Frequent Causes and Treatment of Infertility
Male
Low sperm counts, low numbers of motile sperm and abnormal sperm can cause infertility.
Sometimes medicine can improve the situation. IUI (intrauterine insemination) and IVF (in vitro fertilization) with ICSI (intracytoplasmic sperm injection or directly injecting the sperm into the egg) can work around the low numbers. With patients with no sperm, sometimes sperm can be retrieved for IVF directly from the testicle. If no method for sperm collection works then donor sperm can be used.
We recommend men with a problem be evaluated by a urologist with special training in infertility.
Female
1.Ovulation problems –can be resolved with oral medicines or injectable hormones.
2.Tubal problems
Tubal Ligation –Tubes can be put back together or IVF.
Blocked tubes—IVF. Surgery on blocked tubes not as successful as IVF.
Unexplained Infertility—All tests are normal in both the male and female. Treatment involves either IUI or IVF.
3. Explanation of IUI
The sperm (semen) specimen is mixed with culture medium and centrifuged to isolate the sperm. The sperm motility is enhanced and then the specimen is placed in the uterus just after ovulation.
4. Explanation of IVF
The woman is stimulated (superovulated) with potent hormone injections to obtain as many eggs as possible. The eggs are removed from the ovaries via ultrasound in the clinic under sedation. The eggs are examined and then fertilized with sperm by directly injection the sperm into the eggs (ICSI). The fertilized eggs are then cultured in the laboratory for 4-6 days until they reach the blastocyst stage of development. The area that will develop into the placenta is biopsied and sent to a genetics laboratory for analysis. The blastocyst is then frozen until needed.
Once the genetics are known the most normal embryo is transferred back into the woman. The remaining normal embryos can be transferred during later cycles.
Eggs or sperm can be used from anonymous donors and a surrogate can gestate the embryos.