Pregnancy SuperwheelPregnancy SuperwheelCOURTESY OF THECOURTESY OF THE

Fertility Treatment CenterFertility Treatment Center

ContentsContentsGestational Calculator Capabilities ------------------ 3Side A -------------------------------------------------------- 5Side B -------------------------------------------------------- 6LMP and Average Cycle Length ----------------------- 7Conception Cycle Landmarks -------------------------- 9Sperm Exposure Scale ---------------------------------- 10Embryo Transfer Scale ---------------------------------- 11Gestational Age Day Markers -------------------------- 12First Day of the Month Markers ------------------------ 13Using Cursors ---------------------------------------------- 14Early Ultrasound Probability Chart -------------------- 15Crown Rump Length (CRL) Scale --------------------- 17CRL with Unknown Dates ------------------------------- 19Obstetrical Tests and Landmarks --------------------- 20Bi-Parietal Diameter (BPD) Scale --------------------- 21Femur Length (FL) Scale -------------------------------- 23

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BPD with Unknown Dates ------------------------------ 25Femur Length with Unknown Dates ------------------ 26Weekday Scale -------------------------------------------- 27Genetic Risk Table --------------------------------------- 29Pre-Term Delivery Risk Table ------------------------- 31Cervical Length Risk of PreTerm Labor ------------- 33Placenta Previa Perinatal Mortality ------------------- 35Age Related IVF and IUI Success -------------------- 37Body Mass Index (BMI) Calculator ------------------- 39BMI Body Type Range ---------------------------------- 41Estimated Fetal Weight (EFW) Calculator ---------- 43EFW Normal Range Calculation ---------------------- 45Early Pregnancy B-hCG Calculator ------------------ 46B-hCG Normal Range Calculation ------------------- 48Referral to Fertility SubSpecialist --------------------- 49Infertility Diagnostic Cycle ----------------------------- 52Fertility Treatment Center Services ----------------- 53HSG and Hysteroscopy “HI-TEC” Services ------- 54

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Gestational Calculator CapabilitiesGestational Calculator Capabilities

- What is the Due Date if the Patient’s average cycle length is 36 days? If the average cycle length is 24 days?- Did the Patient get pregnant from intercourse on May 12th or on May 19th?- Was embryo Implantation the likely cause of spotting around July 2nd? - What is the chance of seeing a fetal pole next Wednesday with vaginal probe ultrasound?- Is the pregnancy viable if fetal heart motion was not detected on August 12th?

In addition to determining the Due Date from a patient’s Last Menstrual Period and displaying the Gestational Age for corresponding calendar dates, the Pregnancy Superwheel is designed to answer a variety of questions commonly encountered in the Ob-Gyn or Family Practice office. Examples:

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- What is the term risk of fetal Down syndrome at age 39? Of Aneuploidy at age 41?- What is the chance of neonatal survival at 24 weeks delivery? Of having a significant handicap if delivered at that time?- To schedule a C-Section, what calendar date is the third Tuesday from today?- What is the chance of achieving pregnancy with IVF at age 38? At age 41?- How much weight should the Patient lose to have a normal BMI?- Is the EFW normal at 29 weeks gestation if the BPD is 7 cm and the Abdominal Circumference is 22 cm?- Is a B-hCG mIU/ml of 1530 too low today if the urine LH surge was on June 3rd?

- What is the normal range of gestational age if the CRL is 10mm?

- What date should the Patient receive her first dose of RhoGam? When should she have her CVS or amniocentesis scheduled?- Is a BPD of 6.4 cm in the normal range for ultrasound done on October 9th?

- When will a gestational sac be visible on ultrasound if IVF embryo transfer was done last Thursday?

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Side A

- Determines calendar date of EDC- Average cycle length adjustment- Urine LH surge indicator- Conception risk from Sperm Exposure- Dates of Ovulation and Implantation- IVF embryo transfer date indicator- Early ultrasound clinical probabilities- Pregnancy tests and treatment gestational ranges- Average value and normal ranges for CRL, BPD, and Femur Length- Standard Tables for evaluating Genetic Risk, Preterm Labor, Preterm Cervix, Placenta Previa, and Age vs Fertility- Weekday Scale

