an online Instagram web viewer

#centerofreproductivemedicine medias

Photos

#Infertility means not being able to get pregnant after one year of trying (or six months if a woman is 35 or older). Women who can get pregnant but are unable to stay pregnant may also be infertile. 
Our reproductive endocrinologists are recognized for their expertise in treating infertility. They treat patients with the kindness, empathy, and passion that you should expect.

#IVF #IUI  #CenterOfReproductiveMedicine #onegoal #two lines #InfertilityTexas #InfertilitySucks #DocsOfInstagram  #drschnell #drperfetto #drcrochet #drsims #drkathiresan #InfertilityDoctorHouston
#Infertility  means not being able to get pregnant after one year of trying (or six months if a woman is 35 or older). Women who can get pregnant but are unable to stay pregnant may also be infertile. Our reproductive endocrinologists are recognized for their expertise in treating infertility. They treat patients with the kindness, empathy, and passion that you should expect. #IVF  #IUI  #CenterOfReproductiveMedicine  #onegoal  #two  lines #InfertilityTexas  #InfertilitySucks  #DocsOfInstagram  #drschnell  #drperfetto  #drcrochet  #drsims  #drkathiresan  #InfertilityDoctorHouston 
#ONEGOALTWOLINES
How many times have you seen a single line on your pregnancy test? 
At the #CenterOfReproductiveMedicine, we are committed to achieving your dream of starting a family. It’s time you see two lines. Call us today at (281) 332-0073 and schedule an appointment.

#InfertilityTexas #ivf #InfertilityClinic #infertilitysucks #infertility #infertilityawareness #fertilitytreatment #miraclebaby #ivfmiracle #ttccommunity #ivfsupport  #drschnell #drsims #drcrochet #drperfetto #drkathiresan #InfertilityDoctorHouston
#ONEGOALTWOLINES  How many times have you seen a single line on your pregnancy test? At the #CenterOfReproductiveMedicine , we are committed to achieving your dream of starting a family. It’s time you see two lines. Call us today at (281) 332-0073 and schedule an appointment. #InfertilityTexas  #ivf  #InfertilityClinic  #infertilitysucks  #infertility  #infertilityawareness  #fertilitytreatment  #miraclebaby  #ivfmiracle  #ttccommunity  #ivfsupport  #drschnell  #drsims  #drcrochet  #drperfetto  #drkathiresan  #InfertilityDoctorHouston 
We are celebrating all of the physicians at #CenterOfReproductiveMedicine as each have been recognized as a #TopDoc or #RisingStar, but today we are cheering extra loud for #DrSchnell.

Dr. Vicki Schnell received her medical degree from Baylor College of Medicine in 1983, where she also completed her internship and residency in Obstetrics and Gynecology. She furthered her training by completing a two-year fellowship in Reproductive Endocrinology and Infertility at Wayne State University in Detroit, Michigan. Prior to opening her private medical practice in 1993, Dr. Schnell worked as Assistant Professor at the University of Texas Medical Branch in Galveston. Currently, she serves as an Associate Clinical Professor. Dr. Schnell is board certified in both Reproductive Endocrinology/Infertility and Obstetrics/Gynecology by the American Board of Obstetrics and Gynecology (ABOG), as well as a fellow of the American Congress of Obstetricians and Gynecologists (FACOG).
Texas Super Doctors 2018
Texas Super Doctors 2017
Texas Super Doctors 2016
Texas Super Doctors 2015
Texas Super Doctors 2014
Texas Super Doctors 2013
Texas Super Doctors 2012
Texas Super Doctors 2011
Texas Super Doctors 2009
Texas Super Doctors 2008
Texas Super Doctors 2007
Texas Super Doctors 2006
Texas Super Doctors 2005
Texas Super Doctors 2004

#TopDocsOfTexas #SuperDocs #DocsOfInsta #DocsOfTheDay #WomanCrushWednesday #MakingMiraclesEveryday #IVF #Infertility #Fertility #FertilityTreatment #DrSchnell
We are celebrating all of the physicians at #CenterOfReproductiveMedicine  as each have been recognized as a #TopDoc  or #RisingStar , but today we are cheering extra loud for #DrSchnell . Dr. Vicki Schnell received her medical degree from Baylor College of Medicine in 1983, where she also completed her internship and residency in Obstetrics and Gynecology. She furthered her training by completing a two-year fellowship in Reproductive Endocrinology and Infertility at Wayne State University in Detroit, Michigan. Prior to opening her private medical practice in 1993, Dr. Schnell worked as Assistant Professor at the University of Texas Medical Branch in Galveston. Currently, she serves as an Associate Clinical Professor. Dr. Schnell is board certified in both Reproductive Endocrinology/Infertility and Obstetrics/Gynecology by the American Board of Obstetrics and Gynecology (ABOG), as well as a fellow of the American Congress of Obstetricians and Gynecologists (FACOG). Texas Super Doctors 2018 Texas Super Doctors 2017 Texas Super Doctors 2016 Texas Super Doctors 2015 Texas Super Doctors 2014 Texas Super Doctors 2013 Texas Super Doctors 2012 Texas Super Doctors 2011 Texas Super Doctors 2009 Texas Super Doctors 2008 Texas Super Doctors 2007 Texas Super Doctors 2006 Texas Super Doctors 2005 Texas Super Doctors 2004 #TopDocsOfTexas  #SuperDocs  #DocsOfInsta  #DocsOfTheDay  #WomanCrushWednesday  #MakingMiraclesEveryday  #IVF  #Infertility  #Fertility  #FertilityTreatment  #DrSchnell 
We love hearing from our patients and knowing their hearts are full with their #miraclebaby.

Hello Dr. Crochet, 
I wanted to thank you for taking excellent care of me and having faith in my fertility. I wanted to let you know that your surgery was a success and I am now in my 2nd trimester of pregnancy. I am due in MAY! Thank you for performing this surgery on me and helping my family grow. You have no idea how thankful I am!!! Words can NEVER express! You turned my 0% possibility to a 50%, to now a 100% success story. I am forever grateful. Thank you!!!! Sincerely, Noelle Yawn

#TestimonialTuesday #WeLoveOurPatients #CenterOfReproductiveMedicine #MakingMiracleBabies #IVF #Infertility #TTC #TTCsisters #InfertilityJourney #DocsOfInsta #DrCrochet
We love hearing from our patients and knowing their hearts are full with their #miraclebaby . Hello Dr. Crochet, 
I wanted to thank you for taking excellent care of me and having faith in my fertility. I wanted to let you know that your surgery was a success and I am now in my 2nd trimester of pregnancy. I am due in MAY! Thank you for performing this surgery on me and helping my family grow. You have no idea how thankful I am!!! Words can NEVER express! You turned my 0% possibility to a 50%, to now a 100% success story. I am forever grateful. Thank you!!!! Sincerely, Noelle Yawn #TestimonialTuesday  #WeLoveOurPatients  #CenterOfReproductiveMedicine  #MakingMiracleBabies  #IVF  #Infertility  #TTC  #TTCsisters  #InfertilityJourney  #DocsOfInsta  #DrCrochet 
Happy Monday! My day started off so great! An iui patient excited about a positive pregnancy test, who greeted me at the office front door with a hug ☺️. This was followed by a patient that I graduated to her OB. She had a difficult transfer. There are a few strategies we can try in these cases: go to the operating room to map out the path to her uterus, cervical stitches, performing the transfer under anesthesia, empty or fill the bladder to get a better angle, or trying a firmer catheter. We tried all of the these. Thankfully, we got the embryo in the right spot. We wait. We got pregnant! We had some bleeding scares, but we made it to graduation day! It’s always bittersweet to say goodbye- we feel every hardship with them along the way, which makes the arrival to the finish line even more impactful. What a great way to start out the week! ☺️ #embryotransfer #ivfjourney #ivfsuccess #infertilitytexas #centerofreproductivemedicine #houston #ttc #memorialcity
Happy Monday! My day started off so great! An iui patient excited about a positive pregnancy test, who greeted me at the office front door with a hug ☺️. This was followed by a patient that I graduated to her OB. She had a difficult transfer. There are a few strategies we can try in these cases: go to the operating room to map out the path to her uterus, cervical stitches, performing the transfer under anesthesia, empty or fill the bladder to get a better angle, or trying a firmer catheter. We tried all of the these. Thankfully, we got the embryo in the right spot. We wait. We got pregnant! We had some bleeding scares, but we made it to graduation day! It’s always bittersweet to say goodbye- we feel every hardship with them along the way, which makes the arrival to the finish line even more impactful. What a great way to start out the week! ☺️ #embryotransfer  #ivfjourney  #ivfsuccess  #infertilitytexas  #centerofreproductivemedicine  #houston  #ttc  #memorialcity 
The patient sitting on this exam bed just saw her babies 👶🏽heart beat for the first time.
.
Two weeks ago, she sat in my consultation room with her husband and was convinced that her 3rd and final #iui cycle had failed. She was supposed to get her period the next day and she had been spotting for 2 days. I tried to convince her to think positively and to wait until her beta hcg level came back before counting her cycle out. I told her that women have spotting all the time in early pregnancy - I told her that I know from personal experience.
.
Unconvinced, the couple sat in my office to talk with my team about the #ivf process and cost. While she sat in the consultation room, we got her beta hcg level back and she was PREGNANT!
.
I have never seen my clinical staff so excited to tell someone she was pregnant. My whole office was overwhelmed with joy for this couple. To go from asking about IVF ➡️ to scheduling an OB ultrasound is like a story out of a movie.
.
It is not always easy, but it is so important to not give up hope!
.
.
.
#fertilityfeelgoodfriday #feelgoodfriday #ttc #ttcsisters #fertilitytreatment #ttcwithpcos #pcos #infertility #infertilityjourney #infertilityblogger #houstondoctor #centerofreproductivemedicine #drperfetto
The patient sitting on this exam bed just saw her babies 👶🏽heart beat for the first time. . Two weeks ago, she sat in my consultation room with her husband and was convinced that her 3rd and final #iui  cycle had failed. She was supposed to get her period the next day and she had been spotting for 2 days. I tried to convince her to think positively and to wait until her beta hcg level came back before counting her cycle out. I told her that women have spotting all the time in early pregnancy - I told her that I know from personal experience. . Unconvinced, the couple sat in my office to talk with my team about the #ivf  process and cost. While she sat in the consultation room, we got her beta hcg level back and she was PREGNANT! . I have never seen my clinical staff so excited to tell someone she was pregnant. My whole office was overwhelmed with joy for this couple. To go from asking about IVF ➡️ to scheduling an OB ultrasound is like a story out of a movie. . It is not always easy, but it is so important to not give up hope! . . . #fertilityfeelgoodfriday  #feelgoodfriday  #ttc  #ttcsisters  #fertilitytreatment  #ttcwithpcos  #pcos  #infertility  #infertilityjourney  #infertilityblogger  #houstondoctor  #centerofreproductivemedicine  #drperfetto 
Let’s celebrate life! Our December to Remember Special is underway now until December 31, 2018. The #CenterOfReproductiveMedicine is giving 10% off ALL of our treatment cash-pay contracts.  And the magic doesn’t end there… In-house financing is also available for the standard IVF contract allowing patients to pay only 75% down to get started! 
Call 281-332-0073 and make this your December to Remember! 
#IVF #IUI #Infertility #infertilitysucks #fertility #ttc #ttccommunity #miraclebabies #givingback
Let’s celebrate life! Our December to Remember Special is underway now until December 31, 2018. The #CenterOfReproductiveMedicine  is giving 10% off ALL of our treatment cash-pay contracts.  And the magic doesn’t end there… In-house financing is also available for the standard IVF contract allowing patients to pay only 75% down to get started! Call 281-332-0073 and make this your December to Remember! #IVF  #IUI  #Infertility  #infertilitysucks  #fertility  #ttc  #ttccommunity  #miraclebabies  #givingback 
Have you considered a second opinion? For couples frustrated with the failure of their current #IVF treatments there is so much to be gained from seeking a second opinion.

At #CenterOfReproductiveMedicine, our doctors can help by answering all of your #infertility questions and helping infertile couples achieve their dream of having a baby.

Call us today and schedule an appointment (281) 332-0073

#onegoal #two lines #InfertilityTexas #DocsOfInstagram #infertilitysupport #ttc #infertilitydoctor #fertilitydoctor #drschnell #drsims #drcrochet #drperfetto #drkathiresan #InfertilityDoctorHouston
Have you considered a second opinion? For couples frustrated with the failure of their current #IVF  treatments there is so much to be gained from seeking a second opinion. At #CenterOfReproductiveMedicine , our doctors can help by answering all of your #infertility  questions and helping infertile couples achieve their dream of having a baby. Call us today and schedule an appointment (281) 332-0073 #onegoal  #two  lines #InfertilityTexas  #DocsOfInstagram  #infertilitysupport  #ttc  #infertilitydoctor  #fertilitydoctor  #drschnell  #drsims  #drcrochet  #drperfetto  #drkathiresan  #InfertilityDoctorHouston 
“Gratitude unlocks the fullness of life. It turns what we have into enough, and more. It turns denial into acceptance, chaos to order, confusion to clarity. It can turn a meal into a feast, a house into a home, a stranger into a friend. Gratitude makes sense of our past, brings peace for today and creates a vision for tomorrow.” ―Melody Beattie

#HappyThanksgiving #GiveThanks #Grateful #Gratitude #Infertility #Fertility #InfertilitySupport #TTC #TTCsisters #YouAreNotAlone #InfertilityTexas #CenterOfReproductiveMedicine #infertilitysucks #ttccommunity #FertilityAwareness
“Gratitude unlocks the fullness of life. It turns what we have into enough, and more. It turns denial into acceptance, chaos to order, confusion to clarity. It can turn a meal into a feast, a house into a home, a stranger into a friend. Gratitude makes sense of our past, brings peace for today and creates a vision for tomorrow.” ―Melody Beattie #HappyThanksgiving  #GiveThanks  #Grateful  #Gratitude  #Infertility  #Fertility  #InfertilitySupport  #TTC  #TTCsisters  #YouAreNotAlone  #InfertilityTexas  #CenterOfReproductiveMedicine  #infertilitysucks  #ttccommunity  #FertilityAwareness 
Are you looking for an amazing IVF centre so that you can be wonderful parents to your bundle(s) of joy? Book an appointment with us now! Link in bio. .
#motherhood #motherhoodrising #momtips #newmomtips #healthymomtips #tipsformom #tips #baby #pregnant #pregnancy #pregnancyhealth #pregnancytips #pregnancytip #infertility #infertilityjourney #ttc #ttcsisters #fertilitytreatment #fertilityjourney #ivfcycle #ivfsuccess #embryotransfer #fertilityspecialist #centerofreproductivemedicine
.
Are you looking for an amazing IVF centre so that you can be wonderful parents to your bundle(s) of joy? Book an appointment with us now! Link in bio. . #motherhood  #motherhoodrising  #momtips  #newmomtips  #healthymomtips  #tipsformom  #tips  #baby  #pregnant  #pregnancy  #pregnancyhealth  #pregnancytips  #pregnancytip  #infertility  #infertilityjourney  #ttc  #ttcsisters  #fertilitytreatment  #fertilityjourney  #ivfcycle  #ivfsuccess  #embryotransfer  #fertilityspecialist  #centerofreproductivemedicine  .
What a beautiful day driving to #CenterOfReproductiveMedicine. Our staff will be assisting me with a frozen embryo transfer in our #IVF lab in #Beaumont. It is thrilling to see such high frozen embryo success rates with the new vitrification technology.

The drive is nice today but can be very bad due to the weather and traffic on I 10. I have been doing this drive every week for 16 years and am thankful to help so many Golden Triangle #infertility patients achieve their dreams of having a baby.

