Infertility and reproductive endocrinology specialists from DMC Women and Infant Services work with women and couples having trouble getting pregnant. Our doctors listen to you and your story, evaluating medical history and any previous treatment in order to best treat the cause of your infertility. When necessary, our physicians identify which advanced procedure(s) may be helpful, and can perform these procedures when needed.
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In Vitro Fertilization (IVF)
In in vitro fertilization (IVF), eggs (ova) are removed from the mother's body and combined with the father’s sperm in a laboratory. If fertilization occurs, the fertilized egg is implanted in the mother's (or a surrogate mother's) body for normal development in the uterus. Fertilized ova can also be frozen for later implantation.
IVF is a form of assisted reproductive technology (ART), meaning special medical techniques are used to help a woman become pregnant.
The five basic steps to IVF include:
- Stimulation, also called super ovulation. Fertility drugs are given to boost your egg production, telling the ovaries to produce several eggs. During this step, you will have regular transvaginal ultrasounds to examine the ovaries and blood tests to check hormone levels.
- Egg retrieval. A minor surgery, called follicular aspiration, is done to remove the eggs. Using ultrasound images as a guide, your physician will carefully remove eggs from your ovaries. There may be some cramping after the procedure, but it usually goes away within a day. If you do not or cannot produce any eggs, donated eggs may be used.
- Insemination and Fertilization. The man's sperm is placed together with the best quality eggs and stored in an environmentally controlled chamber. Sperm usually fertilizes an egg a few hours after insemination. If the doctor thinks the chance of fertilization is low, sperm may be injected directly into the egg. This is called intracytoplasmic sperm injection (ICSI). Many fertility programs routinely do ICSI on some of the eggs even if everything is normal.
- Embryo culture. When the fertilized egg divides, it becomes an embryo. Within about 5 days, a normal embryo has several cells that are actively dividing. Couples who have a high risk of passing a genetic (hereditary) disorder to a child may consider pre-implantation genetic diagnosis (PGD).
- Embryo transfer. Embryos are placed into the woman's womb 3 - 5 days after egg retrieval and fertilization. The procedure is done in the doctor's office while the woman is awake. The doctor inserts a thin tube (catheter) containing the embryos into the woman's vagina, through the cervix, and up into the womb. If an embryo sticks to (implants) in the lining of the womb and grows, pregnancy results. More than one embryo may be placed into the womb at the same time, which can lead to twins, triplets, or more. The exact number of embryos transferred is a complex issue that depends on many factors, especially the woman's age. Unused embryos may be frozen and implanted or donated at a later date.
Preimplantation Genetic Diagnosis (PGD)
Preimplantation genetic diagnosis (PGD) is used in combination with in vitro fertilization (IVF) to select embryos free of chromosomal abnormalities and specific genetic disorders. This allows the best chance for success while limiting some genetic conditions that can interfere with embryo implantation, result in pregnancy loss, or in the birth of a child with physical problems, developmental delay or mental retardation.
Intracytoplasmic Sperm Injections (ICSI)
If the number or quality of sperm is not enough for traditional in vitro fertilization to succeed, individual sperm may be injected directly into the mother’s eggs with intracytoplasmic sperm injection (ICSI). This method differs from IVF in that ICSI only requires one sperm per egg, whereas IVF requires several hundred thousand.
Donor Egg Procedures
Donor egg procedures enable pregnancy in women who would otherwise be unable to conceive. If a woman wanting to get pregnant does not have any viable eggs (ova) of her own, healthy and mature ova can be extracted from an egg donor during a minimally invasive outpatient procedure. The donor eggs can then be fertilized using in vitro fertilization techniques before implantation in the mother’s uterus.
Polycystic Ovary Syndrome (PCOS)
Polycystic Ovary Syndrome (PCOS) is a fairly common medical problem affecting approximately 5 to 10 percent of women of reproductive age. It can cause women to have difficulty getting pregnant, among other serious medical consequences. Our physicians treat many patients with PCOS, some of whom have been successful in getting pregnant without fertility drugs and special procedures. Click here more information on PCOS