Most of us expect our lives to follow a predictable path — get an education, land a good job, find a mate, then start a family by getting pregnant and giving birth to a perfect child. Unfortunately, for 10% of the reproductive-aged population, those expectations will not be realized. More than 6 million couples in the U.S. are diagnosed with infertility and the underlying medical conditions that cause it. Treatment options are available.
Infertility represents a complex physical, spiritual and emotional crisis that affects all areas of a person’s well-being. The causes of infertility are almost equally shared by conditions affecting women and men. Often, there are combined factors affecting both the male and female partner that contribute to a couple’s inability to create and sustain a healthy pregnancy. The clinical staff at Fertility & Endocrine Associates partners with each couple to identify these factors, provide education and consultation, and develop a customized plan for treatment.
In addition to fertility treatments, we offer help for other related problems: couples who struggle with recurrent pregnancy loss, non-fertility related hormonal and gynecologic problems, as well as sperm cryopreservation to preserve fertility for men who are undergoing chemotherapy or radiation for cancer treatment or men who choose to delay childbearing.
Comprehensive Fertility Workup
Our fertility experts will review the health histories and provide basic screenings for both partners. For the woman, we’ll check all hormone values and prescribe treatment to correct any abnormalities. We’ll also doa complete pelvic exam with a transvaginal ultrasound. Our doctors may use a saline enhanced sonogram (sonohysterograms) to evaluate the woman’s uterine cavity and rule out abnormal masses that could interfere with pregnancy. We also may order a hysterosalpingogram, which is a simple, outpatient procedure performed at a hospital to determine if the fallopian tubes are open. For the male partner, we’ll perform a comprehensive semen analysis. If we detect abnormal sperm parameters, we’ll refer him for a urological consultation.
Treatment Options to Enhance Fertility
This is a common treatment for women who either don’t ovulate on their own, or have unexplained infertility. In ovulation induction, the ovaries are stimulated using medications like clomiphene or letrozole to produce one or more eggs. Throughout treatment, our fertility experts monitor the patient’s estrogen levels and follicle development. When the follicles are ready to release mature eggs, patients may choose to engage in either timed intercourse or intrauterine inseminations that coordinate with the release of the eggs, to increase their chances of becoming pregnant.
Intrauterine insemination (IUI) This simple office procedure is used to increase the number of sperm during fertilization. Sperm are washed and concentrated in a small volume and placed directly into the uterus. Our fertility experts often use IUI in conjunction with ovulation induction drugs to enhance fertilization success rates. It can be performed with a woman’s partner’s sperm or with anonymous donor sperm.
In vitro fertilization was first successfully used in 1978. IVF utilizes fertility medication to stimulate ovulation to produce multiple eggs. The eggs are retrieved from the woman and are combined with sperm in the laboratory to enhance the possibility of fertilization. The resulting fertilized eggs are cultured into embryos and are then transferred to the woman’s uterus where, hopefully, a pregnancy will develop.
Third-party Reproduction In third-party reproduction, patients may choose to use donated eggs, donated sperm or donated embryos to become pregnant. Our clinical team can assist both couples and single women with a variety of fertility treatment options using known or anonymous third-party donations.
Surgeries In outpatient laparoscopic and hysteroscopic surgery, our physicians are able to clearly see the pelvis, uterus, ovaries and fallopian tubes. Using laser technology, we can address problems caused by scar tissue and endometriosis during surgery. During the same procedure, we obtain valuable information about the uterus, tubes and ovaries that will guide recommendations for future therapies. Surgery can also be helpful to remove uterine fibroids that are causing problems becoming pregnant, or heavy periods and pelvic pain.
Recurrent pregnancy loss, or miscarriage, is defined by two or more failed pregnancies. Most losses happen early on in the pregnancy. A lot of different things can cause recurrent pregnancy loss, such as hormonal abnormalities, chromosomal abnormalities, clotting abnormalities and anatomical abnormalities related to the uterus. Even if no cause can be found, our experts can recommend treatment options that may increase the chance to have a healthy, successful pregnancy despite a history of losses.
INVOCELL: An Alternative IVF Treatment
Fertility & Endocrine Associates is excited to offer INVOCELL, a new FDA-approved, intravaginal culture system that offers a more natural alternative to traditional in vitro fertilization (IVF).
Non-fertility Treatment Options
PCOS Polycystic ovarian syndrome is a medical condition present in about 10% of women of childbearing age, characterized by irregular menstrual periods and elevated androgen (male-type) hormone levels. Women with PCOS have enlarged ovaries that contain multiple small cysts. They rarely ovulate on their own, which often leads to infertility. In many cases, PCOS can be corrected with hormone medication.
Fibroids Uterine fibroids (leiomyomas or myomas) are growths that develop from the muscle tissue of the uterus. The size and shape of the fibroids can vary greatly and may be present inside the uterus, on its outer surface or within its wall, or attached to it by a stem-like structure (pedunculated). Fibroids may cause changes in menstruation, pain, pressure, an enlarged uterus, pregnancy loss and infertility. In most patients, fibroids can be removed during a simple outpatient surgical procedure performed by one of our expert physicians.
Endometriosis is an often painful disorder in which tissue that normally lines the inside of your uterus (the endometrium) grows outside your uterus. In addition to pain, endometriosis can cause infertility. Our doctors will customize a treatment plan for endometriosis based on a patients’ goals — whether she wants to relieve pain or improve fertility. Pain can usually be controlled with hormonal medication. Treatments for endometriosis related to infertility vary, depending on how severe it is.
Pelvic pain Pelvic pain occurs in the area below a woman’s belly button and between her hips. It can be a symptom of another disease, such as endometriosis, or a condition on its own. When we can determine the source of the pain, individualized treatment focuses relieving as much discomfort as possible.