#HappyThanksgiving 🦃
#doctorsofinstagram 
#infertility #fertility #ttc #frozenembryotransfer #fet #drschnell #infertilitysupport #infertilitytexas #onegoal #twolines
What a beautiful day driving to #CenterOfReproductiveMedicine . Our staff will be assisting me with a frozen embryo transfer in our #IVF  lab in #Beaumont . It is thrilling to see such high frozen embryo success rates with the new vitrification technology. The drive is nice today but can be very bad due to the weather and traffic on I 10. I have been doing this drive every week for 16 years and am thankful to help so many Golden Triangle #infertility  patients achieve their dreams of having a baby. #HappyThanksgiving  🦃 #doctorsofinstagram  #infertility  #fertility  #ttc  #frozenembryotransfer  #fet  #drschnell  #infertilitysupport  #infertilitytexas  #onegoal  #twolines 
Roughly 15 percent of all known pregnancies end in miscarriage. A healthy lifestyle before and during the pregnancy may help in reducing the chances of miscarriage. 
Find a link in bio for a list of 8 lifestyle tips an eager mom-to-be can follow to have a successful pregnancy. .
#motherhood #motherhoodrising #momtips #newmomtips #healthymomtips #tipsformom #tips #baby #pregnant #pregnancy #pregnancyhealth #pregnancytips #pregnancytip
#infertility #infertilityjourney #ttc #ttcsisters #fertilitytreatment #fertilityjourney #ivfcycle #ivfsuccess #embryotransfer #fertilityspecialist  #centerofreproductivemedicine
.
Roughly 15 percent of all known pregnancies end in miscarriage. A healthy lifestyle before and during the pregnancy may help in reducing the chances of miscarriage. Find a link in bio for a list of 8 lifestyle tips an eager mom-to-be can follow to have a successful pregnancy. . #motherhood  #motherhoodrising  #momtips  #newmomtips  #healthymomtips  #tipsformom  #tips  #baby  #pregnant  #pregnancy  #pregnancyhealth  #pregnancytips  #pregnancytip  #infertility  #infertilityjourney  #ttc  #ttcsisters  #fertilitytreatment  #fertilityjourney  #ivfcycle  #ivfsuccess  #embryotransfer  #fertilityspecialist  #centerofreproductivemedicine  .
Sometimes you have a good week. Sometimes you have a great week ... I have had a couple of really great weeks!
.
In the last two weeks 9 out of 11 of my #ivf patients who had a frozen #embryotransfer with me had a positive pregnancy🤰🏼test! Yay!! This calls for a #fertilityfeelgoodfriday for sure.
.
In addition to my patients getting knocked up, my practice is also on a wave 🌊of success. Since August, we have had a 68% pregnancy rate in ALL of our frozen #embryo transfers. That is super impressive because we treat every patient, every age, every diagnosis, every low or high responder. We want every patient or couple to have a family and we do not cherry-pick patients to boost our success rates.
.
Like many #womeninmedicine, I have a strong aversion to talking about what makes me an excellent #doctor. I dislike feeling like I am “bragging” and although I appreciate others giving me #positivefeedback, I rarely give it to myself.
.
Well, today I am going to let my success rates and happy patients speak for themselves.
.
.
.
As an aside, @drcorriel recently wrote an article encouraging us to “toot with no apologies.” I ❤️ it and thoroughly enjoy her perspective on life, medicine and family. I highly encourage you to check her out.
.
.
.
#feelgoodfriday #infertility #infertilityjourney #ttc #ttcsisters #fertilitytreatment #fertilityjourney #ivfcycle #ivfsuccess #embryotransfer #fertilityspecialist #doctorsofinstagram #somedocs #houstonblogger #centerofreproductivemedicine #drperfetto
Sometimes you have a good week. Sometimes you have a great week ... I have had a couple of really great weeks! . In the last two weeks 9 out of 11 of my #ivf  patients who had a frozen #embryotransfer  with me had a positive pregnancy🤰🏼test! Yay!! This calls for a #fertilityfeelgoodfriday  for sure. . In addition to my patients getting knocked up, my practice is also on a wave 🌊of success. Since August, we have had a 68% pregnancy rate in ALL of our frozen #embryo  transfers. That is super impressive because we treat every patient, every age, every diagnosis, every low or high responder. We want every patient or couple to have a family and we do not cherry-pick patients to boost our success rates. . Like many #womeninmedicine , I have a strong aversion to talking about what makes me an excellent #doctor . I dislike feeling like I am “bragging” and although I appreciate others giving me #positivefeedback , I rarely give it to myself. . Well, today I am going to let my success rates and happy patients speak for themselves. . . . As an aside, @drcorriel recently wrote an article encouraging us to “toot with no apologies.” I ❤️ it and thoroughly enjoy her perspective on life, medicine and family. I highly encourage you to check her out. . . . #feelgoodfriday  #infertility  #infertilityjourney  #ttc  #ttcsisters  #fertilitytreatment  #fertilityjourney  #ivfcycle  #ivfsuccess  #embryotransfer  #fertilityspecialist  #doctorsofinstagram  #somedocs  #houstonblogger  #centerofreproductivemedicine  #drperfetto 
After completing the initial visit and #infertility evaluation (HSG, semen analysis, ultrasound) it is time to decide on treatment.
.
Not every #fertilitytreatment is an option for every patient/couple. If every option is available, here are the choices I discuss:
.
1️⃣Ovulation induction - This is typically for patients who are not ovulating (#pcos). It involves the female taking medications (typically oral #Letrozole) to stimulate #ovulation. This can be paired with timed intercourse or intrauterine #insemination depending on the #semenanalysis.
2️⃣ Cycle management - This is typically for patients that are already ovulating and need medications to help increase follicle number and manage the cycle. The female is typically taking Letrozole + Injectable meds and we almost always pair it with #IUI.
3️⃣ In Vitro Fertilization - This is a more aggressive form of treatment and it generally has the highest success rates. It is a must for females with blocked fallopian tubes, males with a low semen analysis and those that have failed the less aggressive treatments above. Also, some patients move to #ivf from the beginning for genetic reasons or because they want a higher success rate and quicker pregnancy.
.
Next … more on the actual steps of each option.
.
.
.
These posts are for educational purposes only. They are not medical advice.
.
.
.
#infertilitysucks #infertilityawareness #fertilityawareness #ttc #ttcwithpcos #ttcsisters #ttcjourney #fertilityspecialist #doctorsofinstagram #obgyn #somedocs #houstondoctors #infertilityblogger #centerofreproductivemedicine #drperfetto
After completing the initial visit and #infertility  evaluation (HSG, semen analysis, ultrasound) it is time to decide on treatment. . Not every #fertilitytreatment  is an option for every patient/couple. If every option is available, here are the choices I discuss: . 1️⃣Ovulation induction - This is typically for patients who are not ovulating (#pcos ). It involves the female taking medications (typically oral #Letrozole ) to stimulate #ovulation . This can be paired with timed intercourse or intrauterine #insemination  depending on the #semenanalysis . 2️⃣ Cycle management - This is typically for patients that are already ovulating and need medications to help increase follicle number and manage the cycle. The female is typically taking Letrozole + Injectable meds and we almost always pair it with #IUI . 3️⃣ In Vitro Fertilization - This is a more aggressive form of treatment and it generally has the highest success rates. It is a must for females with blocked fallopian tubes, males with a low semen analysis and those that have failed the less aggressive treatments above. Also, some patients move to #ivf  from the beginning for genetic reasons or because they want a higher success rate and quicker pregnancy. . Next … more on the actual steps of each option. . . . These posts are for educational purposes only. They are not medical advice. . . . #infertilitysucks  #infertilityawareness  #fertilityawareness  #ttc  #ttcwithpcos  #ttcsisters  #ttcjourney  #fertilityspecialist  #doctorsofinstagram  #obgyn  #somedocs  #houstondoctors  #infertilityblogger  #centerofreproductivemedicine  #drperfetto 
We do not only do #ivf. Actually more than half of our patients get pregnant with less aggressive treatment- like ovulation induction or #iui.
.
That being said, sometimes In Vitro Fertilization is absolutely required or is the appropriate next step to achieve pregnancy.
.
Everyone knows that IVF is expensive. Now, it’s not as expensive as it used to be and it’s actually less expensive than a lot of patients think when they first walk through the door, but it is still very expensive.
.
Unfortunately, most insurance companies do not cover it either (although more are - we will post on that at another time).
.
So, what can patients do if they do not have coverage and cannot afford the treatment?
.
One option may be an IVF Study. IVF Studies are typically an #ivfcycle done under a specific protocol (approved by the FDA) and are generally done at a major discount (or free).
.
We are very lucky to be a #fertility practice that participates in a large number of IVF studies (high success rates = studies want to work with you 😊). Basically, if it is an active study, we are probably participating.
.
This is not something we have discussed on Instagram  previously, mostly because if we have a new study we try and fill it with our current patients.
.
Today, we are sharing because we are involved in a rather large study and we have more spots available than normal.
.
We can offer a broad list of inclusion/exclusion criteria, but absolutely cannot guarantee a spot to anyone.
.
What are the requirements? Age between 18-42, BMI <38, 2 ovaries, No more than 3 miscarriages, Sperm on sperm analysis, Regular cycles every 24-35 days and Normal prolactin.
.
If you think you may qualify or you just want more information, please reach out to our office at (281) 332-0073 EXT 283. Please note that calls are being returned in the order that they are received... We will be more than happy to try and help you! Good luck!🍀
.
.
.
#infertility #infertilitysucks #ttc #ttcsisters #ttccommunity #fertilityawareness #fertilityspecialist #docsofinsta #doctorsofinstagram #houstondoctors #centerofreproductivemedicine #drschnell #drsims #drcrochet #drperfetto #drkathiresan
We do not only do #ivf . Actually more than half of our patients get pregnant with less aggressive treatment- like ovulation induction or #iui . . That being said, sometimes In Vitro Fertilization is absolutely required or is the appropriate next step to achieve pregnancy. . Everyone knows that IVF is expensive. Now, it’s not as expensive as it used to be and it’s actually less expensive than a lot of patients think when they first walk through the door, but it is still very expensive. . Unfortunately, most insurance companies do not cover it either (although more are - we will post on that at another time). . So, what can patients do if they do not have coverage and cannot afford the treatment? . One option may be an IVF Study. IVF Studies are typically an #ivfcycle  done under a specific protocol (approved by the FDA) and are generally done at a major discount (or free). . We are very lucky to be a #fertility  practice that participates in a large number of IVF studies (high success rates = studies want to work with you 😊). Basically, if it is an active study, we are probably participating. . This is not something we have discussed on Instagram previously, mostly because if we have a new study we try and fill it with our current patients. . Today, we are sharing because we are involved in a rather large study and we have more spots available than normal. . We can offer a broad list of inclusion/exclusion criteria, but absolutely cannot guarantee a spot to anyone. . What are the requirements? Age between 18-42, BMI <38, 2 ovaries, No more than 3 miscarriages, Sperm on sperm analysis, Regular cycles every 24-35 days and Normal prolactin. . If you think you may qualify or you just want more information, please reach out to our office at (281) 332-0073 EXT 283. Please note that calls are being returned in the order that they are received... We will be more than happy to try and help you! Good luck!🍀 . . . #infertility  #infertilitysucks  #ttc  #ttcsisters  #ttccommunity  #fertilityawareness  #fertilityspecialist  #docsofinsta  #doctorsofinstagram  #houstondoctors  #centerofreproductivemedicine  #drschnell  #drsims  #drcrochet  #drperfetto  #drkathiresan 
I do not only do #ivf. Actually more than half of my patients get pregnant with less aggressive treatment- like ovulation induction or #iui.
.
That being said, sometimes In Vitro Fertilization is absolutely required or is the appropriate next step to achieve pregnancy.
.
Everyone knows that IVF is expensive. Now, it’s not as expensive as it used to be and it’s actually less expensive than a lot of patients think when they first walk through the door, but it is still very expensive.
.
Unfortunately, most insurance companies do not cover it either (although more are - I’ll post on that at another time).
.
So, what can patients do if they do not have coverage and cannot afford the treatment?
.
One option may be an IVF Study. IVF Studies are typically an #ivfcycle done under a specific protocol (approved by the FDA) and are generally done at a major discount (or free).
.
I am very lucky to be at a #fertility practice that participates in a large number of IVF studies (high success rates = studies want to work with you😊). Basically, if it is an active study, we are probably participating.
.
This is not something I have discussed on IG previously, mostly because if we have a new study we try and fill it with our current patients.
.
Today, I am sharing because we are involved in a rather large study and we have more spots available than normal.
.
I can offer a broad list of inclusion/exclusion criteria, but absolutely cannot guarantee a spot to anyone.
.
What are the requirements? Age between 18-42, BMI <38, 2 ovaries, No more than 3 miscarriages, Sperm on sperm analysis, Regular cycles every 24-35 days and Normal prolactin.
.
If you think you may qualify or you just want more information, please reach out to my office at 281-332-0073 ext 283 (UPDATED - please leave a message and calls will be answered in the order received). Good luck!🍀
.
.
.
#infertility #infertilitysucks #ttc #ttcsisters #ttccommunity #fertilityawareness #fertilityspecialist #obgyn #docsofinsta #doctorsofinstagram #somedocs #houstondoctors #infertilityblogger #houstonblogger #centerofreproductivemedicine #drperfetto
I do not only do #ivf . Actually more than half of my patients get pregnant with less aggressive treatment- like ovulation induction or #iui . . That being said, sometimes In Vitro Fertilization is absolutely required or is the appropriate next step to achieve pregnancy. . Everyone knows that IVF is expensive. Now, it’s not as expensive as it used to be and it’s actually less expensive than a lot of patients think when they first walk through the door, but it is still very expensive. . Unfortunately, most insurance companies do not cover it either (although more are - I’ll post on that at another time). . So, what can patients do if they do not have coverage and cannot afford the treatment? . One option may be an IVF Study. IVF Studies are typically an #ivfcycle  done under a specific protocol (approved by the FDA) and are generally done at a major discount (or free). . I am very lucky to be at a #fertility  practice that participates in a large number of IVF studies (high success rates = studies want to work with you😊). Basically, if it is an active study, we are probably participating. . This is not something I have discussed on IG previously, mostly because if we have a new study we try and fill it with our current patients. . Today, I am sharing because we are involved in a rather large study and we have more spots available than normal. . I can offer a broad list of inclusion/exclusion criteria, but absolutely cannot guarantee a spot to anyone. . What are the requirements? Age between 18-42, BMI <38, 2 ovaries, No more than 3 miscarriages, Sperm on sperm analysis, Regular cycles every 24-35 days and Normal prolactin. . If you think you may qualify or you just want more information, please reach out to my office at 281-332-0073 ext 283 (UPDATED - please leave a message and calls will be answered in the order received). Good luck!🍀 . . . #infertility  #infertilitysucks  #ttc  #ttcsisters  #ttccommunity  #fertilityawareness  #fertilityspecialist  #obgyn  #docsofinsta  #doctorsofinstagram  #somedocs  #houstondoctors  #infertilityblogger  #houstonblogger  #centerofreproductivemedicine  #drperfetto 
This post from @bymariandrew is filling our hearts with all sorts of love and gratitude. They are thoughtful, kind, and beautiful. Some things to say when you don’t know what to say to a family member, coworker, or a dear friend that is going through infertility.
...
#Repost @bymariandrew
.
.
.
#ttc #ttcsisters #fertilityawareness #infertilitysucks #infertilitysupport #infertilityawareness #infertilitytexas #centerofreproductivemedicine
After 10-12 days of ovarian stimulation it is time for the #eggretrieval.
.
I perform the egg retrieval procedure at our surgery center, which is attached to our #ivf lab.
.
The patient walks herself to the OR, lays on the bed and places her legs in the stirrups. Our CRNA then puts her under anesthesia. The patient is completely asleep and will not remember anything from the procedure. The one difference between an egg retrieval and other surgeries is that our patients are all still breathing on their own during the case- so the sedation is pretty light.
.
After being put to sleep, I insert a speculum and clean the vagina and cervix. I then place a transvaginal ultrasound probe (with a needle guide on it) into the vagina. Once I reach the top of the vagina, I typically have a clear view of the ovary.
.
I then insert a thin needle directly into the ovary and apply gentle suction to remove the follicular fluid and (hopefully) the egg.
.
The fluid is handed off to our amazing #embryologist and they tell me if there is an egg.
.
The whole process typically takes <15 minutes and is relatively painless.
.
.
.
These posts are for educational purposes only.
.
.
.
#ivfcommunity #ivfcycle #infertility #infertilitysucks #infertilityawareness #infertilitytreatment #infertilityblogger #fertilityawareness #ttc #ttcsupport #ivfsuccess #houstondoctors #centerofreproductivemedicine #drperfetto
After 10-12 days of ovarian stimulation it is time for the #eggretrieval . . I perform the egg retrieval procedure at our surgery center, which is attached to our #ivf  lab. . The patient walks herself to the OR, lays on the bed and places her legs in the stirrups. Our CRNA then puts her under anesthesia. The patient is completely asleep and will not remember anything from the procedure. The one difference between an egg retrieval and other surgeries is that our patients are all still breathing on their own during the case- so the sedation is pretty light. . After being put to sleep, I insert a speculum and clean the vagina and cervix. I then place a transvaginal ultrasound probe (with a needle guide on it) into the vagina. Once I reach the top of the vagina, I typically have a clear view of the ovary. . I then insert a thin needle directly into the ovary and apply gentle suction to remove the follicular fluid and (hopefully) the egg. . The fluid is handed off to our amazing #embryologist  and they tell me if there is an egg. . The whole process typically takes <15 minutes and is relatively painless. . . . These posts are for educational purposes only. . . . #ivfcommunity  #ivfcycle  #infertility  #infertilitysucks  #infertilityawareness  #infertilitytreatment  #infertilityblogger  #fertilityawareness  #ttc  #ttcsupport  #ivfsuccess  #houstondoctors  #centerofreproductivemedicine  #drperfetto 
#TBT morning doctor meeting. 
It’s great when we all come together twice a month to talk about how to make #CenterOfReproductiveMedicine a better practice.