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- Calculates Body Mass Index (BMI)- Displays BMI Body Type Range- Calculates Estimated Fetal Weight (EFW) from BPD and Abdominal Circumference- Determines Average EFW and Normal Range of EFW for Gestational Age- Displays Gestational Age related Percentile Values for EFW- Determines Average B-hCG Values for Early Pregnancy - Displays Normal Range and Gestational Age Related Percentile Values of B-hCG for Early Pregnancy

Side B

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Last Menstrual Period MarkerLast Menstrual Period MarkerThe Average Cycle Length scale automatically adjusts the position of the LMP marker to compensate for variations in Menstrual Cycles

The scale ranges from 22 to 40 days Average Cycle Length, with a prominent marker for 28 day cycles

LMP on April 12 for 36 day cycles

LMP on April 20 for 28 day cycles

LMP on April 26 for 22 day cyclesExamples:

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Using the Average Cycle Length ScaleUsing the Average Cycle Length Scale

Example: For Patient with LMP on April 30th

If her average cycle length is 26 days, then align the red marker for ‘26’ on the cycle length scale with the black marker for April 30th. The Due Date is on February 2nd .

If her average cycle length is 34 days, then align the red marker for ‘34’ on the cycle length scale with the black marker for April 30th. The Due Date is on February 10th .

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Conception Cycle LandmarksConception Cycle Landmarks

EXAMPLE:

LMP was on May 4th, with average cycle length of 30 days

Urine LH test kit was positive (or the hCG ovulation trigger injection was administered) on May 19th Ovulation was on May 20th

Embryo Implantation wason May 27th

Next Menstrual Period (if not pregnant)should be on June 3rd

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Using the Sperm Exposure ScaleUsing the Sperm Exposure ScaleThe Sperm Exposure Scale displays the period of time during the menstrual cycle in which conception may occur, either by intercourse or by insemination.

Most conceptions occur with sperm 0 to 3 days old. Rarely, sperm may remain viable for up to 7 days. Eggs are fertilizable for 28 hours after ovulation, so intercourse up to 24 hours after ovulation may result in conception.

Example: Intercourse betweenMay 13th and 21st may resultin pregnancy.

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Using the Embryo Transfer ScaleUsing the Embryo Transfer Scale

DAY 3 embryo transfer (8 to 12 cell stage) is represented by the mark just before the CM ET bold line.

DAY 4 embryo transfer (compact morula stage) is represented by the CM ET bold line.

DAY 5 embryo transfer (blastocyst stage) is represented by the mark just after the CM ET bold line.

DAY 1 embryo transfer (Pronuclear stage or ZIFT) is represented by the mark just after the Ovulation bold line.

Example – Egg Capture with In Vitro Fertilization was done on March 16th, with subsequent Compact Morula Embryo Transfer done on March 20th.

For In Vitro Fertilization pregnancies, the CM Embryo Transfer marker displays the day when embryos at the Compact Morula stage were transferred into the uterus. In general, compact morula is the best stage for maximizing pregnancy and frozen embryo implantation rates. The CM Embryo Transfer marker is also a reference point for embryo transfers done on post-IVF days 1, 3, 4, and 5 (or for ZIFT cycles).

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Gestational Age Day MarkersGestational Age Day Markers

---- Bold – Day 0---- Short – day 1---- Short – day 2---- Long ----- day 3---- Long ----- day 4---- Short – day 5---- Short – day 6---- Bold – day 0

Example:The second ‘long mark’ is ‘day 4’ so the 15 th of this month is at 20 weeks 4 days gestation.

The Gestational Age WEEK and DAY markers are designed for easy and rapid identification when aligned with the Calendar Day scale.

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First Day of the Month MarkersFirst Day of the Month Markers

A small Diagonal Line marker is used to easily and rapidly identify the first day of each month on the Calendar Scale.

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Using CursorsUsing Cursors

LEFT Cursor

RIGHT Cursor

The Left Cursor is used for gestational ages less than 13 weeks.

The Right Cursor is used for gestational ages greater than 13 weeks.

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<13 wks >13 wks

Early Ultrasound Probability ChartEarly Ultrasound Probability Chart

The Probability of detecting certain gestational ultrasound landmarks (using vaginal probe scan) between 3½ weeks and 9 weeks gestation is displayed.

When the Left Cursor is aligned with the gestational age marker, the chance (%)of detecting an ultrasound landmark for the associated calendar date is displayed by the cursor probability scale.

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Using the Early Ultrasound Probability ChartUsing the Early Ultrasound Probability Chart

On April 11, the patient is 5 weeks 5 days gestation

Align the Left cursor on the gestational date.

