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Frequently Asked Questions


Am I infertile?

About 85% of young, healthy heterosexual couples conceive after one year of trying, and about 93% are successful after two years. The standard definition of infertility is the inability to conceive after 12 months of unprotected sexual intercourse. Today, this has been modified to take age into account, and now women over 35 may be considered infertile if they have failed to conceive after trying for six months. Some specialists halve that number to three months for women over 40. If you suspect you are infertile or are at risk for being infertile, make an appointment with Dr. Ramirez for an infertility evaluation.

What’s the difference between sterility and infertility?

Sterility means that it is impossible for a couple to conceive a child. A diagnosis of sterility is given after a thorough examination concludes that there is no sperm production and ovulation cannot occur.

Infertility means that a couple is not sterile but for some reason has not been able to conceive a child. There are three conditions that need to be met for conception to be possible: sperm must be present, the fallopian tubes must be open, and ovulation must be able to occur. If one or more of these conditions is not met, the couple suffers from “true infertility.” If all three conditions are met but the couple has failed to conceive, the diagnosis is “sub-fertility.”

Once a couple is diagnosed as infertile, Dr. Ramirez will perform tests to determine the cause or causes. Then treatment can begin. Today’s advanced reproductive technology can allow many infertile couples to conceive a child. In extreme cases it is sometimes with the assistance of a third party donor or surrogate.

Should I consider seeking professional treatment for infertility?

People who consider undergoing ovulation induction, IUI,  IVF or other assisted reproductive techniques (ART) often do so after they have failed to conceive for 12 months. Others who have known risk factors for infertility seek treatment sooner. Reasons for this include:

The female partner is over 35 years old.
Either partner has received injuries or been diagnosed with conditions that affect fertility (endometriosis, pelvic infection, polycystic ovarian syndrome, undescended testicles).
Either partner has a family history of genetic disorders (Tay-Sachs disease, thalassemia).
The couple has not been helped by ovulation induction or infertility treatments.
The female partner has had multiple unsuccessful pregnancies for other reasons.

Single women and LGBT couples may also obtain professional assistance when attempting to conceive a child.

ve been diagnosed as infertile. Will I need in vitro fertilization (IVF)?

Not necessarily. Most couples find that they can successfully conceive with the help of medications, fertility drugs, or occasionally surgery. Only a small percentage of infertile couples – about 5% – require advanced treatments such as IVF, IVF with ICSI (intracytoplasmic sperm injection) , Egg Donation or the use of a Gestational Surrogate.

What can I do to prepare for my first appointment?

Gather your medical records and exam results from any tests you have already undergone. Some patients have also found it helpful to write about their experiences with infertility and bring that as well. You can download a PDF of our “new patient” form and if you need to have records transferred to us, a “medical records transfer request”. Please see the “New Patient” section for the PDF forms you need which you can print out to bring, scan and email or fax to our office.

How can I increase my chances of conceiving?

See my blog post: “Eight Tips For Increasing Your Fertility” which goes into more detail.

There are life style choice you can make to increase your chances. These include:

Losing or gaining weight. Women with normal body mass indices (BMI) have been shown to enjoy a higher probability of successfully conceiving a child.

Stop smoking. Smoking directly affects menstruation and reproductive function.

Eat well. Give your body the nutrition it needs – eat healthy foods, and supplement with vitamins and antioxidants.

Manage your stress. Emotional and mental well-being is as important as physical health. Try tension-reducing activities such as meditation, yoga or acupuncture.

What tests will I need to have?

Tests vary from patient to patient, and depend on a number of factors including age, medical history, previous treatment results and projected treatment plans. Some tests are for the intended mother, some for the male partner and some are for both. Common exams are blood tests, ultrasound, disease screening, and sperm analysis. Dr. Ramirez will be able to tell you and your partner which tests you will need after your consultation. See our section on “Infertility Evaluation” for a better idea on the tests you may need.

Are treatments painful?

The medications given before egg harvesting are injected under the skin with a small hypodermic needle and should not cause much discomfort.

Egg retrieval is performed using unconscious sedation, so the patient is asleep and does not feel the ultrasound equipment or the fine needle. There will be a team of anesthesiologists closely monitoring the patient, but unconscious sedation is not the same as general anesthesia. The procedure lasts about 15 minutes and the patient wakes quickly.

I am having trouble with the emotional highs and lows of this whole process. Is help available?

Absolutely. We refer all of our patients – both women and men – to counselors from the beginning stages of treatment to help them through this difficult and stressful time in their lives. Counselors can help patients minimize stress levels and deal with the range of emotions experienced during treatment, including anger, denial, depression and grief as well as euphoria. See our section on “Coping With Infertility” for more information.

I have a very weak, one day menstrual flow. What could be wrong?

The amount of bleeding will vary from person to person and cycle to cycle. As long as your cycles are regular, that is the important part. Certainly if the endometrium is not developing adequately, that could impair your fertility. I would not worry about this at this point in time. Just wait and see what happens when you begin trying for pregnancy. If you have difficulty, then testing and evaluation will be done to see if the endometrium is not developing adequately. If that is the case, then supplemental hormone can be given.

I have been off depo-provera for a year but my period has not returned? What’s wrong?

Certainly, something is not working correctly which is preventing the ovary from ovulating, hence no periods. This is not due to the Depo Provera, since it does not last this long. It can delay periods for 1-3 months but not usually longer. There is something else going on and you need to undergo evaluation.


The Fertility & Gynecology Center - Monterey Bay IVF
9833 Blue Larkspur Lane
Monterey, CA 93940
Phone: 831-649-4483
Fax: 831-649-9010

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