A major plus is we get a few hours to see our partners and staff in #ClearLake!
.
#infertilitytexas #infertility #doctorsofinstagram #meetingroom #infertilitysupport #ttc #infertilitydoctor #fertilitydoctor #drschnell #drsims #drcrochet #drkathiresan 
Repost @infertilitydrperfetto
So proud to work with these two amazing Medical Assistants at our #ClearLake office. Their support of our #infertility patients is amazing. Thank you for all you do @ajpilman and SylviaVelasquez
.
#CenterOfReproductiveMedicine #onegoal #twolines #workingtogether
.
#Repost @vischnell
UPDATE: In July one of my patients with #pcos had a robust response to ovulation meds. Instead of cancelling her cycle secondary to our mutual fear of higher order multiples (triplets, quads, etc.) we flipped her to an #ivfcycle.
.
Unfortunately, she did not get pregnant after her fresh #embryotransfer. She took a short break and had a frozen embryo transfer a couple of weeks ago.
.
I am super excited to report that she is pregnant 🤰🏼! Yes, it took more than one transfer, but we just got back a healthy beta hCG level.
.
I am super excited for this couple! Not only did we “save” her treatment cycle, drastically reduce her chance of multiples (single embryo transfer has <2% chance of twins), but we also have a few frozen #embryos remaining in storage for her future use.
.
This is definitely an #ivfsuccess story!
.
Important learning lessons from this:
1️⃣ An over-response to medications can lead to multiples (which may be cute, BUT they arehigh risk for mom and babies).
2️⃣ I do consider converting good candidates from #iui to #ivf if appropriate.
3️⃣ Do not give up. Sometimes the first transfer does not work, even in the best circumstances. If you can, try again.
.
.
.
These posts are for educational purposes only.
.
.
.
#infertility #infertilitysucks #ttc #ttcwithpcos #pcosawareness #pcosfighter #pcossupport #fertility #fertilityawareness #fertilityspecialist #infertilityblogger #houstondoctors #somedoc #doctorsofinstagram #docsofinsta #centerofreproductivemedicine #drperfetto
UPDATE: In July one of my patients with #pcos  had a robust response to ovulation meds. Instead of cancelling her cycle secondary to our mutual fear of higher order multiples (triplets, quads, etc.) we flipped her to an #ivfcycle . . Unfortunately, she did not get pregnant after her fresh #embryotransfer . She took a short break and had a frozen embryo transfer a couple of weeks ago. . I am super excited to report that she is pregnant 🤰🏼! Yes, it took more than one transfer, but we just got back a healthy beta hCG level. . I am super excited for this couple! Not only did we “save” her treatment cycle, drastically reduce her chance of multiples (single embryo transfer has <2% chance of twins), but we also have a few frozen #embryos  remaining in storage for her future use. . This is definitely an #ivfsuccess  story! . Important learning lessons from this: 1️⃣ An over-response to medications can lead to multiples (which may be cute, BUT they arehigh risk for mom and babies). 2️⃣ I do consider converting good candidates from #iui  to #ivf  if appropriate. 3️⃣ Do not give up. Sometimes the first transfer does not work, even in the best circumstances. If you can, try again. . . . These posts are for educational purposes only. . . . #infertility  #infertilitysucks  #ttc  #ttcwithpcos  #pcosawareness  #pcosfighter  #pcossupport  #fertility  #fertilityawareness  #fertilityspecialist  #infertilityblogger  #houstondoctors  #somedoc  #doctorsofinstagram  #docsofinsta  #centerofreproductivemedicine  #drperfetto 
The time it takes for a couple to visit a #fertilityspecialist can be varied. I see patients for their first visit when they have been #ttc for as short as 2 months to as long as 17 years. What #motivates a couple to seek a #fertility evaluation is very personal and I never judge them for coming in “too early” or “too late.” The truth is, just making that first visit is frequently the hardest step in the process.
.
Ideally, couples should seek an eval if they have been ttc for 12months and the female is <35 and has regular cycles. If the female is >35, then they should head in for a visit after 6 months of unprotected intercourse. If the couple has known #malefactorinfertility or the female has a history of tubal disease or irregular cycles (#pcos) then they should come in even sooner. 
Repost @infertilitydrperfetto
.
.
#infertility #infertilityjourney #ttccommunity #ttcjourney #ivf #ivfjourney #iui #endometriosis #fertilityjourney #centerofreproductivemedicine #corm #onegoaltwolines
The time it takes for a couple to visit a #fertilityspecialist  can be varied. I see patients for their first visit when they have been #ttc  for as short as 2 months to as long as 17 years. What #motivates  a couple to seek a #fertility  evaluation is very personal and I never judge them for coming in “too early” or “too late.” The truth is, just making that first visit is frequently the hardest step in the process. . Ideally, couples should seek an eval if they have been ttc for 12months and the female is <35 and has regular cycles. If the female is >35, then they should head in for a visit after 6 months of unprotected intercourse. If the couple has known #malefactorinfertility  or the female has a history of tubal disease or irregular cycles (#pcos ) then they should come in even sooner. Repost @infertilitydrperfetto . . #infertility  #infertilityjourney  #ttccommunity  #ttcjourney  #ivf  #ivfjourney  #iui  #endometriosis  #fertilityjourney  #centerofreproductivemedicine  #corm  #onegoaltwolines 
I was on-call for my practice this weekend. For over 60 hours I was the #doctor 👩🏼‍⚕️who was available for any #eggretrieval, patient calls and all challenging ultrasounds or #iui.
.
So, how was my weekend? Amazing. I had very few phone calls and I only needed to go into the office on Sunday for procedures.
.
Why was my #oncall weekend so easy? It was 100% because of my staff.
.
My staff truly makes my everyday life and my on-call life easy.
.
I am pointing this out today because I am not a one man team. I may be the face of this account, but there are lots of people standing behind me making sure the #centerofreproductivemedicine rocks ⭐️.
.
My #nurses make sure our patients have medications, know how to reach the office at all times with any questions and understand when to call for an emergency.
My #medicalassistants make sure patients are in rooms, ultrasounds are prepped and every consent is signed and ready.
My #embryologist and andrologists double and triple check everything we do and they run an #ivf lab with AMAZING success rates.
My surgery center team makes sure the patients always feel safe and comfortable and they run on time!
My admin team puts the patients first, bends over backwards to help with insurance and try their hardest to always answer with a smile 😃.
.
Thank you all for making this #fertilitydoctor so happy. I am very lucky to be part of this team.
.
.
.
#fertilityspecialist #infertility #infertilityawareness #infertilitysupport #fertilityawareness #ttc #ttccommunity #obgyn #medicalteam #houstondoctors #doctorsofinstagram #docsofinsta #SoMeDocs #medstudent #premed #drperfetto
I was on-call for my practice this weekend. For over 60 hours I was the #doctor  👩🏼‍⚕️who was available for any #eggretrieval , patient calls and all challenging ultrasounds or #iui . . So, how was my weekend? Amazing. I had very few phone calls and I only needed to go into the office on Sunday for procedures. . Why was my #oncall  weekend so easy? It was 100% because of my staff. . My staff truly makes my everyday life and my on-call life easy. . I am pointing this out today because I am not a one man team. I may be the face of this account, but there are lots of people standing behind me making sure the #centerofreproductivemedicine  rocks ⭐️. . My #nurses  make sure our patients have medications, know how to reach the office at all times with any questions and understand when to call for an emergency. My #medicalassistants  make sure patients are in rooms, ultrasounds are prepped and every consent is signed and ready. My #embryologist  and andrologists double and triple check everything we do and they run an #ivf  lab with AMAZING success rates. My surgery center team makes sure the patients always feel safe and comfortable and they run on time! My admin team puts the patients first, bends over backwards to help with insurance and try their hardest to always answer with a smile 😃. . Thank you all for making this #fertilitydoctor  so happy. I am very lucky to be part of this team. . . . #fertilityspecialist  #infertility  #infertilityawareness  #infertilitysupport  #fertilityawareness  #ttc  #ttccommunity  #obgyn  #medicalteam  #houstondoctors  #doctorsofinstagram  #docsofinsta  #SoMeDocs  #medstudent  #premed  #drperfetto 
We truly have two #ttcsisters in our CORM family. Crystina B. and baby boy Brayden (left) and Mary B. and baby girl Wren (right) are both friends... and did their fertility treatment together both with Dr. Crochet (same delivering OB too). Their babies are about 4 weeks apart... Such a wonderful story for them to share with their sweet #miracles.
.
Love. Hope. Strength. Inspiration.
.
#MiracleBaby #IVF #DreamsDoComeTrue #NeverGiveUp #CenterOfReproductiveMedicine #onegoal #two lines #InfertilityTexas #IVF #DocsOfInstagram
We truly have two #ttcsisters  in our CORM family. Crystina B. and baby boy Brayden (left) and Mary B. and baby girl Wren (right) are both friends... and did their fertility treatment together both with Dr. Crochet (same delivering OB too). Their babies are about 4 weeks apart... Such a wonderful story for them to share with their sweet #miracles . . Love. Hope. Strength. Inspiration. . #MiracleBaby  #IVF  #DreamsDoComeTrue  #NeverGiveUp  #CenterOfReproductiveMedicine  #onegoal  #two  lines #InfertilityTexas  #IVF  #DocsOfInstagram 
Supplements ... what exactly are you taking?
.
I have daily conversations with my patients and their partners about #dietarysupplements. They typically want me to verify that everything they are taking is “safe.”
.
I’m completely honest with them - I have no clue if what they are taking is safe. Why? Because #supplements are considered “food” and therefore they are not monitored by the FDA for safety or effectiveness.
.
This means what is in one supplement (even by the same company) may not be the same from one bottle to the next.
.
A recent article published in JAMA Network proves this point. It found that unapproved pharmaceutical ingredients were identified in 776 supplements.
.
The supplements that I discuss and worry about the most for my couples who are #ttc ➡️ preworkout muscle building supplements.
.
This study found that 89% of this type of supplement had synthetic 💪steroids or steroid-like ingredients in them! WHAT? Can’t steroids cause #malefactorinfertility?!? YES!!!
.
Take-home point: Supplements are not monitored by the FDA and for that reason they can have anything in them. If you are an #infertility patient make sure to discuss all your supplements and meds with your #fertilityspecialist. Even “harmless” pre-workout supplements may be adversely affecting your success rates.
.
.
.
These posts are for educational purposes only.
.
.
.
#infertilitysucks #infertilityawareness #infertilityjourney #fertilityawareness #fertility #ttccommunity #ttcsupport #fertilitydoctor #houstondoctors #docsofinsta #obgyn #medstudent #premed #somedoc #centerofreproductivemedicine #drperfetto
Supplements ... what exactly are you taking? . I have daily conversations with my patients and their partners about #dietarysupplements . They typically want me to verify that everything they are taking is “safe.” . I’m completely honest with them - I have no clue if what they are taking is safe. Why? Because #supplements  are considered “food” and therefore they are not monitored by the FDA for safety or effectiveness. . This means what is in one supplement (even by the same company) may not be the same from one bottle to the next. . A recent article published in JAMA Network proves this point. It found that unapproved pharmaceutical ingredients were identified in 776 supplements. . The supplements that I discuss and worry about the most for my couples who are #ttc  ➡️ preworkout muscle building supplements. . This study found that 89% of this type of supplement had synthetic 💪steroids or steroid-like ingredients in them! WHAT? Can’t steroids cause #malefactorinfertility ?!? YES!!! . Take-home point: Supplements are not monitored by the FDA and for that reason they can have anything in them. If you are an #infertility  patient make sure to discuss all your supplements and meds with your #fertilityspecialist . Even “harmless” pre-workout supplements may be adversely affecting your success rates. . . . These posts are for educational purposes only. . . . #infertilitysucks  #infertilityawareness  #infertilityjourney  #fertilityawareness  #fertility  #ttccommunity  #ttcsupport  #fertilitydoctor  #houstondoctors  #docsofinsta  #obgyn  #medstudent  #premed  #somedoc  #centerofreproductivemedicine  #drperfetto 
Go harder, climb smarter. 
@Regran_ed from @infertilitytexas -  #mondaymotivation... because who doesn’t wish that the weekend could last one more day?@!
.
.
.
#longerweekendplease #ivf #infertility #ttcsisters #fertility #centerofreproductivemedicine #infertilitytexas #infertilitysucks #viewfromthetop#health #healthyliving #healthylifestyle #medicaldevices #vitamins #herbalsupplements #OnlineHealthHub #healthace - #regrann
Had so much fun at ASRM 2018! Great to see new research being presented by the next generation of REIs, great to hear from experts in our field and think about different perspectives, and great to reconnect with old friends! Until next time ☺️ #constantlearning #asrm2018 #ucla #infertilitytexas #centerofreproductivemedicine
Last week, I outlined the differences between a biochemical pregnancy (BC) and a clinical #miscarriage (MC).
.
We discussed that no matter the time of the loss, it is still painful and will leave the patient/couple devastated and raw. One of the more challenging issues for me as a #fertilityspecialist is discussing what to do after these recurrent losses- both CM and BC.
.
The most important thing I can point out is that every #doctor, medical practice and society (ie. ASRM) has different outlooks on what to do after 2 or more losses.
.
For #recurrentmiscarriage (specifically CM only)- ASRM has specific guidelines for uterine cavity evaluation, antiphospholipid antibody testing, hormone testing and parental karyotypes (I have discussed this in the past). They do not however, recommend this testing in those patients suffering from recurrent BC.
.
Why is this? It really comes down to how common BC are, the high chance of recurrence BUT most importantly the even higher likelihood of a live birth without any testing or intervention.
.
Meaning, based on chance alone:
1️⃣Chance of CM = about 15%
So, risk of 3 = (0.15^3) = <1% 
2️⃣ Chance of BC = about 60%
So, risk of 3 = (0.6^3) = 20%
.
The above data does not negate the loss of a BC, nor should you feel like it does not count. It should be used to reassure those with a history of BC that the likelihood of a live birth is incredibly high.
.
October is infant and pregnancy loss month. Although these babies are forever in our ❤️, the least we can do is use this month to honor them and discuss the losses we have suffered.
.
.
.
These posts are for educational purposes only
.
.
.
#infantandpregnancylossawareness #pregnancyloss #infertility #infertilitysucks #infertilityawareness #infertilitysupport #ttc #ttcaftermiscarriage #ttcafterloss #houstondoctors #infertilityblogger #obgyn #centerofreproductivemedicine #drperfetto
Last week, I outlined the differences between a biochemical pregnancy (BC) and a clinical #miscarriage  (MC). . We discussed that no matter the time of the loss, it is still painful and will leave the patient/couple devastated and raw. One of the more challenging issues for me as a #fertilityspecialist  is discussing what to do after these recurrent losses- both CM and BC. . The most important thing I can point out is that every #doctor , medical practice and society (ie. ASRM) has different outlooks on what to do after 2 or more losses. . For #recurrentmiscarriage  (specifically CM only)- ASRM has specific guidelines for uterine cavity evaluation, antiphospholipid antibody testing, hormone testing and parental karyotypes (I have discussed this in the past). They do not however, recommend this testing in those patients suffering from recurrent BC. . Why is this? It really comes down to how common BC are, the high chance of recurrence BUT most importantly the even higher likelihood of a live birth without any testing or intervention. . Meaning, based on chance alone: 1️⃣Chance of CM = about 15% So, risk of 3 = (0.15^3) = <1% 2️⃣ Chance of BC = about 60% So, risk of 3 = (0.6^3) = 20% . The above data does not negate the loss of a BC, nor should you feel like it does not count. It should be used to reassure those with a history of BC that the likelihood of a live birth is incredibly high. . October is infant and pregnancy loss month. Although these babies are forever in our ❤️, the least we can do is use this month to honor them and discuss the losses we have suffered. . . . These posts are for educational purposes only . . . #infantandpregnancylossawareness  #pregnancyloss  #infertility  #infertilitysucks  #infertilityawareness  #infertilitysupport  #ttc  #ttcaftermiscarriage  #ttcafterloss  #houstondoctors  #infertilityblogger  #obgyn  #centerofreproductivemedicine  #drperfetto 
I had such great intentions for a rockstar ⭐️ #feelgoodfriday post. But, sometimes things just do not work out as planned.
.
Here I am, still in my office at 6pm- writing notes, reviewing labs and trying to catch up on patient tasks that I let build up all week long.
.
