
Infertility Resources & Support
Fertility Treatments
Letrozole for Fertility
Infertility is a common problem for many people trying to get pregnant. Fortunately, many treatment options are available to help those struggling with infertility. Medications, such as letrozole, are often recommended as part of an infertility treatment plan.
What is Letrozole?
Letrozole is an oral medication that influences reproductive hormone balance in the body. Letrozole is an aromatase inhibitor, which reduces the hormone estrogen. It's widely used in breast cancer treatment, but it's also an effective treatment for infertility since its hormonal effects stimulate ovulation.
How Safe is Letrozole, and Does It Work?

Letrozole has been used to treat infertility for over twenty years. Success rates will always vary from person to person. Still, many studies suggest that letrozole is especially helpful for women dealing with polycystic ovarian syndrome (PCOS) or ovulation problems, like anovulation.
Luckily, letrozole is safe to take, but like any medication, it can have side effects. Some women may experience hot flashes, night sweats, headaches, tiredness, breast tenderness, dizziness, and spotting, to name a few. Letrozole's side effects are mainly related to how it affects estrogen levels.
Medication Alternatives to Letrozole
Medications are often the first-line treatment for women going through ovulation problems. Fertility drugs like letrozole impact hormones that affect ovulation and reproduction.
Clomiphene is one common alternative to letrozole. This oral drug works on the pituitary gland, promoting the release of hormones that encourage the growth of ovarian follicles containing eggs. Clomiphene may be more effective for women who don't have PCOS.
Human chorionic gonadotropin (hCG) is an injectable medication that may also help the body develop multiple ovarian follicles during an in vitro fertilization (IVF) cycle.
Letrozole and IVF

Letrozole can be a valuable part of IVF and IUI treatments since stimulating ovulation can help increase the chances of conception.
Letrozole is also commonly used during an intrauterine insemination (IUI) cycle. Before IUI, you'll typically take either clomiphene or letrozole to stimulate your ovaries. Next, an injection of hCG is given, inducing ovulation. Then, sperm from a donor or a partner is collected, prepared, and placed into the uterus using a thin tube. An IVF cycle has several steps, including ovarian and pituitary suppression, ovarian stimulation, egg retrieval, egg fertilization in a lab, and the transfer of embryos into the uterus. Letrozole can be used in select patients as part of an IVF cycle to improve ovulation or impact the menstrual cycle to help make IVF as effective as possible.
Embracing Letrozole as an Effective Fertility Aid
Letrozole continues to be a safe and effective choice for many people struggling with infertility when used appropriately under the guidance of a fertility specialist. If you're coping with infertility, it's important to empower yourself with the knowledge to make the best decisions for your unique situation.
Our caring team of fertility experts at Advanced Fertility Care is always here to answer any questions. We strive to provide compassionate, individualized care to support you in building a family. Contact us today to schedule a consultation.

Infertility Resources & Support
Testicular Varicocele and Male Infertility
A testicular varicocele is a common but often unnoticed condition that can significantly impact male fertility. It is characterized by enlarged veins in the scrotum, similar to varicose veins in other parts of the body. This condition can cause discomfort, testicular shrinkage, and, most importantly, hinder the production of healthy sperm.
This article explains what a testicular varicocele is, the symptoms, the connection to infertility, the available treatment options, and when to seek medical care.
What is Testicular Varicocele?

A varicocele refers to the swelling of the veins that transport oxygen-depleted blood away from the testicle, located within the scrotum.
Under normal conditions, two arteries (one for each testicle) provide the testicles with oxygen-rich blood. Two testicular veins return the blood to the heart once depleted of oxygen. Along with these larger testicular veins, the scrotum contains many small veins forming the pampiniform plexus network. This network acts as a conduit between the testicle and the testicular vein. A varicocele happens when blood pools in the vessels of the pampiniform plexus, causing the vessels to dilate.
Cause and Risk Factors
The exact cause of varicoceles is unknown, but they are believed to occur when the valves within the veins prevent proper blood flow. This results in pooling, which causes the veins to dilate. Varicoceles often form during puberty and are more common on the left side, probably due to the position of the left testicular vein.
Symptoms and Diagnosis
Many men with varicoceles are asymptomatic and may discover the condition during a fertility evaluation or routine physical exam. Symptoms, if present, include a lump in the testicle, testicular discomfort, or swelling.
When to Seek Medical Attention
Given its potential impact on male fertility, those planning to father children, should seek medical evaluation if they notice any discomfort, lump, or swelling in the testicle.
What to Expect
Medical evaluation involves a physical examination where doctors can often feel a varicocele during a routine physical exam. However, smaller varicoceles might be detected only with an ultrasound, which can precisely determine the presence and size of a varicocele.
Testicular Varicocele and Infertility in Men
Varicoceles can lead to infertility by reducing the quality, quantity, and motility of sperm. They can also lead to testicular atrophy or shrinking. Approximately 10% to 20% of men have a varicocele, and among infertile men, this increases to 40%.
Treatment Options

