IVF Phoenix

When it comes to the things that we can control with regards to our fertility, there isn’t much. But our lifestyle choices can still have a huge impact!

There are a few key lifestyle parameters to be cognizant of including sleep habits, stress management, nutrition and exercise.

Sleep is a major lifestyle parameter that isn’t talked about enough! Sleep deprivation and late night use of screen time/keeping bright lights on etc. can suppress melatonin levels, a hormone known to play a large role in normal female reproduction. Sleeplessness has been shown to suppress melatonin production in shift workers and in some studies has been shown to contribute to early pregnancy loss, failed implantation, an ovulation and amenorrhea.

Stress management is another important one. Whether it’s physical or emotional stress or both, they can be key contributors to subfertility. When under signifiant stress, cortisol levels increase. This is a big player in the steroid pathway; a pathway that is responsible for producing estrogen and progesterone!

When it comes to nutrition and exercise, the key is moderation! Extremes are almost always harmful whether it’s over-eating or under-eating/over-exercising or being sedentary. Aiming for a well balanced diet including healthy fats, complex carbs and lean or plant based proteins is a great place to start and easy to sustain! Finally, your exercise routine should contain a combination of cardio and resistance training aiming at 30 minute intervals 5 times per week. Whether that includes a bootcamp class, a peloton ride, go for what is most enjoyable to you to be able to maintain consistency!

You shouldn’t have to overthink your lifestyle choices. You’ll have some good days and some bad days, and that’s ok! But overall consistency is the game changer here 😉

Women are often concerned that during an IVF cycle, since they are getting high dose medications that significantly increases estrogen levels followed by progesterone supplementation during the embryo transfer that this will increase the risk of breast, ovarian and uterine cancer. Luckily, this simply is not the case.

In an Australian multicenter study looking at 29,700 women who underwent IVF, showed no increase in breast, ovarian or uterine cancer compared to the general population. Several other publications have confirmmilar results however some studies have shown a possible increase in the risk of borderline ovarian cancer (also known as tumors of low malignant potential), though this increase is very small and not for sure known to be caused by IVF treatments. Additionally, increasing number of IVF cycles doesn't appear to further increase that risk!

Overall, the data is pretty compelling that there is no real cause for concern for developing cancer if you use fertility medications!

Something that sets IVF Phoenix™️ apart from other fertility clinics, is our team. Dr. John Couvaras, a double-board certified fertility specialist at IVF Phoenix™️, leads the friendly and experienced team at IVF Phoenix™️. Dr. Couvaras is a board-certified Reproductive Endocrinologist who received his training at the prestigious University of Texas Southwest Medical Center and completed his internship and residency at Baylor College of Medicine in Dallas.

"He is a very intelligent doctor. I have experienced 3 miscarriages before going to this clinic and within the 20-minute consultation he felt like he understood why I had recurrent loss when other doctors could not help. He looks at the whole person and not just the eggs and s***m. He will always give you his honest opinion and if you aren't understanding something he will creat an analogy to better explain the situation”

Listen up. This is not a conversation to skim over. Indulge me for just a minute.

We spend most of our adult life preventing pregnancy. Life happens, career demands. Professional milestones achieved. But please, try and not take the scenic route when it comes to reproductive choices.
Learn from my story. More responsibility. Less time. More work, less time. Yeah, maybe children one day. But not today. Right?

Is Egg Freezing right for me?
🔸Who can benefit?
🔸 Who is a candidate?
🔸 How does it work?
🔸 What are my other options if I decide not to freeze?

It is important for you to have a biological children in the future?

Women have never had more options to plan for a family than now.

Friends, let's learn from other paths and experiences. I want to share my experience for your benefit.

Looking back in my 30's I had the fab career, got my first house, and was setting into my career.

Frankly, I was in my prime. And that could have not been more true. But I was the time thinking I was in my professional prime and really I was in my reproductive prime.

My Love Life had it's bumps and glory days but no life partner presented until I was 43.

