVF1? ******************************************* Register online here: https://patient.ivf1.com/PatientPorta... Or call: 630-357-6540

Miscarriage and natural killer (NK) cells - Everything you know is wrong

Miscarriage and natural killer cells - Dr Randy Morris MD-The BOARD CERTIFIED fertility expert with weekly TTC tips on InfertilityTV

If you have suffered a #miscarriage or multiple miscarriages chances are you've gone online and done a Google search to try to figure out what the cause for the losses. And if you did that, you probably came across some web pages that talked about natural killer cells. This probably terrified you because what sounds scarier than “killer” cells attacking your pregnancy.

Here is the basic idea. You have a blood test to look at how many natural killer cells there are. If your levels are high that means you're at greater risk for having a miscarriage. In order to prevent miscarriage you do a really expensive therapy called intravenous immunoglobulin or IVIG. Unless you do this you are doomed to have miscarriages over and over. Sounds reasonable right? Unfortunately it is completely wrong.

Natural killer cells are one type of white blood cell and are therefore part of the immune system. They circulate in the blood and they can also be found in the uterine lining. In the blood, natural killer cells work as an early defense to destroy cells infected with viruses and cancer cells.

However in the uterus, these cells are not cell killers...in fact, they are distinctly different than the natural killer cells in the blood and have a completely different function. So let's not call them natural killer cells any more... let's refer to them as scientists do which are NK cells.

The most recent research suggests that NK cells in the uterus are essential to allow the embryo to implant and allow the placenta to grow in the uterus. In fact, uterine NK cells increase in number after ovulation around the time that an embryo is expected to implant. These levels stay high during early pregnancy. So measuring the number of NK cells in the blood or in the uterus is a useless test.

So what are all these NK cells doing in the uterus? In order to answer that question we need to ask another question first and that is how is it that an embryo which is foreign to the mother is not rejected by her immune system like a liver or a kidney transplant? The answer is that the mother’s immune system somehow learns not to reject an embryo. This is called immune tolerance. Recent evidence suggests that uterine NK cells are involved in the process of allowing immune tolerance to embryos.

In certain cases, based on the mother's genetic makeup and the father's genetic makeup, the mother may fail to develop tolerance to an embryo. There may be some embryos which therefore get rejected by the mother's immune system. this may be more likely to occur in situations like egg donation where there is twice as much tissue which is foreign to the mother. This is an area of active research.

In the meantime don't waste time and money doing blood tests for NK cells or biopsies of the uterus for NK cells. And certainly don't have treatments like IVIG which are risky and unproven.


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Recurrent miscarriage? New testing may finally help you find the answer

Recurrent miscarriage - Dr Randy Morris MD discusses old and NEW recurrent miscarriage testing. -The BOARD CERTIFIED fertility expert with weekly TTC tips on InfertilityTV

Approximately 1% of couples attempting pregnancy will suffer from #recurrentmiscarriage.. Evaluation of the causes of recurrent #miscarriage is extensive and includes evaluating a woman for problems with her uterus, immune system, hormones, blood clotting system, and testing for possible systemic diseases such as infections, diabetes and Celiac disease. Both the woman and her partner also have a chromosome analysis.

However, roughly 50% of the time, the causes of recurrent #miscarriage are not found. Numerous attempts have been made to look for specific gene mutations that may cause recurrent miscarriage. Several candidate genes have been studied but definitive evidence that they cause recurrent miscarriage was lacking.

Recently, researchers found that women with variations in their #FOXD1 gene are TEN times more likely to have recurrent miscarriage compared to women without these variants. This is a more potent cause for #miscarriage than any previously studied factor. In fact, FOXD1 variants were found ONLY in women with recurrent miscarriage. They were never found in women without recurrent miscarriage.

Depending on the specific variant found, there are different possible treatments that can be employed to help reduce the risk for future miscarriages. Currently, this testing is only available at #IVF1.

This video focuses on:
#recurrentmiscarriagetesting
#recurrentmiscarriagetreatment
#recurrentmiscarriagesuccess

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Hashimotos, Hypothyroid and Fertility| Finally! A clear and logical expl...