For a Normal Pregnancy,there is a:

100% chance of seeinga Gestational Sac

90% chance of seeinga Fetal Pole

35% chance of seeingFetal Heart Motion

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Crown – Rump Length ScaleCrown – Rump Length Scale(CRL scale)(CRL scale)

Displays the Average CRL (in mm) in the first trimester, along with the Normal Range for CRL, within two standard deviations, for each gestational age and corresponding calendar date.

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On June 15, the Patient is 9 weeks 0 days Gestation.

The minus 2 S.D.CRL = 18 mm

The plus 2 S.D.CRL = 30 mm

The AverageCRL = 22 mm

Using the CRL ScaleUsing the CRL Scale

The Green reference lines cross at Plus and minus 2 standard deviations

Align the Left Cursor On the gestational date.

The Average CRL is 22 mm, with aNormal Range of 18 mm to 30 mm

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Using the CRL scale with Unknown DatesUsing the CRL scale with Unknown DatesA Patient with Unknown Dates has a CRL of 10 mm. Position the Left Cursor so that the second Green reference lines cross directly over the 10 mm mark on the CRL scale, and read the associated gestational age (6 weeks 5 days). Then reposition the cursor until the first Green reference lines cross directly over the 10 mm mark, and read the associated gestational age (7 weeks 6 days).

The normal gestational age range for a CRL of 10mm is between 6 weeks 5 days and 7 weeks 6 days. The Most Likely gestational age (cursor line on the 10 mm mark) is 7 weeks 1 day.

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Obstetrical Tests and Landmarks ScaleObstetrical Tests and Landmarks Scale

Biochemical Screen –----- April 22 to May 24Chorionic Villus Sample -- April 29 to May 13Nuchal Translucency ------ May 9 to May 27Amniocentesis ------------- May 27 to June 17Tri/Quad-Screen AFP ---- June 10 to June 24

Level II Ultrasound --- June 24 to July 15Early Viability –------- July 22 to August 5GTT, RPR, H/H, Ab --- August 5 to Sept 2RhoGam injection ------ Sept 2 to Sept 16CBC ----------------- Sept 30 to October 21

The multi-colored band is a scale that displays the Gestational Age Ranges for certain pregnancy landmarks and obstetrical tests. When properly aligned with the Calendar Scale, the associated range of dates for scheduling these tests is displayed. The Right Cursor line can be used to accurately determine the boundaries of each test or landmark range.

Example:28 day cyclesLMP Feb 18

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Bi-Parietal Diameter ScaleBi-Parietal Diameter ScaleBPD scaleBPD scale

Displays the Average BPD (in cm) in the second and third trimesters, along with the Normal Range for BPD (within two standard deviations), for each gestational age and corresponding calendar date.

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On August 20, the Patient is 25 weeks 1 day gestation.

The minus 2 S.D.BPD = 5.9 cm

The plus 2 S.D.BPD = 6.8 cm

The AverageBPD = 6.4 cm

Using the BPD scaleUsing the BPD scale

The Red reference lines cross at plus and minus 2 standard deviations

Align the Right Cursor on the gestational date.

The Average BPD is 6.4 cm, with a Normal Range of 5.9 cm to 6.8 cm

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Femur Length ScaleFemur Length Scale FL scaleFL scale

Displays the Average Femur Length (in cm) in the second and third trimesters, along with the Normal Range for FL (within two standard deviations), for each gestational age and corresponding calendar date.

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Using the Femur Length ScaleUsing the Femur Length Scale

The minus 2 S.D.F.L. = 4.35 cm

The AverageF.L. = 4.7 cm

The plus 2 S.D.F.L. = 5.0 cm

On August 20, the Patient is 25 weeks 1 day Gestation

The Red reference lines cross at plus and minus 2 standard deviations

Align the Right Cursor On the gestational date.

The Average FL is 4.7 cm, with a Normal Range of 4.35 cm to 5.0 cm

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Using the BPD scale with Unknown DatesUsing the BPD scale with Unknown DatesA Patient with Unknown Dates has a BPD of 8.1 cm. Position the Right Cursor so that the second RED reference lines cross directly over the 8.1 cm mark on the BPD scale, and read the associated gestational age (29 weeks 6 days). Then reposition the cursor until the first RED reference lines cross directly over the 8.1 cm mark on the BPD scale, and read the associated gestational age (32 weeks 4 days).