To be down right honest, I had a poopy 💩 week. I had two patients with beautiful, euploid embryos and perfect transfers not get pregnant. I had two patients with beautiful pregnancies miscarry 😫. I had to cancel a transfer (in the OR) because I could not get into my patient’s uterus and I was not willing to decrease her chance of pregnancy to force the transfer.
.
I know these are not #fertilityfeelgoodfriday moments, but they are a reality. Even when I want everything to go right, when I try my best and my patient does everything right, #infertilitysucks.
.
Now for the feel good part ... My patients are amazing❤️. When I walked in slumped over about the negative pregnancy test, they told me “you are such an amazing #doctor. God bless you.” When I told my couple I cannot get into the uterus, you have blood on the catheter and if I push through on this transfer your pregnancy rates will decrease, they said “we trust you. You just tell us what you would do.”
.
I appreciate my patients so much. I am honored to be their #fertilityspecialist and I feel so lucky to be involved in what may be one of the most difficult times of their lives.
.
.
.
#infertility #infertilityawareness #infertilityjourney #infertilitysupport #infertilityblogger #houstondoctors #fertility #fertilityawareness #fertilityjourney #ivf #embryotransfer #ttc #ttccommunity #centerofreproductivemedicine #drperfetto
I had such great intentions for a rockstar ⭐️ #feelgoodfriday  post. But, sometimes things just do not work out as planned. . Here I am, still in my office at 6pm- writing notes, reviewing labs and trying to catch up on patient tasks that I let build up all week long. . To be down right honest, I had a poopy 💩 week. I had two patients with beautiful, euploid embryos and perfect transfers not get pregnant. I had two patients with beautiful pregnancies miscarry 😫. I had to cancel a transfer (in the OR) because I could not get into my patient’s uterus and I was not willing to decrease her chance of pregnancy to force the transfer. . I know these are not #fertilityfeelgoodfriday  moments, but they are a reality. Even when I want everything to go right, when I try my best and my patient does everything right, #infertilitysucks . . Now for the feel good part ... My patients are amazing❤️. When I walked in slumped over about the negative pregnancy test, they told me “you are such an amazing #doctor . God bless you.” When I told my couple I cannot get into the uterus, you have blood on the catheter and if I push through on this transfer your pregnancy rates will decrease, they said “we trust you. You just tell us what you would do.” . I appreciate my patients so much. I am honored to be their #fertilityspecialist  and I feel so lucky to be involved in what may be one of the most difficult times of their lives. . . . #infertility  #infertilityawareness  #infertilityjourney  #infertilitysupport  #infertilityblogger  #houstondoctors  #fertility  #fertilityawareness  #fertilityjourney  #ivf  #embryotransfer  #ttc  #ttccommunity  #centerofreproductivemedicine  #drperfetto 
We love @resolveorg and we love our local Houston Support groups. Thank you to the wonderful Resolve volunteers who host the monthly support group meetings! Your time and dedication is appreciated by us and all who attend. ・・・
When you say you’re OK but really you’re not. You are not alone. We have support groups nationwide. You can find one near you see link in bio for support groups.
.
.
Repost @resolveorg
.
.
#infertilityjourney
#TTC
#getsupport 
#ttcjourney 
#IVF
#infertilitysupport
#ivfjourney 
#Adoption 
#miscarriagesupport 
#ttccommunity 
#yournotalone
#InfertilityTexas
#CenterOfReproductiveMedicine
We love @resolveorg and we love our local Houston Support groups. Thank you to the wonderful Resolve volunteers who host the monthly support group meetings! Your time and dedication is appreciated by us and all who attend. ・・・ When you say you’re OK but really you’re not. You are not alone. We have support groups nationwide. You can find one near you see link in bio for support groups. . . Repost @resolveorg . . #infertilityjourney  #TTC  #getsupport  #ttcjourney  #IVF  #infertilitysupport  #ivfjourney  #Adoption  #miscarriagesupport  #ttccommunity  #yournotalone  #InfertilityTexas  #CenterOfReproductiveMedicine 
Let’s be honest - an #eggretrieval video is worth a thousand words.
.
Today, after taking 10 days of #ivf stimulation medications, our patient underwent her #eggretrieval. She graciously allowed my staff to record and share today. Even our patients are rockstars ⭐️when it comes to #fertility education!
.
This video clip shows her ovary with multiple stimulated follicles (black circles) present. As you watch the video you can see a thin needle inserted into one of the follicles. These follicles are filled with fluid and an egg 🥚. As we gently aspirate the fluid, the egg comes out with it.
.
The fluid (with the egg) is then examined by my #embryologist (you can hear him call out “4” in the background) and as we go through the procedure he tells me how many eggs we have retrieved.
.
Once we have completely aspirated all of the follicles, the procedure is considered complete. The anesthesiologist wakes up our patient and she typically recovers within a day.
.
The eggs are then in the hands🖐 off to our amazing  embryologists. They inseminate the eggs with the partner (or donor) sperm. They follow the #embryos daily and update the patient on how they are progressing. Thank goodness for  our awesome #embryology team!
.
.
.
These posts are for educational purposes only.
.
#Repost @infertilitydrperfetto
.
#ivfcycle #ivfjourney #ivfsuccess #ivfsupport #ivfcommunity #infertility #infertilityawareness #infertilitysupport #infertilityjourney #infertilitywarrior #infertilityblogger #houstondoctors #fertilityspecialist #fertilityjourney #centerofreproductivemedicine #drperfetto
Let’s be honest - an #eggretrieval  video is worth a thousand words. . Today, after taking 10 days of #ivf  stimulation medications, our patient underwent her #eggretrieval . She graciously allowed my staff to record and share today. Even our patients are rockstars ⭐️when it comes to #fertility  education! . This video clip shows her ovary with multiple stimulated follicles (black circles) present. As you watch the video you can see a thin needle inserted into one of the follicles. These follicles are filled with fluid and an egg 🥚. As we gently aspirate the fluid, the egg comes out with it. . The fluid (with the egg) is then examined by my #embryologist  (you can hear him call out “4” in the background) and as we go through the procedure he tells me how many eggs we have retrieved. . Once we have completely aspirated all of the follicles, the procedure is considered complete. The anesthesiologist wakes up our patient and she typically recovers within a day. . The eggs are then in the hands🖐 off to our amazing embryologists. They inseminate the eggs with the partner (or donor) sperm. They follow the #embryos  daily and update the patient on how they are progressing. Thank goodness for our awesome #embryology  team! . . . These posts are for educational purposes only. . #Repost  @infertilitydrperfetto . #ivfcycle  #ivfjourney  #ivfsuccess  #ivfsupport  #ivfcommunity  #infertility  #infertilityawareness  #infertilitysupport  #infertilityjourney  #infertilitywarrior  #infertilityblogger  #houstondoctors  #fertilityspecialist  #fertilityjourney  #centerofreproductivemedicine  #drperfetto 
Let’s be honest - an #eggretrieval video is worth a thousand words.
.
Today, after taking 10 days of #ivf stimulation medications, our patient underwent her #eggretrieval. She graciously allowed my staff to record and share today. Even our patients are rockstars ⭐️when it comes to #fertility education!
.
This video clip shows her ovary with multiple stimulated follicles (black circles) present. As you watch the video you can see a thin needle inserted into one of the follicles. These follicles are filled with fluid and an egg 🥚. As we gently aspirate the fluid, the egg comes out with it.
.
The fluid (with the egg) is then examined by my #embryologist (you can hear him call out “4” in the background) and as we go through the procedure he tells me how many eggs we have retrieved.
.
Once we have completely aspirated all of the follicles, the procedure is considered complete. The anesthesiologist wakes up our patient and she typically recovers within a day.
.
The eggs are then in the hands🖐 off to our amazing  embryologists. They inseminate the eggs with the partner (or donor) sperm. They follow the #embryos daily and update the patient on how they are progressing. Thank goodness for  our awesome #embryology team!
.
.
.
These posts are for educational purposes only.
.
.
.
#ivfcycle #ivfjourney #ivfsuccess #ivfsupport #ivfcommunity #infertility #infertilityawareness #infertilitysupport #infertilityjourney #infertilitywarrior #infertilityblogger #houstondoctors #fertilityspecialist #fertilityjourney #centerofreproductivemedicine #drperfetto
Let’s be honest - an #eggretrieval  video is worth a thousand words. . Today, after taking 10 days of #ivf  stimulation medications, our patient underwent her #eggretrieval . She graciously allowed my staff to record and share today. Even our patients are rockstars ⭐️when it comes to #fertility  education! . This video clip shows her ovary with multiple stimulated follicles (black circles) present. As you watch the video you can see a thin needle inserted into one of the follicles. These follicles are filled with fluid and an egg 🥚. As we gently aspirate the fluid, the egg comes out with it. . The fluid (with the egg) is then examined by my #embryologist  (you can hear him call out “4” in the background) and as we go through the procedure he tells me how many eggs we have retrieved. . Once we have completely aspirated all of the follicles, the procedure is considered complete. The anesthesiologist wakes up our patient and she typically recovers within a day. . The eggs are then in the hands🖐 off to our amazing embryologists. They inseminate the eggs with the partner (or donor) sperm. They follow the #embryos  daily and update the patient on how they are progressing. Thank goodness for our awesome #embryology  team! . . . These posts are for educational purposes only. . . . #ivfcycle  #ivfjourney  #ivfsuccess  #ivfsupport  #ivfcommunity  #infertility  #infertilityawareness  #infertilitysupport  #infertilityjourney  #infertilitywarrior  #infertilityblogger  #houstondoctors  #fertilityspecialist  #fertilityjourney  #centerofreproductivemedicine  #drperfetto 
#Repost @infertilitydrperfetto (@get_repost)
・・・
How do I decide the best treatment for a patient?
.
This is a question I get all of the time and it is actually very easy for me to answer.
.
I do not have a set protocol for anyone. I look at the whole couple/patient, the entire evaluation, the long term family planning goals and then we make a decision together.
.
The most important factors?
1. Are the tubes open? We test this with the #hsg. If blocked then we must move to #ivf.
2. Is there adequate sperm for spontaneous conception? An #iuicycle? Or is it too low and we need to move to an #ivfcycle?
3. Is the female patient ovulating on her own? If not, then I can offer the most conservative option- oral medications to help with ovulation. If she is already ovulating on her own, then she can still be offered all treatment options, but her success rates are likely much lower.
4. What are the long term family planning goals? If the female is older (>37) and they/she wants more than 1-2 children then they/she may need to consider more aggressive treatment sooner.
5. There are numerous other things that I consider when helping guide a couple or single female to creating a family.
.
As you can see there is no one size fits all. I view my job as one that helps educate and guide, not tell patients what they have to do.
.
.
.
These posts are for educational purposes only.
.
.
.
#infertility #infertilitysucks #infertilityhurts #fertility #fertilityjourney #fertilitytreatment #ttc #ttcsisters #ttcsupport #infertilityblogger #infertilityawareness #obgyn #houstondoctors #onegoaltwolines #centerofreproductivemedicine #drperfetto
#Repost  @infertilitydrperfetto (@get_repost) ・・・ How do I decide the best treatment for a patient? . This is a question I get all of the time and it is actually very easy for me to answer. . I do not have a set protocol for anyone. I look at the whole couple/patient, the entire evaluation, the long term family planning goals and then we make a decision together. . The most important factors? 1. Are the tubes open? We test this with the #hsg . If blocked then we must move to #ivf . 2. Is there adequate sperm for spontaneous conception? An #iuicycle ? Or is it too low and we need to move to an #ivfcycle ? 3. Is the female patient ovulating on her own? If not, then I can offer the most conservative option- oral medications to help with ovulation. If she is already ovulating on her own, then she can still be offered all treatment options, but her success rates are likely much lower. 4. What are the long term family planning goals? If the female is older (>37) and they/she wants more than 1-2 children then they/she may need to consider more aggressive treatment sooner. 5. There are numerous other things that I consider when helping guide a couple or single female to creating a family. . As you can see there is no one size fits all. I view my job as one that helps educate and guide, not tell patients what they have to do. . . . These posts are for educational purposes only. . . . #infertility  #infertilitysucks  #infertilityhurts  #fertility  #fertilityjourney  #fertilitytreatment  #ttc  #ttcsisters  #ttcsupport  #infertilityblogger  #infertilityawareness  #obgyn  #houstondoctors  #onegoaltwolines  #centerofreproductivemedicine  #drperfetto 
Great info if you are pregnant or planning on becoming pregnant. 🤰 🤱🏻 If you are a weight loss surgery patient that is pregnant or planning on becoming pregnant and need nutrition advice please make an appointment with Lin Lin (713) 493-7700 (Tlcsurgery dietitian.) #Repost @infertilitydrperfetto with @get_repost
・・・
We have addressed the importance of being at a healthy weight while #ttc. Just as important is that once you are pregnant 🤰🏼, you need to gain the appropriate amount of weight to support and nourish your pregnancy.
.
The CDC has published a easy to follow chart indicating the appropriate weight gain based on your pre-pregnancy BMI:
Underweight (BMI<18.5) ➡️ 28-40lbs
Normal weight (18.5-24.9) ➡️ 25-35lbs
Overweight (25-29.9) ➡️ 15-25lbs
Obese (>30) ➡️ 11-20lbs
.
The weight gain is more for twins 👯. Swipe ⬅️to see the CDC charts for weight gain in Singleton and twin pregnancies.
.
Weight gain is important because too little may lead to lower birth weight babies and poor feeding. Too much weight gain will increase the risk of cesarean section, gestational diabetes, gestational hypertension and large birth weight babies 👶🏻 (just to name a few).
.
.
.
These posts are for educational purposes only.
.
.
.
#ttcsisters #ttccommunity #ttcjourney #ttcsupport #ttcdiet #ttcwithpcos #pregnancy #pregnancyworkout #pregnancydiet #pregnancyfitness #pregnancyexercise #pregnancynutrition #pregnancyweight #infertility #fertility #fertilitydiet #fertilityawareness #infertilityblogger #houstondoctors #centerofreproductivemedicine #drperfetto #tlcsurgery #pregnacynutrition #healthypregnancy #pregnancyhealth #themoreyouknow
Great info if you are pregnant or planning on becoming pregnant. 🤰 🤱🏻 If you are a weight loss surgery patient that is pregnant or planning on becoming pregnant and need nutrition advice please make an appointment with Lin Lin (713) 493-7700 (Tlcsurgery dietitian.) #Repost  @infertilitydrperfetto with @get_repost ・・・ We have addressed the importance of being at a healthy weight while #ttc . Just as important is that once you are pregnant 🤰🏼, you need to gain the appropriate amount of weight to support and nourish your pregnancy. . The CDC has published a easy to follow chart indicating the appropriate weight gain based on your pre-pregnancy BMI: Underweight (BMI<18.5) ➡️ 28-40lbs Normal weight (18.5-24.9) ➡️ 25-35lbs Overweight (25-29.9) ➡️ 15-25lbs Obese (>30) ➡️ 11-20lbs . The weight gain is more for twins 👯. Swipe ⬅️to see the CDC charts for weight gain in Singleton and twin pregnancies. . Weight gain is important because too little may lead to lower birth weight babies and poor feeding. Too much weight gain will increase the risk of cesarean section, gestational diabetes, gestational hypertension and large birth weight babies 👶🏻 (just to name a few). . . . These posts are for educational purposes only. . . . #ttcsisters  #ttccommunity  #ttcjourney  #ttcsupport  #ttcdiet  #ttcwithpcos  #pregnancy  #pregnancyworkout  #pregnancydiet  #pregnancyfitness  #pregnancyexercise  #pregnancynutrition  #pregnancyweight  #infertility  #fertility  #fertilitydiet  #fertilityawareness  #infertilityblogger  #houstondoctors  #centerofreproductivemedicine  #drperfetto  #tlcsurgery  #pregnacynutrition  #healthypregnancy  #pregnancyhealth  #themoreyouknow 
We have addressed the importance of being at a healthy weight while #ttc. Just as important is that once you are pregnant 🤰🏼, you need to gain the appropriate amount of weight to support and nourish your pregnancy.
.
The CDC has published a easy to follow chart indicating the appropriate weight gain based on your pre-pregnancy BMI:
Underweight (BMI<18.5) ➡️ 28-40lbs
Normal weight (18.5-24.9) ➡️ 25-35lbs
Overweight (25-29.9) ➡️ 15-25lbs
Obese (>30) ➡️ 11-20lbs
.
The weight gain is more for twins 👯. Swipe ⬅️to see the CDC charts for weight gain in Singleton and twin pregnancies.
.
Weight gain is important because too little may lead to lower birth weight babies and poor feeding. Too much weight gain will increase the risk of cesarean section, gestational diabetes, gestational hypertension and large birth weight babies 👶🏻 (just to name a few).
.
.
.
These posts are for educational purposes only.
.
.
.