Today, assisted reproduction is no longer about helping couples conceive. It is has made an enormous shift to proactive family panning, especially if no life partner has shown up.

Egg Freezing was experimental and has made huge strides for women over the last half dozen years. The decision to whether or not to undergo egg freezing is very personal and far traditionalists like me, I can fully appreciate that.

Take advantage of this option.

It is important to know egg freezing is not a guarantee but it is a pretty darn good option to have younger eggs retrieved for potential use later. The reality is that the average patient seen in our office was 38-42. Today, the average is 32 years of age. This statistic is telling us something.

It should be telling you something something, too.

Continue reading in the comments ⬇️

The day has arrived and it's time for the Embryo Transfer. The day is often met with a considerable amount of anxiety and more so for couples who have one last or only embryo.

Let's review what factors that can help make the embryo transfer successful. . .

1. Quality of the embro - The quality of an embryo represents a crucial condition for a successful transfer. Of course, a good-quality embryo can only be obtained from a good-quality oocyte, and no less it depends on the quality of the s***m, the quality of the culture method (top-quality culture media and solutions, the first-class incubator with the time-lapse system).

2. The perfect lining of uterus ~ The second essential condition for the success of embryo transfer is the quality of endometrium. The good-quality signs are sufficient thickness of at least 8mm and the so-called triple line image during the ultrasound examination. Further precision can be achieved by determining the day of the transfer on the basis of the ERA method when the so-called implantation window increase their lining despite various attempts to do so past 6.5mm at least 1/3 of patients will go on to obtain a positive pregnancy test.

So, are you wondering what you can do in preparation for transfer day, to help ensure you have a top-quality embryo and a perfect lining?

First of all, it is important to strictly follow the instructions of the physician and other staff of the clinic and take the medication accurately. It also helps to follow the principles of a healthy lifestyle and maintain mental well being.

Continue reading in the comments ⬇️

At IVF Phoenix™️ we understand the emotions of your journey and want to walk alongside of you every step of the way.

"This thank you is a year overdue and unfortunately, we're right back in the same place we were last year.

It's difficult to put into words the gratitude I have for you both. Rhoda, I am so very thankful for your kindness and compassion. Last year you called to check on me, gained privileges to the hospital to causally sit at my feet in pre-op, gave me a hug, and held my hand. You've been where I've been and when I look into the eyes of another soul who completely understands me it's immediate medicine to my heart and soul. You've done the same this time around and my gratitude for you continues to grow.

Dr. Couvaras, I'm so very thankful for your brilliant intelligence, kindness, and lighthearted personality. My faith and trust in you has completely washed away any fears that there could have been anything that I could have done differently to avoid our losses. This is a gift that is utterly priceless and one that will keep on giving as I process my grief.

This book perfectly put into words my experience with finding beauty and joy in pain after losing twins prior to finding you. I've learned pain is inevitable but suffering is optional. My sentiments are the same with our recent losses. Thank you both for being such a beautiful light in the midst of this incredibly painful journey."

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It's that time of year here in Arizona where temperatures are rising and its getting hard to avoid a sunburn no matter how diligent you are with protection.

Here are our top Dermatologist Approved lotions to help when you get a painful sunburn. We ran all of these items through the Think Dirty App, so they are toxin-free as well.

☀️ Weleda Calendula Lotion (Think Dirty Rating-0) This is a great lotion for sensitive skin. It contains calendula which is a healing ingredient for superficial burns.
☀️Avenue Thermal Spring Water (Think Dirty Rating-2) This cool mist soothes sunburnt skin and helps to ease the hot sensation that comes from a burn. Use as often as needed.
☀️ Tropic Sun Soothe Cooling Aftersun Lotion (Think Dirty Rating-0) This lotion contains calendula and aloe, along with jojoba and eucalyptus to help heal and soothe.

Remember that during our Arizona heat, it only takes a short amount of time in the sun to burn, especially if you have sensitive skin. So make sure to wear protective clothing, hates that cover your face like the one I am wearing in this picture and reapply non-toxic sunscreen to minimize exposure.

