Fertility Treatment Options

 

 

In many patient/couples, a correctable abnormality remains absent even after extensive investigation work-up, thus the therapy for this so-called ‘unexplained infertility’ is, by default, empiric. Proposed treatment regimens include intrauterine insemination (IUI), ovulation induction with oral or injectable medications, combination of IUI with ovulation induction, and assisted reproductive technologies (ART), i.e. in vitro fertilization (IVF).

fertility treatment
FERTILITY EVALUATIONS
If you have been trying to conceive for over a year, you should consider a fertility evaluation. According to the American Society of Reproductive Medicine (ASRM), infertility is the result of a disruption of bodily functions of the male or female reproductive tract. As a result, the disruption prevents the conception of a child or the ability to carry out a pregnancy to full term. 
 
However, with patients 35 years and older, we recommend beginning infertility evaluation after six months of trying to conceive to not delay potential treatment alternatives. We urge patients to seek care when they have reasons to suspect an underlying problem. For instance, if you have irregular menstrual cycles, that suggest you are not ovulating or releasing an egg or if you or your partner has a known fertility problem, we recommend not waiting an entire year before seeking evaluation or treatment. 
 
If you and your partner are struggling to have a baby, just remember, you are not alone. At least one out of seven couples have trouble conceiving. Though it is completely normal to experience feelings of frustration, jealousy, anger, and stress, it is important to explore what your medical options are. You will find that fertility treatments offer more hope for a successful pregnancy than ever before. The vast majority of patients who seek care from a fertility specialist reach their goal of becoming pregnant.
INTRAUTERINE INSEMINATION (IUI)
In order for a woman to get pregnant, a man’s sperm must travel up the vagina, through the cervix into the uterus, and up into one of the Fallopian tubes. If the sperm arrives in the tubes soon after ovulation, the sperm and egg are able to meet in the tube and most commonly, fertilization occurs. Because the cervix naturally limits the number of sperms that enter the uterus, only a few sperms actually make their way to the Fallopian tubes. 
 
Intrauterine insemination (IUI) is procedure that bypasses into the cervix and directly places the sperm in a woman’s uterus around the time of ovulation. By placing the sperm directly into the uterus, this procedure gives the sperm a better chance at making their way to the egg. IUI is performed to improve a woman’s chances of getting pregnant. 
After the semen sample is collected, it is then washed in the laboratory to concentrate the sperm and remove the seminal fluid. The seminal fluid is removed because it can cause severe cramping to the woman. This process takes less than two hours to complete. 
 
The IUI is performed around the time of ovulation. It is a relatively simple procedure that only takes a few minutes. During this procedure, the woman lies on an examining table and the clinician inserts a speculum into her vagina to be able to see her cervix. Then, a catheter, or narrow tube, is inserted through the cervix and into the uterus where the washed semen sample is slowly injected. Though this procedure is relatively painless, some patient have experienced mild and temporary cramps.
IN VITro FERTILIZATION (IVF)
IVF is a method of assisted reproduction in which the sperm and egg are combined outside of the patient’s uterus in a laboratory dish. One or more fertilized eggs (embryos) are then transferred into the woman’s uterus, where the embryo can impact in the uterine lining and began to develop. Patients have the option of cryopreserving (freezing) their extra embryos for future use. 
 
Initially, IVF was introduced to treat women with blocked, damaged, or absent Fallopian tubes. However, today, IVF is used to treat many causes of infertility, such as endometriosis, male factors, or unexplained infertility. The basic steps in an IVF treatment cycle are ovarian stimulation, egg retrieval, fertilization, embryo culture, and embryo transfer. 
CLASSIC IVF
During ovarian stimulation, also known as ovulation induction, medications are used to stimulate multiple eggs to grow in the ovaries as opposed to a single egg that normally develops each cycle. Multiple eggs are stimulated to increase the chances of development because some eggs will not fertilize or develop normally after fertilization. 
 
Timing is crucial in an IVF cycle. The ovaries are evaluated during treatment with vaginal ultrasound examination to monitor the development of ovarian follicles. Blood samples are also drawn to measure the response to ovarian stimulation medications. Usually, estrogen levels increase as follicles develop and progesterone levels are low after ovulation. 
 
By using ultrasound examinations and blood testing, the physician can determine when the follicles are ready for egg retrieval. Generally, eight to fourteen days of stimulation is required. When the follicles are ready, hCG, which replaces the woman’s natural LH surge and causes the final stage of egg maturation so the eggs are ready for fertilization, or other medications are given. The eggs are retrieved before ovulation occurs, usually 34 to 36 hours after the hCG injections are given.
ivf fertility clinic

Stress free IVF is a treatment that centers around a more patient-friendly and less strenuous approach. The advantage of having a natural cycle is that it decreases the need for intensive monitoring since the only goal is to retrieve the follicle before ovulation occurs. Because little to no medication is required, it decreases the cost of IVF to only 1-2 consultations before aspiration with a single follicle aspiration that requires no anesthesia. 

MILD BOOST IVF
The Mild Boost IVF approach controls ovulation by adding oral fertility medication and a low-dose of FSH. This allows multiple follicles to develop and 3-5 eggs are obtained per cycle. 
 
In addition to suppressing natural ovulation with oral fertility medication from the third day of menstruation, a small amount of FSH preparation is used in combination from the middle if necessary. With this, the eggs that are selected from the process are grown as many as necessary. Ovulation is induced by the use of GnFH agonist or hCG, which are both a body-friendly and naturally provided IVF method that reduces the amount as much as possible, and makes the best quality eggs. 
Unmarried and LGBTQ+ Family Planning
At Labryo, we treat every patient with respect and understanding. It is our ethical duty to treat each individual with the same compassion regardless of sexuality, gender, or status. We have went through great lengths to ensure that our services do not discriminate based on those factors. We have extensive success stories in treating patients through the use of a third-party gamete donor or a surrogate carrier. We stand by ASRM that marital reproduction is no longer solely coital and may include a third-party gamete donor or surrogate carrier. Though reproduction for same-sex couples is much more complex than in straight couples, we provide an experienced and integrated team approach that protects the best interests of the partners, their child, and the providers involved. We have formed a dedicated compassionate network in assisting these patients through establishing relationships with several of this country’s highest regarded surrogacy and donor agencies. 
 
Currently in the United States, there are an estimated six to fourteen million children being raised by a homosexual parent. We are proud to have been a part of bringing these children into this world. 

The use of cryopreservation with both embryo, egg, and sperm as a standard clinical procedure by the American Society for Reproductive Medicine (ASRM) have led to an increasing demand for fertility preservation for oncologic, non-oncologic, and personal reasons, for example, delayed child-bearing and transgender/gender reassignment. Gametes and embryos are generally produced using standard assisted reproduction technology protocols and procedures. However, women with certain types of cancers may require modified ovarian stimulation protocols to enhance follicle development while maintaining low estrogen levels. Men with pretreatment azoospermia or extreme oligospermia will require cryopreservation of testicular tissue (TESE). 

Sign up for free consultation