Author: Dr. Michael C. Allemand, M.D.

Conceiving a pregnancy naturally requires several key steps in order to be successful:

  • Ovulation-the release of an egg from the ovary
  • The pickup of the egg from the pelvis by the fallopian tube
  • The presence of sperm in the fallopian tube after intercourse correctly timed with ovulation
  • Binding and fertilization of the egg by the sperm with embryo development in the fallopian tube
  • Implantation of an embryo in the endometrial cavity of the uterus

All of our fertility treatment options; Clomid/Letrozole ovulation treatments, FSH injection ovulation treatment, intrauterine insemination (IUI), are designed to improve the natural function of this basic fertility system. However, in some cases these more basic treatments may have a limited chance of success. Examples of this scenario include absent or blocked fallopian tubes, severely reduced sperm count, significant ovulation resistance, pelvic adhesive disease, extensive endometriosis, unexplained infertility. An alternative approach that can be very successful for couples is In Vitro Fertilization (IVF). IVF is a type of fertility treatment that does not require fallopian tubes, ovulation, or a normal sperm count to be successful.

An IVF treatment cycle starts with injectable fertility hormones to stimulate the ovaries to develop more eggs than would normally occur. The woman’s response to medication is monitored with blood work and ultrasounds to verify appropriate egg development. The eggs are removed from the ovaries with an ultrasound guided egg retrieval performed in the office with intravenous medications to make the woman comfortable. The eggs are then fertilized in the lab under a microscope with sperm. The now fertilized embryos are grown in an incubator in the IVF lab, taking the place of the function of the fallopian tubes. After growing in the lab, the best embryos are then selected for embryo transfer back in to the woman’s uterus. Embryos from IVF can be transferred around 5 days after the egg retrieval, or after being frozen from a previous IVF stimulation cycle. The embryo transfer is performed in the office with no intravenous medications required. Approximately 9 days after the embryo transfer, a pregnancy test can be performed to verify success.

Prior to beginning an IVF cycle, a couple should undergo a workup including:

  • Assessment of the woman’s egg supply (ovarian reserve)
  • Semen analysis for sperm count and other important markers of male fertility potential
  • Assessment of the woman’s uterus and fallopian tubes

A Reproductive Endocrinologist can review this workup and design a treatment plan for the couple to maximize their potential for IVF success.

In some cases patients may be able to pursue a Shared Risk package for their IVF care that includes the possibility of a partial refund of their out of pocket costs if they are unsuccessful in delivering a baby.

If you are interested in an IVF consultation with one of our Board Certified physicians, please contact us at 205-870-9784.

 

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