When going through infertility, it can seem like a very lonely journey. At IVF Phoenix™️ we listen and help create a plan that is different for everyone because we know infertility is not a one size fits all.

"Dr. Couvaras is the best doctor I've ever had. Period. He listens to your problem and treats you as an individual case. He created a plan for me after experiencing a late term loss. When all other doctors told me I was 100% healthy to try to conceive, Dr. Couvaras was the only one who took my symptoms seriously and dug deep enough to find my genetic/health vulnerabilities. We are so grateful to him and now I can be pregnant with confidence and knowledge on my side again.
Thank you!

BTW his staff is so caring and amazing. Staff are so patient and always answered all of my many questions."

Can we talk about Medical Records?

First and foremost, your medical records are yours. You should be able to obtain medical records from any Provider within a reasonable period of time. In the state of Arizona, providers have up to 30 days to do so. At IVF Phoenix™, we make every effort to get them to you within a week and many times it can be sooner.

I wanted to share some of our best practices with you to keep your very personal data safe.
Medical records can be obtained by filling out a Medical Request Form. Drop it in your patient portal and we will work to start the process for you.

If you are seeing another specialist or graduating (YEAH!) and no longer have Cryo (frozen embryos, eggs or s***m) in our facility your patient portal will be marked INACTIVE.

Why do we do this?

Earlier last year, we received confirmation of an “Attempted Breach.” We took this risk very seriously and upon the advice of our Compliance/IT Consultant, we were advised to adopted the practice of not leaving patient portals open when patients are not actively in care with IVF Phoenix™. This would reduce our risk for a global breech of your personal information.

This practice is not at all meant to restrict your access but more to protect your data. If you are graduating from the practice and going to an OBGYN or MFM, often the provider will want medical records before they will allow you to make an appointment. So typically we ask you to complete the request form as early as you can so that we make for a smoothe transition for you.

Always here to support you!
xoRhoda

I wanted to be a Doctor since I was 12 years old.
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Today is National Doctor's Day. As a physician, I am in a unique and blessed position to be a witness to the miracle of life for my patients. I am honored to be a doctor. It was not an easy path to become one.
Help us celebrate Dr. C this day by dropping a comment of gratitude❤️

It's true! At IVF Phoenix™️ you are not a number in the line of infertility patients. Each one of our patients gets a that maximizes a positive and healthy outcome. Patient testimonials mean the world to us as it gives hope to those less optimistic or

“Dr. C is one of the best doctors I have ever seen. He doesn't treat you just like another number. He listens, cares and gets to the bottom of the problem! Not only is he a wonderful Doctor, but his staff is amazing and understanding. He has come in on his day off to take care of me. They have an after hours number and respond right away if you have any questions or concerns. IVF Phoenix™️ is the best of the best! I recommend them to anyone that has fertility issues!”

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Friends, the pain of miscarriage is something one never forgets. You always remember the shock of being told “there is no heartbeat”. You will recall the birthday celebrations you never got to plan.

We need to offer support. We should talk less, listen more.

XO, Rhoda ♥️

Does birth control decrease fertility?

The short answer is NO.

You may have friends or family members warn you about not taking the pill too long because it may delay you getting pregnant once you're off of it, but, luckily, that's a myth. The birth control pill gets a bad rap when it comes to fertility. Similarity, a women spend more that's 2-3 decades avoiding pregnancy so it is understandable this may cause some confusion. Birth control is a valuable tool. However, in some cases we will begin a patient's treatment protocol with a 2 to 4-week dose of birth control pill, which has showed to improved outcome of treatment.

For example, for women with PCOS, a short period of birth control can suppress testosterone and LH levels. Birth control can help prevent ovaries from making a single dominant follicle instead of many follicles to creat multiple eggs.

Fertility is naturally declining already because of age and this likely is the actual reason conceiving is harder for you. It is not because of being on birth control pill.

