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Due to the recent rise and concern of Coronavirus, we are taking every measure to protect our patients. In addition to following CDC guidelines, please note that we will only be allowing new or active female and male patients in our facility at this time. For any upcoming procedures, we will only allow one escort for transportation into the facility.

We are now offering virtual consultations through ferTELEty©, Kofinas Fertility Group's telemedicine program!


    Discover the root cause of your fertility problems

    Once we know the source of your fertility issues, we will design your treatment plan to directly address them and give you the best possible chance for a healthy, complication-free pregnancy.
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    Talking Through ICSI Procedure and other Fertility Treatment Options

    Causes and Signs of Fertility Challenges

    Infertility is a common issue—one that can be a difficult journey to embark on if you and your partner aren't sure where to start. Even though you may be facing challenges, such as low sperm count or are in need of medication to increase fertility, that doesn't mean you're alone in the process. Kofinas Fertility Group specializes in giving you the best opportunity at starting a family, and our expert team of top fertility specialists can answer all the questions you have to alleviate any concerns.

    To give you a better idea of what kinds of issues you and your partner may be facing, we have constructed a guide that you can use to stay ahead of any unknown terrain. As you follow along, you'll learn about what infertility is, what the causes are, how you can identify signs of infertility in your body, and when to seek treatment.

    In addition, we will talk about therapy options that can help you through this difficult and emotional situation, what medical treatments you can seek, and what your insurance coverage and financing options are if treatment is necessary. 

    No matter what your experiences have been like so far, it's important to remember that you are taking steps in the right direction. Starting a family is a wonderful process that takes time, so try your best to be patient with yourselves and don't be afraid to seek assistance from the best. We’re here to help!

    Infertility 101

    Understanding the differences between fertility and infertility can be a little confusing since the terms are regularly used to describe the same concept. However, each one represents a stage of diagnosing a problem and taking steps to solve it. 

    According to The International Committee for Monitoring Assisted Reproductive Technologies (ICMART), infertility is recognized as the failure to achieve a successful pregnancy after 12 months of consistent, unprotected sexual intercourse. Infertility can also persist if a person's ability to reproduce as an individual or with a partner is impaired.

    If either of these situations is the case, fertility interventions may be started depending on the subject's age, physical condition, and medical, sexual, and reproductive history. Essentially, infertility means recognizing that there is a problem, whereas fertility means taking action to fix it. 

    Keep in mind, stating that someone is infertile represents a different meaning whether one is referring to a man or woman. In either case, it's important to know what infertility means for each sex. 

    Cartoon of Dr Kofinas Discussing Fertility Help
    Read More

    Infertility In Women

    Unfortunately, women bear the brunt of infertility issues when it comes to diagnosing reasons for unsuccessful pregnancies. In most cases, female ...
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    Infertility In Men

    The other 40% of sources of infertility among couples is largely due to a man's inability to produce optimal levels of healthy semen. When analyzing ...
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    Emotional and Financial Concerns

    Of course, deciding to start a family comes with its own obstacles, but dealing with infertility on either side can take a huge emotional and ...

    Understanding the Signs of Infertility

    Now that you understand the basics of infertility, the next thing to be aware of are any warning signs that can help distinguish your odds of getting pregnant.

    Before it's too late, there are early indicators of infertility that you can take charge of to make a difference. In addition, there are also risk factors that you should work to prevent in order to increase your chances of reproducing. Sadly, there are plenty of individuals or couples that will show no infertility signs at all even though they will face the symptoms.


    Here are several common things to consider for each sex:

    Warning Signs of Female Fertility Challenges

    Irregular Menstrual Periods

    Having a cycle that is inconsistent or unpredictable when compared to an average 28-day timeframe.

    Painful or Heavy Menstruation

    Periods that may be more painful than normal cramps, disrupting your daily life (potential sign of endometriosis).

    Hormonal Changes

    A change in sex drive, skin irritations, facial hair growth, damaged hair follicles, or excessive weight gain.