#ttcsisters #ttccommunity #ttcjourney #ttcsupport #ttcdiet #ttcwithpcos #pregnancy #pregnancyworkout #pregnancydiet #pregnancyfitness #pregnancyexercise #pregnancynutrition #pregnancyweight #infertility #fertility #fertilitydiet #fertilityawareness #infertilityblogger #houstondoctors #centerofreproductivemedicine #drperfetto
We have addressed the importance of being at a healthy weight while #ttc . Just as important is that once you are pregnant 🤰🏼, you need to gain the appropriate amount of weight to support and nourish your pregnancy. . The CDC has published a easy to follow chart indicating the appropriate weight gain based on your pre-pregnancy BMI: Underweight (BMI<18.5) ➡️ 28-40lbs Normal weight (18.5-24.9) ➡️ 25-35lbs Overweight (25-29.9) ➡️ 15-25lbs Obese (>30) ➡️ 11-20lbs . The weight gain is more for twins 👯. Swipe ⬅️to see the CDC charts for weight gain in Singleton and twin pregnancies. . Weight gain is important because too little may lead to lower birth weight babies and poor feeding. Too much weight gain will increase the risk of cesarean section, gestational diabetes, gestational hypertension and large birth weight babies 👶🏻 (just to name a few). . . . These posts are for educational purposes only. . . . #ttcsisters  #ttccommunity  #ttcjourney  #ttcsupport  #ttcdiet  #ttcwithpcos  #pregnancy  #pregnancyworkout  #pregnancydiet  #pregnancyfitness  #pregnancyexercise  #pregnancynutrition  #pregnancyweight  #infertility  #fertility  #fertilitydiet  #fertilityawareness  #infertilityblogger  #houstondoctors  #centerofreproductivemedicine  #drperfetto 
#Repost @infertilitydrperfetto with @get_repost
・・・
Today I am all about positivity. I was so impressed by the responses I got about the #twnts movement yesterday I want to keep the positive momentum going.
.
Today, and who knows - maybe every Friday going forward, I want our rockstar #infertility and #ttccommunity to take a moment to think about and share some positives.
.
Maybe we can call it - #fertilityfeelgoodfriday 😁
.
I’ll start:
1. My patient (who I fought with her insurance to get her #ivf covered after only 3 #iui cycles- which was a win on its own!) is pregnant with her ONLY embryo. 🎉 .
2. I saw 2 #recurrentmiscarriage patients today and when they left they both looked hopeful. Still heartbroken 💔, but hopeful about their future. The fact that I can offer even the smallest bit of hope is why I love this job.
.
Alright, I would love some of you to join me... big or small - let’s celebrate the good stuff today.
.
.
.
#infertilityawareness #infertilitysupport  #infertilityblogger #fertilityjourney #fertilityspecialist #fertilitysupport #fertilityawareness #ttcsisters #ttcafterloss #positivethinking #thinkpositive #onegoaltwolines #centerofreproductivemedicine #drperfetto
#Repost  @infertilitydrperfetto with @get_repost ・・・ Today I am all about positivity. I was so impressed by the responses I got about the #twnts  movement yesterday I want to keep the positive momentum going. . Today, and who knows - maybe every Friday going forward, I want our rockstar #infertility  and #ttccommunity  to take a moment to think about and share some positives. . Maybe we can call it - #fertilityfeelgoodfriday  😁 . I’ll start: 1. My patient (who I fought with her insurance to get her #ivf  covered after only 3 #iui  cycles- which was a win on its own!) is pregnant with her ONLY embryo. 🎉 . 2. I saw 2 #recurrentmiscarriage  patients today and when they left they both looked hopeful. Still heartbroken 💔, but hopeful about their future. The fact that I can offer even the smallest bit of hope is why I love this job. . Alright, I would love some of you to join me... big or small - let’s celebrate the good stuff today. . . . #infertilityawareness  #infertilitysupport  #infertilityblogger  #fertilityjourney  #fertilityspecialist  #fertilitysupport  #fertilityawareness  #ttcsisters  #ttcafterloss  #positivethinking  #thinkpositive  #onegoaltwolines  #centerofreproductivemedicine  #drperfetto 
Think before you speak. It is a phrase we hear from the time we are little. I like to think we are all pretty good about it most of the time, but for some reason when it comes to #infertility and #miscarriage people frequently bypass the “think before” part.
.
I am guilty of this myself. As a #medstudent rotating through my #obgyn rotation, then as a resident on the floor and in the emergency room I always felt like I stumbled when it came to discussing #pregnancyloss.
.
I do feel like my approach has improved immensely with experience, feedback and my own personal struggles. That being said, I still leave an ultrasound or consultation questioning if I said the right things.
.
So, what do I say now?
.
1. ALWAYS the first and most important thing - This is not your fault. You did not cause this, you cannot cause a loss.
2. I am sorry you are going through this, I wish you were not.
3. I am here if you need me- you can come for another visit, call or email - whatever you need.
.
Of course, as the #doctor and #fertilityspecialist I still have to discuss next steps, which can sometimes be overwhelming for my patient. Sometimes, we talk that day, other times we talk when she feels up to it (I offer a return visit in a week).
.
I am so appreciative of @thisisalicerose for reaching out to me to join the “Think what not to say” campaign. It is so important for us medical professionals, family members and friends to get the opportunity to discuss and learn from each other to help others during their time of need.
#twnts
.
.
.
#infertilitysucks #infertilityawareness #ttc #ttcafterloss #ttccommunity #ttcsisters #fertility #fertilityjourney #fertilityawareness #premed #medicalstudent #medschool #centerofreproductivemedicine #drperfetto
Think before you speak. It is a phrase we hear from the time we are little. I like to think we are all pretty good about it most of the time, but for some reason when it comes to #infertility  and #miscarriage  people frequently bypass the “think before” part. . I am guilty of this myself. As a #medstudent  rotating through my #obgyn  rotation, then as a resident on the floor and in the emergency room I always felt like I stumbled when it came to discussing #pregnancyloss . . I do feel like my approach has improved immensely with experience, feedback and my own personal struggles. That being said, I still leave an ultrasound or consultation questioning if I said the right things. . So, what do I say now? . 1. ALWAYS the first and most important thing - This is not your fault. You did not cause this, you cannot cause a loss. 2. I am sorry you are going through this, I wish you were not. 3. I am here if you need me- you can come for another visit, call or email - whatever you need. . Of course, as the #doctor  and #fertilityspecialist  I still have to discuss next steps, which can sometimes be overwhelming for my patient. Sometimes, we talk that day, other times we talk when she feels up to it (I offer a return visit in a week). . I am so appreciative of @thisisalicerose for reaching out to me to join the “Think what not to say” campaign. It is so important for us medical professionals, family members and friends to get the opportunity to discuss and learn from each other to help others during their time of need. #twnts  . . . #infertilitysucks  #infertilityawareness  #ttc  #ttcafterloss  #ttccommunity  #ttcsisters  #fertility  #fertilityjourney  #fertilityawareness  #premed  #medicalstudent  #medschool  #centerofreproductivemedicine  #drperfetto 
The use of Metformin in Polycystic Ovarian Syndrome is a topic I have received a lot of questions about.
.
💊What is #metformin?
It is an Insulin sensitizing medication - it lowers the glucose level by reducing absorption in the stomach/intestines, blocks liver production of glucose and increases glucose uptake in the cells.
.
⏰When should it be used?
I recommend it in those patients with diabetes or pre-diabetes. I also offer it to any PCOS patient who requests it, especially those with laboratory proven insulin resistance (IR). There are A LOT of ways to test for IR, so the studies on Metformin in PCOS are very mixed - that’s why I feel comfortable prescribing it this way.
.
⭐️How does it help women with #polycysticovariansyndrome?
1️⃣ Increases ovulation rate compared to placebo
2️⃣ Increases ovulation and pregnancy rate when paired with Clomid
3️⃣ Increases live birth rate when given for 3 months before starting an oral agent (Letrozole or Clomid)
4️⃣ Increases ovulation and pregnancy rates if added to Clomid in Clomid resistant patients
.
Is there a benefit after you get pregnant?
5️⃣ There is insufficient data to show Metformin will reduce the risk of #miscarriage
6️⃣ In those women with diabetes, pre-diabetes or insulin resistance I do continue it until the patient sees her OB. This is to help with glucose control given the elevated risk of gestational diabetes in patients with PCOS.
.
.
.
These posts are for educational purposes only.
.
.
.
#infertility #infertilitysucks #infertilityblogger #infertilityawareness #fertility #fertilityjourney #fertilitysupport #fertilitytreatment #ttc #ttccommunity #ttcwithpcos #ttcwithinfertility #iui #ivf #onegoaltwolines #houstondoctors #obgyn #centerofreproductivemedicine #drperfetto
The use of Metformin in Polycystic Ovarian Syndrome is a topic I have received a lot of questions about. . 💊What is #metformin ? It is an Insulin sensitizing medication - it lowers the glucose level by reducing absorption in the stomach/intestines, blocks liver production of glucose and increases glucose uptake in the cells. . ⏰When should it be used? I recommend it in those patients with diabetes or pre-diabetes. I also offer it to any PCOS patient who requests it, especially those with laboratory proven insulin resistance (IR). There are A LOT of ways to test for IR, so the studies on Metformin in PCOS are very mixed - that’s why I feel comfortable prescribing it this way. . ⭐️How does it help women with #polycysticovariansyndrome ? 1️⃣ Increases ovulation rate compared to placebo 2️⃣ Increases ovulation and pregnancy rate when paired with Clomid 3️⃣ Increases live birth rate when given for 3 months before starting an oral agent (Letrozole or Clomid) 4️⃣ Increases ovulation and pregnancy rates if added to Clomid in Clomid resistant patients . Is there a benefit after you get pregnant? 5️⃣ There is insufficient data to show Metformin will reduce the risk of #miscarriage  6️⃣ In those women with diabetes, pre-diabetes or insulin resistance I do continue it until the patient sees her OB. This is to help with glucose control given the elevated risk of gestational diabetes in patients with PCOS. . . . These posts are for educational purposes only. . . . #infertility  #infertilitysucks  #infertilityblogger  #infertilityawareness  #fertility  #fertilityjourney  #fertilitysupport  #fertilitytreatment  #ttc  #ttccommunity  #ttcwithpcos  #ttcwithinfertility  #iui  #ivf  #onegoaltwolines  #houstondoctors  #obgyn  #centerofreproductivemedicine  #drperfetto 
I am so excited and honored to be featured by @westuniversitymoms today on their Meet a Mom Monday.
.
One of the toughest things about medicine is that we are constantly uprooting ourselves and our families during #medicalschool, #residency, #fellowship and then when we finally settle down for our first “real” job as an #attending.
.
My family and I feel so blessed that we landed in #houstontx and that my career at the #centerofreproductivemedicine has been so positive.
.
Thank you #htx for making us feel so welcome. We are so happy to call this home!
.
.
.
#Repost @westuniversitymoms with @get_repost
・・・
Meet a Mom Monday! Meet Dr. Candice Perfetto, Fertility Specialist at Center of Reproductive Medicine @infertilitydrperfetto -read her inspirational interview in bio 🌟✨✨ -
-
#houstonmom #houstondoctors #infertilitysupport
I am so excited and honored to be featured by @westuniversitymoms today on their Meet a Mom Monday. . One of the toughest things about medicine is that we are constantly uprooting ourselves and our families during #medicalschool , #residency , #fellowship  and then when we finally settle down for our first “real” job as an #attending . . My family and I feel so blessed that we landed in #houstontx  and that my career at the #centerofreproductivemedicine  has been so positive. . Thank you #htx  for making us feel so welcome. We are so happy to call this home! . . . #Repost  @westuniversitymoms with @get_repost ・・・ Meet a Mom Monday! Meet Dr. Candice Perfetto, Fertility Specialist at Center of Reproductive Medicine @infertilitydrperfetto -read her inspirational interview in bio 🌟✨✨ - - #houstonmom  #houstondoctors  #infertilitysupport 
Sometimes things do not go the way you want or expect.
.
This morning was one of those days. I had five procedures planned and although the schedule looked perfect and each patient was prepped exactly how I wanted, things were not perfect.
.
This morning was a little reminder that we cannot control everything. We can prepare as best a possible, but that is the best we can do.
.
So, how do we adjust? For me, the first step is to take a deep breath and accept what is in front of me. Yep, I take a moment to breathe (it’s better than yell 🤬).
.
Next, we adjust accordingly - move patients around if need be, call in reinforcements if we can and take a time out if you need one. Finally assess what happened, ask yourself, your colleagues and your patients - how can we use this experience to improve the next time around?
.
Bingo, it’s not always bad if it does not go perfect. It’s only bad if we let it get the best of us and do not use it as a learning opportunity.
.
.
.
#breathe #breatheinbreatheout #neverstoplearning #doctor #doctorlife #obgyn #medstudent #medicalschool #premed #infertility #ivf #embryotransfer #fertilitytreatment #fertilityspecialist #houstondoctors #centerofreproductivemedicine #drperfetto
Sometimes things do not go the way you want or expect. . This morning was one of those days. I had five procedures planned and although the schedule looked perfect and each patient was prepped exactly how I wanted, things were not perfect. . This morning was a little reminder that we cannot control everything. We can prepare as best a possible, but that is the best we can do. . So, how do we adjust? For me, the first step is to take a deep breath and accept what is in front of me. Yep, I take a moment to breathe (it’s better than yell 🤬). . Next, we adjust accordingly - move patients around if need be, call in reinforcements if we can and take a time out if you need one. Finally assess what happened, ask yourself, your colleagues and your patients - how can we use this experience to improve the next time around? . Bingo, it’s not always bad if it does not go perfect. It’s only bad if we let it get the best of us and do not use it as a learning opportunity. . . . #breathe  #breatheinbreatheout  #neverstoplearning  #doctor  #doctorlife  #obgyn  #medstudent  #medicalschool  #premed  #infertility  #ivf  #embryotransfer  #fertilitytreatment  #fertilityspecialist  #houstondoctors  #centerofreproductivemedicine  #drperfetto 
Look at these two... Grace and Isabelle! Thank you Lindsay for sending us these beautiful pictures of your miracle babies born December 2007. 
Love. Hope. Strength. Inspiration.
.
.
.
#MiracleBaby #IVF #TTCSisters #DreamsDoComeTrue #NeverGiveUp #TTC #CenterOfReproductiveMedicine #InfertilityTexas
This little babe is a combination science and art.
SCIENCE 🔬= Letrozole + Metformin + Dexamethasone
.
ART = Parental determination + Physician dedication + A lot of love ❤️
.
This #pcospregnancy occurred after multiple treatment attempts and failures.
1. No response to #Letrozole
2. Over response to Clomid - #drperfetto cancelled the cycle!
3. Finally pregnant after a perfect concoction of Letrozole + Metformin + Dexamethasone
.
Approximately 80% of patients with #PCOS will respond to and ovulate with oral ovulation induction medications (like Letrozole). If a patient does not develop a follicle with Letrozole (like this patient), then I consider other medication choices or I will pair it with other adjuvant medications to encourage a response.
.
I typically will add Metformin and/or Dexamethasone to reduce resistance to Letrozole. Or my other option is to try oral Clomid, which may work better in some patients. I have also tried adding gonadotropin injections, but that has a high risk of multiple follicles, which can be risky for multiple pregnancies or cancellation.
.
Although PCOS can seem like a horrible diagnosis, there are typically lots of options to help you conceive. And this little nugget is proof that sometimes you just need to find the right combination!
.
#Repost @infertilitydrperfetto
.
These posts are for educational purposes only.
.
.
.
#pcosawareness #pcoswarrior #pcosjourney #pcosawarenessmonth #infertility #infertilitysucks #infertilityjourney #infertilityblogger #ttc #ttcwithpcos #ttcsisters #ttcsupport #houstondoctors #obgyn #centerofreproductivemedicine
This little babe is a combination science and art. SCIENCE 🔬= Letrozole + Metformin + Dexamethasone . ART = Parental determination + Physician dedication + A lot of love ❤️ . This #pcospregnancy  occurred after multiple treatment attempts and failures. 1. No response to #Letrozole  2. Over response to Clomid - #drperfetto  cancelled the cycle! 3. Finally pregnant after a perfect concoction of Letrozole + Metformin + Dexamethasone . Approximately 80% of patients with #PCOS  will respond to and ovulate with oral ovulation induction medications (like Letrozole). If a patient does not develop a follicle with Letrozole (like this patient), then I consider other medication choices or I will pair it with other adjuvant medications to encourage a response. . I typically will add Metformin and/or Dexamethasone to reduce resistance to Letrozole. Or my other option is to try oral Clomid, which may work better in some patients. I have also tried adding gonadotropin injections, but that has a high risk of multiple follicles, which can be risky for multiple pregnancies or cancellation. . Although PCOS can seem like a horrible diagnosis, there are typically lots of options to help you conceive. And this little nugget is proof that sometimes you just need to find the right combination! . #Repost  @infertilitydrperfetto . These posts are for educational purposes only. . . . #pcosawareness  #pcoswarrior  #pcosjourney  #pcosawarenessmonth  #infertility  #infertilitysucks  #infertilityjourney  #infertilityblogger  #ttc  #ttcwithpcos  #ttcsisters  #ttcsupport  #houstondoctors  #obgyn  #centerofreproductivemedicine 