At IVF Phoenix™️, we often request that patients place the pill va**nally for the 1st pass effect. A drug taken orally absorbed through the intestinal mucosa and transported to the liver before entering the systemic bloodstream and flowing to the brain and other organs. Research shows it is largely enzymes in the liver that break down the drug. Avoiding first-pass metabolism allows a much larger portion of the dose to reach the brain or other organs.

Oral consumption is much less efficient than va**nal administration. This is because when a drug is administered by these routes it is absorbed across the mucus membranes (in the va**na) and passes directly into the systemic blood stream, traveling straight to the brain and other organs without "first pass" liver metabolism taking place.

Infertility Myths: infertility is largely a female issue.

Male Factor Infertility is as prevalent as female factors. In fact, male factor is on the rise!

Here are some big contributions affecting s***m quality:

🍻Excess consumption of alcohol - consuming alcohol brings down testosterone levels, leading to erectile dysfunction and low s***m production.

🚬Smoking is known to lower s***m count - second hand smoke also affects male infertility. Male smokes can experience poor s***m quality with decreased mobility and it boosts the number of abnormally shaped s***ms. Moreover, if you are a chain smoker is may also decrease the s***ms ability to fertilize eggs. Va**ng is also making headlines to suggest it is not beneficial if undergoing treatment.

♥️ Hormonal balance - we all know that hormones play a vital role in maintaining one's s*xual health. In males, fat cells produce estrogen so by any chance, if it gets affected it will lead to harsh complications for your s*xual health. Moreover, thyroxin which is no-s*x hormone can also affect your s*x hormones.

💉Testosterone is a s***m killer so if vou are on testosterone vou might be "shooting blanks"!

🏋🏻‍♀️'Harsh fitness regime - could decrease s***m count by lowering the amount of testosterone in the male body. Also, men should stay away from steroids as it can lead to testicular shrinkage and infertility.

⚖️In men, being overweight tends to decrease the semen parameters. Overweight men often face decreased libido and erectile dysfunction.

We are honored when a patient from out of state chooses to work with us and makes the additional sacrifices to get the results they want!

"I can't begin to explain my gratitude and how happy, thankful, and thrilled we are that we chose IVF Phoenix™️. After years of "unexplained infertility", naturally I began to do research on IVF facilities. Looking for those that have a good reputation, success rates, and overall someone who would make us feel comfortable through this delicate process. After intense research, Dr. C and his wife won us over! They surpassed our expectations from the little details to the big. The little ones start with their "image" (website, social medial, reviews, and overall presentation). The largest was definitely the Doctor's extensive knowledge and transparency! They not only back up their image (which is hard to do, as it's so easy to paint a perfect picture) they exceeded it! So we made the drive from CA to AZ and the moment we walked into the clinic we felt right at home. It was so warm and full of smiles! When we met Dr. Couvaras and his team, everyone was so professional and pleasant to talk to. He was so focused on us, and asked a ton of questions and was even able to finish our sentences! It was as if he knew us better than we did!
That's impressive!! Unfortunately, Rhoda (his wife) wasn’t in, but within a few days of arriving home she sent me a personal (handwritten) card saying she was sorry we missed one another. That's extremely classy, warm and made us feel completely supported! They even made running our labs-out-of-state a breeze and their communication is top-notch! I love their online portal that makes it easy to spend and receive fast and friendly response, every time!
Basically I could go on and on, and we only just started! So I'll leave it at this, I highly recommend IVF Phoenix™️ because for the first time, in a long time, I feel hope again. Positive everyday and honest support truly does radiate from the Scottsdale location!"

Is it time to see a Fertility Specialist??

Endometriosis is a painful disease that's affects a woman's reproductive system. In this condition, the lining that usually grows inside the uterus grows outside of the uterus instead. Endometriosis affects over 200 million women worldwide.

Painful periods are also called dysmenorrhea. The pain can begin several days before the period begins and can last until several days after it ends. Menstrual cycles cause pain in the form of cramps anyway, but the pain from endometriosis is different. It can be much more severe than regular period cramps, even debilitating.