Hashimoto's or Hypothyroid? Dr Randy Morris MD-The BOARD CERTIFIED fertility expert explains the difference on #InfertilityTV
Few things cause more confusion amongst my patients than the thyroid. But its really pretty straightforward once you understand some basic points.
The thyroid is a gland that both men and women have that is located in the front of the neck. There are two major hormones produced by the thyroid. T3 and T4. When the levels of one or both of these hormones are low, it is called #hypothyroidism or an under active thyroid. When they are high, it is called hyperthyroidism.
#Hypothyroidism is common in women, get more common as they get older and can cause them to have difficulty in getting pregnant. This occurs because hypothyroidism can interfere with ovulation. Treating hypothyroidism is an effective method to restore ovulation and improve fertility.
#Hashimoto’s Disease or Hashimoto’s Thyroiditis is a condition in which the body has high levels of antibodies that attack and cause damage to the thyroid. A person who has elevated levels of thyroid antibodies might, at any given moment, have a thyroid gland that is producing too much, too little or just the right amount of thyroid hormones. So why bother measuring the levels of thyroid antibodies if the thyroid gland is functioning normally?
Well, we know two things about people who have high thyroid antibody levels:
First, They are mo re likely to develop thyroid problems in the future. So even if the thyroid is producing the correct amount of hormones today, these individuals are at greater risk than others for having hypothyroidism in the future. For women, this could happen during pregnancy or after delivery. So this helps doctors to identify women that need to be watched more closely for the development of thyroid problems.
Second, there is a fair amount of evidence that suggests that women with elevated levels of thyroid antibodies are at greater risk for miscarriage. One study found that the risk for #miscarriage was double in women with elevated thyroid antibody levels.
Do you have a topic or question you would like answered on Infertility TV? Let us know in the comments. You don't want to miss any episodes so subscribe to Infertility TV now and visit our website at ivf1.com
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Mini IVF| Fertility Expert Randy Morris answers - Is it right for you?

Randy Morris -The BOARD CERTIFIED fertility expert with weekly TTC tips on InfertilityTV

One of the reasons that #IVF is so successful is that it is a selection progress. If you start out with a large number of eggs, you are more likely to find some that will produce healthy embryos.

This is the reason why #fertility experts use high doses of fertility medications when women do IVF. These medications are the best way to try to get a large number of eggs. But are there some women who might be better off using low doses of injections or even oral medications to stimulate their ovaries. Let’s take a look.

First, ALL well done studies and the U.S. IVF database have shown that overall, pregnancy rates are significantly LOWER with mini-IVF than with standard IVF. This makes sense, fewer eggs means a lower chance for finding good eggs. There is NO evidence that egg quality is better with mini-stimulations.

However, there are some women who do not respond well to fertility medications. Even with high doses of meds, they may still produce very few eggs. Since fertility injections are very expensive, this can make the treatment very costly.

Using a medication like #Clomid will typically get only a small number of eggs to develop but it is much less expensive and easier to take - it’s a pill - not a shot. The egg quality is no better buts its not any worse either. So… instead of trying to get a large number of eggs at one retrieval, you can try to get just one or two eggs - but repeat the process several times.

So the main advantage of mini IVF is for women who would need a high dose of fertility meds. They can save a lot of money on expensive injections. The disadvantage is that they may need to have several egg retrieval procedures.

If you liked this video remember to like “THIS” video and share it in your support groups and on your favorite social media channels

Do you have a topic or question you  would like answered on Infertility TV? Let us know in the comments.  You dont want to miss any episodes so subscribe to Infertility TV now and visit our website at ivf1.com

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Frozen embryo transfer ( FET ) or Fresh? | Infertility TV

Should you be doing a frozen embryo transfer ( FET )? Dr Randy Morris | The BOARD CERTIFIED Fertility Expert |Weekly TTC tips on InfertilityTV: IVF Embryo Transfer-Fresh or Frozen?



There are two options for transferring embryos during IVF.



During a FRESH TRANSFER, the embryos are placed in the uterus within 5 days of the egg retrieval without being frozen.



The embryo transfer can be deferred until a later time, however, by freezing the embryos. (FROZEN TRANSFER or #FET )



There are several advantages to a deferred transfer.

Most importantly, studies now show that the chance that the embryos will implant into the uterine lining is improved by waiting until a later time.

Second, deferred transfer helps avoid a serious complication of IVF treatment called ovarian hyperstimulation syndrome.



Third, deferring transfer allows genetic testing of the embryos to be performed with improves the chance for pregnancy and reduces the risk for miscarriage.