This little babe is a combination science and art.
SCIENCE 🔬= Letrozole + Metformin + Dexamethasone
.
ART = Parental determination + Physician dedication + A lot of love ❤️
.
This #pcospregnancy occurred after multiple treatment attempts and failures.
1. No response to #Letrozole
2. Over response to Clomid - #drperfetto cancelled the cycle!
3. Finally pregnant after a perfect concoction of Letrozole + Metformin + Dexamethasone
.
Approximately 80% of patients with #PCOS will respond to and ovulate with oral ovulation induction medications (like Letrozole). If a patient does not develop a follicle with Letrozole (like this patient), then I consider other medication choices or I will pair it with other adjuvant medications to encourage a response.
.
I typically will add Metformin and/or Dexamethasone to reduce resistance to Letrozole. Or my other option is to try oral Clomid, which may work better in some patients. I have also tried adding gonadotropin injections, but that has a high risk of multiple follicles, which can be risky for multiple pregnancies or cancellation.
.
Although PCOS can seem like a horrible diagnosis, there are typically lots of options to help you conceive. And this little nugget is proof that sometimes you just need to find the right combination!
.
.
.
These posts are for educational purposes only.
.
.
.
#pcosawareness #pcoswarrior #pcosjourney #pcosawarenessmonth #infertility #infertilitysucks #infertilityjourney #infertilityblogger #ttc #ttcwithpcos #ttcsisters #ttcsupport #houstondoctors #obgyn #centerofreproductivemedicine
This little babe is a combination science and art. SCIENCE 🔬= Letrozole + Metformin + Dexamethasone . ART = Parental determination + Physician dedication + A lot of love ❤️ . This #pcospregnancy  occurred after multiple treatment attempts and failures. 1. No response to #Letrozole  2. Over response to Clomid - #drperfetto  cancelled the cycle! 3. Finally pregnant after a perfect concoction of Letrozole + Metformin + Dexamethasone . Approximately 80% of patients with #PCOS  will respond to and ovulate with oral ovulation induction medications (like Letrozole). If a patient does not develop a follicle with Letrozole (like this patient), then I consider other medication choices or I will pair it with other adjuvant medications to encourage a response. . I typically will add Metformin and/or Dexamethasone to reduce resistance to Letrozole. Or my other option is to try oral Clomid, which may work better in some patients. I have also tried adding gonadotropin injections, but that has a high risk of multiple follicles, which can be risky for multiple pregnancies or cancellation. . Although PCOS can seem like a horrible diagnosis, there are typically lots of options to help you conceive. And this little nugget is proof that sometimes you just need to find the right combination! . . . These posts are for educational purposes only. . . . #pcosawareness  #pcoswarrior  #pcosjourney  #pcosawarenessmonth  #infertility  #infertilitysucks  #infertilityjourney  #infertilityblogger  #ttc  #ttcwithpcos  #ttcsisters  #ttcsupport  #houstondoctors  #obgyn  #centerofreproductivemedicine 
There is nothing more controversial in medicine than diet and weight loss. Given, the majority of Americans (2 out of 3) are overweight or obese it is not surprising that one of the most frequent question I get as a #physician is: what diet is the best when #ttc?
.
Let me start by pointing out that I truly champion a healthy lifestyle. I think a well-balanced diet with appropriate caloric restriction and moderate exercise is the only way to truly maintain weight loss. I was significantly heavier in #college and #medicalschool and I tried numerous diets (Atkins, big breakfast, etc). They were all just quick, short term fixes to see the number on the scale drop. Once I focused on caloric control and actually DECREASED my exercise habits, that is when I fell into a healthy weight category.
.
Today, I will focus specifically on diets in polycystic ovarian syndome (PCOS). The data is consistent that ANY #weightloss in PCOS will improve cycle regularity, insulin resistance, abnormal lipid profiles and overall quality of life.
.
Interestingly, there does seem to be some data supporting greater weight loss and even improved bloodwork in low-carbohydrate and fat-enriched diets. Enter, the interest in the #ketogenicdiet. After reviewing pubmed, I did find studies to support low carb diets (but most were not specifically <20gm of carbs a day) in women with PCOS. Almost every study showed improvement in PCOS signs, symptoms and hormone/endocrine profiles.
.
So, how do these diets affect those patient with #leanpcos? There is even less data on thin PCOS patients compared to “traditional” PCOS patients. Would these women also benefit from a low-carbohydrate diet? Maybe. Do they benefit from a highly restrictive diet like that of the ketogenic diet?  Maybe, but it is very hard to maintain long term.
.
My take: I still champion the benefits of a well-rounded healthy diet. There may be an even greater overall benefit for a low carb or diabetic diet in those with PCOS.
.
Importantly- if pregnant you absolutely do not want to be on a low carbohydrate diet. It is not good for baby 👶🏻 brain to have constant exposure to ketones.
.
.
.
These posts are for educational purposes only.
There is nothing more controversial in medicine than diet and weight loss. Given, the majority of Americans (2 out of 3) are overweight or obese it is not surprising that one of the most frequent question I get as a #physician  is: what diet is the best when #ttc ? . Let me start by pointing out that I truly champion a healthy lifestyle. I think a well-balanced diet with appropriate caloric restriction and moderate exercise is the only way to truly maintain weight loss. I was significantly heavier in #college  and #medicalschool  and I tried numerous diets (Atkins, big breakfast, etc). They were all just quick, short term fixes to see the number on the scale drop. Once I focused on caloric control and actually DECREASED my exercise habits, that is when I fell into a healthy weight category. . Today, I will focus specifically on diets in polycystic ovarian syndome (PCOS). The data is consistent that ANY #weightloss  in PCOS will improve cycle regularity, insulin resistance, abnormal lipid profiles and overall quality of life. . Interestingly, there does seem to be some data supporting greater weight loss and even improved bloodwork in low-carbohydrate and fat-enriched diets. Enter, the interest in the #ketogenicdiet . After reviewing pubmed, I did find studies to support low carb diets (but most were not specifically <20gm of carbs a day) in women with PCOS. Almost every study showed improvement in PCOS signs, symptoms and hormone/endocrine profiles. . So, how do these diets affect those patient with #leanpcos ? There is even less data on thin PCOS patients compared to “traditional” PCOS patients. Would these women also benefit from a low-carbohydrate diet? Maybe. Do they benefit from a highly restrictive diet like that of the ketogenic diet? Maybe, but it is very hard to maintain long term. . My take: I still champion the benefits of a well-rounded healthy diet. There may be an even greater overall benefit for a low carb or diabetic diet in those with PCOS. . Importantly- if pregnant you absolutely do not want to be on a low carbohydrate diet. It is not good for baby 👶🏻 brain to have constant exposure to ketones. . . . These posts are for educational purposes only.
There is truth in this statement. #Infertility is not something any of us wished for, but if we are to face it, we always try to look for the positive outcome (even if some days are harder than others) and how it will last forever.
.
.
.
#ThursdayThoughts #MakingMiracles #InfertilitySucks #IVF #ivfsupport #ivfjourney #ivfcommunity #ivfsisters #ivfwarrior #infertility #infertilityjourney #infertilitysupport #infertilityawareness #ttc #ttcsupport #ttcsisters #ttcjourney #ttccommunity #hope #encouragement #inspiration #dontgiveup #hopeful #onedayatatime #oneday #onegoal #twolines #InfertilityTexas #centerofreproductivemedicine
There is truth in this statement. #Infertility  is not something any of us wished for, but if we are to face it, we always try to look for the positive outcome (even if some days are harder than others) and how it will last forever. . . . #ThursdayThoughts  #MakingMiracles  #InfertilitySucks  #IVF  #ivfsupport  #ivfjourney  #ivfcommunity  #ivfsisters  #ivfwarrior  #infertility  #infertilityjourney  #infertilitysupport  #infertilityawareness  #ttc  #ttcsupport  #ttcsisters  #ttcjourney  #ttccommunity  #hope  #encouragement  #inspiration  #dontgiveup  #hopeful  #onedayatatime  #oneday  #onegoal  #twolines  #InfertilityTexas  #centerofreproductivemedicine 
Polycystic ovarian syndrome (PCOS) is incredibly common, affecting about 10% all of reproductive aged women. When I see patients with #pcos it is typically because they are TTC and they are not having a regular cycle (ie. not ovulating = not releasing an egg 🥚 = not pregnant). They come to me to find out if they have PCOS, discuss how to treat it and then #ttc.
.
What is PCOS? To diagnosis it, I follow the Rotterdam Criteria. You need 2 out of 3 of the following:
1. Irregular or no cycles (Cycle length >35 days)
2. Evidence of high androgens (Either hair growth or elevated Testosterone in the blood)
3. High number of early follicles on ultrasound (>12 in one ovary). Most importantly I tell them that I consider PCOS a spectrum. Technically you need 2 out of 3 for the diagnosis, but some patients are more severe than others. .
Seventy-five percent of women with PCOS are overweight and/or obese, the others are considered “lean.” Most patients with PCOS (even those that have a normal BMI) have metabolic (insulin resistance and abnormal lipid profiles) and anthropometric abnormalities, although there are definitely differences between those with a normal BMI and those who have a BMI >25.
.
The first line for treatment for all PCOS patient is lifestyle management (specifically weight loss if overweight or obese). The ideal diet 🥗composition has not been identified for PCOS (I will post specifically on this soon- ie. #ketogenic 🥩, diabetic, etc.), but it has been shown in numerous studies that any weight loss will return menstrual regularity, decrease insulin resistance and cholesterol, and improve overall quality of life.
.
For those women with lean PCOS, weight loss may not be feasible. For these patients, they may see improvement with a change in diet composition and resistance exercise 🏃‍♀️.
.
After lifestyle management, #metformin also may be beneficial. I prescribe it to those women with diabetes or pre-diabetes, but there is even some evidence that it may be useful in all patients with PCOS. It has been shown to return menses and improve response to oral ovulation induction meds (future post here🤓).
.
.
These posts are for educational purposes only.
Polycystic ovarian syndrome (PCOS) is incredibly common, affecting about 10% all of reproductive aged women. When I see patients with #pcos  it is typically because they are TTC and they are not having a regular cycle (ie. not ovulating = not releasing an egg 🥚 = not pregnant). They come to me to find out if they have PCOS, discuss how to treat it and then #ttc . . What is PCOS? To diagnosis it, I follow the Rotterdam Criteria. You need 2 out of 3 of the following: 1. Irregular or no cycles (Cycle length >35 days) 2. Evidence of high androgens (Either hair growth or elevated Testosterone in the blood) 3. High number of early follicles on ultrasound (>12 in one ovary). Most importantly I tell them that I consider PCOS a spectrum. Technically you need 2 out of 3 for the diagnosis, but some patients are more severe than others. . Seventy-five percent of women with PCOS are overweight and/or obese, the others are considered “lean.” Most patients with PCOS (even those that have a normal BMI) have metabolic (insulin resistance and abnormal lipid profiles) and anthropometric abnormalities, although there are definitely differences between those with a normal BMI and those who have a BMI >25. . The first line for treatment for all PCOS patient is lifestyle management (specifically weight loss if overweight or obese). The ideal diet 🥗composition has not been identified for PCOS (I will post specifically on this soon- ie. #ketogenic  🥩, diabetic, etc.), but it has been shown in numerous studies that any weight loss will return menstrual regularity, decrease insulin resistance and cholesterol, and improve overall quality of life. . For those women with lean PCOS, weight loss may not be feasible. For these patients, they may see improvement with a change in diet composition and resistance exercise 🏃‍♀️. . After lifestyle management, #metformin  also may be beneficial. I prescribe it to those women with diabetes or pre-diabetes, but there is even some evidence that it may be useful in all patients with PCOS. It has been shown to return menses and improve response to oral ovulation induction meds (future post here🤓). . . These posts are for educational purposes only.
Polycystic ovarian syndome (PCOS) is incredibly common. Patients with #pcos typically have irregular cycles - meaning their menstrual cycles occur less frequently than normal (intervals of >35 days) or they may not come at all.
.
Having irregular cycles means that you may be ovulating at irregular intervals or you may not be ovulating at all. As you can guess, if you are not ovulating - you are not releasing an egg 🥚, then it will be incredibly hard to conceive.
.
If a patient has PCOS and wants to #ttc we discuss her taking oral medications to help her ovulate. I typically prescribe Letrozole and then follow the patient with a mid-cycle ultrasound to see if she develops a follicle on the medication.
.
If she does develop a follicle, we trigger her with a medication to stimulate ovulation and as long as there is not male factor infertility we can time intercourse based on her triggered ovulation.
.
After that the couple deals with the dreaded #2ww to find out if she is pregnant🤰🏼. On a positive note, patients with PCOS that ovulate on oral medications have a high chance of conception. With about 50% conceiving within 3 cycles⭐️.
.
Just so you know, most women with PCOS do ovulate with #letrozole (about 80%), but not everyone does. If a patient does not ovulate, I have a few options to try - I’ll post more on those soon.
.
.
.
These posts are for educational purposes only.
Polycystic ovarian syndome (PCOS) is incredibly common. Patients with #pcos  typically have irregular cycles - meaning their menstrual cycles occur less frequently than normal (intervals of >35 days) or they may not come at all. . Having irregular cycles means that you may be ovulating at irregular intervals or you may not be ovulating at all. As you can guess, if you are not ovulating - you are not releasing an egg 🥚, then it will be incredibly hard to conceive. . If a patient has PCOS and wants to #ttc  we discuss her taking oral medications to help her ovulate. I typically prescribe Letrozole and then follow the patient with a mid-cycle ultrasound to see if she develops a follicle on the medication. . If she does develop a follicle, we trigger her with a medication to stimulate ovulation and as long as there is not male factor infertility we can time intercourse based on her triggered ovulation. . After that the couple deals with the dreaded #2ww  to find out if she is pregnant🤰🏼. On a positive note, patients with PCOS that ovulate on oral medications have a high chance of conception. With about 50% conceiving within 3 cycles⭐️. . Just so you know, most women with PCOS do ovulate with #letrozole  (about 80%), but not everyone does. If a patient does not ovulate, I have a few options to try - I’ll post more on those soon. . . . These posts are for educational purposes only.
Treatment of #endometriosis is different depending on the goals of the patient.
.
In those patients who are #ttc (>90% of my patients), my approach is to optimize natural fertility and then identify the best options to improve the pregnancy rate. That may be through ovulation medications and #iui or #ivf.
.
In those not TTC, the goals may be pain management and a better understanding of their disease. I try and focus on hormonal medications to try and improve the pain symptoms. I also consider surgery, but it’s typically after a patient fails medical management. I do not typically prescribe narcotics and instead I encourage patients to seek the advice of pain management specialists and other experts in the field.
.
I am a big believer in the value of a multidisciplinary approach to this disease. After being on IG I have seen how pelvic floor therapy and nutrition can positively impact the patient suffering from endometriosis (when ttc and when not).
.
Take home points:
⏸ Treatment of endometriosis is not the same for everyone and your #doctor should understand your short and long term goals before rushing to a treatment plan.
⏸ Endometriosis is a disease that benefits from a multidisciplinary approach. You will likely benefit from a number of practitioners, including: #gynecologist, #painmanagement specialist, #pelvicfloor specialist, #psychiatrist, #nutrionist, and a good #supportgroup.
.
I am tagging a few of the IG accounts I have found helpful when learning more about “non-traditional” endometriosis treatment.
