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Choosing the Right Path: IVF Considerations and Clinics in Dallas
In the journey towards parenthood, many couples encounter unexpected challenges. Infertility affects millions worldwide, and for those who seek assisted reproductive technologies (ART), In Vitro Fertilization (IVF) stands as a beacon of hope. Today, let’s delve deep into understanding IVF, its intricacies, and the transformative possibilities it offers.
What is IVF?
IVF, or In Vitro Fertilization, is a fertility treatment where eggs are retrieved from the ovaries and fertilized with sperm in a laboratory setting. The resulting embryos are then implanted into the uterus. This groundbreaking technique has revolutionized reproductive medicine, offering a pathway to conception for individuals and couples facing various infertility issues.
The IVF Process:
1. Initial Consultation:
The journey typically begins with an initial consultation with a reproductive endocrinologist at a reputable fertility clinic. In Dallas, Texas, one such renowned establishment is the Center for Reproductive Endocrinology. Led by the best IVF doctors in Dallas, they offer personalized care and cutting-edge treatments to aspiring parents.
2. Ovarian Stimulation:
Once the decision for IVF is made, the female partner undergoes ovarian stimulation using hormone injections. This process aims to stimulate the ovaries to produce multiple eggs, enhancing the chances of successful fertilization.
3. Egg Retrieval:
When the eggs are mature, they are retrieved through a minor surgical procedure known as follicular aspiration. This is usually performed under sedation to ensure comfort and safety.
4. Fertilization:
In the laboratory, the retrieved eggs are fertilized with sperm from the male partner or a donor. This can be done through traditional IVF or Intracytoplasmic Sperm Injection (ICSI), where a single sperm is injected directly into an egg.
5. Embryo Culture:
The fertilized eggs are monitored as they develop into embryos over the next few days. The healthiest embryos are selected for transfer.
6. Embryo Transfer:
Typically, one or two embryos are transferred into the uterus using a thin catheter. Any remaining embryos of good quality may be cryopreserved (frozen) for future use.
7. Pregnancy Test:
Approximately two weeks after embryo transfer, a pregnancy test is conducted to determine if the procedure was successful.
Who Can Benefit from IVF?
IVF is a versatile fertility treatment that can help individuals and couples facing various challenges, including:
Tubal Factor Infertility: When fallopian tubes are blocked or damaged, preventing natural conception.
Male Factor Infertility: In cases of low sperm count or motility, or abnormal sperm morphology.
Unexplained Infertility: When the cause of infertility cannot be determined through conventional testing.
Age-related Infertility: Women of advanced reproductive age may benefit from IVF due to diminished ovarian reserve.
Genetic Disorders: Couples at risk of passing on genetic disorders to their offspring may opt for preimplantation genetic testing (PGT) during IVF.
Success Rates and Considerations:
While IVF offers hope to many, it’s essential to understand that success rates can vary depending on various factors, including age, reproductive health, and the quality of the clinic and medical team. Choosing the best fertility clinic in Dallas, TX, with experienced doctors and state-of-the-art facilities, such as the Center for Reproductive Endocrinology, can significantly impact outcomes.
Emotional and Financial Considerations:
Embarking on the IVF journey can be emotionally and financially taxing. It’s crucial for individuals and couples to prepare themselves mentally and seek support when needed. Many fertility clinics offer counseling services to help navigate the emotional rollercoaster of infertility treatment.
Conclusion:
In Vitro Fertilization (IVF) has transformed the landscape of reproductive medicine, offering hope and possibilities to those struggling with infertility. With advancements in technology and the expertise of skilled medical professionals, such as the best IVF doctors in Dallas at the Center for Reproductive Endocrinology, the dream of parenthood is within reach for many. As we continue to unravel the complexities of human reproduction, IVF stands as a beacon of hope, lighting the way for countless individuals and couples on their journey to parenthood.
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Update on Texas Reproductive Laws
- The US Supreme Court overturned Roe vs. Wade and the Texas Human Life Protection Act took effect in 2022. This law defines embryos an “unborn child” starting at fertilization and includes embryonic stages. This law bans all abortions unless the mother has “a life-threatening physical condition like an ectopic pregnancy. To date, the Texas abortion law only applies to women who are already pregnant, not to embryos outside the womb.