    Pain During Sexual Intercourse

    May be the result of hormonal fluctuations, endometriosis, or other issues that can increase odds of infertility.

    Polycystic Ovarian Syndrome (PCOS)

    A hormonal disorder that causes tiny cysts to form on the outer edge of swollen ovaries.
    Having a cycle that is inconsistent or unpredictable when compared to an average 28-day timeframe.
    Periods that may be more painful than normal cramps, disrupting your daily life (potential sign of endometriosis).
    A change in sex drive, skin irritations, facial hair growth, damaged hair follicles, or excessive weight gain.
    May be the result of hormonal fluctuations, endometriosis, or other issues that can increase odds of infertility.
    A hormonal disorder that causes tiny cysts to form on the outer edge of swollen ovaries.

    You should strive to cope with these signs with great care to avoid further complications as you begin your journey to a healthy pregnancy. As a reminder, couples who have been trying to achieve pregnancy over the course of 1 year with no results should consult with a doctor. If a woman is over the age of 35, she should seek assistance after a period of 6 months. Typically, issues with infertility tend to increase as a person gets older.

    Baby Conceived Through Surrogacy and Egg Donation with Help from Fertility Doctors in NYC


    Warning Signs of Male Fertility Challenges

    • Testicular Pain or Swelling:

      Issues with testicular pain or swelling could be caused by a variety of reasons, but many of them can also cause infertility.
    • Loss of Sexual Desire:

      A man's sexual desire is often linked to his hormones, so any changes in their sex drive could indicate problems of infertility.
    • Difficulty Keeping Erections:

      Issues maintaining an erection are also linked to insufficient hormone levels.
    • Ejaculatory Issues:

      Having consistent dry spells or losing the ability to ejaculate can indicate a serious underlying issue that requires attention.
    • Poor Testicular Health:

      Since the testicles are vital for sperm production, this condition can tell a lot about the reproductive health of an individual. If the testicles are small or firm, chances of infertility may be increased.

    One of the benefits of recognizing male infertility includes warning signs that potential issues are on the outside of the body. If any of these instances occur, undergoing an exam and speaking with a medical professional can be a tremendous help. Also, if any pain or discomfort is felt within the testes, seek immediate medical attention.

    Having problems on both sides is normal to encounter. It's estimated that roughly 15% of all couples trying to conceive a child will face infertility issues, so if you and a loved one are experiencing any difficulties, trust that you can overcome them with the right plan. Being aware of what common signs to look out for can help keep you prepared, but more importantly, there are a number of contributing causes of infertility that you should also consider.

    Take our Fertility Quiz to figure out where your journey should begin!

    Contributing Causes

    Along with common infertility signs, there are a number of contributing causes for each sex that you should understand in order to present the best odds of achieving pregnancy. We will also examine major risk factors that can increase infertility, giving you insight into what measures can be taken to lead a healthier lifestyle and maximize your efforts. 

    When reading through this section, be advised that some issues that cause infertility occur at birth for an individual. For others, infertility issues may develop over time. In either case, many issues can be solved with the right treatment, so any fears moving forward shouldn't deter you from starting the family you've dreamed of. 

    Additional Causes of Female Infertility

    We touched on some of the female fertility challenges in the previous section, but there are several extensions of common causes that you should understand:

    • There are several disorders that can damage the ovaries and their functionality. As mentioned before, PCOS (see Infertility 101) causes severe hormonal changes, hyperprolactinemia (when too much prolactin is created, stimulating breastmilk production) can damage the ovulation process, and fluctuating levels of hyperthyroidism can stifle the menstrual cycle, leading to infertility. In some cases, eating disorders, physical injuries, too much physical activity, and tumors have also been known to increase odds of infertility. 
    • Damaged fallopian tubes, uterus, or cervix have the potential to cause infertility due to several abnormalities or infections. For example, salpingitis is a condition where the fallopian tubes become enflamed, resulting in damage or blockage to passageways. Often, pelvic inflammatory disease is to blame, stemming from an STD, endometriosis, or other membranous fibers. When analyzing the uterus, harmful polyps can form that disrupt sperm penetration, as well as benign tumors (uterine fibroids) forming along the uterine wall and blocking the fallopian tubes in rare situations. 
    • Signs of early menopause (primary ovarian insufficiency) can occur in patients who are under the age of 40. In this circumstance, the ovaries stop functioning altogether, ending the menstrual cycle for unknown reasons. Possible reasons for early menopause have been linked to genetics (Turner syndrome, Fragile X syndrome) radiation therapy, chemotherapy, smoking cigarettes, and immune system diseases. However, most cases cannot be accurately diagnosed. 
    • After pelvic surgeries or pelvic-related issues (infections, appendicitis), scar tissue can form and block transport of the egg. This is known as pelvic adhesions, which is often a result of endometriosis. 
    • Cancers affecting reproductive organs have the potential to cause infertility. Unfortunately, radiation therapy and chemotherapy can make matters worse. 
    • There are a number of other medical issues that contribute to infertility in women. These include celiac disease, diabetes, lupus, and amenorrhea

    Additional Causes of Male Infertility

    Here are some other causes of male infertility to consider in addition to those listed in the previous section:

    Everyone's battle with infertility is different, and almost all of these conditions can be properly managed with professional help to ensure a healthy pregnancy.

    On the other hand, you are in control of many fertility factors on your own! Being aware of the following issues is only half the battle; the other 50% relies on you making good decisions and eliminating any risk factors that can increase your odds of a healthy pregnancy whenever possible. 


    Risk Factors & Prevention

    There are no specific risk factors tailored for only men or only women. Instead, these are general things to avoid that can make a tremendous difference in your reproductive health and stability.

    • Don't Start Trying Too Late:

      Remember, after the age of 35, female infertility starts to plummet. Female eggs have the best shot of attaching during a woman's early to late 20s. The same rules apply to men who are over the age of 40. Sperm quality and quantity tend to drop as you move away from younger years.
    • Quit Smoking:

      Aside from it being terrible for your general health, it's even worse on your chances of fertility. Smoking cigarettes leads to damaged fertility treatments, increased odds of miscarriages, erectile dysfunction, and a decreased sperm count. 
    • Obesity:

      Being overweight has a negative effect on your reproductive health due to constant inactivity, which can lead to infertility. For men, obesity has the potential to stunt sexual desire and lower sperm counts. 
    • Eating Disorders:

      Especially for women, making sure to eat enough calories and follow a balanced diet is crucial for a healthy pregnancy. Fertility issues can greatly increase from eating disorders, such as bulimia and anorexia
    • Not Exercising:

      If you don't exercise regularly, your health will start to deteriorate, increasing your odds of infertility. Additionally, a lack of exercise can lead to obesity or weak physical stature. To counteract any negative effects, make sure to stay physically active with moderate exercise. Doing this will increase sperm production and can help lead to a healthy pregnancy.

    Your ultimate goal is to maintain a healthy lifestyle so that your chances of achieving pregnancy are at an all-time high. Staying away from detrimental behavior will make a huge difference in your success, so make sure to take great care of yourself. 

    For couples looking to improve their odds of pregnancy a bit more, try your best to have consistent intercourse (several times) close to the ovulation period (a span of 5 days before and 1 day after). For women with 28-day menstrual cycles, ovulation periods can happen midway between menstruation. If challenges still persist after taking measures to have consistent sex and take control of your health, then knowing your options for treatment is the next best move.

    Knowing Your Fertility Treatment Options

    It can be intimidating to reach a point where you require fertility treatments to become pregnant, but Kofinas Fertility Group offers expert medical care and guidance to help you have the family you've always dreamed of. 