.
Do you have others you think I should follow?!?
.
.
.
#infertility #infertilitysucks #infertilityhurts #fertility #fertilitytreatment #fertilityjourney #fertilitydiet #ttcwithendo #endometriosisawareness #endometriosissurgery #obgyn #fertilityspecialist #womenshealth #womeninmedicine #centerofreproductivemedicine #drperfetto
Treatment of #endometriosis  is different depending on the goals of the patient. . In those patients who are #ttc  (>90% of my patients), my approach is to optimize natural fertility and then identify the best options to improve the pregnancy rate. That may be through ovulation medications and #iui  or #ivf . . In those not TTC, the goals may be pain management and a better understanding of their disease. I try and focus on hormonal medications to try and improve the pain symptoms. I also consider surgery, but it’s typically after a patient fails medical management. I do not typically prescribe narcotics and instead I encourage patients to seek the advice of pain management specialists and other experts in the field. . I am a big believer in the value of a multidisciplinary approach to this disease. After being on IG I have seen how pelvic floor therapy and nutrition can positively impact the patient suffering from endometriosis (when ttc and when not). . Take home points: ⏸ Treatment of endometriosis is not the same for everyone and your #doctor  should understand your short and long term goals before rushing to a treatment plan. ⏸ Endometriosis is a disease that benefits from a multidisciplinary approach. You will likely benefit from a number of practitioners, including: #gynecologist , #painmanagement  specialist, #pelvicfloor  specialist, #psychiatrist , #nutrionist , and a good #supportgroup . . I am tagging a few of the IG accounts I have found helpful when learning more about “non-traditional” endometriosis treatment. . Do you have others you think I should follow?!? . . . #infertility  #infertilitysucks  #infertilityhurts  #fertility  #fertilitytreatment  #fertilityjourney  #fertilitydiet  #ttcwithendo  #endometriosisawareness  #endometriosissurgery  #obgyn  #fertilityspecialist  #womenshealth  #womeninmedicine  #centerofreproductivemedicine  #drperfetto 
For the 4th consecutive year, the CDC reported an increase in cases of chlamydia, gonorrohea and syphilis.
.
This is a big deal for the those seeking future #fertility because sexually transmitted infections are one of the most common causes of tubal factor #infertility.
.
Tubal factor infertility (TFI) is identified as a cause of infertility 15-30% of the time. Tubal disease can occur from sexually transmitted infections (STI, most commonly chlamydia), pelvic inflammatory disease (PID- severe cases of STI), previous abdominal surgery and/or #endometriosis.
.
In those patients exposed to an STI, there is a greater risk of TFI the longer it goes untreated, as well as with increasing severity of the infection. For example, the risk of TFI is about 10% after one, 25% after two or >50% after three episodes of PID.
.
This is just one of many reasons why it is important to practice safe sex at every age!
#Repost @infertilitydrperfetto
.
.
.
#infertilitysucks #infertilityawareness #infertilitysupport #infertilityblogger #fertilityjourney #fertilityawareness #ttc #ttcwithendo #miscarriage #ttccommunity #ttcsupport #obgyn #safesex #sexeducation #onegoaltwolines #centerofreproductivemedicine #drperfetto
For the 4th consecutive year, the CDC reported an increase in cases of chlamydia, gonorrohea and syphilis. . This is a big deal for the those seeking future #fertility  because sexually transmitted infections are one of the most common causes of tubal factor #infertility . . Tubal factor infertility (TFI) is identified as a cause of infertility 15-30% of the time. Tubal disease can occur from sexually transmitted infections (STI, most commonly chlamydia), pelvic inflammatory disease (PID- severe cases of STI), previous abdominal surgery and/or #endometriosis . . In those patients exposed to an STI, there is a greater risk of TFI the longer it goes untreated, as well as with increasing severity of the infection. For example, the risk of TFI is about 10% after one, 25% after two or >50% after three episodes of PID. . This is just one of many reasons why it is important to practice safe sex at every age! #Repost  @infertilitydrperfetto . . . #infertilitysucks  #infertilityawareness  #infertilitysupport  #infertilityblogger  #fertilityjourney  #fertilityawareness  #ttc  #ttcwithendo  #miscarriage  #ttccommunity  #ttcsupport  #obgyn  #safesex  #sexeducation  #onegoaltwolines  #centerofreproductivemedicine  #drperfetto 
Life is like a box of adorable anatomy-based cookies 🍪
.
Trying to conceive a baby can quickly turn from all-fun to all-consuming. Although most couples (80%) do conceive spontaneously within a year of #ttc, many couples do not. I see patients who have been trying for a few months to trying for over a decade. No matter when a patient comes in, by the time they are seeing me they are usually overwhelmed, disheartened 💔and frustrated by the process.
.
These adorable cookies, brought to us by one of our sweet patients, remind us and hopefully others that most of the time the end of the #fertilityjourney is sweet. This particular patient had more than her fair share of #iui, #ivf, mock cycles and #embryo transfers.
.
She is not unique. A lot of patients go through a lot to get their baby👶🏻. Today, I am wishing everyone in the middle of this incredibly stressful journey a super sweet success story soon!
.
.
.
#infertilitysucks #infertility #infertilityawareness #infertilitywarrior #infertilityblogger #fertility #fertilitytreatment #ttcjourney #ttcaftermiscarriage #miscarriage #embryotransfer #ivfcycle #houstondoctors #somedoc #onegoaltwolines #centerofreproductivemedicine #drperfetto
Life is like a box of adorable anatomy-based cookies 🍪 . Trying to conceive a baby can quickly turn from all-fun to all-consuming. Although most couples (80%) do conceive spontaneously within a year of #ttc , many couples do not. I see patients who have been trying for a few months to trying for over a decade. No matter when a patient comes in, by the time they are seeing me they are usually overwhelmed, disheartened 💔and frustrated by the process. . These adorable cookies, brought to us by one of our sweet patients, remind us and hopefully others that most of the time the end of the #fertilityjourney  is sweet. This particular patient had more than her fair share of #iui , #ivf , mock cycles and #embryo  transfers. . She is not unique. A lot of patients go through a lot to get their baby👶🏻. Today, I am wishing everyone in the middle of this incredibly stressful journey a super sweet success story soon! . . . #infertilitysucks  #infertility  #infertilityawareness  #infertilitywarrior  #infertilityblogger  #fertility  #fertilitytreatment  #ttcjourney  #ttcaftermiscarriage  #miscarriage  #embryotransfer  #ivfcycle  #houstondoctors  #somedoc  #onegoaltwolines  #centerofreproductivemedicine  #drperfetto 
Today on our Facebook page we posted a video from one of our patients, Kaitlin Miller. She is sharing about her experience with #infertility and the struggle and loss she experienced while growing her family. Thank you for sharing such a personal video and your journey... Be sure to watch. 
We love seeing your baby boys, so much love in these pics.
.
.
.
FROM @Kaitlin Miller: Such a taboo subject no one wants to talk about. Something I haven’t talked about to anyone really other than my husband. Infertility and loss.
Such a taboo subject no one wants to talk about. 
Something I haven’t talked about to anyone really other than my husband. 
Infertility and loss.
.
Love. Hope. Strength. Inspiration.
#miraclebaby #CenterOfReproductiveMedicine #InfertilityTexas 
#IVF #TTCSisters #DreamsDoComeTrue #NeverGiveUp #TTC
Today on our Facebook page we posted a video from one of our patients, Kaitlin Miller. She is sharing about her experience with #infertility  and the struggle and loss she experienced while growing her family. Thank you for sharing such a personal video and your journey... Be sure to watch. We love seeing your baby boys, so much love in these pics. . . . FROM @Kaitlin Miller: Such a taboo subject no one wants to talk about. Something I haven’t talked about to anyone really other than my husband. Infertility and loss. Such a taboo subject no one wants to talk about. Something I haven’t talked about to anyone really other than my husband. Infertility and loss. . Love. Hope. Strength. Inspiration. #miraclebaby  #CenterOfReproductiveMedicine  #InfertilityTexas  #IVF  #TTCSisters  #DreamsDoComeTrue  #NeverGiveUp  #TTC 
Today I graduated from the Center of Reproductive Medicine. It was bitter sweet! I spent the last year here almost every week, sometimes couple of times a week. Our journey didn’t start here but I am glad it ended here. It had its trials and tribulations, tears, heartache, uncertainty and pain. But it created friendships and taught me strength and to be more humble. I wouldn’t change a thing. Can’t wait to meet our sweet Jameson and to one day tell him his story and how hard we fought to make him 💙 Again I thank everyone for the support, prayers and love! 
#ivfbaby #ttcjourney #centerofreproductivemedicine #corm #retrievebelieveconceive #embryotransfer
Today I graduated from the Center of Reproductive Medicine. It was bitter sweet! I spent the last year here almost every week, sometimes couple of times a week. Our journey didn’t start here but I am glad it ended here. It had its trials and tribulations, tears, heartache, uncertainty and pain. But it created friendships and taught me strength and to be more humble. I wouldn’t change a thing. Can’t wait to meet our sweet Jameson and to one day tell him his story and how hard we fought to make him 💙 Again I thank everyone for the support, prayers and love! #ivfbaby  #ttcjourney  #centerofreproductivemedicine  #corm  #retrievebelieveconceive  #embryotransfer 
Male factor infertility.
.
I require every male partner to have a #semenanalysis before we can start #fertilitytreatment. Why? Because approximately 30% of couples who are struggling to conceive have #malefactorinfertility.
.
After I review the analysis I typically discuss what is abnormal and if there is anything we can do to improve the numbers.
.
1. What is a normal semen analysis? Based on the WHO criteria we consider the following parameters “normal”:
.
Volume 1.5-5.9ml
Count >15million/ml
Motility >50%
Morphology >4% (strict)
.
It’s important to understand that men can still father a child 👶🏻 if outside of these ranges.
.
2. What are frequent causes of low sperm parameters?
.
Previous chemotherapy, previous surgery, certain medications (exogenous #testosterone 💪!!), excessive alcohol/drug use, excessive heat (hot tubs).
.
I have seen men go from a normal SA to minimal or no sperm after: excessive hot tub use, taking workout supplements, having a high fever. Weird things can happen!
.
If I have a concern about the analysis, I usually repeat it, I may draw labs and I frequently send to a qualified male #urologist👨‍⚕️ who specializes in reproductive medicine.
.
.
.
These posts are for educational purposes only.
.
.
.
#infertility #infertilitysucks #infertilityawareness #infertilityhurts #fertility #fertilityspecialist #fertilityjourney #fertilityjourney #ttc #ttccommunity #ttcsupport #infertilityblogger #houstondoctors #houstonblogger #menshealth #ivf #ivfjourney #ivfcycle #iui #onegoaltwolines #centerofreproductivemedicine #drperfetto
Male factor infertility. . I require every male partner to have a #semenanalysis  before we can start #fertilitytreatment . Why? Because approximately 30% of couples who are struggling to conceive have #malefactorinfertility . . After I review the analysis I typically discuss what is abnormal and if there is anything we can do to improve the numbers. . 1. What is a normal semen analysis? Based on the WHO criteria we consider the following parameters “normal”: . Volume 1.5-5.9ml Count >15million/ml Motility >50% Morphology >4% (strict) . It’s important to understand that men can still father a child 👶🏻 if outside of these ranges. . 2. What are frequent causes of low sperm parameters? . Previous chemotherapy, previous surgery, certain medications (exogenous #testosterone  💪!!), excessive alcohol/drug use, excessive heat (hot tubs). . I have seen men go from a normal SA to minimal or no sperm after: excessive hot tub use, taking workout supplements, having a high fever. Weird things can happen! . If I have a concern about the analysis, I usually repeat it, I may draw labs and I frequently send to a qualified male #urologist 👨‍⚕️ who specializes in reproductive medicine. . . . These posts are for educational purposes only. . . . #infertility  #infertilitysucks  #infertilityawareness  #infertilityhurts  #fertility  #fertilityspecialist  #fertilityjourney  #fertilityjourney  #ttc  #ttccommunity  #ttcsupport  #infertilityblogger  #houstondoctors  #houstonblogger  #menshealth  #ivf  #ivfjourney  #ivfcycle  #iui  #onegoaltwolines  #centerofreproductivemedicine  #drperfetto 
National rainbow 🌈 baby day
.
Today we remember the babies that have blessed us after suffering a #pregnancyloss.
.
There is nothing more challenging in #fertility than trying to relax and enjoy a pregnancy when you have lost others before. Every cramp, spot of blood or milestone is a bitter memory of the past.
.
Patients who have lost babies always tell me they just need to get past week X and then they will feel better. I listen to them and then gently suggest that probably is not true, they will likely be worried about this baby until the day he or she is born. And then they will continue to worry after the birth, but for other reasons.
.
This anxiety is completely normal. You have lost something so important to you in the past, it is appropriate to fear it may happen again. My most important advice is to understand that you did not cause the last loss and you cannot cause another one, so try and believe me and try to enjoy every small milestone you reach in this pregnancy.
.
I am so grateful 💛we have a day to celebrate these babies. They are often the child that helps a patient start to heal her heart. They will never take the place of the baby lost, but they often help make the family feel whole.
.
.
.
#NationalRainbowBabyDay #rainbowbabyday #rainbowbaby #pregnancyafterloss #miscarriage #miscarriageawareness #miscarriagesupport #ttcaftermiscarriage #ttc #ttcsisters #infertility #infertilitysucks #infertilityhurts #infertilityblogger #houstonblogger #houstondoctors #centerofreproductivemedicine #drperfetto
National rainbow 🌈 baby day . Today we remember the babies that have blessed us after suffering a #pregnancyloss . . There is nothing more challenging in #fertility  than trying to relax and enjoy a pregnancy when you have lost others before. Every cramp, spot of blood or milestone is a bitter memory of the past. . Patients who have lost babies always tell me they just need to get past week X and then they will feel better. I listen to them and then gently suggest that probably is not true, they will likely be worried about this baby until the day he or she is born. And then they will continue to worry after the birth, but for other reasons. . This anxiety is completely normal. You have lost something so important to you in the past, it is appropriate to fear it may happen again. My most important advice is to understand that you did not cause the last loss and you cannot cause another one, so try and believe me and try to enjoy every small milestone you reach in this pregnancy. . I am so grateful 💛we have a day to celebrate these babies. They are often the child that helps a patient start to heal her heart. They will never take the place of the baby lost, but they often help make the family feel whole. . . . #NationalRainbowBabyDay  #rainbowbabyday  #rainbowbaby  #pregnancyafterloss  #miscarriage  #miscarriageawareness  #miscarriagesupport  #ttcaftermiscarriage  #ttc  #ttcsisters  #infertility  #infertilitysucks  #infertilityhurts  #infertilityblogger  #houstonblogger  #houstondoctors  #centerofreproductivemedicine  #drperfetto 
What a wonderful surprise 2 week visit from baby Everett and moms Amanda and Chelsey. These pictures are giving us all the feels on this Monday.
.
.
.
Love. Hope. Strength. Inspiration.
.
#miraclebaby #CenterOfReproductiveMedicine #InfertilityTexas #IVF #TTCSisters #DreamsDoComeTrue #NeverGiveUp #TTC #loveislove
Struggling with infertility is like dealing with the five stages of grief.
.
One of my former patients recently posted on this and I cannot agree with her more. When struggling to conceive it is common to deny, bargain, get angry, cry and then accept.
.
In a typical day, I may visit with patients in every stage of the grieving process. What is interesting about grief is that we all do not grieve in the same order, nor do we experience each stage similarly.
.
In one day, I may see two different patients suffering with 5 years of #infertility - One may be angry about her diagnosis and the other may be accepting it and planing to move in another direction.
.
Grief is so often associated with the loss of a loved one. What is unique to those suffering from infertility, is that they are grieving the loss of their future, their future children and the dreams they had for those children.
.
Much like how we experience the stages of grief, we all work through it differently. I encourage my patients to speak with family, friends and counselors who specialize in infertility, journal, go on walks and make sure to take time for themselves.
.
I would love to hear any suggestions you may have to help get you through this challenging time.
