Infertility Treatments

    Published: 06-16-2009
    Views: 27,952
    Dr. Roger Lobo of the American Society of Reproductive Medicine discusses the various treatments for infertility.

    Dr. Roger Lobo: Hi! I am Dr. Roger Lobo with the American Society for Reproductive Medicine. Today we are talking about treatments for infertility. One of the most common reasons for female fertility problems is anovulation. When a woman is not making or releasing matured eggs. Anovulation is most often treated with medications that work in two ways. One is to stimulate a woman's own hormones to work more effectively. The second is to provide additional hormones called Gonadotropins to stimulate the ovary directly. Both treatments stimulate the ovaries to produce and release eggs. Talk to your doctor to see which method is best for you. For some patients, basic infertility therapies do not work and other treatment options can be considered. In vitro fertilization called IVF, is probably the best known form of Assisted Reproductive Technologies or ART. In IVF, a man's sperm and a woman's eggs are combined outside of the body in a laboratory dish. The embryos that develop are transferred to the woman's uterus to hopefully implant under uterine lining and continue to develop. Michelle Brock: Physically, IVF is probably the most difficult thing I have ever done to my body. When we wanted to have a baby and our last resort was really IVF, so the decision didn't come easily, but it was really the decision left to be made in our journey. Dr. Roger Lobo: IVF is a delicate procedure and should be performed in specialty centers by experienced, reproductive care clinicians. It involves many stages of preparation, including medications given to the woman to stimulate multiple eggs, retrieving and inseminating the eggs with her partner's sperm and returning the embryos to her uterus. ART also includes other procedures often used with IVF. A procedure called Intracytoplasmic sperm injection or ICSI is often used for men with sperm abnormalities. In a very delicate procedure, a single sperm is introduced through the eggs outer shell into the area where it can more easily fertilize the egg. Multiple eggs are usually produced in an IVS center. After fertilization any embryos over the number that should be transferred can be cryopreserved or frozen for future use. Third party reproduction, using another source sperms, eggs or embryos, maybe an option. When these are not biologically possible for a couple, some may use a gestational carrier or a surrogate, when a woman cannot physically carry a pregnancy. Dr. Janet Choi: In situations where a woman is missing a uterus either because she was born without a uterus or because she had it surgically removed in the past, if she still has eggs that are functional, it maybe possible for her to go through a process where she gets those eggs extracted. Those eggs are then mixed with her partner's sperm in the laboratory, and then the embryo which then develop can be inserted in another woman's body, so that other person, the gestational carrier can actually carry the pregnancy for the patient. Dr. Roger Lobo: A newer technology called Preimplantation Genetic Diagnosis, or PGD allows for certain genetic conditions to be diagnosed in the embryo before being transferred. This is a very complex procedure and is currently recommended only for specific known genetic abnormalities. For men with infertility, there are unfortunately fewer treatments available; usually for an abnormal semen analysis, a special type of insemination called intrauterine insemination is used. Sperm are washed and concentrated to provide more sperm in a small amount of fluid. When the woman cycle timing is right for insemination, the small sample can be inserted through a catheter directly into her uterus. Other treatments for infertile men may involve surgery, such as correction of varicocele. When the basic infertility therapies do not work, patients can begin to consider moving on to other treatment options.