Doctor consulting young couple in fertility clinic.
Going to a fertility clinic doesn’t mean you’re signing yourself up for IVF. Far from it. In fact, the best fertility clinics treat each patient individually and will do their best to get patients pregnant with the least invasive technique possible.
Once we’ve established, you’re ovulating and your partner’s sperm is active we have a few tricks up our sleeve.
Natural Cycles or ‘Timed Intercourse’: We can help you determine when you are ovulating and send you home to do the job on your own. We recommend an ovulation kit so you can find the right time and date and sometimes this is all our patients need to become pregnant.
Natural Monitored Cycles: You and your partner are basically doing it on your own with an ovulation kit and we add in an ultrasound to make sure ovulation occurred and perform a progesterone blood test after ovulation. Some of our patients have irregular cycles or skip months of ovulation due to PCOS or other conditions. This technique is helpful for women who do ovulate consistently.
Medicated Cycles: If we discover that a patient does have trouble ovulating then we can do an Ovulation Induction with medication. These are prescription oral pills followed by a series of in-office ultrasounds so that we can monitor closely when ovulation occurs. Then, we can either send the patient home to do the deed or we can do an IUI.
IUI: Intrauterine Insemination is a medical procedure where the sperm is washed and injected directly into the uterus timed correctly for ovulation. IUIs can be done with partner sperm or donor sperm.
We ‘wash’ the sperm so concentrated, healthy sperm reach the uterus just before ovulation and swim into the fallopian tubes to hopefully meet and fertilize one lucky egg. Washing sperm results in a much cleaner and more concentrated sample with most of the non-motile sperm and other fluids removed.
Also, we usually recommend two sperm injections per IUI cycle for increased odds of success.
We are skilled at IUIs and have an excellent lab on-site. Fresh or frozen (then thawed) sperm can be used. So even if your partner is overseas, a planned IUI can work.
Medicated IUI Cycles: Stimulating the female patient to ovulate with oral tablets and injections, then using IUI with concentrated, healthy sperm injections twice during monitored ovulation can be highly successful. We offer packages of IUIs where you pay for two cycles and receive a third cycle free, if needed. One of our IUI packages allows money spent on IUIs to go towards IVF (up to $4,000) if the IUIs are unsuccessful. This allows couples to try IUIs first before stepping up to IVF.
If a patient is suffering from PCOS, endometriosis or diminished ovarian reserve these enhanced IUI techniques may be all that’s needed to produce a healthy baby. And a medicated IUI package is substantially less expensive than IVF.
Every patient is different, and some patients find success with a combination of these techniques. IUI may not work on the first try but may work perfectly on the second or third attempt. If IUI does not work in three tries, we suggest trying something different.
In Vetro Fertilization (IVF)
We have a universal method of IVF that we find gets the highest success rates for our patients. It includes growing the embryos to days 5 – 7, taking a biopsy of each viable embryo for PGT-A (Preimplantation Genetic Testing for Aneuploidies), flash freezing them, and after the PGT-A test results come back from a genetic lab a cycle later, transferring one healthy embryo at a time. Adopting these practices into our routine care have resulted in dramatic increases in the success rates at our practice
- PGT-A (Preimplantation Genetic Testing for Aneuploidies). PGT-A involves the selection of only genetically normal embryos for transfer, increasing implantation rates and markedly reducing miscarriage rates. It also allows for family balancing for eligible patients (patients with one child desiring another child of the opposite gender).
- Freeze all cycles. This refers to the practice in IVF of freezing (vitrifying, or cryopreserving) all appropriate blastocysts (embryos) on Day 5/7 and transferring them in a subsequent frozen embryo transfer (FET) cycle. Vitrification technology (or freezing) is safe for eggs, sperm and embryos.
- Single embryo transfer (SET). SET has been an option for years, and while the benefits of it (safer, reduced chance of multiples) are real, its use most often would result in a decreased pregnancy rates and, as such, patients would still elect to transfer more than one embryo in order to increase their chances of a successful cycle. The advent of PGT-A has changed that. Now we can offer SET and achieve very high pregnancy rates and a much safer, healthier pregnancy and outcome.
Because women only ovulate once a month, time is of the essence when addressing infertility. A patient only has 12 chances per year. And an unsuccessful pregnancy or a miscarriage can take up precious months in a fertility window — in addition to the emotional toll. If your dream is to have a family, please don’t delay getting the professional help you need.