The normal gestational age range for a BPD of 8.1 cm is between 29 weeks 6 days and 32 weeks 4 days. The Most Likely gestational age (cursor line on the 8.1 cm mark) is 31 weeks 1 day.

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Using the FL scale with Unknown DatesUsing the FL scale with Unknown DatesA Patient with Unknown Dates has a Femur Length of 6.5 cm. Position the Right Cursor so that the second RED reference lines cross directly over the 6.5 cm mark on the FL scale, and read the associated gestational age (31 weeks 3 days). Then reposition the cursor until the first RED reference lines cross directly over the 6.5 cm mark on the FL scale, and read the associated gestational age (35 weeks 1 day). The normal gestational age

range for a Femur Length of 6.5 cm is between 31 weeks 3 days and 35 weeks 1 day. The Most Likely gestational age (cursor line on the 6.5 cm mark) is 33 weeks 1 day.

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The day of the week (M Tu W Th F Sa Sun)for any calendar date is quickly displayed by alignment of the Weekday Scale.

This feature simplifies scheduling of future appointments, tests, and surgeries, or ofpinpointing past dates for LMP’s, etc, for up to five weeks before or after the currentdate without having to consult a calendar.

The Weekday Scale is at the top of the ‘Window’

Weekday ScaleWeekday Scale27

Using the Weekday ScaleUsing the Weekday Scale

Double bold lines are weekends. Monday markers are the first light line after each set of double bold lines.

If June 15 is a Monday, then a return Monday visit in 4 weeks will be on July 13.

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Genetic Risk TableGenetic Risk Table

Allows rapid determination of the Term delivery risk of Down syndrome, or of any aneuploidy based upon Maternal Age.

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Using the Genetic Risk TableUsing the Genetic Risk Table

At age 38, the risk ofDown’s is 1 in 180deliveries, and the riskof all aneuploidies is1 in 110 deliveries.

Align the window cursor line on the patient’s age (bottom scale), then read the risk of Down syndrome at the cursor position on the top scale, and the risk of any aneuploidy at the cursor position on the middle scale.

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Pre-Term Delivery Risk TablePre-Term Delivery Risk Table

Displays the chance ofNeonatal Survival and the chance of Significant Handicap in surviving infants based upon the Gestational Age at the time of delivery.

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Using the Pre-Term Delivery Risk TableUsing the Pre-Term Delivery Risk Table

If delivered at 23 weeks gestation, the infant has a 25% chance of survival, and a 40% chance of significant handicap.

Example:

Align the window cursor line on the gestational age at delivery (bottom scale), then read the risk of preterm survival at the cursor position on the top scale, and the risk of a significant handicap in the survivors at the cursor position on the middle scale.

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Cervical Length Risk of PreTerm LaborCervical Length Risk of PreTerm Labor

Displays the chance ofPreTerm Labor with

Positive fetal Fibronectin or with

Negative fetal Fibronectin

associated with theLength of the Cervix as determined by ultrasound.

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Using the Pre-Term Cervix Risk TableUsing the Pre-Term Cervix Risk Table

With a Cervical Length of 33 mm, the chance ofPreTerm labor is 11% if Fibronectin is Negative, but increases to 26% if Fibronectin is Positive.

Align the window cursor line on the Cervix Length (bottom scale), then read the risk of preterm labor if fetal fibronectin is positive at the cursor position on the top scale, and the risk of preterm labor if fetal fibronectin is negative at the cursor position on the middle scale.Example:

fFNPos

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Placenta Previa Perinatal Mortality RiskPlacenta Previa Perinatal Mortality Risk

Displays the risk ofPerinatal Mortality associated with the Gestational Age at the time of the first episode of significant vaginal bleeding.

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Using the Placenta Previa Mortality Risk ScaleUsing the Placenta Previa Mortality Risk Scale

A patient with complete placenta previa who has her first episode of significant vaginal bleeding at 33½ weeks gestation has an associated risk of fetal mortality of 12%.

Align the window cursor line on the Gestational Age at First Bleeding Episode (bottom scale), then read the risk of Perinatal Mortality at the cursor position on the top scale.

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Age Related IVF and IUI Success TableAge Related IVF and IUI Success Table

Displays the chance ofachieving Term Pregnancy withIn Vitro Fertilization (IVF), or withControlled Ovarian Hyper-stimulation followed by Intra Uterine Insemination (COH-IUI),

associated with Maternal Age at the time of therapy.