    To get started, a fertility specialist will give you a general assessment to have a complete understanding of your issues. Once the source of your infertility is discovered, a treatment plan will be designed for you that directly solves the problem and gives you the best possible chance for having a successful, complication-free pregnancy. During your assessment, you will undergo the following procedures:

    Ovulatory Function Evaluation

    Analysis of your ovulatory cycle to develop a strong treatment plan.


    Ultrasound and X-ray imaging to examine reproductive tract, discover any major issues, and develop targeted therapies.

    Sample Testing

    Gathering of reproductive samples to understand any issues or abnormalities that can prevent a healthy pregnancy.
    Analysis of your ovulatory cycle to develop a strong treatment plan.
    Ultrasound and X-ray imaging to examine reproductive tract, discover any major issues, and develop targeted therapies.
    Gathering of reproductive samples to understand any issues or abnormalities that can prevent a healthy pregnancy.

    Once your case is fully examined, you and your fertility team will put your unique treatment into action. Your unique fertility therapies might include some of the following:

    1. Low-complexity therapies
    2. Cryopreservation
    3. In vitro fertilization
    4. Genetic testing
    5. Donation & surrogacy
    6. Surgical procedures

    Each one has proven to be highly successful among former patients, and we at Kofinas Fertility Group are proud to be of service to so many wonderful families around the country.

    Rima F., one of our patients in October 2017, wrote that, "It was a long journey for me, with many twists and turns. But I always felt a lot of support from the staff at Kofinas, especially from the wonderful Dr. Brzechffa. I couldn't be more pleased with the results: a beautiful healthy son." On September 27, 2017, Marina G. wrote, "Kofinas Fertility Group made my dream come true." 

    There are plenty of testimonials to read through of happy patients living their lives to the fullest, and the start of your future is just one appointment away. Kofinas Fertility Group has a team of dedicated specialists and compassionate nurses who truly believe in the power of family. We make it our mission to help you achieve your fertility goals, while being strong advocates for your personal and long-term health. Potential patients can rest assured that all of your questions and needs will be taken care of with utmost patience and knowledge.

    We have many amazing resources available to patients, such as family counseling, LGBTQ therapy, online resources and FAQs, and our online patient portal to easily connect with professionals and seek assistance. We also have several financial and insurance opportunities that can help manage the cost of expensive treatments. 

    Financial and Insurance Opportunities

    People often assume infertility treatments come with outrageous price tags, but in fact, there are several ways to offset high prices and come up with a plan that is easy to manage financially. 

    It's important to remember that most patients will become pregnant using less expensive treatment options, such as intrauterine insemination (IUI) or by treating medical conditions (such as ovulatory disorders). Something like an in vitro fertilization (IVF), which can be pricey with initial costs and medications, will only be required for a small percentage of patients. Typically, any treatment options can be financed with third-party loan options from Prosper Healthcare Lending. In addition, Kofinas Fertility Group offers an Insured IVF Success program that will refund you completely if your IVF procedure isn't successful.

    This incredible program gives patients peace of mind when investing in their futures and the extra boost of financial relief can be a great way to keep your mind focused on what really matters: starting a family!

    Essentially, couples who medically qualify for the program are offered up to three IVF or fresh donor egg cycles, along with as many frozen embryo transfer cycles until you have a viable 12-week pregnancy. We understand that most couple do not have insurance to cover the cost of an IVF, which is why we do our best to support couples in need and fully support your journey in any way possible. 

    After reading this guide, we hope you have a better understanding of what challenges lie ahead and how you can overcome them. Starting this new chapter in your life may be trickier than you once thought, but Kofinas Fertility Group is here to do whatever we can to help you reach your destination.

    Take our Fertility Mandate Quiz to find out if you qualify for coverage! 

    Couple Who Underwent IVF Procedures and Artificial Insemination Services

    Are you ready to get started? Schedule an appointment today to understand your unique situation and the path forward to starting your family.

    Schedule an appointment today