Varicoceles treatment is unnecessary unless there is pain, testicular atrophy, or infertility. Treatment options include over-the-counter pain relievers, supportive underwear, or surgical intervention, which can often improve sperm numbers and function. Lifestyle modifications like wearing looser clothing, avoiding strenuous activities, or taking cold baths can also help.
Boost Your Fertility by Addressing Testicular Varicocele Issues Today!
Don't let testicular varicoceles hinder your journey to parenthood. Advanced Fertility Care's fertility specialists offer comprehensive fertility evaluations and personalized treatments tailored to your unique needs. Contact us today and take the first step toward parenthood.

Fertility Treatments
Infertility Resources & Support
Why Male Infertility Evaluations Are So Important
All genders can contribute to infertility. Early evaluation of the male partner is a common starting point when investigating fertility struggles.
Why is Early Male Evaluation Important?
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Male fertility evaluations are important for identifying potential fertility issues, ruling out medical conditions, planning appropriate treatment, and providing emotional support for couples struggling with infertility.
Early evaluation answers some crucial questions:
- Is the male a factor in the couple's infertility?
- Can the male benefit from treatment? (About 20% respond to treatment)
- Are assisted reproductive technologies (ART) indicated?
Male Fertility Testing
Male fertility testing includes a thorough review of your history, a physical exam, and a semen analysis. The most important lab indicator is the semen analysis. Because up to 15% of infertile men may have chromosome abnormalities or other genetic defects that can be transmitted to their offspring, the analysis may include genetic screening.
Guide for Treatment
A male fertility evaluation can help to determine the appropriate treatment for infertility. Treatment options may include lifestyle changes, medication, surgery, or assisted reproductive technologies such as intrauterine insemination (IUI), in vitro fertilization (IVF), or intractyoplasmic sperm injection (ICSI). Understanding the underlying cause will help determine the best path forward and will guide your individual treatment plan.
Connect with our team today to start your journey to parenthood.

Infertility Resources & Support
How To Be Supportive to a Loved One Struggling with Infertility
Infertility is a disheartening experience for those who want to build a family. And since infertility is a common health issue affecting all genders, you likely know someone dealing with it. After all, as many as 15% of couples, and about one in five women between ages 15-49, cannot conceive after a year of trying.
A variety of factors can cause infertility. But whatever its cause, infertility is a difficult journey. On top of that, no two fertility stories are alike. If someone you care about struggles with infertility, you may wonder how you can best support them. In this article, we'll look at ways to be there for a friend or family member struggling with infertility.
6 Ways to Support a Loved One Struggling with Infertility
Naturally, you want to be there for the people you love. Yet, infertility can be a sensitive topic, and you may be afraid to do or say the wrong things.
Fortunately, there are some simple ways to be a safe space for your loved one as they cope with infertility.
1. Offer a Listening Ear

