IVF:
(In vitro Fertilization)
In vitro fertilization involves both the
female and the male partners. Eggs
are retrieved from the ovaries and are placed with the male partner’s
sperm in a petri dish in a laboratory, where fertilization occurs to
produce embryos. After the
embryos have matured for several days in the laboratory, they are placed
into the uterus for implantation and a pregnancy should result.
At the proper time in her cycle, the
female partner is given hormone medication that should produce multiple
eggs in each ovary. Egg production is monitored by a series of
vaginal ultrasounds and blood tests. When the eggs are ready, the
patient is sedated in the office, and the eggs are retrieved using an
ultrasound guided needle through the vagina. The needle is
advanced into the ovarian follicle and the eggs are aspirated into a
test tube for transport to the lab. After the retrieval procedure, the
patient spends a short time recovering and can then go home.
Limited activity is recommended for a time.
Just prior to egg retrieval, the male
partner’s sperm is obtained and processed. A suspension of the
best population of sperm is added to the eggs for fertilization.
If the quality of the sperm is very poor, ICSI (intracytoplasmic sperm
injection) can be performed. When ICSI is used, a single sperm is
captured in a needle-like pipet and is then injected directly into the
egg to facilitate fertilization.
The eggs and sperm are monitored
regularly to assess fertilization and the production of embryos.
Embryos are allowed to mature for several days until they reach the
blastocyst stage.
When the embryos are ready, 2 or 3 are
transferred into the uterus using a small catheter threaded through the
cervix. No sedation is required; the transfer takes approximately
10 minutes. After a short rest period, the patient can go home.
Again, limited activity is recommended for a time. Any remaining embryos
can be cryopreserved, or frozen, for possible use with another cycle.
Back
to procedures
For more information, please click here.
^top
Intrauterine
Insemination
Intrauterine Insemination is an office
procedure where washed sperm are delivered directly into the uterus
using a small catheter that is passed through the cervix. The
procedure is relatively quick with very minimal discomfort. The
cervical mucus, which can sometimes be hostile to the sperm, is
completely bypassed. All of the sperm in the ejaculation are
placed in the uterus as compared to the 1% (approximately) that make it
during natural intercourse.
Back
to procedures
For more information, please click here.
^top
Success in achieving a pregnancy depends
on the quality of both the female egg and the male sperm. In some cases,
treatment for male factor infertility is unsuccessful. Donor sperm from
an approved sperm bank may be used in conjunction with intrauterine
insemination (IUI). The sperm bank provides profiles on various proven
sperm donors and a donor can be selected based upon his genetic and
physical factors.
Back
to procedures
For more information, please click here.
^top
Ovulation
Induction:
Occasionally, a woman’s body does not
produce mature eggs on its own during a monthly cycle. It may
be necessary to use medication to help stimulate the maturation of one
or more eggs. This is referred to as ovulation induction.
Ovulation induction may be achieved by taking pills for several days
during a cycle or may require alternate medication in the form of
injections.
Back
to procedures
For more information, please click here.
^top
Hysteroscopic
Evaluation of the Uterus
The uterine cavity can be visualized by
inserting a small optical tube called a hysteroscope, through the vagina
and cervix. The uterus is filled with saline to enhance visualization.
The physician can evaluate the size and depth of the uterus, the
presence of abnormalities inside the uterus, the presence of polyps or
adhesions, and the quality of the endometrium. The procedure is
usually performed in the early half of a woman’s cycle and can be done
in the office. It takes approximately 20 minutes.
Back
to procedures
For more information, please click here.
^top
Hysterosalpingogram:
A hysterosalpingogram (HSG) is a
procedure used to x-ray the uterine cavity and fallopian tubes. It
is performed in the x-ray department and takes approximately 15 minutes.
The patient is allowed to go home after the procedure. A thin
catheter is passed through the cervix into the uterus. The uterine
cavity and fallopian tubes are then flushed with an x-ray contrast dye
(through the catheter). There may be some cramping associated with
the injection of the dye. The movement of the dye is observed as it
makes its way through the uterus into the fallopian tubes and spills
into the pelvic area. An HSG can detect: an abnormally shaped
uterine cavity, fibroid tumors, polyps, scar tissue, partially or
completely blocked fallopian tubes, and normally shaped uterine cavity and
tubes.
Back
to procedures
For more information, please click here.
^top
Tubal
Catheterization:
When a blocked fallopian tube is
discovered with a hysterosalpingogram (HSG), a tubal catheterization can
be performed to correct the blockage. The procedure is performed
in the x-ray department and takes approximately 20 minutes. The patient can go
home after the procedure. Under fluoroscopic guidance, a thin
balloon catheter is threaded through the cervix, uterus and into the
affected fallopian tube. At the site of the blockage, the balloon
is inflated, correcting the obstruction. The area is then flushed
with an x-ray contrast dye to verify results. There is an 85 –
90% chance that a blocked tube will be opened. About 60% of those
will still be open after 6 months, and 30 – 40 % will conceive.
Back
to procedures
For more information, please click here.
^top
Follicular
Cyst Aspiration
Typically, ovarian cysts are not disease
related and disappear on their own. During ovulation, a follicle
grows but fails to rupture and release an egg. It retains fluid
and becomes a cyst. Ovarian cysts can cause a variety of symptoms
including abnormal uterine bleeding, pelvic pain, and nausea and
vomiting. An ovarian cyst can be drained in the office using a
needle with ultrasound guidance. The procedure takes approximately
15 minutes.
Back
to procedures
For more information, please click here.
^top