- In 2023, in Antoun vs. Antoun, the Texas Court of Appeals rejected the argument that embryos were children and upheld the definition used in IVF clinic’s consents that defines embryos as “property”.
- So far, two of Texas most vocal anti-abortion groups, Texas Alliance for Life and Texas Right to Life have stated that Texas abortions Laws should not affect or prevent IVF treatments, even when embryos are concerned.
- However, to date, the term “live unborn child” in the Texas Human Life Protection Act is still undefined and confusing. The Texas Supreme Court may address this issue at any time and a petition for the “protection of IVF embryos” has been filed and is pending.
- We will continue to update you in case there is any change in the current law.
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How to make the dietary choices to help your fertility
January often feels like the right time to start fresh – making new commitments to a well-lived life. For people seeking to grow their family, many often wonder, “is there anything I can do with my lifestyle to help make that happen?” Thankfully, many dedicated researchers have committed their careers to understand the impact of nutritional choices on fertility. Patients can take this best information to guide their own lifestyle choices as they continue their fertility journeys.
The three dietary patterns associated with the best fertility outcomes have been called the “fertility diet,” “the pro-fertility diet,” and the Mediterranean diet.
The “fertility diet” features:
More monounsaturated fats, reduced saturated and especially trans fats (Examples of monounsaturated fats include olive, canola, avocado, and sesame oils, as well as nuts and peanuts, while saturated fats often come from animal sources, such as butter and fatty meats)
More vegetable protein and decreased animal protein
Low-glycemic carbohydrates (see https://www.nhrmc.org/~/media/testupload/files/low-gylcemic-meal-planning.pdf for a complete list)
Inclusion of dairy
This diet has been shown to be particularly helpful in women with irregular menstrual cycles and ovulatory dysfunction.
The “pro-fertility diet” includes the elements of “the fertility diet,” plus:
Supplemental folate/folic acid
Supplemental Vitamin B12 and D
Reduced pesticide intake – e.g., avoidance of the “dirty dozen” fruits and vegetables, or a change to an organic/selectively organic diet
Increased whole grains
Inclusion of seafood (fish and/or shellfish) in the diet
This diet has been shown to be associated with more successful IVF outcomes.
The Mediterranean diet is not simply eating Italian food all the time. Rather, it includes:
Whole grains rather than simple carbohydrates (e.g. sugars, white rice/bread/pasta)
Plant-based oils rather than butter and animal fats
Significant vegetable proteins from nuts and legumes, moderate lean animal proteins from fish and poultry, and minimal red meat
In addition to being associated with better chances of conception (both at home and assisted), the Mediterranean diet has been named the healthiest overall dietary plan for the sixth year in a row by leading nutritional experts.
It is important to recognize that dietary changes are rarely the only thing a couple needs. For instance, no specific diet will open blocked tubes, make fibroids disappear, or serve as a “fountain of youth” to reverse the well-documented impairment that advancing age has on egg quality (and thus fertility). Incorporating these dietary changes generally works best when done alongside fertility evaluation and management by a board-certified endocrinologist.
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Fresh vs. Frozen Embryo Transfer: Exploring the Differences
There are many decisions to make on your journey to becoming a parent. Which infertility clinic is a good fit? What treatments are you willing to undergo? Is it better to transfer fresh or frozen embryos for IVF (In Vitro Fertilization)? Luckily, your treatment team can help guide you to the choices that are right for you, and Dr. Walid Saleh of SIRM Dallas in Dallas, Texas can give you some insight into the pros and cons of fresh versus frozen embryo transfer below.
A Fresh Perspective
All embryos start out fresh. In a woman’s initial IVF cycle, she takes medication to first “quiet” the ovaries followed by medication to stimulate them to produce extra eggs. After the eggs have been surgically retrieved, they are fertilized. The resulting embryos grow in a special incubator until they are ready to be transferred to the uterus. In most cases, one embryo is selected for transfer and the remaining embryos are frozen. Fresh cycles were, for decades, the gold standard…until the last few years when rapid advancements in freezing and cryopreservation methods improved the outcome of frozen embryo transfers.