One of the best things you can do is just be there for your friend. Everyone needs to feel supported, heard, and validated, especially during a difficult time.
Living with infertility can feel like a lonely path. Your friend may not know who they can talk to, even if they're in a relationship. This is because everyone experiences infertility differently; their partner is likely dealing with their own complex emotions.
It helps to have an outside person to lean on. You can support your loved one just by letting them know you're always available if they need to talk. Some people may not want to discuss their infertility, while others do. Therefore, it's important not to pry or assume anything. Still, just knowing you're there for them can mean a lot to your friend.
2. Don't Give Unsolicited Advice
It may be tempting to offer your own opinions and advice — but it's unhelpful in supporting your loved one.
For example, your gut reaction might be to say things like, "you can try again next month," "maybe you should adopt," or "why don't you try IVF?" However, statements like these can feel like you're minimizing the situation or judging your friend's choices.
Not only that, but not everyone wants to pursue fertility treatments or adoption. So instead of offering up advice, try saying things like, "I'm sorry you're going through this," "how can I help?" or "I wish I could fix it...I'm here if you need to talk."
This way, you can provide a supportive, non-judgmental space for the person you care about.
3. Be Mindful
It's essential to lead with compassion and mindfulness when supporting a friend with infertility. Understand that it may be difficult for them to attend certain events, like baby showers, while they struggle to start a family themselves. Be mindful of this and let your loved one know it's okay if they don't want to attend such events.
On the other hand, don't feel like you can't invite them to your baby shower or kid's birthday party. It may mean a lot just to be invited, even if they don't feel up to attending. Besides, your family is a huge part of your life — it would probably feel more uncomfortable if you refrain from talking about them in front of your friend.
What matters the most is your consideration of your friend's feelings. For instance, if you're about to announce your pregnancy, you might tell your friend in private first. This way, they'll have time to quietly process any emotions.
4. Educate Yourself on Infertility
Infertility looks different for everyone, and well-meaning friends and family often have many questions. It can be exhausting for your friend to answer these similar questions repeatedly when they're struggling with infertility.
Educating yourself about infertility and fertility treatments is a great way to be supportive. Instead of asking for details from your friend, you can find tons of valuable information online.
This way, you're prepared to have a meaningful heart-to-heart about any treatments your friend is undergoing. Then, they can talk freely with you on level ground rather than having to explain their medical choices.
5. Don't Minimize What They're Going Through

Infertility can be profoundly heartbreaking on multiple levels. It's also a significant health issue, even if it's not life-threatening. Avoid comparing infertility to other medical conditions or minimizing your friend's experience.
Statements like "at least you don't have cancer" or "at least you can sleep in" don't help your friend feel supported. Instead, let them know you understand how difficult it is to struggle with infertility.
6. Find Concrete Ways to Help Out
There are many ways to be supportive besides talking it out. For example, you could help your friend with things like watching their other children while they attend fertility appointments. Or help them find a support group in the area.
Going through fertility treatments can be physically and emotionally draining. Offering to clean your friend's house after treatment could mean a lot to them! Sending cards, flowers, or home-cooked meals are all thoughtful ways to show your support.
The bottom line is that there are many simple ways to show heartfelt care to a loved one struggling with infertility. Most importantly, you approach them from a place of love and understanding.
At Advanced Fertility Care, we strive to help couples and individuals achieve their family-building goals through cutting-edge technology and patient-centered care at different locations. We're always here to answer any questions about infertility or fertility treatments that you may have. Contact us today to learn more.

Infertility Resources & Support
Prenatal Vitamins to Boost Your Fertility: What Works and What Doesn't
There's no doubt that a healthy diet holds many benefits, from lowering heart disease risk to supporting mental health. Nutrition also plays a role in fertility and reproductive health.
While you may not have control over some of the factors involved in fertility — like your age or a medical condition — several vitamins may help boost fertility when you're trying to conceive.
Six Vitamins and Nutrients to Help Boost Fertility
In recent years, much research has been done on the relationship between diet, nutrition, and fertility. Let's look at critical vitamins and nutrients that could benefit people who want to build a family.
Folate (Folic Acid)

Folic acid is commonly found in prenatal vitamins. Pregnant women should take folic acid supplements before and during pregnancy since adequate B vitamin levels can help prevent neural tube defects like spina bifida.
Research suggests folic acid may also increase the likelihood of getting pregnant. Folic acid supplementation may help increase progesterone levels and support regular ovulation, which can bolster fertility.
Folate, or vitamin B9, is the vitamin form that occurs naturally in food. When you take a folic acid supplement, your body converts it into folate so it can be used.
Where to get it:
Folate is naturally present in dark leafy green vegetables, beans, sunflower seeds, fresh fruits, whole grains, and eggs. You'll want to take a folic acid supplement if you're pregnant or trying to conceive. Folic acid is found in most prenatal vitamins.
Omega 3 Fatty Acids
Omega-3 fatty acids are essential fats the human body can't produce. This means we must get omega-3s from our diets. Omega-3 fatty acids have numerous benefits, such as reducing the risk of cardiovascular disease and supporting brain health.
Although it's unclear what role omega-3 fatty acids play in natural fertility, some research suggests that omega-3 supplementation may increase an infertile woman's probability of pregnancy following in vitro fertilization (IVF).
Where to find them:
Salmon, tuna, mackerel, and several other fish are excellent sources of omega-3 fatty acids. Some plant foods also provide them, such as chia seeds, hemp seeds, flaxseed, and walnuts. There are many popular over-the-counter supplements available as well.
CoQ10

