 Fertility services
Infertility can be one of the most challenging obstacles a couple can ever
face. Getting help may be the only way to achieve their dream.
There may be many reasons why a couple cannot conceive. The goal is to
evaluate both partners to find the cause, and then to overcome the issues to achieve a pregnancy.
Resources to help you:
Infertility
Approximately 50% of women have physical factors which cause infertility.
By using various procedures we are able to determine whether any of these
symptoms are causing your infertility problems.
Another 30% of infertility issues are caused from problems with ovulation.
Tests can find if ovulation is a leading cause of infertility, and you could be
placed on drug therapy to regulate ovulation.
Men are responsible for about 40% of infertility problems. To determine the
specific issue, patients receive a detailed social and medical history
evaluation. A number of treatments, such as artificial insemination, are
available.
Approximately 20% of couples will experience some type of infertility from
both the male and female partner, so both partners should be tested
simultaneously.
Assisted Reproductive Technologies
(ART)
ART offer options to couples who
otherwise would not be able to conceive.
In Vitro Fertilization
The most commonly used form of ART is In Vitro Fertilization (IVF). First, a
woman's ovaries are stimulated by medications to produce multiple follicles. The
eggs are retrieved and are then cultured with the sperm of the male partner. The
resulting embryos are cultured in the laboratory for 3 days, after which the
best embryos are selected for transfer back to the mother's uterus. The embryos
are inserted into the top of the uterus with a soft ultrasound-guided catheter.
Blastocyst Transfer
Embryos are cultured for 5-6 days to develop into blastocysts. At this point the embryos have developed into an inner cell mass
(the cells that form the baby) and the the cells that form the placenta.
Transferring blastocysts on day 5 increases the pregnancy rate and reduces the
chance of multiple pregnancies.
Assisted Hatching
This technique is used to assist the embryo to hatch from its surrounding
shell. This hatching must occur for the embryo to implant in the uterus. The
procedure consists of making a microscopic opening in the shell to assist the
embryo in the hatching process.
Intracytoplasmic Sperm Injection (ICSI)
One of the best advances in treating male infertility is intracytoplasmic
sperm injection (ICSI), injecting a single sperm directly into a
mature egg. ISCI is used to assist men who have abnormal sperm parameters. This
can also help patients with antisperm antibodies or spinal cord
injuries.
Egg Donation
This is an option for women who have had problems with their ovaries producing eggs. Eggs can come from a friend or relative, or the donor may
be anonymous from a donor bank. Donors are screened according to guidelines set
by the American Society for Reproductive Medicine.
The recipient of the egg must have her uterus tested to rule out any
structural defects. She is placed on hormones to synchronize her cycle with the
donor's cycle. Estrogen and progesterone are given to prepare
the uterus lining for an embryo implant.
When the donor's eggs are ready, they are inseminated with the patient's
sperm for fertilization. The embryos are monitored in the laboratory for 3-5
days, and then placed with a soft catheter into the mother's uterus.
Sperm Donation
Sperm donors or sperm banks are available for when the male's sperm
is the factor for infertility. The donated sperm is extensively screened for
sexually transmitted diseases and genetic abnormalities. The couple can match up
physical characteristic traits if they choose sperm from a sperm bank.
Surrogate Program/Host Uterus
This option is for women who have viable eggs, but have difficulties
carrying a child due to a problem with their uterus. The process involves
taking embryos that are created with the patient's eggs and her partner's
sperm and transferring them to another woman to carry the pregnancy. The
surrogate woman carries and delivers the baby and the child is placed with the
parents.
Reproductive Microsurgery
Prior to the development and success of ART, microsurgery was the most
common treatment. Although the number has decreased substantially, there are
still times when microsurgery is the best form of treatment. For example, women
who have had their tubes tied can have them reattached with successful pregnancy
rates nearing 80% for women up to age 35. Women with severe endometriosis and
pelvic adhesions can also benefit from microsurgery.
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