Back in the Day
First, a little history on frozen embryo transfer (FET). Embryos were initially frozen slowly which caused intracellular ice to form; unfortunately, the ice often damaged the embryos. Many damaged embryos didn’t survive, and those that did had very low potential for successful implantation. However, in the last several years we’ve seen a dramatic increase in the quality of frozen embryos due to the introduction of vitrification. Vitrification is an ultra-rapid freezing method that freezes the embryo approximately 60,000 times faster than the older method of freezing. This process takes ice formation out of the equation, resulting in a significant increase in viable embryos with successful implantation and pregnancy potential equal to fresh embryos.
If you think frozen embryo transfers may be right for you, schedule an appointment at SIRM Dallas in Dallas, Texas to learn more.
Timing is Everything
Another reason we see markedly higher FET success rates now than several years ago is that the timing of when the embryo is frozen has changed. It’s been shown that freezing blastocysts (embryo at day 5-6) has a better outcome than freezing early-cleaved embryos (day 2-3). In many cases embryos that don’t successfully develop to the expanded blastocyst stage are aneuploid (chromosomally compromised) and don’t result in healthy babies. An additional benefit of frozen embryo transfers using expanded blastocysts is that fewer embryos – because we’re able to determine which are most viable – need to be transferred. This means we can minimize the chance of a multiple pregnancy, along with the inherent risks to both mom and baby.
Fresh or Frozen?
At this point, studies show that successful outcomes using frozen embryo transfers are about equal to those of fresh embryo transfers. The slight edge that fresh embryo transfer may have is that, typically, the best embryo is selected for the first transfer. However, there are some key benefits that make FET appealing:
Because you underwent ovarian stimulation and egg retrieval for your fresh cycle, you won’t have to go through it again. The medications necessary to prepare your body for FET have fewer potential side effects and take less of a toll on your body.
Many patients report that FET cycles are not nearly as stressful as fresh cycles since they already know they have viable embryos.
It’s easier to schedule and plan for FET cycles than fresh cycles.
If you’d like to learn more about how fresh and/or frozen embryo transfers and IVF may benefit you, schedule an appointment at SIRM Dallas in Dallas, Texas to meet with Dr. Saleh and discuss your options.
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Genetic Testing – Preimplantation Genetic Diagnosis (PGD)
Also known as Preimplantation Genetic Screening, the purpose of this process is to evaluate the chromosomal makeup of an egg/embryo. Because the majority of miscarriages are due to chromosomal abnormalities, many couples undergo Preimplantation Genetic Diagnosis in order to select embryos that are chromosomally “normal” and increase their chances of IVF success. An egg/embryo with too many or too few chromosomes will either fall under the following:
- Fail to implant in the uterus
- Lead to a miscarriage
- Result in a chromosomal birth defect such as Down Syndrome or Turner Syndrome
Should I have genetic testing/PGD done on my embryos?
This depends on a number of factors including your age, medical history, and other risk factors. As a rule, genetic testing can improve pregnancy rates by identifying those embryos that are most likely to make a baby. The additional cost may negate the advantages for some couples. Another reason for having genetic testing done is for Gender Selection. IVF with PGD is really the only accurate method of gender selection available.
Preimplantation Genetic Diagnosis (PGD) Gender Selection
Another reason for performing PGD is for family balancing through gender selection. Because the gender chromosomes are identified during PGD, it is possible to select a “male” or “female” embryo for transfer to the uterus. There are several methods of PGD, the most common of which is known as Fluorescence In Situ Hybridization (FISH). This method screens 8-12 pairs of chromosomes. After the egg is fertilized and progresses to the embryo stage, one or more cells are removed from each embryo to be tested. The cells are then analyzed via the FISH process and any extra or missing chromosomes are revealed (an extra or missing chromosome is referred to as Aneuploidy).
The shortcoming of FISH as a method of PGD is in the fact that it only screens 8-12 pairs of an embryo’s 23 pairs of chromosomes, so it is far from 100% accurate. Until recently, FISH was virtually the only way to screen embryos for Aneuploidy prior to IVF embryo transfer. A new method refined by CRE (previously SIRM-Dallas) known as Comparative Genomic Hybridization (CGH) evaluates all 23 pairs of chromosomes for a far more comprehensive analysis. CGH is available at Center for Reproductive Endocrinology (previously SIRM-Dallas).
