|
Hysterosalpingogram (HSG Test): An X-ray examination of the uterus and fallopian tubes.
Intrauterine insemination (IUI): This is an in-office procedure that involves exposing the patient to sperm, either vaginally, intra-cervically, or intrauterinally. Sperm can be from the husband or frozen donor semen. If sperm is placed inside the uterus it must be washed several times to remove substances that can cause severe cramping or shock. Once the sperm are washed, they can remain active and viable for 24-48 hours. Intrauterine insemination involves washing and condensing the sperm into a small volume of less than 1.0 cc. The aim is to get sperm beyond the cervical barrier and enable them to find the egg. The soft plastic catheter is threaded through the cervical canal into the uterine cavity before injecting the semen. Insemination optimizes your chances of achieving pregnancy within a cycle, thereby bringing you up to potential 20% pregnancy rate/cycle.
In vitro fertilization (IVF): The letters IVF stand for In-Vitro Fertilization, otherwise known as test-tube baby. These days, fertilization takes place in a dish, not a test tube. Due to improvements in ultrasound imaging, surgery is no longer necessary for most In Vitro Fertilization patients. A technique for recovery of eggs from the ovary is described below. It uses a sonographically-guided needle to replace the surgical procedure which previously was used to recover oocytes (eggs). This procedure requires neither hospitalization nor general anesthesia.
In order to prepare a proper environment in the woman and to increase the chances of recovering several healthy and mature eggs, the woman will undergo about two weeks of intensive preparation. This will include hormonal therapy with fertility drugs (clomid, metrodin, pergonal). Blood tests and ultrasound scans of the ovaries are used to determine the optimal time to retrieve the eggs from the ovary. This optimal time is just before ovulation when the oocytes are almost ready for fertilization.
At the proper time, an outpatient procedure under local anesthesia will allow the wife's eggs to be visualized by ultrasound and retrieved from the ovary by placing a needle through the vaginal wall. After a short rest, the wife will be able to go home and resume normal activities.
The fluid from the follicles is examined under the microscope by the embryologist, who locates the eggs and keeps them in the laboratory under physiologic conditions. The embryologist will place the sperm with the eggs when they are ready for fertilization. The fertilized eggs are maintained in laboratory dishes in a nutrient mixture which acts as a substitute for the environment that would otherwise have been provided by the fallopian tubes. After two days, the fertilized eggs have divided 2 to 4 times and are ready to be transferred back into the woman. Using a special catheter, 3 to 6 of the couple's pre-embryos will be passed through the vagina and into the uterus. After the pre-embryo placement in the uterus, the wife will lie quietly in a bed for about an hour, and then will return home. The chance of implantation and pregnancy is up to about 25% per cycle of treatment. The remaining pre-embryos can be frozen for future use.
Support Groups
Resolve is a national non-profit organization that assists people in resolving their infertility by providing information, support, and advocacy.
|
