Sperm
Cryopreservation:
Like embryos, sperm can also be
cryopreserved, or frozen, in liquid nitrogen at an extremely low
temperature where they can remain viable indefinitely. This can be
useful for patients with poor sperm quality who are undergoing IVF.
Several semen samples can be processed and added together to provide a
specimen with a larger population of higher quality sperm.
Patients undergoing cancer therapy or vasectomy may also choose sperm
cryopreservation prior to their treatments.
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Intracytoplasmic
Sperm Injection:
ICSI (Intracytoplasmic Sperm
Injection)
is performed in the laboratory when the quality or concentration of the
sperm is very low and the possibility of fertilization of the eggs is
unlikely. When the eggs are retrieved, one sperm is captured in a
needle-like pipet. Using a microscope for viewing, the sperm is
then directly injected into the egg. ICSI can be used to treat
several sperm issues including low motility, low concentration,
antisperm antibodies, prior failure to fertilize in IVF ans use of frozen
sperm collected prior to cancer treatment. Although ICSI is very
successful, the process may damage some eggs.
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PGD:
PGD (Preimplantation Genetic Diagnosis)
is a clinical diagnostic procedure used with IVF for testing human
embryos for the presence of genetic abnormalities (inherited diseases),
before transfer to the uterus and pregnancy. Only embryos that are shown
to be free of the genetic disorders are transferred to the uterus. PGD
is a major advance in treating infertility in couples who may have a
genetic disorder.
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Donor
Egg:
In some cases, disease or ovarian failure
(including menopause) may diminish the ability to produce a fertilizable
egg. Egg donation offers a realistic opportunity for pregnancy.
Egg donation involves retrieving eggs from one woman (the donor),
fertilizing them in the laboratory, and transferring the resulting
embryos into the uterus of the recipient, who will carry the baby to
term.
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Post-Coital
Test
The post-coital test is used to assess
the function of the sperm within the cervical mucus and is usually
scheduled 1-2 days prior to ovulation. Several hours after the
patient has intercourse, a small sample of the cervical mucus is
examined under the microscope. The amount of sperm seen in the
mucus and the quality of motility are evaluated. Cervical mucus
that has an adverse effect on the function of the sperm can be
associated with infertility.
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Follicle
Study Ultrasound
Each cycle, eggs mature in the ovaries
within small sacs called follicles. It is important to monitor
the formation of the follicles during the first half of the monthly
cycle as the amount and size of the follicles tell the physician how
many eggs are being produced by the body. Adjusting
medication can regulate the number of eggs produced. A slender
wand attached to an ultrasound machine is introduced into the vagina and
directed towards the ovaries. The ovaries and follicles can be
seen on a screen. Follicles are counted and measured and
medication is adjusted accordingly. The procedure takes
approximately 15 minutes in the office and causes very minimal
discomfort.
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Cultures:
Occasionally a microorganism harbored in
the reproductive tract can be the cause of infertility. Culture
swabs of the area can give your physician valuable information regarding
any unusual organisms.
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Reversal
of Tubal Ligation:
Tubal ligation is a term used when the
fallopian tubes have been surgically tied to prevent pregnancy. Patients
usually request reversal due to a change in marital status.
Success depends very much on what type of tubal ligation was done.
Generally, success varies from 50% - 70%. Reversal of tubal ligation is
a surgical procedure, and hospital stay is 2 – 3 days.
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Endometrial
Biopsy
The lining of the uterus is called the
endometrium. The endometrium responds to changing hormone levels
during the menstrual cycle. Sending a small sample, or biopsy, of
this lining for microscopic examination can tell your doctor if your
ovaries are producing enough progesterone, a hormone needed to support a
pregnancy. The biopsy is usually scheduled just prior to the
beginning of the menstrual cycle. Before the biopsy, a urine
pregnancy test will be performed. If the pregnancy test is
negative, a speculum is introduced into the vagina. Then, a small
catheter is passed through the cervix to obtain a piece of tissue.
The entire procedure takes approximately 5 minutes and may cause minimal
menstrual-like cramping.
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