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For
Couples:
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Infertility
consultation
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Intrauterine
insemination
This is a technique in which the male’s sperm are prepared in the laboratory and then placed into the female’s uterine cavity.
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In-Vitro
Fertilization (IVF)
If a woman has abnormally functioning or blocked fallopian tubes, in-vitro fertilization
(IVF) is an option. In this procedure, ova are aspirated from the ovaries and placed in a dish in the laboratory. They are then combined with sperm cells. After fertilization, the embryos are inserted back into the woman’s uterus.
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Gamete
Intrafallopian Transfer (GIFT)
In this procedure, egg and sperm cells are inserted separately into the fallopian tube to aide in fertilization.
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Zygote
Intrafallopian Transfer (ZIFT)
Similar to GIFT, except that the eggs placed in the fallopian tubes are already fertilized. The fertilized eggs are placed into the tube, not the uterus. They then travel down the fallopian tube and into the uterus, as they would in a natural conception.
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Intracytoplasmic
Sperm Injection (ICSI)
This procedure involves surgical placement of a single sperm into an egg. This is considered the most effective treatment for male infertility.
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Embryo
replacement
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Cryopreservation
of Preimplantation Embryos
Cryopreservation
is the process of freezing and preserving tissue for future use.
Sperm, egg or embryos can be cryopreserved. At the end of a
fertility cycle a larger number of embryos may be produced that can
be transferred at one time. Cryopreservation is used to store the
"extra" embryos for future use.
For
Women:
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Endometriosis
testing (antiendometrial Antibody "AEA" Assay)
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Pregnancy
testing
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Antisperm
Antibody testing
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Endocrine
testing
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Artificial
Inseminations (from donor sperm)
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Oocyte
(egg) donation
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Pediatric
adolescent gynecology
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Abnormal
sexual development
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Menopause
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Natural
hormone replacement therapy
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Polycystic
Ovarian Syndrome (PCOS)
For
Men:
-
Epididymal
sperm aspiration
This procedure is used when sperm are not able to move through the genital tract on their own for such reasons as failed vasectomy reversal or congenital absence of the vas deferens or seminal vesicles.
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Comprehensive
semen analysis
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Antisperm
Antibody testing
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Sperm
functional analysis
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Sperm
washing and capacitation
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Cryopreservation
of semen
Cryopreservation
is the process of freezing and preserving tissue for future use.
Sperm, egg or embryos can be cryopreserved. At the end of a
fertility cycle a larger number of embryos may be produced that can
be transferred at one time. Cryopreservation is used to store the
"extra" embryos for future use.
-
Male
hormone replacement
Other
services
Donor
egg procedures: Some women
are unable to conceive for a variety of reasons including poor egg
quality or ovarian function, surgical removal of ovaries due to
chemotherapy or genetic issues. In these situations, the use of
donor eggs becomes an option when seeking treatments that will
lead to the conception of a child.
The egg donation process involves a donor selected by the recipient
couple, known or anonymous, who will go through
ovulation induction to produce multiple eggs. The eggs are retrieved
from the donor and fertilized with the recipient's partner's sperm
and the embryos are then transferred to the recipient. It is
important to understand the role of each participant, the donor,
recipient and recipient's partner when exploring the option of
donor eggs as fertility treatment.
Intrauterine
insemination: Intrauterine
insemination (IUI) is a procedure than can be used to treat many
causes of infertility. The first step in doing intrauterine
insemination is the collection of a semen sample at the CAMC
Andrology Lab or at home. If the semen is brought in from home, it
should be collected in a sterile container, kept warm and delivered
to the Andrology Lab within 30-45 minutes of collection. The semen
sample is then “washed.” Washing is a procedure in which the
moving sperm are separated from the non-moving sperm. The moving
sperm are suspended in a small amount of fluid. The sperm washing
takes about 1 ˝ hours. Once the sperm is washed, it is inseminated
into the woman with a procedure that is generally no more
uncomfortable than a Pap test. The inseminations are generally done
by the physician or nurse coordinator.
The procedure is as follows: As determined by a transvaginal
ultrasound, once follicular development has occurred and follicle(s)
have been found to be of optimum size, ovulation is induced with an
injection of hCG. hCG (in the form a medication named Ovidrel) is an
injection which will require administration at home, and the nurse
coordinator will provide detailed instructions on this technique.
Approximately 36 hours after the hCG injection, the IUI will take
place in our office.
It
is a relatively painless procedure, and similar to that of having a
pap test performed. A sterile speculum is placed into the vagina and
the cervix is then cleaned with sterile cotton swabs. A syringe and
very small catheter containing the washed semen specimen is inserted
through the cervix and placed high into the uterus. After the
speculum is removed, the female patient will be asked to remain in a
lying down position for approximately 20 to 30 minutes to maximize
the use of gravity in assisting the sperm cells to reach their goal.
After the period of rest, the patient is encouraged to go about her
daily routine, remembering that moderation is the key to most
activities. Occasionally, patients will get cramp-like pain
following the procedure. This is usually mild, and will pass in
several hours. Patients may also experience light spotting after the
procedure. Since water is used on the speculum and cervical mucus
tends to be abundant at the time of ovulation, a slight watery
discharge can also be expected.
Micromanipulation:
Specialized technologies
may be used to assist the fertilization process. Intracytoplasmic
Sperm Injections and Assisted Hatching are two methods available at
the Fertility Center
Intracytoplasmic
sperm injections - a single sperm cell is injected into the egg
to cause fertilization and minimize damage to the egg. This
procedure may be the most effective for infertility due to male
factors.
Assisted hatchings - This technique "helps" prepare a fertilized egg to be implanted in the mother's uterus. It
is believed that by manipulating the outer shell of the egg in older
mothers may help a successful pregnancy "take."
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