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In Vitro Fertilization: A Comprehensive Guide
Introduction:
In the realm of reproductive medicine, In Vitro Fertilization (IVF) stands as a beacon of hope for individuals and couples grappling with infertility. This groundbreaking technique navigates the intricate landscape of both male and female reproductive systems, addressing conditions that impede natural conception. The term “in vitro,” derived from Latin, meaning “in glass,” encapsulates the essence of this process, as fertilization takes place within a controlled environment, symbolized by a glass container in the laboratory.
Understanding the IVF Process:
At its core, IVF is a meticulous orchestration of laboratory and assisted reproductive techniques. The primary objective is to enhance the likelihood of successful sperm-egg fertilization, culminating in the formation of a healthy embryo. This multifaceted process involves several key steps, including ovarian stimulation, egg retrieval, fertilization in the laboratory, embryo culture, and ultimately, embryo transfer. Each phase is carefully calibrated to optimize the chances of a successful pregnancy.
Unraveling the Complexity of Infertility:
Infertility, a condition that affects a significant number of individuals worldwide, arises when natural conception is compromised. Structural abnormalities or imbalances in reproductive hormones within the male, the female, or both can thwart the intricate dance of fertilization. The decision to pursue IVF often hinges on a thorough understanding of these factors, as well as a personalized assessment of whether the procedure is a suitable course of action.
Is IVF Right for Me?:
The question of whether IVF is the right path is deeply personal and involves a comprehensive evaluation of various factors. Structural issues within the reproductive systems, such as blocked fallopian tubes or low sperm count, can be significant indicators for the use of IVF. Similarly, hormonal imbalances that disrupt the delicate interplay of reproductive processes may also prompt consideration of this assisted reproductive technology. Consulting with fertility specialists and undergoing thorough diagnostic assessments helps individuals and couples make informed decisions about the most appropriate fertility treatment for their unique circumstances.
The Laboratory as a Gateway to Possibility:
The pivotal shift of the fertilization process into the laboratory is a defining aspect of IVF. By doing so, fertility specialists extend a lifeline to those who may have faced insurmountable challenges in conceiving naturally. This controlled environment allows for a level of precision and intervention not possible within the confines of the human body alone.
Empowering Parenthood:
The crux of IVF lies in its ability to empower individuals and couples with the possibility of parenthood that might otherwise be unattainable or highly unlikely. The controlled setting of the laboratory enables fertility specialists to overcome natural limitations by combining a greater quantity of sperm with a heightened number of eggs. This strategic merging substantially increases the chances of creating a robust and healthy embryo, laying the foundation for successful implantation and, ultimately, a viable pregnancy.
Breaking Down Barriers:
IVF serves as a groundbreaking solution that breaks down barriers imposed by infertility. It offers a renewed sense of hope to those who have faced the heartache of unsuccessful attempts at conception. By delving into the intricacies of reproductive biology within the laboratory, IVF transcends the limitations imposed by natural processes, providing a tangible pathway to parenthood.
Conclusion:
In vitro fertilization, with its roots in the Latin term “in vitro,” exemplifies the transformative power of science and medicine in the realm of reproductive health. It not only addresses the complexities of infertility but also opens doors to parenthood for individuals and couples navigating the challenging journey of conception. As technology continues to advance, IVF stands as a testament to the remarkable strides made in the field of assisted reproductive technologies, offering a beacon of hope for those in pursuit of the dream of building a family.
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Fertility Preservation in Dallas, Texas
As the success rates for cancer treatments continue to rise, more and more patients are living long, active lives. While cancer treatments have allowed patients to survive at higher rates, they also can have a negative impact on fertility.
Fertility Preservation for Women Before Cancer Treatment
Chemotherapy and radiation have both been shown to negatively affect the fertility of both men and women, often damaging eggs and possible leaving the woman infertile. Freezing a woman’s eggs, or embryos created using sperm from her partner or an anonymous donor, can provide women with the chance to have a biological child in the future.