The pain from endometriosis comes from the fact the endometrium doesn't have any way to filter out of the body after it breaks down during the menstrual cycle. It creates a fibrous substance that sticks to the organs and ends up causing cysts, scar tissue, and other problems. It may even cause organs to stick together.

A recent study showed over fifty percent of women with endometriosis suffered from chronic fatigue. Based on this research, having endometriosis more than doubles the number of women who suffer from chronic fatigue.

Endometriosis is associated with diminished ovarian reserve so it is essential to seek a fertility physician who can properly assess and implement your fertility plan. Removing your endometriosis is important but also understanding what is driving it to occur is absolutely imperative.

Did you know we offer multi cycle egg freezing package? You choose 2 or 3 egg freeze cycles at a reduced bundles rate.

Male infertility is something that we truly believe needs to be talked about more. The incidence of infertility due to male factor has increased over the past several years. It is no longer exclusively a female issue.

Currently, the vast majority of infertility due to low s***m counts or very poor quality s***m is treated by IVF using a technique in which s***m is selected and injected into the egg, known as Intacytoplasmic S***m Injection (ICSI).

At least 25 percent of couples will conceive when ICSI is used to overcome 'male factor' s***m problems. That is a significant amount of couples!

My urology colleagues and I share the view that certainly we should be investigating more sub-fertile men because treatable conditions are found in more than half of the cases. Equally as important is to find a reason, and therefore an explanation and even a treatment. Because up until now, all men with poor s***m have been offered IVF without investigation or treatment, there is no robust, worldwide data to prove that treating men influences either natural pregnancy rates or outcomes from IVF with ICSI.

However, those of us who see large numbers of 'male factor infertility' and who are lucky enough to have access to the most recent laboratory testing (DNA fragmentation, Reactive Oxygen Species and other tests for infection) believe that many cases can be improved and that pregnancy rates are also positively affected.

Male infertility needs to be discussed more because many time, their infertility is usually treatable with lifestyle changes. We are counseling patients to opt for a plant based diet, reduce alcohol consumptions and quit smoking (ci******es, ci**rs and Ma*****na).

This, in turn, will help to increase pregnancy rates, and in many cases, overall make a notice health impact.

How many IUI’s should you do before moving to IVF?

The luteal phase of the menstrual cycle is a vital part of preparing the uterine lining for implantation and pregnancy. This involves the corpus luteum (the follicle that released the egg at the time of ovulation), producing enough progesterone to help support the first 7-10 weeks of pregnancy before the placenta forms. 
 
You have made heard of the term luteal phase defect where the luteal phase of pregnancy, which is supposed to be 14 days in duration lasts 3ng/mL indicates that ovulation occurred but there is not set level to establish normal luteal function (this is because progesterone is secreted in pulses between 5-40 ng/ml so levels vary at different times of day)
* Endometrial biopsy is not an accurate tool to test if lower P levels results in an inadequate endometrial lining for implantation
* There is no evidence that progesterone is beneficial for fertility in natural cycles or for treating luteal phase defect (thought randomized clinical trials are still lacking)
 
Overall, no treatment has been shown to improve pregnancy rates with the exception of IVF cycles, where progesterone supplementation is needed. 

Rehearsing tragedy. Do you do this?

Miscarriage and the finality of miscarriage is deeply complex. Yes, it does take time to heal. But friends, you need to give yourself a time limit so that you can welcome HOPE back into your life.

Don't press pause and isolate yourself.
Don't decline going to your friend's baby shower.
Don't be ashamed.Don't be angry.
Don't apologize.re-engage.
Don't squander joy from coming back into your life.

Stop rehearsing tragedy about the next pregnancy. I know, you don't want to be blindsided so you are already rehearsing for the worst.

Stop holding your breath and breathe.
Resist the temptation of waiting for the other shoe to drop. What if?
Will it work? What if I fail again? Stop.

