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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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Dr. Barry Witten performing reproductive services including in vitro fertilization, intracytoplasmic sperm injection, embryo cryopreservation, sperm cryopreservation, ovulation induction, intrauterine insemination, post-coital test, follicle study ultrasound, follicular cyst aspiration, endometrial biopsy, cultures, reversal of tubal ligation, exploratory laparotomy, diagnostic laparoscopy, laser vaporization of endometriosis, laser vaporization of pelvic adhesions for St. Louis and the surrounding area.

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