Struggling with infertility is like dealing with the five stages of grief. . One of my former patients recently posted on this and I cannot agree with her more. When struggling to conceive it is common to deny, bargain, get angry, cry and then accept. . In a typical day, I may visit with patients in every stage of the grieving process. What is interesting about grief is that we all do not grieve in the same order, nor do we experience each stage similarly. . In one day, I may see two different patients suffering with 5 years of #infertility  - One may be angry about her diagnosis and the other may be accepting it and planing to move in another direction. . Grief is so often associated with the loss of a loved one. What is unique to those suffering from infertility, is that they are grieving the loss of their future, their future children and the dreams they had for those children. . Much like how we experience the stages of grief, we all work through it differently. I encourage my patients to speak with family, friends and counselors who specialize in infertility, journal, go on walks and make sure to take time for themselves. . I would love to hear any suggestions you may have to help get you through this challenging time.
How do I decide the best treatment for a patient?
.
This is a question I get all of the time and it is actually very easy for me to answer.
.
I do not have a set protocol for anyone. I look at the whole couple/patient, the entire evaluation, the long term family planning goals and then we make a decision together.
.
The most important factors?
1. Are the tubes open? We test this with the #hsg. If blocked then we must move to #ivf.
2. Is there adequate sperm for spontaneous conception? An #iuicycle? Or is it too low and we need to move to an #ivfcycle?
3. Is the female patient ovulating on her own? If not, then I can offer the most conservative option- oral medications to help with ovulation. If she is already ovulating on her own, then she can still be offered all treatment options, but her success rates are likely much lower.
4. What are the long term family planning goals? If the female is older (>37) and they/she wants more than 1-2 children then they/she may need to consider more aggressive treatment sooner.
5. There are numerous other things that I consider when helping guide a couple or single female to creating a family.
.
As you can see there is no one size fits all. I view my job as one that helps educate and guide, not tell patients what they have to do.
.
.
.
These posts are for educational purposes only.
.
.
.
#infertility #infertilitysucks #infertilityhurts #fertility #fertilityjourney #fertilitytreatment #ttc #ttcsisters #ttcsupport #infertilityblogger #infertilityawareness #obgyn #houstondoctors #onegoaltwolines #centerofreproductivemedicine #drperfetto
How do I decide the best treatment for a patient? . This is a question I get all of the time and it is actually very easy for me to answer. . I do not have a set protocol for anyone. I look at the whole couple/patient, the entire evaluation, the long term family planning goals and then we make a decision together. . The most important factors? 1. Are the tubes open? We test this with the #hsg . If blocked then we must move to #ivf . 2. Is there adequate sperm for spontaneous conception? An #iuicycle ? Or is it too low and we need to move to an #ivfcycle ? 3. Is the female patient ovulating on her own? If not, then I can offer the most conservative option- oral medications to help with ovulation. If she is already ovulating on her own, then she can still be offered all treatment options, but her success rates are likely much lower. 4. What are the long term family planning goals? If the female is older (>37) and they/she wants more than 1-2 children then they/she may need to consider more aggressive treatment sooner. 5. There are numerous other things that I consider when helping guide a couple or single female to creating a family. . As you can see there is no one size fits all. I view my job as one that helps educate and guide, not tell patients what they have to do. . . . These posts are for educational purposes only. . . . #infertility  #infertilitysucks  #infertilityhurts  #fertility  #fertilityjourney  #fertilitytreatment  #ttc  #ttcsisters  #ttcsupport  #infertilityblogger  #infertilityawareness  #obgyn  #houstondoctors  #onegoaltwolines  #centerofreproductivemedicine  #drperfetto 
Come one, come all! 
Step right up and join us for the 
2018 BABY REUNION!
WHEN: Saturday, September 22, 2018
TIME: 12:00pm-2:00pm
WHERE: Clear Lake Park
Landlot Pavilion
5002 E. Nasa Pkwy.
Seabrook, TX 77586
RSVP: (281) 332-0073 thamil@infertilitytexas.com
Petting Zoo, Balloon Artist, Face Painting, BBQ, Popcorn, and Snow Cones… You won’t want to miss it!
.
.
.
#babyreunion #infertilitytexas 
#centerofreproductivemedicine #circus #circusparty #family #familyfun #familyfunday #2018
Come one, come all! Step right up and join us for the 2018 BABY REUNION! WHEN: Saturday, September 22, 2018 TIME: 12:00pm-2:00pm WHERE: Clear Lake Park Landlot Pavilion 5002 E. Nasa Pkwy. Seabrook, TX 77586 RSVP: (281) 332-0073 thamil@infertilitytexas.com Petting Zoo, Balloon Artist, Face Painting, BBQ, Popcorn, and Snow Cones… You won’t want to miss it! . . . #babyreunion  #infertilitytexas  #centerofreproductivemedicine  #circus  #circusparty  #family  #familyfun  #familyfunday  #2018 
You probably cannot tell, but I have serious Operating Room Face on right now.
.
I take my role as a #surgeon very seriously. My patients and their families trust me with their health, bodies and lives and I will do my absolute best for them.
.
First, I always prepare for the case. I review the patients history (present complaints, surgical history, allergies, current medications) and I always do a complete evaluation before rushing to the #operatingroom. Some diagnoses need an ultrasound, hysterosonogram, MRI, hysterosalpingogram, etc. I never want any surprises in the middle of a #surgery. Now don’t get me wrong, there are always surprises, but some you can be better prepared for than others.
.
Second, I do not perform surgeries that are beyond my skill set. This is something I learned once I entered #privatepractice. As an #obgyn resident I would perform every surgery offered- hysterectomy, myomectomy, urethral slings, stage 4 cancer, etc. and it was excellent training. I felt like I could do anything in the OR, and I could because someone far more skilled than me was also there and could fix my mistake if I made one (now I was never a cowboy so that was rare).
.
Third, BE NICE in the OR. There is absolutely no reason not to be.  The admin staff, OR circulators, #surgicalassistant, surgical #nurses, nurses anesthetists, anesthesiologists all want the case to go successful and being rude or nasty will not help you in any way. Remember you will be working with these people for a long time, they deserve as much respect as you do.
.
.
.
Now, back to the OR; time to take out a hydrosalpinx, transect a septum and resect a few polyps!
You probably cannot tell, but I have serious Operating Room Face on right now. . I take my role as a #surgeon  very seriously. My patients and their families trust me with their health, bodies and lives and I will do my absolute best for them. . First, I always prepare for the case. I review the patients history (present complaints, surgical history, allergies, current medications) and I always do a complete evaluation before rushing to the #operatingroom . Some diagnoses need an ultrasound, hysterosonogram, MRI, hysterosalpingogram, etc. I never want any surprises in the middle of a #surgery . Now don’t get me wrong, there are always surprises, but some you can be better prepared for than others. . Second, I do not perform surgeries that are beyond my skill set. This is something I learned once I entered #privatepractice . As an #obgyn  resident I would perform every surgery offered- hysterectomy, myomectomy, urethral slings, stage 4 cancer, etc. and it was excellent training. I felt like I could do anything in the OR, and I could because someone far more skilled than me was also there and could fix my mistake if I made one (now I was never a cowboy so that was rare). . Third, BE NICE in the OR. There is absolutely no reason not to be. The admin staff, OR circulators, #surgicalassistant , surgical #nurses , nurses anesthetists, anesthesiologists all want the case to go successful and being rude or nasty will not help you in any way. Remember you will be working with these people for a long time, they deserve as much respect as you do. . . . Now, back to the OR; time to take out a hydrosalpinx, transect a septum and resect a few polyps!
Fresh vs. Frozen? We are not talking veggies or pizza ... We are talking embryos.
.
An #embryotransfer can be performed one of two ways.
.
Fresh —> It is part of the #ivfcycle. After the retrieval the patient starts progesterone to prepare the lining for implantation. At my practice this is almost always a day 5 (blastocyst stage) transfer. Day 3 transfers used to be common, but now most #ivf centers prefer a day 5 transfer - they have higher success rates.
.
Frozen —> It is typically performed after the IVF cycle. The patient has a menses and we can plan the transfer the next month (or months/years later). The patient typically starts estrogen and once the lining thickens we add progesterone to prepare the uterus for the transfer.
.
Personally, we perform far more frozen transfers than fresh transfers. The reasons for that?
.
1. More and more of our patients are opting for PGT-A testing of their embryos. That means the embryos must be frozen after the biopsy while we wait for the embryo results.
2. Patients with high ovarian response (lots of eggs and high estradiol levels) are at risk of ovarian hyperstimulation and it is better not to get pregnant in that situation.
3. There is data to support that frozen embryo transfers are better for the baby. They tend to stay in the uterus a little longer and have a slightly higher live birth rate.
4. A lot of clinics have higher success rates with frozen transfers. This is for many different reasons (some of which are patient related), so frequently the decision for a #frozenembryotransfer may be patient or practice preference.
.
Every situation, patient and clinic are different. You definitely want to speak with your own #fertilityspecialist about your options.
.
.
Oh, for pizza 🍕 and veggies 🌽- Always fresh!
.
.
.
These posts are for educational 📓purposes only.
Fresh vs. Frozen? We are not talking veggies or pizza ... We are talking embryos. . An #embryotransfer  can be performed one of two ways. . Fresh —> It is part of the #ivfcycle . After the retrieval the patient starts progesterone to prepare the lining for implantation. At my practice this is almost always a day 5 (blastocyst stage) transfer. Day 3 transfers used to be common, but now most #ivf  centers prefer a day 5 transfer - they have higher success rates. . Frozen —> It is typically performed after the IVF cycle. The patient has a menses and we can plan the transfer the next month (or months/years later). The patient typically starts estrogen and once the lining thickens we add progesterone to prepare the uterus for the transfer. . Personally, we perform far more frozen transfers than fresh transfers. The reasons for that? . 1. More and more of our patients are opting for PGT-A testing of their embryos. That means the embryos must be frozen after the biopsy while we wait for the embryo results. 2. Patients with high ovarian response (lots of eggs and high estradiol levels) are at risk of ovarian hyperstimulation and it is better not to get pregnant in that situation. 3. There is data to support that frozen embryo transfers are better for the baby. They tend to stay in the uterus a little longer and have a slightly higher live birth rate. 4. A lot of clinics have higher success rates with frozen transfers. This is for many different reasons (some of which are patient related), so frequently the decision for a #frozenembryotransfer  may be patient or practice preference. . Every situation, patient and clinic are different. You definitely want to speak with your own #fertilityspecialist  about your options. . . Oh, for pizza 🍕 and veggies 🌽- Always fresh! . . . These posts are for educational 📓purposes only.
Endometrial receptivity array.
.
I have received quite a few DMs and questions about Endometrial receptivity array (ERA) testing. So, let’s look into it:
.
1. What is it? ERA is a biopsy of the endometrium that is performed at the time of a “typical” #embryotransfer. Meaning you prepare the uterus for a transfer, but instead of placing an embryo in the cavity your #fertilityspecialist performs an endometrial biopsy to obtain tissue lining. That tissue is then sent to an outside company to look for specific genes that are expressed when the uterus is typically receptive to an embryo implanting.
2. What is it looking for? The ERA is assessing if the time an embryo is being put back into the uterus is the correct time for that patient. Meaning, we know there is a specific “window of implantation” for every woman, we used to think it was the same for everyone, but we have found it is actually not universal. So, this test is designed to find the right time to perform an embryo transfer for an individual. Ie. #personalizedmedicine 
3. Is there data to support this testing? Yes, there is a little data (on a fairly small number of patients) out there to support using this test in women with a history of recurrent implantation failure (RIF). RIF = failure to have implantation of 3 or more high quality embryos. This being said- doing this test does NOT mean your implantation rate sky-rockets. They have found patients without RIF are “not receptive” 12% of the time, whereas it is 25% in those with RIF. Those with RIF that then had an appropriately timed transfer had a 50% pregnancy rate (Again, NOT 100%).
4. When do I perform an ERA? I think the test has value for patients who have RIF of 3 untested (no PGT-A) embryos, failure to implant 1-2 euploid embryos or in those older women who have only 1 euploid embryo and have a low chance of having another successful IVF cycle.
.
I hope this helps! I think ERA has promise, but also has limitations. It is likely a piece of the very important #fertility puzzle.
.
.
.
These posts are for educational 📓purposes only.
Endometrial receptivity array. . I have received quite a few DMs and questions about Endometrial receptivity array (ERA) testing. So, let’s look into it: . 1. What is it? ERA is a biopsy of the endometrium that is performed at the time of a “typical” #embryotransfer . Meaning you prepare the uterus for a transfer, but instead of placing an embryo in the cavity your #fertilityspecialist  performs an endometrial biopsy to obtain tissue lining. That tissue is then sent to an outside company to look for specific genes that are expressed when the uterus is typically receptive to an embryo implanting. 2. What is it looking for? The ERA is assessing if the time an embryo is being put back into the uterus is the correct time for that patient. Meaning, we know there is a specific “window of implantation” for every woman, we used to think it was the same for everyone, but we have found it is actually not universal. So, this test is designed to find the right time to perform an embryo transfer for an individual. Ie. #personalizedmedicine  3. Is there data to support this testing? Yes, there is a little data (on a fairly small number of patients) out there to support using this test in women with a history of recurrent implantation failure (RIF). RIF = failure to have implantation of 3 or more high quality embryos. This being said- doing this test does NOT mean your implantation rate sky-rockets. They have found patients without RIF are “not receptive” 12% of the time, whereas it is 25% in those with RIF. Those with RIF that then had an appropriately timed transfer had a 50% pregnancy rate (Again, NOT 100%). 4. When do I perform an ERA? I think the test has value for patients who have RIF of 3 untested (no PGT-A) embryos, failure to implant 1-2 euploid embryos or in those older women who have only 1 euploid embryo and have a low chance of having another successful IVF cycle. . I hope this helps! I think ERA has promise, but also has limitations. It is likely a piece of the very important #fertility  puzzle. . . . These posts are for educational 📓purposes only.
#mondaymotivation... because who doesn’t wish that the weekend could last one more day?@!
.
.
.
#longerweekendplease #ivf #infertility #ttcsisters #fertility #centerofreproductivemedicine #infertilitytexas #infertilitysucks #viewfromthetop
Good times with #coworkers and #friends that have become #family. A night filled with so much fun @TopGolf!
.
.
.
There are friends, there is family, and then there are friends that become family.
.
.
.
#workfamily #oneteam #bettertogether #OurFamilyHelpsMakeFamilies #employeeappreciation #employeeperks #coworkers #team #squad #squadgoals #greattimeswithgreatpeople #topgolfwebster #CenterOfReproductiveMedicine
Good times with #coworkers and #friends that have become #family. A night filled with so much fun @TopGolf!
.
.
.
There are friends, there is family, and then there are friends that become family.
.
.
.
#workfamily #oneteam #bettertogether #OurFamilyHelpsMakeFamilies #employeeappreciation #employeeperks #coworkers #team #squad #squadgoals #greattimeswithgreatpeople #topgolfwebster #CenterOfReproductiveMedicine #InfertilityTexas
So this happened today in our #Houston office... @infertilitydrperfetto was able to share the exciting news with our patient and her husband that they are one of three $10K #IVFGiveaway WINNERS!
.
.
#centerofreproductivemedicine #ivf #infertility #fertility #ttc #ttcsisters #miraclemakers #tearsofjoy
#Congratulations to the three lucky winners of our 2018 Summer IVF Giveaway!!! ♥️♥️♥️
.
Each winner was randomly selected to receive $10,000 in reimbursement for IVF services from the #CenterofReproductiveMedicine.

Thank you to everyone who participated and helped make this contest a success.
.
.
.
#IVFGiveaway #InfertilityTexas #ttc #MakingMiraclesHappen