If you have learned anything through miscarriage, I hope it is this:

Expecting the worst does not prepare you at all. What if, in fact, tells you is how unprepared you really are.

Yes, it's scary to try again.
Only you can make the choice to transition from a phase of self doubt, doomed filled possibilities and perpetual disappointment to yes, MOTHERHOOD.

Love, R ♥️

Something that sets IVF Phoenix™️ apart from other fertility clinics, is our team. Dr. John Couvaras, a double-board certified fertility specialist at IVF Phoenix™️, leads the friendly and experienced team at IVF Phoenix™️. Dr. Couvaras is a board-certified Reproductive Endocrinologist who received his training at the prestigious University of Texas Southwest Medical Center and completed his internship and residency at Baylor College of Medicine in Dallas.

"He is a very intelligent doctor. I have experienced 3 miscarriages before going to is clinic and within the 20-minute consultation he felt like he understood why I had recurrent loss when other doctors could not help. He looks at the whole person and not just the eggs and s***m. He will always give you his honest opinion and if you aren't understanding something he will create an analogy to better explain the situation.”

Ladies, do you have endometriosis or know someone who does?

In a research study, it was found that an increased tendency towards blood clotting could be associated with endometriosis and may be used as a diagnostic tool.

This clotting is likely due to inflammatory nature of endometriosis.

In the study, which was published in BMC Women's Health, the researchers aimed to determine the levels of inflammatory markers and coagulation parameters and how they are correlated in women with endometriomas and healthy women or those with benign ovarian cysts.

The researchers found that the thrombin and prothrombin times were significantly shorter with ovarian endometriomas compared to healthy women and those with benign ovarian cysts. Moreover, the levels of fibrinogen were significantly higher in the blood of women with ovarian endometriomas compared to the other two groups. These findings suggest that women with endometriomas have an increased tendency towards blood clotting compared to healthy women or those with benign ovarian cysts.

What does that mean for you? If you know someone who has endometriosis, it is important to investigate what is causing the endometriosis and investigate further before moving forward with embryo transfer.

"Every person deserves the dream of having a child!"

The first period after a miscarriage may be more painful than in the past, especially if ovulation doesn't take place. That's because the endometrial lining becomes thicker when you don't ovulate - and menstrual pains and cramps tend to be worse with a heavier flow.

We do want you to try not to stress: Your periods won't be this way forever. Eventually, they will will most likely be very similar to the way they were before the pregnancy loss.

Hormonal fluctuations after a miscarriage can be significant, and the miscarriage itself can be distressing. Sometimes the emotional symptoms women experience after a pregnancy loss may be similar (though less dramatic) to those of postpartum depression. In fact, research suggest about 20 percent of women have symptoms of anxiety or depression following a miscarriage, especially those with a history of depression, and those who don't have good social support systems.

If you are experiencing changes in your periods and with your body, we always suggest you reach out to us if you have any questions or if you still aren’t feeling like yourself.

Did you know that uterine septum is the most common congenital abnormality of the uterus?
In fact, uterine septa affects 2-4 out of 100 women! During fetal development, the uterus starts off as two horns that fuse together and the middle membrane has to reabsorb in order to create a normal uterine cavity.

Anatomic defects of the uterus actually accounts for up to 15% of recurrent pregnancy loss cases (35% of which are from a uterine septum), which is why a hysterosalpingogram or saline sonogram are part of a routine evaluation after pregnancy loss. The mechanism causing pregnancy loss in the presence of a uterine septum is that implantation in the septum, which has poor blood supply, leads to abnormal early embryo development.

The solution? Surgical resection of the septum. This is a minimally invasive procedure using a hysteroscopy (a scope that enters the uterus through the cervical opening).

Good news is after this surgery, prognosis is much improved! One recent meta-analysis demonstrated a pregnancy rate following surgery to be 63% and a live birth rate of 50%. Hysteroscopic septoplasty has also been suggested to improve outcomes for couples with otherwise unexplained infertility.