Sperm function and motility can play a role in infertility. According to an analysis of several studies, Coenzyme Q10 (CoQ10) significantly increases sperm concentration and motility.
Studies suggest that CoQ10 may also benefit women trying to get pregnant through IVF. Women who took CoQ10 for two months before undergoing IVF had higher egg quantity, improved ovarian response, and more high-quality embryos. However, it's unclear if CoQ10 is helpful for women who are trying to conceive naturally.
Where to find it:
CoQ10 can be taken as a dietary supplement or obtained from foods like salmon, tuna, organ meats, and whole grains.
Selenium
Selenium is another nutrient that's excellent for male infertility. One study determined that supplementation with this important trace element improves sperm count, sperm motility, and sperm quality in men.
It's unclear whether selenium benefits fertility in women. However, another study suggested that selenium deficiency could increase a woman's risk of luteal phase deficiency. This can affect the ovulation cycle and uterine lining, putting her at risk of infertility. So it could be worth supplementing.
Where to find it:
Besides over-the-counter supplements, selenium is present in foods like brazil nuts and seafood.
Vitamin D
This vitamin is important for healthy bones and helps the body retain calcium and phosphorous. Some research suggests vitamin D may play a role in reproductive health. For example, vitamin D may impact hormone levels in men and women and affect semen quality.
Polycystic ovarian syndrome (PCOS) is a chronic health condition that can cause infertility. Vitamin D supplements may help with menstrual frequency and metabolic issues in women with PCOS who are vitamin D deficient, potentially boosting fertility. However, it's unclear if vitamin D improves fertility generally, especially if a person is not deficient. Still, it doesn't hurt to up your vitamin D intake, especially if you live with PCOS.
Where to find it:
Your body makes vitamin D with sun exposure, but it may be hard to get enough sun, especially during winter in colder climates. There aren't many foods with vitamin D, so it's a good idea to supplement or eat foods fortified with vitamin D.
Zinc
Zinc is a mineral that helps with cell function, immunity, healing, and metabolism. According to some research, zinc may also play a part in egg quality, and zinc deficiency could contribute to male infertility.
Where to find it:
Zinc is found in dietary supplements, as well as chicken and red meat.
Things to Avoid When You're Trying to Conceive

Ultimately, there isn't one single vitamin or supplement that will guarantee fertility.
But some other dietary factors could affect your chances of getting pregnant. For example, one study found that women who ate more fast food and less fresh fruit took longer to get pregnant. Interestingly, another study found that replacing animal protein sources with plant protein may lower the risk of ovulation-related infertility.
The bottom line is that a healthy, balanced diet rich in fruits and vegetables promotes overall health and well-being. Regarding fertility and reproductive health, a wholesome diet is essential for people of all genders. It can also help maintain a healthy weight, exercise regularly, and reduce stress if you're trying to conceive.
Support Your Fertility and Grow Your Family
Of course, infertility happens for many reasons, and your diet and nutrient intake may or may not be a factor. If you've been trying to conceive for more than a year or experiencing infertility due to a medical condition, speak to a fertility specialist.
At Advanced Fertility Care, our dedicated and experienced team will answer any fertility questions and support you on your journey to becoming a parent. We offer services at different locations. Contact us today to schedule a consultation.

Infertility Resources & Support
Fertility Treatments
Top Frequently Asked Questions About PCOS
Polycystic Ovarian Syndrome, or PCOS, is a common disorder that can contribute to infertility and long-term health risks. If you think you may be dealing with symptoms of the disorder, you're certainly not alone. In fact, as many as 12% of women of reproductive age in the U.S. live with PCOS.
If you have PCOS, you may have many questions about the condition, its treatment, and what it might mean for your chances of getting pregnant. In this article, we'll answer some common questions about PCOS.
What Is PCOS?
PCOS is a multi-system disorder affecting many women of reproductive age. The cause of the disorder is unknown, but people with PCOS commonly exhibit imbalances in certain reproductive hormones, such as androgens. As the name implies, people with PCOS often have large numbers of follicles which are the small egg-containing cysts found in the ovaries. During a normal menstrual cycle, your ovaries mature and release an egg every month. Due to the effects of PCOS, your ovaries may be unable to make or release an egg regularly. This can result in infertility issues.
What Are the Symptoms of PCOS?