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Using the IVF and IUI Success Rate TableUsing the IVF and IUI Success Rate Table

At age 40, the average pregnancy rate with IVF is 21% and the average pregnancy rate with COH-IUI is 4% per cycle.

Align the window cursor line on the Maternal Age (bottom scale), then read the chance of achieving pregnancy per IVF cycle at the cursor position on the top scale, and the chance of achieving pregnancy per stimulated IUI cycle

at the cursor position on the middle scale.Example:

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Body Mass Index CalculatorBody Mass Index Calculator

Calculates the Patient’s Body Mass Index (BMI) from her Height and Weight, and displays the result using color coded body type ranges.

Use the Yellow field on Side B

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Using the BMI CalculatorUsing the BMI Calculator

Example:

Patient Weight is 160 lbs Patient Height is 5’ 6”

Align 5’ 6” with 160 lbs on the Height and Weight scales

The result is displayed in the BMI window:

BMI = 26

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BMI Body Type RangeBMI Body Type Range

The Patient’s BMI body type is indicated by the color coded range in the BMI result window.

For example, the range for Normal BMI is between 18.5 and 25, and the range for Overweight is between 25 and 30.

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Pregnancy SuperwheelPregnancy SuperwheelEstimated Fetal Weight Calculator DisclaimerEstimated Fetal Weight Calculator Disclaimer

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Estimated Fetal Weight CalculatorEstimated Fetal Weight CalculatorDetermines the normal range and percentile values of EFW for gestational ages between 20 and 42 weeks.

Use the Pink field on Side B

Calculates the Estimated Fetal Weight (EFW) from the Abdominal Circumference (AC) and the BiParietal Diameter (BPD).

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Using the EFW CalculatorUsing the EFW Calculator

Align 22.0 and 7.0 onthe AC and BPD scales:

BEWARE – The BPD scale runs Left to Right !

EFW = 1100 gms

The most likely gestational age is 28 weeks, with a normal range between 23 weeks and 31½ weeks.

Example:

7.58.5

The result is displayedin the EFW window:

Abd Circ = 22.0 cmBPD = 7.0 cm

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EFW Normal Range CalculationEFW Normal Range Calculation

At 40 weeks gestation, the Normal Range of EFW is between 2700 and 4150 gms. The average EFW is 3250 gms.

The 5th percentileEFW is 2700 gms

The 50th percentileEFW is 3250 gms

The 95th percentileEFW is 4150 gms

Example – to determine the normal range for fetal weight at 40 weeks gestation, align the 40 week mark against the 5th percentile line of the EFW graph, then read the low normal weight on the EFW scale. Next, realign the 40 week mark against the 95th percentile line, then read the high normal weight on the EFW scale.

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Early Pregnancy B-hCG CalculatorEarly Pregnancy B-hCG Calculator Use the Blue field on Side B

Determines the normal range and percentile values of the serum B-hCG level for gestational ages between 3 weeks 0 days and 5 weeks 2 days.

Calculates the gestational age range associated with B-hCG levels between10 and 5000 mIU/ml.

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Percentile Range of B-hCG ValuesPercentile Range of B-hCG Values

--- 5th Percentile

--- 25th Percentile

--- 50th percentile

--- 75th Percentile

--- 95th Percentile

The percentile range of B-hCG values is plotted on the blue field graph, and is read against the gestational age scale when aligned with the associated serum level on the B-hCG scale.

Example - For a B-hCG level of 1060 mIU/ml , the Normal Range for gestational age is between 4 weeks 4 days and 4 weeks 6 days.

The most likely gestational age is 4 weeks 5 days.

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B-hCG Normal Range CalculationB-hCG Normal Range Calculation

At 4 weeks 3 days gestation, the Normal Range of B-hCG is between 290 and 750 mIU/ml. The average level is 480 mIU/ml.

The 5th percentile B-hCG level is 290 mIU/ml

The 50th percentile B-hCG level is 480 mIU/ml

The 95th percentile B-hCG level is 750 mIU/ml

Example – to determine the normal range for B-hCG at 4 weeks 3 days gestation, align the 4 week 3 day mark against the 5th percentile line of the B-hCG graph, then read the low normal level on the B-hCG scale. Next, realign the 4 week 3 day mark against the 95th percentile line, then read the high normal level on the B-hCG scale.

