Infertility Treatment

Male Treatment

Medication or surgery are the primary means of treating male infertility.

Generally, there is no effective medication for sperm quality causes like e.g. oligospermia. Medications include Clomiphene citrate, an anti-estrogen drug designed as a fertility medicine for women but sometimes used to boost sperm production in men with low sperm counts and poor sperm motility. Vitamin E helps counter oxidative stress, which is associated with sperm DNA damage and reduced sperm motility.Azoospermia can sometimes be treated with HCG injections. If that fails after six months, FSH can be added. A hormone-antioxidant combination may improve sperm count and motility.

• Surgery is often the choice in posttesticular causes.

• IVF or even ICSI may be additional alternatives.


Prevention

Some strategies suggested or proposed for avoiding male infertility include the following:

• Avoiding smoking as it damages sperm DNA

• Taking a lycopene supplement.

 

Female Treatment

VIMRC offers a full range of treatments for infertility. Through a careful evaluation, Mayo physicians will explain the options, answer all questions, and help patients decide on the most appropriate treatment for them. VIMRC program achieves high success rates (see statistics) while limiting the number of embryos transferred to avoid multiple births (twins or triplets).

Treatment options include:

• In vitro fertilization (IVF)

• Embryo cryopreservation

• Assisted hatching

• Blastocyst transfer

• Intrauterine insemination (IUI)

• Pre-implantation genetic diagnosis (PGD)

• Egg removal

• Fertilization / intracytoplasmic sperm injection (ICSI)

• Embryo transfer

• Electroejaculation

• Semen cryopreservation

• Donor oocytes

• Donor sperm

• In Vitro Fertilization (IVF)


IVF is the most common assisted reproductive technology method and is the treatment of choice if both fallopian tubes are blocked. IVF is also widely used for conditions such as:

• Endometriosis

• Unexplained infertility

• Cervical factor infertility

• Male factor infertility

• Ovulation disorders


The process typically includes four steps: ovarian stimulation, egg retrieval, fertilization and embryo transfer.

Embryo Cryopreservation

VIMRC IVF laboratory is a leader in embryo cryopreservation — the freezing of embryos. More than 60 percent of patients entering VIMRC reproductive endocrinology program have extra embryos available for freezing. A frozen embryo transfer is less costly and safer than repeated courses of ovulation stimulation and egg retrieval. Mayo's high success rates with frozen embryos help reduce the cost of infertility treatment and maximizes the chance of having one or more babies from a single egg retrieval.

Assisted Hatching

Assisted hatching is a laboratory procedure that helps the embryo hatch out of its outer shell, a process necessary for implantation and the establishment of pregnancy. Assisted hatching may be recommended to increase the chance of pregnancy in women

• over age 38

• who have diminished egg production

• who have undergone failed IVF cycles.

Blastocyst Transfer

Blastocyst transfer is intended to improve the chance of identifying the single embryo most likely to result in pregnancy. The technique allows embryos to mature longer, usually five to six days, before transfer. Embryos that progress to the blastocyst stage may have a higher chance of pregnancy than those transferred earlier.

Intrauterine Insemination (IUI)

Intrauterine insemination has been shown to increase the chance of pregnancy in women undergoing induced ovulation. During this procedure, the partner's sperm is placed directly into the uterus near the time of ovulation. IUI is often performed in the case of a low sperm count, abnormalities of ejaculation (retrograde ejaculation, impotence, spinal cord injury), when the cervix prevents sperm from entering the uterus, or with donor sperm.

Pre-Implantation Genetic Diagnosis

Preimplantation genetic diagnosis is used to test embryos for genetic disorders before transfer to the uterus (womb) and before pregnancy has started. This procedure can help couples have a successful pregnancy and a child free from specific genetic disorders such as hemophilia, Duchenne muscular dystrophy and cystic fibrosis.

Egg Retrieval

During egg retrieval, a needle (guided by ultrasound) is inserted through the vaginal wall into the follicles (the sac of fluid containing the eggs). Egg retrieval usually takes less than 30 minutes. In general, eggs are retrieved from about 80 percent of the mature follicles seen on ultrasound. Patients receive a mild intravenous anesthetic to help with relaxation during the procedure.

Fertilization/Intracytoplasmic Sperm Injection (ICSI)

Following egg retrieval, sperm is injected into an egg. About 70 percent of eggs become fertilized. Fertilization is confirmed 24 hours after retrieval. ICSI is a highly successful technique used to help couples who have previously failed to achieve conception with standard IVF. One sperm is injected into the egg using a special microscope. ICSI can dramatically improve the likelihood of fertilization when male infertility disorders such as low sperm counts, low sperm motility or abnormally shaped sperm are present.

Embryo Transfer

This brief procedure transfers the embryos to the uterus through the cervix, two to five days after retrieval. Depending on the quality of the embryos and other factors, typically two or three embryos are transferred.

Electroejaculation

In the past, men with ejaculatory dysfunction were considered infertile because they couldn't ejaculate even though they produced sperm within their testicles. Electroejaculation stimulates the nerves and produces an ejaculation. If the specimen collected is of very good quality, it can be used for intrauterine insemination (IUI).

Semen Cryopreservation

Semen cryopreservation (the freezing of sperm) is a way to store sperm for future use. Men who must undergo medical procedures that may leave them sterile may wish to consider semen cryopreservation. Semen cryopreservation is also used before IVF to acquire multiple semen samples in men with low sperm counts.

Donor Oocytes

The use of donor oocytes (eggs) is an option for patients who cannot become pregnant using their own eggs. Donor oocytes allow recipients to experience pregnancy and deliver a healthy child who is biologically related to one parent. In a non-anonymous oocyte donor program, patients use the eggs of a willing family member or friend. Anonymous donor oocyte programs are available for patients who do not have a known donor.

Donor Sperm

Donor sperm are recommended when sperm is absent from the semen, often due to genetic causes, chemotherapy, radiation therapy or vasectomy. Donor sperm are also an option for single women, couples with genetic disorders, and couples in which the woman is Rh-sensitized and the man is Rh-positive. In most cases, anonymous donors provide semen to sperm banks.

All donor sperm and embryos derived from donated oocytes are frozen and quarantined as the donor undergoes screening for infectious diseases such as HIV. Sperm banks usually provide information regarding physical traits to match donors with recipient requests.

 

Male Infertility

 

Female Infertility

 

Diagnosis Male

 

Diagnosis Female

   
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