If you’re trying to have a baby and it is taking longer than you expected, you are not alone! One in every nine couples of childbearing age has a problem conceiving, but there is hope for you at the SIU Fertility and IVF Center. Recent medical advances make pregnancy possible for most couples wishing to undergo treatments to have a baby.
Female Treatment Options
Female Anatomy Problems
Problems with the fallopian tubes, uterus or cervix require immediate attention. After diagnosing the problem by using hysteroscopy ( a close visual examination of the uterus) or imaging procedures including ultrasound (the use of sound waves to see the ovaries and uterus) and hysterosalpingogram (HSG, an x-ray technique which uses dye injected into the uterus to see if it is normal and if the tubes are open), fertility specialists may perform a laparoscopy (minimally invasive surgery) to correct the anatomic problems, or robotic surgery for more complex cases. This type of surgery results in less scarring, less time away from daily activites, and shorten the amount of time it takes to recover.
Infertility can be related to problems with ovulation, commonly caused by polycystic ovarian syndrome (PCOS), excessive weight gain or loss, age, excessive exercise and extreme emotional stress. Medications are available to stimulate ovulation.
Patients at times decide to have their fallopian tubes tied as a form of permanent contraception. Occasionally, couples that have undergone this procedure change their mind and would like to have more children. A tubal reversal procedure allows the removal of the blockage from the fallopian tube and reopen the tube to allow for the egg and sperm to meet in a natural way. This surgery is usually performed on an outpatient basis and can sometimes be done with minimally invasive techniques including robotic surgery, which allows physicians to place the tubes together with greater precision, less blood loss and a quicker recovery.
Intrauterine Insemination (IUI, or Artificial Insemination)
Intrauterine insemination is a simple, painless nonsurgical office procedure in which sperm from the male partner is placed inside the woman’s uterus. Patients can resume normal activities immediately following the procedure.
In Vitro Fertilization
In Vitro Fertilization (IVF)
In vitro fertilization (IVF) is a procedure by which eggs removed from the ovaries are fertilized in the laboratory with sperm from the male partner. The fertilized eggs develop into embryos over 2-5 days in the laboratory, then are placed inside the woman’s uterus. IVF is used in cases where the fallopian tubes are blocked, and also in other diagnoses, where conventional medical treatments and surgery have not been successful.
Remaining embryos can be frozen for later use for several years. In these instances the uterus first is prepared hormonally to accept the embryos, then the embryos are transferred back to the patient.
Preimplantation Genetic Diagnosis
Preimplantation genetic diagnosis is where a cell is removed from the embryo during IVF and is then analyzed for genetic conditions or chromosomal abnormalities.
Blastocyst Stage Embryo Transfer
It now is possible to develop the fertilized eggs in the laboratory for up to 5 days, the stage when embryos are referred to as blastocysts, before transfer back into the uterus. Because blastocysts are much further developed, fewer are needed, and consequently the risk of multiple births is reduced.
Oocyte (Egg) Donation
If testing determines that the female partner does not have sufficient or good quality eggs to get pregnant, the couple may choose oocyte donation as an alternative. Anonymous donor’s eggs and the male partner’s sperm are combined during the IVF process. When the resulting fertilized eggs develop into embryos, they are transferred to the female partner to carry the pregnancy. Our patients can select from our screened, healthy young egg donors; or they may have a friend or family member donate eggs for them. Donors undergo extensive genetic and medical testing and complete a thorough questionnaire prior to being admitted as donors to ensure their health.
There are different types of egg donation:
Anonymous Oocyte Donation - Couples may choose to have the oocyte donor remain unknown to them.
Shared Oocyte Donation - Women younger than 35 who will undergo IVF may choose to share their eggs anonymously with women who cannot produce eggs. Each woman receives eggs fertilized with her partners own sperm. The egg donor and the egg recipient share the cost of the IVF treatment, and it remains anonymous.
Known Egg Donor - Patients may choose a sister, family member, or a friend to be the egg donor.
Surrogate Host (Gestational Carrier)
Women under age 42 and ovulating, but for whom pregnancy is inadvisable or not possible, may wish to consider having a surrogate host carry their genetic child. Circumstances include health problems, recurrent miscarriages, absence of the uterus due to hysterectomy or being born without a uterus. Following IVF of the couple’s eggs and sperm, the couple’s biological embryos are placed in the uterus of the surrogate host.
Male Treatment Options
The conservative treatment of male infertility may involve medical therapies such as hormonal stimulation, antibiotics, antihistamines, or a variety of surgical procedures to improve the production, quality, or motility of sperm.
Non-Surgical Sperm Aspiration (NSA)
NSA is a procedure to obtain sperm directly from the testicle using a needle. It is used when the sperm count is exceptionally low or when there is no sperm in the semen due to vasectomy or other types of duct obstructions. NSA also is an alternative to vasectomy reversal.
Intracytoplasmic Sperm Injection (ICSI)
ICSI, a recent revolutionary breakthrough in fertility treatments, is another means of placing sperm and eggs together in the laboratory setting. In this procedure a single sperm is injected directly into an individual egg retrieved from the woman’s ovaries. ICSI can result in pregnancy even in the most severe forms of male infertility as long as there are viable sperm available.
Diagnostic and Therapeutic Testicular Biopsy
A simple outpatient procedure for accurate diagnosis, or therapy, a testicular biopsy is invaluable for selected male factor infertility cases. Our pathology and genetics researchers are on the forefront of these new technologies; they can process and analyze testicular tissue for genetic or other abnormalities in conjunction with the procedure.
Patients at times decide to undergo a vasectomy as a method of birth control where the male partner has a ligation of the ducts that bring sperm as a form of contraception. When patients want to have children again, physicians can bring these tubes together with microsurgical techniques under a microscope and allow for the sperm to reach the ejaculate for a natural conception. The procedure is generally done on an outpatient basis, with an easy and quick recovery.
Male partners, in spite of undergoing multiple treatment attempts and surgeries, are sometimes still unable to produce sperm. After extensive counseling and discussion with the couple, the decision is made to use a sperm donor to achieve the dream of a child. We have extensive lists of screened sperm donors available for these cases, and couples can choose their sperm donor in the privacy of their homes. Following the selection of a sperm donor, the female partner is then monitored to determine the optimal time for ovulation and then an intrauterine insemination (IUI) is done with donor sperm on an outpatient basis. It only requires a few minutes for the patient to be in the office and she can resume her normal schedule thereafter.