PCOS symptoms vary between individuals and can range from mild to severe. Many people may experience irregular periods, erratic ovulation, infertility, oily skin, extra hair on the face or body, hair loss on the scalp, and weight gain. More recently, PCOS has been linked with depression or mood disorders. Some people with PCOS are overweight, although people who are not overweight can have it also. Being overweight can make the signs and symptoms of PCOS worse.
A common problem in people with PCOS is insulin resistance (more on this below). People with insulin resistance can often find darkening of the skin along creased areas like the groin or neck can occur, as well as the development of skin tags.
Who is at Risk for PCOS?
The condition affects women of all ethnicities and can develop at any time during reproductive years or any time after puberty. The precise cause of PCOS is unknown. However, you may be at higher risk if you have a family history of the disorder.
As noted above, people with PCOS often have insulin resistance. People with insulin resistance can make insulin, but their cells don't respond to insulin as they should. As a result, insulin levels in the body may increase. This can cause the ovaries to produce higher levels of a group of hormones known as androgens which causes some of the symptoms of PCOS like unwanted hair growth.
In addition to PCOS, other factors can contribute to insulin resistance such as being overweight, having an unhealthy diet, or a family history of diabetes. These people can see a worsening of their symptoms of PCOS. It's important to take action if you have high insulin or blood sugar levels since this may increase your risk of developing diabetes.
How Is PCOS Diagnosed?
Since PCOS is a syndrome with many different signs and symptoms, not all experts agree on the criteria to diagnose PCOS. The three most commonly used criteria are seen here.
As you can see, some criteria rely on blood tests, others rely on ultrasound, and still, others emphasize signs and symptoms. Therefore, your doctor may perform an exam and discuss your medical history to diagnose PCOS. They may perform a pelvic ultrasound to examine your ovaries and do blood tests to determine your hormone levels. These exams and tests will help rule out any other possible causes of your symptoms.
How Is PCOS Treated?
There is no total cure for PCOS. But fortunately, you can take steps to manage or improve your symptoms. Getting adequate exercise, managing your weight, and eating a healthy diet can all help. You may also be able to take medication to lessen physical symptoms, like hair growth and acne. Making lifestyle changes can lower your long-term risks like type 2 diabetes.
It's not easy to hear that you may have PCOS, but you can talk to your doctor about how to lessen your symptoms. Some simple lifestyle changes may improve things.
Can You Get Pregnant if You Have PCOS?

It's possible to get pregnant if you have PCOS. While PCOS can cause infertility struggles, there are a few things you can do to increase your chances of pregnancy.
Having irregular ovulation will make it harder to track the fertile phase of your menstrual cycle. Even so, you could still be able to get pregnant naturally. If this doesn't happen, there are fertility treatment options available.
Can Fertility Treatments Help You Get Pregnant With PCOS?
Absolutely! If you're having trouble getting pregnant, one possible option is in vitro fertilization (IVF). During this advanced fertility treatment, a doctor extracts your eggs, fertilizes them in a laboratory with collected sperm, and transfers the fertilized egg into your uterus. IVF bypasses the fallopian tubes, enabling a fertilized egg to be placed directly into your uterus, where it can implant. IVF can be an effective choice for many people, including those with PCOS, endometriosis, or damaged fallopian tubes.
However, many patients don't require IVF to get pregnant.
Reducing insulin resistance by lifestyle changes or medication can often result in more regular ovulation and pregnancy. Another alternative is ovulation induction with intercourse or intrauterine insemination (IUI). For this procedure, you take fertility drugs to induce ovulation before having intercourse or undergoing artificial insemination so that your eggs can become fertilized.
Does Having PCOS Increase Your Risk of Pregnancy Complications?
If you have PCOS, there can be some increased risk of certain complications like gestational diabetes and preeclampsia during pregnancy. However, this does not always happen, and you can reduce your risks by maintaining a healthy weight and making sure your blood sugar levels are normal before trying to become pregnant.
No matter your situation, the team of caring professionals is here to support you on your fertility journey. We would be glad to answer any questions you may have about PCOS, infertility, and fertility treatment options. Explore our website or schedule a consultation with our experts today if you'd like more information.