Female Infertility Treatments

Intrauterine Insemination (IUI) Treatment Explained & Common Questions Answered

Also referred to as artificial insemination, Intrauterine Insemination is a tremendously popular infertility treatment option because it is a painless procedure that works naturally with a patient’s cycle and allows patients to resume normal activity immediately. IUI is an Assisted Reproductive Technology (ART) where specially prepared sperm are introduced directly into the uterus which can enhance the chances of conception.

For IUI treatment, the female’s cycle is carefully monitored and on the day of ovulation a semen sample is provided by either her partner or donor sperm is thawed, analyzed and enhanced, and then placed directly into the uterus via a small catheter. For pregnancy to occur, one or both fallopian tubes must be open. Two weeks later, a pregnancy test is given. For each cycle, pregnancy rates range from 20 to 25 percent, so many couples should enter IUI with the expectation that a series of treatments will occur. Also, IUI is often paired with fertility medications as part of a progressive treatment plan for specific patients.

IUI can help overcome a variety of fertility issues, including:

In Vitro Fertilization (IVF) Treatment Explained & Common Questions Answered

Essentially, IVF is a complex series of medical procedures whereby an egg is fertilized by sperm in a laboratory to create a viable embryo to implant into the uterus and ultimately lead to a pregnancy. The IVF process represents a combination of perfectly timed events that occur in several phases and many CRM patients have realized their dream of having a baby through IVF treatment.

IVF Preparation

Prior to beginning the administration of any fertility drug, a screening ultrasound is performed to ascertain that there are no ovarian cysts which could interfere with the process.

Ovarian Stimulation & Your IVF Cycle

In a typical reproductive cycle, a single egg will develop and mature in a fluid-filled sac called a follicle. In an IVF cycle, we stimulate the ovaries to produce multiple eggs with daily injections of medications. The daily injections continue until the follicles are a proper size and the blood estrogen levels reach an optimal level. The Human Chorionic Gonadotropin (hCG) hormone is then used to mimic the body’s LH surge to bring about final maturation of the egg.

Careful monitoring of estrogen levels and follicle size optimizes ovarian stimulation and provides for increased safety. Blood estrogen level checks are performed every one to three days from Cycle Day 2 until the administration of hCG.

IVF Egg Retrieval & What to Expect

Transvaginal egg retrievals are performed by ultrasound-guided probe inserted through the vagina to enable our team to view the reproductive organs on a monitor. When a mature follicle is identified, the physician guides a needle through the vaginal wall and into the follicle. The egg is then removed through the needle by a suction device. During the retrieval, the embryologist will immediately scan follicular fluid for the eggs. Gas composition, temperature and humidity of the environment are specifically controlled. Once identified, the eggs are evaluated for maturity and placed in culture medium.

Although the vagina has a reduced number of pain nerves, this procedure can be associated with some discomfort. Most patients require light sedation. On rare occasion, general anesthesia may be required. An experienced anesthesiologist or nurse anesthetist is available to provide either sedation or anesthesia as required or requested. Patients typically go home the same day, regardless of whether retrieval is done under sedation or general anesthesia. In the unlikely event of a problem or suspected problem, admission to Mobile Infirmary Medical Center will be advised. Being located at and directly connected to this major hospital is another critical advantage CRM offers its patients.

Fertilization of the Eggs & Embryo Culture

Following the egg retrieval, the male is asked to provide a semen specimen for the insemination of the eggs. If a donor is used the specimen will be thawed. The time of the semen collection will vary according to the maturity of the oocytes and the requirement for special treatment of the sperm. The mature eggs are inseminated with the sperm four to six hours after retrieval.

Sixteen to eighteen hours after the insemination, the oocytes are examined for signs of fertilization. Fertilization does not always occur, and sometimes embryo development halts shortly after fertilization. The three to five days wait from oocyte retrieval to embryo transfer is inevitably stressful, and we ensure patients are kept informed about the progress of their eggs during this period.

Embryo Transfer during IVF

Once the embryos have developed satisfactorily, they are transferred into the uterus. Typically, we strive for a single embryo transfer. However, the physicians will make the final decision the morning of transfer after consulting with the patient. Medication to promote relaxation will be prescribed to be taken just before the transfer. The embryologist loads the embryos into a thin catheter that is then given to the physician, who places the embryos into the uterus.

What To Expect after IVF Transfer

Bed rest is encouraged for two hours following the embryo transfer. Decreased activity will be advised for 48 hours.

Embryo Freezing during IVF

Any embryos of sufficient quality that are not transferred may be cryopreserved to use in the future, thus avoiding another round of ovarian stimulation and egg retrieval. Our technology allows for optimal and sustainable embryo cryopreservation and thawing.

IVF Procedure Follow-Up

A pregnancy test will be done 10 days after an embryo transfer. After the transfer, you will receive a “report card” reviewing your cycle, egg retrieval, development, and transfer to discuss with your CRM team.

Elective Single Embryo Transfer (eSET) Explained & Common Questions Answered

CRM is proud to follow the American Society for Reproductive Medicine (ASRM) guidelines for embryo transfer and to offer this option to our patients. Elective Single Embryo Transfer (eSET) has rapidly become a preferred method of IVF embryo transfer due to the long and short-term risks of high-order multiple pregnancies. Patients who choose eSET opt to have just one of those embryos transferred into the uterus, rather than multiple.

While it may seem counterintuitive that transferring a single embryo at a time would ultimately result in the successful birth of more healthy babies, transferring multiple embryos increases the likelihood of becoming pregnant with twins, triplets, etc. A multiple pregnancy is a riskier endeavor for both the mother and her babies. Multiple pregnancies are more likely to result in a premature delivery, which are often associated with problems including cerebral palsy, long-term lung and gastrointestinal difficulties and neonatal death.

Approximately 30% of IVF pregnancies result in a twin pregnancy, and an additional 3% in a triplet (or higher) pregnancy. With eSET this number is dramatically reduced, offering the best possible conditions for the birth of a healthy baby. The following information answers common questions about eSET.