Fertility Preservation Process:
- Fertility specialists of CRE (previously SIRM-Dallas) will induce the maturation of the eggs and retrieve them as would be done for an IVF cycle
- If the patient does not have a partner, or would prefer not to use donor sperm, we would then freeze her eggs through a process called vitrification
- If the patient would like to freeze embryos instead of eggs, CRE’s (previously SIRM-Dallas) fertility specialists would then fertilize the retrieved eggs with sperm from her partner or an anonymous donor prior to being vitrified and stored for later use.
- When the patient is ready to use her frozen eggs or embryos, they will be retrieved from storage and thawed. Frozen eggs that have survived the oocyte freezing process will be fertilized in vitro and the resulting embryo(s) will be transferred to the patient’s uterus.
Fertility Preservation for Men Before Cancer Treatment
Men undergoing cancer treatment are also encouraged to freeze their sperm prior to undergoing treatments such as radiation or chemotherapy, as these treatments can leave men infertile. Patient’s seeking to freeze their sperm will be able to provide a sample to the fertility experts at CRE (previously SIRM-Dallas), which will then be frozen and stored until the patient is ready to use them through IUI or IVF.
To learn more about your fertility preservations options, contact the fertility specialists of CRE (previously SIRM-Dallas) today at 972-566-6686.
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What Are the Advantages of In Vitro Fertilization (IVF)?
The main advantages of In Vitro Fertilization by Center for Reproductive Endocrinology.
In Vitro Fertilization is a reproductive treatment that has been revolutionizing fertility treatments for women. An egg cell is fertilized outside of the body during the treatment process. The process allows couples to overcome fertility issues and helps families grow. Achieving a successful pregnancy and conceive a healthy baby is the ultimate goal of IVF. Here are some of the major benefits of IVF treatment from Center for Reproductive Endocrinology:
High Success Rate & Safety
IVF is one of the most effective fertility treatments available. The strategy employs the few medications with the lower negative effects. IVF with PGT has the highest success rate of all of the other assisted reproductive options. The treatment ensures a successful pregnancy. Methods like IUI do not guarantee success even after a lot of effort. Patients under the age of 35 have a higher rate of success. Patients in their late 30s can also have good results. IVF can not only effective but it is also safe. IVF can maximize the chance of older patients conceiving.
Fertility Preservation
People’s biological clock begins to slow down as they become older. IVF allows a patient to freeze eggs at a young age that can be conceived later with the use of IVF. IVF treatment can now help women of all ages become mothers. Individuals often preserve eggs for research or donation if they are in good condition. IVF treatment can be especially helpful to women who have undergone treatment that can impact fertility.
Prevent Inherited Diseases in Child
IVF with pre-implantation genetic testing (PGT) is one of the most reliable techniques for individuals who are carriers of genetic illnesses. This procedure can be crucial in screening embryos for chromosomal problems including Down’s syndrome, preimplantation genetic screening (PGS) can boost the odds of a successful outcome.
A Reduced Chance of Miscarriage
A genetic mutation in the body is one of the most common causes of miscarriage. PGT is along with IVF to identify whether an embryo is genetically viable ahead of time, increasing the chances of a healthy pregnancy. It can be helpful in preventing the grief and trauma of a miscarriage for families.
Donation of Eggs or Sperm
Optimistic parents aren’t often able to generate viable eggs or sperm. IVF treatment uses donated egg, donor sperm, or both. Same-sex couples can use donated eggs and sperm to conceive through IVF. The treatment is also used for surrogate in the quest for kids. The egg are manually fertilized in the clinic and a resulting, viable embryo is available for IVF in such cases. This treatment is extremely helpful for people with fertility problems.
Call the Center for Reproductive Endocrinology (CRE) if you’re having trouble starting a family. You can chat with one of their double board-certified specialists about how procedures like IVF can help you reach your goals. During a consultation, they conduct a thorough study to determine whether IVF or one of our other reproductive treatments is the right option for you.
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Fertility Awareness: Knowing Where You Stand
Do you have concerns about your fertility? If you’re a millennial woman, you’re not alone – 2 in 3 millennial women have concerns about their fertility, but few talk about it. But for young women today, many of whom are delaying motherhood for a variety of personal and professional reasons, knowing where they stand with their fertility can help them make informed decisions about their plans for building the family of their dreams.
