Fertility Treatment and IVF Services
Assisted Reproductive Technologies (ART)
If your initial treatment options do not bring results, we provide you with the latest assisted reproductive technologies (ART) and techniques. These treatment options may include:
- In Vitro Fertilization
- Assisted Hatching
- Non-anonymous egg donation
- Ovulation induction
- Artificial insemination
- Tubal ligation reversal
IVF (In Vitro Fertilization)
IVF is the most common type of ART treatment for female infertility. During IVF, one or more of the woman's eggs are removed and fertilized with sperm in a lab setting. Then, three to five days later, if the eggs have been fertilized, they're returned to the uterus.
IVF is offered in cases of irreparable tubal damage, severe endometriosis, cervical problems that cannot be corrected, low sperm count, diminished ovarian reserve, and unexplained infertility.
ICSI (Intracytoplasmic Sperm Injection)
ICSI is a form of standard IVF and uses most of the same methods. However, instead of letting the sperm and egg meet together on their own, the egg is stabilized under a special microscope. An embryologist then carefully selects a sperm and injects it into the egg directly. This method is used typically when it's determined that chances of fertilization by traditional IVF are low.
Preimplantation genetic diagnosis (PGD)/ Preimplantation genetic screening (PGS)
Parents at risk of passing on a genetic disorder to a child may choose to have genetic screening done. PGD and PGS are types of screening performed at Sanford Health.
PGD stands for pre-implantation genetic diagnosis and includes procedures that are performed on embryos prior to implantation during IVF. Sometimes (albeit much less commonly), the egg or sperm can be tested prior to fertilization. This method significantly decreases the chances of having a baby born who is affected by the particular disease.
PGS or pre implantation genetic screening is different from PGD in that these procedures don't look for a specific disease, instead they use techniques to identify embryos at risk.
During certain IVF procedures this technique can be used to increase the chances of successful implantation.
As an embryo develops it is contained in a layer of protective proteins. In order for successful implantation into the uterus, the embryo needs to hatch out of that protective layer. Sometimes embryos have a difficult time doing that, so assisted hatching is the process of making a small hole in the outer lining to help the embryos break out.
Non-anonymous egg donation
Sometimes women with early menopause or diminished ovarian reserve (poor egg quality) are best treated with egg donation. We offer the option to choose non-anonymous egg donation. The eggs are donated by a woman who has gone through a rigorous screening process. These eggs are then fertilized using IVF by sperm provided by the partner of the woman looking to become pregnant and carry the pregnancy.
Sometimes infertility is the result of abnormal ovulation. When this is the case, often ovulation induction therapy is enough to help a woman become pregnant. Commonly a physician will prescribe oral medications such as clomiphene citrate. Doctors and patients like it because of it's low cost and relative safety.
Sometimes more potent injected medications are needed for treatment. They can be used to control the timing of ovulation or in conjunction with intrauterine insemination or IVF. These drugs require additional monitoring of your body's response.
The potential risks associated with these medications include an increased chance for multiple births, blood clots, and the development of ovarian cysts (ovarian hyperstimulation syndrome).
Artifical insemination can help treat certain types of infertility in both men and women. During this procedure, sperm are inserted directly into a woman's cervix or uterus. The distance required for the sperm to meet the egg is now shorter and avoids any possible obstructions.
The most common form of artificial insemination is intrauterine insemination (IUI).
The pregnancy rates for women undergoing artificial insemination are not as high as they are for some of the more advanced techniques, however, the advantage to artificial insemination is that it is simple and has few side effects. Doctors often recommend it as an initial form of infertility treatment.
Tubal Ligation Reversal
This surgery reopens or reconnects a woman's fallopian tubes so she can get pregnant again. Although not all women are candidates for this procedure, this surgery may be offered to women who previously had their tubes “tied” during a tubal ligation procedure.
A hysteroscopy can be done to help a doctor look at the lining of your uterus and see what problems might be preventing you from becoming pregnant. It can also be used to remove growths in the uterus such as fibroids or polyps.
To see in to the uterus, the doctor puts a tiny tool called a hysteroscope into your vagina and into the uterus. It has a light and camera hooked to it so the doctor can see the lining on a video screen.
Fibroids are benign tumors of the uterus and are very common. Sometimes fibroids make it difficult for a woman to become pregnant and they can be associated with recurrent miscarriage. When this is the case, a myomectomy is done to remove fibroids from the uterus. While this does increase chances for many woman, pregnancy is not a guarantee.
Sometimes the doctor will shrink the fibroid(s) with gonadotropin-releasing hormone analogue to reduce blood loss from therapy.