Infertility Evaluation, Diagnosis & Treatment
- A detailed, thorough evaluation of a patient and her partner for the causes of their infertility with recommendations for treatment using the most advanced technology.
- This page gives a brief description of the following treatments:
- Assisted Hatching
- Donor Cycles
- Artificial Insemination/IUI
- Reproductive Surgery
- Hormone Treatment
- Infertility Conditions & Treatment
Our services explained
IVF – in vitro fertilization
The process of IVF involves five basic stages:
- Controlled ovarian hyperstimulation – the use of fertility drugs to create multiple oocytes (eggs).
- Oocyte retrieval – a surgical procedure to remove oocytes (eggs) from the ovaries.
- Fertilization of the oocytes by sperm
- Embryo creation and growth.
- Transfer of the embryos into the uterus.
IVF is very useful for women with blocked or damaged fallopian tubes, but now the procedure is used for many infertility factors – such as ovulation, tubal issues, male infertility, age, uterine problems, endometriosis or unexplained infertility – when less invasive and less expensive procedures have failed.
This involves the use of mechanical or chemical thinning of the zona pellucida (outer shell) of the embryo. It is believed this outer shell becomes thicker and hardened with the aging of the oocyte. Assisted hatching is performed before transfer and may be beneficial for women older than 38, for women with thicker zona pellucidas, or for a couple with poor quality embryos. Assisted hatching may also be utilized for couples that have failed to achieve pregnancy after multiple IVF attempts.
Preimplantation Genetic Diagnosis (PGD)
PGD is a process to evaluate embryos for genetic disorders prior to implantation of the embryos in the uterus. The embryos are typically biopsied, a process in which one or two cells are removed at the eight-cell stage. These cells are then tested for specific genetic defects. The remaining portion of the embryo if free of disease is transferred to the uterus, typically on Day 5.
Intracytoplasmic Sperm Injection (ICSI)
ICSI is a procedure in which a single sperm is injected directly into the oocyte (egg). ICSI may be used for male factor infertility, poor quality oocytes, or unexplained infertility.
Some women for a variety of reasons may not be able to use their own oocytes (eggs) for the IVF process. In these cases, oocytes donated from another woman (typically younger than 32 years old) may be an option. Candidates for oocyte donation include:
- women with premature menopause or ovarian failure
- congenital absence of the ovaries from birth (ovarian agenesis or dysgenesis)
- previous chemotherapy
- carriers of genetic disorders
- inadequate response to fertility drugs
- poor oocyte quality
- advanced age
Donor oocytes can be used for women age 50 or younger.
Some couples may choose to achieve pregnancy using embryos donated from other couples. The waiting process for donor embryos is often very long. We can refer you to agencies handling embryo donors.
Donor Sperm Insemination
The use of donor sperm to achieve pregnancy. Often used by single women or in married couples whose husband has no sperm, or who has a genetic disorder.
Intrauterine Insemination (IUI)/Artificial Insemination
Artificial insemination is often a highly effective means of bypassing infertility issues. The most common procedure used today is intrauterine insemination (IUI), which injects sperm directly into the woman’s uterus where they have easier access to the egg.
For IUI to succeed, the woman’s ovaries must be producing viable eggs and the fallopian tubes must be unblocked so that the injected sperm can reach and fertilize the egg.
Sperm retrieval surgical procedures can be used by some men to retrieve sperm when they have no sperm in their ejaculate.
Reproductive surgical procedures are utilized to increase fertility, decrease risk of miscarriage or correct congenital malformations or acquired diseases of the reproductive tract.
Ovulation Induction uses fertility drugs to produce oocytes (eggs) and induce ovulation. Commonly, clomiphene citrate or gonadotropins are utilized.
Blastocyst Embryo Cultures
This is the growth of embryo to the blastocyst stage, usually Day 5.
Single Embryo Transfer
During IVF, only one embryo is transferred, typically at the blastocyst stage. This may be advisable for couples at risk of multiple births.
Menopause Evaluation and Treatment
Patients are evaluated for signs and symptoms of menopause or perimenopause. After evaluation, the physician will make recommendations for therapy. Options may include medication (such as hormone replacement therapy), alternative medicinal therapy, herbal therapy, bioidentical hormone therapy, or observation. The decision of which therapy to use is based on the patient’s individual needs and risk factors.
Endometriosis Diagnosis and Treatment
Endometriosis is a common cause of female infertility. Tissue that normally lines the inside of the uterus spreads to the abdominal cavity, often attaching itself to the reproductive organs within the woman’s pelvis. Patients with endometriosis are evaluated and treated with medical or surgical therapy. UCARM is involved in numerous research studies, which are trying new therapies for woman who have not had good success with conventional medical therapy.
Fibroids: Surgical and Non-Surgical Management
Uterine fibroids are noncancerous growths in the uterus that can cause heavy bleeding and infertility if inside or very close to the uterine cavity. Fibroids can also grow very large inside the uterus, causing the cavity to be distorted. Fibroid treatment options available to women, such as hysteroscopy, can be discussed with patients.
Child and Adolescent Gynecology
UCARM offers evaluation and treatment of children and adolescents with reproductive or menstrual disorders. These disorders may include premature puberty, delayed puberty, absence of menses, irregular menses, excessive hair growth or acne.
Treatment of Congenital Abnormalities of the Uterus & Vagina
We offer evaluation and treatment of patients in which the uterus and/or vagina did not develop normally.