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Refer to the Fertility Treatment Center for:Refer to the Fertility Treatment Center for:

Female Age > 35. Most women are unaware of the dramatic decline in fertility after age 35. The American Society for Reproductive Medicine encourages physicians to inform patients of the loss of fertility and to accelerate treatment in this age group.

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Day 3 FSH > 8. A significant decrease in fertility is documented in women with FSH levels greater than 8 on cycle day 3, and fertility therapy is usually required for these women to achieve pregnancy.

Not Pregnant after Three Treatment Cycles. The pregnancy rate per cycle decreases after the third clomiphene (Clomid) treatment cycle, and more advanced therapy is usually required to restore high success rates.

Blocked Tubes. In addition to standard In Vitro Fertilization therapy, patients with tubal occlusion are often candidates for HSG guided or hysteroscopic guided tubal cannulation procedures, or outpatient laparoscopic laser neosalpingostomy.

480-831-2445

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Hydrosalpinx. Backflow of stagnant hydrosalpinx fluid may be toxic to sperm, eggs, or embryos in the uterus, and appropriate treatment can double pregnancy rates.

Refer to the Fertility Treatment Center for:Refer to the Fertility Treatment Center for:

BTL. Pregnancy after Bilateral Tubal Ligation can be achieved with our outpatient laparoscopic tubal reanastimosis program, or by bypassing the tubes with In Vitro Fertilization.

Vasectomy. Pregnancy after Vasectomy can be achieved with our outpatient vasectomy reversal program, or by testicular or epididimal sperm extraction followed by In Vitro Fertilization using ICSI. Donor sperm IUI is a low cost alternative.

Endometriosis. Depending on the severity of Endometriosis and clinical indications, the appropriate treatment is selected, including aromatase inhibition, GnRH analogs, continuous steroids, androgens, or laparoscopic laser ablation.

Adhesions. Impaired fertility or pelvic pain caused by Pelvic Adhesions are treated with advanced laparoscopic superpulse laser lysis surgery, or are bypassed with In Vitro Fertilization therapy.

Low Sperm Count or Motility. Sperm Counts < 20 million/ml or Motility < 60% are concentrated by centrifuge and density gradient techniques, followed by IntraUterine Insemination. High pregnancy rates can be achieved with profoundly low sperm counts using In Vitro Fertilization with Inter Cytoplasmic Sperm Injection (ICSI).

Refer to the Fertility Treatment Center for:Refer to the Fertility Treatment Center for:51

PCOS. A large variety of customized treatment options are available for women with Polycystic Ovary Syndrome, including aromatase inhibition, insulin sensitization, androgen receptor antagonist, and laparoscopic ovarian diathermy/wedge resection.

Fasting Insulin > 12 or Glucose/Insulin ratio < 8. These lab results are typically diagnostic of Insulin Resistance, which has recently been associated with ovulation dysfunction, recurrent miscarriage, PCOS, and gestational diabetes. Our insulin resistance program provides effective therapy for all of these conditions.

Recurrent Miscarriage. Women with a history of two or more miscarriages are evaluated for anatomic, endocrine, genetic, and immune disorders associated with pregnancy loss, then receive the appropriate targeted therapy to minimize sAb.

PGD. Couples at risk for having children with genetic disorders, such as Cystic Fibrosis, Sickle Cell, Thalasemia, Tay Sachs, Huntington’s, or age related Down syndrome, qualify for our Preimplantation Genetic Diagnosis clinic. Over 60 genetic syndromes can be detected and screened by PCR or FISH technology in the IVF embryos before they are transferred into the uterus. Genetic counseling services for the couple are an intrigral part of the PGD program.

Family Balancing. Selecting the sex of a baby using In Vitro Fertilization PGD is available to couples with X-linked genetic disorders, or who already have one or more children of the opposite sex.

Infertility Diagnostic CycleInfertility Diagnostic CycleOver 80% of infertility pathology (excluding endometriosis or adhesions) can be diagnosed during a single menstrual cycle using a series of simple office tests:

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1. BBT Chart - The Basal Body Temperature chart is used as a reference for the other tests during the cycle. Continuing the BBT chart after the diagnostic cycle is tedious and no longer necessary.