#frozenembryotransfer



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The latest from Dr. Randy Morris's Fertility Blog

Fertility Tips - Fertility Facts - Fertility Myths - Dr. Randy Morris on...

You hear so many fertility tips. Which are fertility facts? and which aren't. Do you know which is true??

For women who are trying to get pregnant, there are many myths about what you are supposed to do when trying get pregnant.

Dr. Randy Morris, a #fertilityspecialist  is here to clear up some facts and fiction.

Question: Are we seeing more couples having trouble conceiving or are women trying to have babies later in life?

#fertilityfact from Dr Morris:

1) We are seeing more couples who are experiencing difficulty primarily because they are waiting until later in life. The older a woman gets, the harder is to get pregnant.

2) Fertility and fertility treatment are a more acceptable thing now so more people with fertility problems are likely to come out and see a doctor about it.

Question: Do birth control pills reduce fertility?

Fertility Fact from Dr. Morris:

This is fiction. The old thinking was that if you are inhibiting ovulation that somehow that was going to cause a problem and we now know that that is not true.

In fact, in certain circumstances birth control pills can be helpful toward promoting fertility

Question: Does stress cause infertility? #stressandfertility

Fertility Fact from Dr Morris

This is fiction. There is very little data to support that. Procreation vacations may give a couple a chance to have intercourse but their chances to get pregnant won't be any better than at home

Question: Does obesity play a role in infertility? #obesityandfertility

Fertility Fact from Dr Morris

The is fact! There are a number of issues. Overweight women will have a higher incidence of #ovulation problems.  They will miscarry more often and they do poorly when put on fertility treatments

Question: Does being underweight cause infertility?

Fertility Fact from Dr Morris

This is fact. Triathletes and marathon runners can also have problems with ovulation and infertility

Question: Does Robitussin (cough medicine) increase your fertility if you have thick cervical mucous?

Fertility Fact from Dr Morris

This is fiction. This one has been around for a long time. If you look in the medical literature, there has never been a single study that supports it.

Question: Does smoking contribute to infertility?

Fertility Fact from Dr Morris

This is fact. Smoking does reduce fertility. Smoking decrease ovarian function. Women go through menopause at an early age if they are smokers

Dr. Randy Morris MD on WGN News - Ovarian Reserve Testing

Dr. Randy Morris, Medical Director of IVF1, discusses testing women's ovarian reserve as an #infertility test or for predicting the age of menopause. This interview aired on WGN News in Chicago.



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Dr. Randy Morris M.D. on FOX News - Public figures lie about using egg d...

Dr. Randy Morris M.D. is interviewed about the growing trend of celebrities using egg donation .
An interview with fertility expert Randy Morris M.D. criticizing public figures who promote their pregnancies but don't admit to the fact that they used egg donation
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Dr. Randy Morris M.D. featured on WGN-TV In vitro Maturation

Dr. Randy Morris MD is interviewed on WGN-TV in Chicago about the new technology known as #IVM or In vitro maturation

#DrMorris is the medical director of #IVF1 and the medical director at the Naperville #Fertility Center. He is an Assoc. Professor at the University of Chicago.

#invitro
#IVF
#invitrofertilization

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Dr. Randy Morris M.D. discusses In Vitro Maturation - CBS Early show

Dr. Randy S. Morris M.D. is well known as the physician who was responsible for the first #pregnancy in the United States using the technology known as In Vitro Maturation or #IVM. This is his interview on the CBS Early show.

#IVF
#invitro
#invitrofertilization

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Treating thryoid antibodies in pregnancy

The effects of selenium in pregnancy were recently evaluated in a study performed in Italy. This study is of interest to me since we have been using selenium to reduce thryoid antibody levels in women with recurrent miscarriage. Selenium has been found in well controlled studies to reduce thryoid antibody levels but it has neve been evaluated in a pregnant population before.


Approximately 150 pregnant with with elevated levels of one group of thyroid antibodies were split into two equal groups. One group received 200 micrograms of selenium and the other group received placebo. During pregnancy and post-partum, more women who took the placebo were more likely to show evidence of thyroid malfunction and need thyroid hormone supplementation.


The levels of thyroid antibodies were reduced in women who took selenium.


Although this study still does not prove that selenium will reduce the risk of miscarriage in these patients, it does indicate that the antibody lowering effects are similar to that seen in non pregnant patients. It also appears to be safe during pregnancy.