This section explains:
The process of becoming pregnant starts with ovulation, the release of an egg from a woman’s ovary. In an average 28-day menstrual cycle, ovulation occurs about 14 days after the first day of your last period. Once an egg is released, it can be fertilized for about 12-24 hours. Fertilization can occur if you have sex during or near the time you ovulate. When the man ejaculates during intercourse, his semen releases into the vagina. Semen is the fluid that carries the sperm. Sperm travel up through the woman’s cervix, uterus and out into the fallopian tubes. Sperm can live in the tubes for 3 days or more. If a sperm and egg join, fertilization occurs. The fertilized egg then moves through the fallopian tube into the uterus. It attaches there and begins to grow. All these events must take place for pregnancy to occur. If there is a problem in this chain of events, infertility may result.
Infertility may be caused by more than one factor. Some are easy to find and treat, while others are not. The factor may relate to the woman (40%) or the man (40%). In some cases, no cause can be found in either partner (10%).The couple’s age can be a factor. For healthy, young couples, the odds are about 20% that a woman will conceive in any one menstrual cycle. This figure starts to decline in a woman’s late 20s and early 30s and decreases even more after age 35 years. A man’s fertility also declines with age, but not as early. For this reason, older couples may not want to wait 6-12 months to seek care if they are having problems conceiving. Male factors most often involve problems with the amount or health of the sperm. Abnormal hormone levels may be a cause. Infection or scarring from a sexually transmitted disease (STD) also may be a cause. Female factors also may involve abnormal hormone levels. The ovaries may not produce enough eggs at the right time. Scarring or blockages in the cervix or tubes also may be a cause. Lifestyle factors, such as poor nutrition, anorexia, and obesity can play a part in infertility. Exposure to a drug called diethylstilbestrol (DES) can cause problems. This might be a concern if you were born in the United States before the late 1980s or in another country before the 1980s. Other health problems also can play a role.
The decision to begin testing depends on a number of factors. They include your age and your partner’s age, as well as how long you have been trying to get pregnant. You and your partner will receive care as a couple. Testing involves an evaluation as follows: 1. Physical exam of both partners 2. Medical history, 3. Semen analysis, 4. Ovulation check, 5.Tests to check for a normal uterus and open fallopian tubes, 6. Discussion about how often and when you have sex. The basic workup of an infertility evaluation can be finished within 14 days from the start of the menstrual cycle . Please discuss with the Center about the costs involved and find out whether they are covered by your insurance.
A general physical examination and semen analysis is a key part of the basic workup for a man. Semen analysis may need to be done more than once. The semen sample is obtained by masturbation. Sometimes it can be obtained at home but usually it is obtained in our lab. Our staff will give you instructions. Our lab will study the sperm using specific criteria for:
Based on the initial evaluation, further testing may be required in the Center, including genetic and chromosomal testing. It is recommended that the man abstain from ejaculation 3- 5 days before the semen test.
There are many tests to see if ovulation occurs. Some are done by the woman, and others are done by the doctor.
Other tests may be done, depending on a woman’s risk factors and symptoms.
Procedures are used to look at a woman’s reproductive organs. They check if the uterus is normal and the fallopian tubes are open. The tests you have depend on your factors and symptoms.
You may be given pain medications for some of these procedures.
After your basic testing as detailed above is completed, you and your partner will have a post testing consultation with the staff and the doctor. At this appointment, the results of all the tests performed are discussed in detail and a treatment plan is adopted. This may include just waiting for natural pregnancy, ovulation induction with clomid and or injectable medications, intrauterine insemination (IUI) or in-vitro fertilization (IVF). Men with very low sperm count may opt for ICSI procedure with IVF. Once a treatment plan is finalized a protocol is written up with dates and time of all appointments, when to take the medications, etc.
|Infertility can be treated in many ways, including lifestyle changes, medication, surgery, and assisted reproductive technologies. After your initial evaluation at the Center, we will discuss with you the appropriate treatment options based on your medical condition, age, personal desires, religious beliefs and financial situation. The common Assisted Reproductive Technologies are:
|The choice depends on the cause. After your evaluation, please discuss with the staff at the Center about the best treatment options for you and your partner. You also may choose adoption, foster parenting or other alternatives. Supporting you in whichever decision you make is our priority.|