2. Lab Tests - LH, FSH, Prolactin, and TSH are drawn on cycle days 1, 2 or 3.

5. Urine Ovulation Test Kit - Test once per day, beginning on cycle day 10. Ovulation occurs the day after this test turns positive, and all remaining diagnostic cycle tests are scheduled using the positive test as a reference day.

3. Semen Analysis is usually done before cycle day 8 (so it won’t affect PCT results).

4. Hyterosalpingogram X-ray (HSG) - done between cycle days 6 and 10. Refer patients to the HI-TEC facility (page 54) for HSG’s done by a BC/BE Reproductive Endocrinologist using advanced digital equipment and with tubal catheter standby.

6. Post Coital Test (PCT) - done the day after positive urine LH surge, with cervical mucus examined under the microscope 3 to 12 hours after intercourse.

7. Mid Luteal Progesterone (MLP) - serum progesterone level is drawn 5 to 6 days after positive urine LH surge.

8. Endometrial Biopsy (EMB) - is done 11 to 12 days after positive urine LH surge test, with the histologic cycle day then compared to the actual cycle day.

Fertility Treatment Center ServicesFertility Treatment Center Services53

Pre Implantation Genetic Diagnosis (PGD) - for recessive, dominant, or X-linked disorders, advanced maternal age, recurrent miscarriage, and family balancing.

Basic and Advanced Infertility Evaluation and Therapy - includes diagnostic cycles, complex ovarian stimulation protocols, & custom sperm processing for IUI and frozen storage.

480-831-2445

In Vitro Fertilization and ICSI - Typically the most successful method to achieve pregnancy for tubal damage, oligospermia, maternal age, or failed standard therapy.

Outpatient Reversal of Tubal Ligation - using advanced laparoscopic techniques.

High IVF and FET Success Rates - among the highest in the Western States.

Donor Egg In Vitro Fertilization - High pregnancy rates for advanced maternal age, prior oophorectomy, ovarian failure, post chemotherapy, or female genetic disorder.

PCOS and Insulin Resistance Treatment - resulting in weight loss, improved ovulation, reduced miscarriage rate, cycle regulation, and decreased hirsuitism.

Recurrent Miscarriage - testing and treatment for all five diagnosis categories.

Ovarian Diathermy - outpatient laparoscopic PCOS ovarian wedge resection.

Donor Sperm (AID) insemination using IUI and quarantined samples.

HSG and Hysteroscopy ServicesHSG and Hysteroscopy Services 54

The Hysteroscopic Imaging and Tubal Evaluation Center “HI-TEC” - provides on site female reproductive tract evaluation and corrective therapy using advanced optical and digital imaging systems. Located at the Fertility Treatment Center, all operative and diagnostic HSG and hysteroscopic procedures are performed by BE/BC reproductive endocrinology and infertility subspecialists.

Hysterosalpingogram X-ray - using low dose X-ray equipment with digital amplifica-tion for diagnostic and operative HSG procedures. Fluoroscopic guided tubal cannula-tions using Novy catheters are done at the time of proximal occlusion diagnosis to avoid a second procedure, and to minimize the need for corrective surgery or IVF. All HSG procedures are done by reproductive endocrinologists, with IV sedation available. Hysteroscopy - on site office based diagnostic and operative hysteroscopies are done by reproductive endocrinologists using high resolution small caliber scopes. Uterine septum transections, endometrial polypectomies, submucous myomectomies, and tubal cannulations for proximal occlusions are available at our HI-TEC center. Procedures are done under IV sedation by an anesthetist to maximize patient comfort.

Pregnancy Superwheel Patent PendingCopyright - Craig 2004

International Center for Vasectomy Reversal FTC Research FoundationArizona Genetics and Fetal Medicine X and Y Consultants Egg Donation Service

The Apothecary Shoppe pharmacy is located on site, offering low fertility drug prices, a generous unused drug return policy, and weekend specialty drug availability.

The Fertility Treatment Center has no patient weight or maternal age restrictions

The Fertility Treatment CenterThe Fertility Treatment Center

MAIN OFFICEDobson Professional Plaza3200 N Dobson RoadSuite F-7Chandler, AZ 85224Phone 480-831-2445Fax 480-897-1283

SCOTTSDALE OFFICECornwell Corporate Centre14861 N Scottsdale RoadSuite 115Scottsdale, AZ 85254Phone 480-998-9876Fax 480-998-4024

Member of SART and ASRM

The Reproductive Medical InstituteAffiliated with: