TREATING INFERTILITY

TREATING INFERTILITY

Treating Infertility


1. Patient education and self-monitoring
  • learning the signs of ovulation; BBT chart
  • timing intercourse

    • 2. Sperm and ovulatory analysis

    3. Drugs for anovulation/hormonal insufficiencies

  • clomiphene citrate
  • exogenous FSH


    • Procedures


    I. Artificial Insemination (AI)

  • reasons: low sperm count; bypass cervical mucus; male sterility; genetic concern; social
  • anonymous donor or directed donor
  • fresh or frozen
  • intravaginal or intrauterine


    • II. Assisted Reproductive Technologies

  • IVF (In Vitro Fertilization)
  • GIFT (Gamete Intrafallopian Transfer)
  • ZIFT (Zygote Intrafallopian Transfer)
  • MESA (Microsurgical Epididymal Sperm Aspiration)
  • ICSI (Intracytoplasmic Sperm Injection)
  • Cytoplasmic Transfer

    • Four Stages of IVF


    1. Stimulate the ovaries to produce multiple eggs (hyperovulation)

  • involoves multiple drugs
  • also multiple office visits to monitor and adjust hormone levels and view ovaries with ultrasound


    • 2. Egg retrieval

  • progesterone supplementation
  • sperm specimen production or retrieval

    • 3. In vitro fertilization


    4. Embryo transfer

  • 3-5 embryos
  • 3 days after egg retrieval

    • Cost of procedure: $7,000-$9,000

    Cost of drugs: $1,500-$3,000

    Cost with donor eggs: $10,000-$60,000

    IVF is the oldest ART procedure, the first baby born in 1978

    GIFT


    1. Hyperovulation

    2. Egg retrieval

    3. Immediate transfer of 3-5 eggs and sperm to f. tube via laparoscopy (requires at least one functioning fallopian tube and no male factor)

    ZIFT


    1. Hyperovulation

    2. Egg retrieval

    3. In vitro fertilization

    4. Tubal embryo transfer with laparoscopy (normal fallopian tubs with severe male factor)

    MESA


  • sperm extracted from epididymis via microsurgery and aspiration
  • must be used in conjuction with IVF or ZIFT
  • indicated for uncorrectable duct blockage

    • Cost: $4,500 for procedure plus IVF costs

    ICSI


  • injection of single sperm into egg
  • in conjunction with IVF or ZIFT
  • indicated for low amounts of weak sperm

    • Cost: $1,500 for procedure plus IVF costs