Here, Dr. Walid Saleh of SIRM Dallas in Dallas, Texas, goes over how women can get a clear picture of their fertility – and how to plan for the future if there are any concerns with the results.
The Information You Need
What does your reproductive health look like? While many women believe that their healthy lifestyles can allow them to achieve and maintain a pregnancy into their 40s, the truth of the matter is that age and family history are some of the biggest indicators of a woman’s fertility. If the women in your family had difficulty achieving or carrying a pregnancy, or if you are an only child, can mean that you may have difficulty building your family as well.
Additionally, fertility testing can help you get the full picture of your reproductive health. These tests allow a fertility specialist to check your uterus for abnormalities, make sure your tubes are open, and check your ovarian reserve – or how many eggs you likely have left (and whether or not it’s high or low compared to others your age).
Rapid Fertility Screenings
At SIRM Dallas, a fertility center in Dallas, Texas, we offer a convenient Rapid Fertility Screening for women and couples. All tests can occur in our office on the same day, with results ready within 48 hours.
Our rapid fertility screenings include the following:
- Anti Mullerian Hormone Screening (AMH): This allows us to measure your ovarian reserve, letting us know how big your future fertility window may be, and how well your body would likely respond to fertility drugs if you choose to pursue treatment.
- Hysterosalpingogram: A quick, minimally invasive procedure that allows us to check the shape of your uterus and whether or not your fallopian tubes are open.
- Semen Analysis: For couples, this is an important exam that will determine male fertility as well (one third of infertility cases are due to male factors).
Elective Egg Freezing
So what can you do if you find out that your ovarian reserve is low and your future fertility window may be small? Thanks to technological advances in egg freezing, women can now choose to freeze their eggs to preserve their future fertility. This will allow you to collect multiple eggs, freeze them, and store them for future use, giving you another option for building your family in the future.
Being aware of your fertility and having the option to plan for your future family is something young women should strongly consider. If you would like to learn more about SIRM Dallas’ Rapid Fertility Screening or about your options for elective egg freezing, contact our team today at 972-566-6686 to schedule an appointment with our fertility specialist.
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Does Stress Affect My IVF Outcome?
Your family and friends may have told you countless times to “stop stressing out” and that “it would improve your chances of success” with in vitro fertilization (IVF) if you were less stressed. This may be completely inaccurate and probably makes you even more stressed. While stress may affect your production of stress hormones, the regularity of your menstrual cycles, and ultimately fertility itself, the relationship of stress with IVF outcome is unproven. In IVF, ovaries are stimulated and eggs are mechanically retrieved without relying on your natural menstrual cycle. Many studies have looked at the relationship between stressand IVF outcome and the results are mixed at best…the same way you would get a 50/50 result when tossing a coin. A Swedish study followed 166 women after their first IVF cycle and found no association between outcome and stress levels1.
I have had many patients who conceived that were emotional wrecks during the ten-day waiting time prior to their beta hCG pregnancy test results. Conversely, many who were calm did not conceive. While stress is a natural coping mechanism for infertility and IVF treatments, it does not affect the quality of your eggs at the molecular level. In the end, the ultimate limiting factor in reproduction is the stability of your eggs’ DNA, not your emotional state. Of course, stress is bothersome to most and it is helpful to learn coping strategies to suppress it and improve your quality of life. It will not, however, affect your IVF outcome. It is important to avoid feeling guilty, convinced that somehow you were responsible for any bad outcome of your IVF treatment. If history has taught us anything, it’s that high stress levels do not affect human fertility. Fertility or miscarriage rates are not affected by events around us. War prisoners, for example, do not have a higher chance of miscarriage or infertility than the non-prisoner population, and this is clearly a high stress environment. In the end, the “seeds” decide the outcome. I find that counseling my patients about the lack of negative effects actually helps reduce their stress level. In the end, stress declines to a large extent once the pregnancy is going well and a nice fetal heartbeat is detected at your six-and-a-half week ultrasound.
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Center for Reproductive Endocrinology 