With modern medical technology pregnancies are now possible that would never have happened a few decades ago. Using state of the art equipment, skilled embryologists and doctors can overcome many fertility hurdles. Some of the techniques used at Arizona Center for REI are described here.
Intrauterine Insemination (IUI)
This treatment can be performed with the patient's partner's sperm or an anonymous donor's sperm. In IUI, a sperm sample is prepared in the lab, then the physician guides a syringe containing the sperm through the vagina to release the solution into the uterus from where they swim into the fallopian tubes.
A wide variety of fertility drugs are now available to induce ovulation. Use of these medications is carefully individualized based on factors such as cost, ease of use, and success rates.
In Vitro Fertilization and Embryo Transfer (IVF)
"In Vitro" literally means "in glass". In medical terminology it implies the performance of a procedure outside the body. The ovaries are stimulated to produce several eggs. The eggs are retrieved from the ovaries prior to ovulation and placed into a dish with sperm to allow fertilization. After three to five days, the embyo(s) are transferred back into the uterus where it implants into the endometrial lining. IVF is used primarily when traditional therapies fail to provide a pregnancy for an infertile couple. The primary medical reason for IVF procedures is tubal damage. This includes patients who have undergone surgical removal of the tubes because of infection, ectopic (tubal) pregnancy and patients in whom surgery on the tubes has failed or the tubes are not amenable to surgery. Other indications for IVF include endometriosis that has failed traditional medical and surgical therapy, abnormalities of the uterus, immunologic disorders, unexplained infertility and poor sperm quality or male factor infertility.
Gamete Intrafallopian Transfer (GIFT)
GIFT is a variation of in vitro fertilization (IVF). A requirement for this procedure is that the female partner having at least one open, normal fallopian tube. With GIFT, fertilization occurs naturally within the female partner's body instead of in the laboratory as with IVF. GIFT involves ovarian stimulation, and egg retrieval like IVF, but with GIFT, sperm and eggs are placed directly into the woman's fallopian tubes for fertilization.
With AI, IUI and IVF, the sperm sample can be processed to increase the likelihood of obtaining a desired sex. Though controversial, it is often used when there is a chance of passing on a gender based genetic abnormality, or for couples who wish to obtain a gender balance in their family planning.
Intracytoplasmic Sperm Injection (ICSI)
ICSI is a technique to treat couples who have a poor probability of achieving fertilization due to the male partner's extremely low numbers of viable sperm. ICSI is used in combination with in vitro fertilization. Under a high power microscope, the egg is held, and one sperm selected to be micro surgically introduced into the egg.
Learn more about ICSI and view a video clip of the proceedure.
This procedure is available for men who for numerous of reasons. Often times this procedure is used for patients who have no sperm in the ejaculate (i.e.patients who have had vasectomies). This is an outpatient procedure, the sperm are extracted directly from the epididymis, or aspirated from thetesticles.
Assisted Hatching (AZH)
Microembryonic hatching is a technique in which the embryologist creates microscopic holes embryonic shell to facilitate easier release of the embryo into the endometrial cavity thereby improving the chances of implantation. AZH maybe recommended for patients embryos having thicker zonas, patients who have an elevated Day three FSH level or those who have failed IVF two or more times.
Preimplantation Genetic Diagnosis (PGD)
The most common type of PGD performed is to look for chromosomal abnormalities due to advancing maternal age. These situations are more likely to occur in women 35 years of age and older and lead to problems such as Down Syndrome or early miscarriage. Another reason to chose PGD is when a couple has a known risk for genetic disorders. Learn More about PGD
Egg donation is an avenue for couples in cases of absent or non functioning ovaries, advanced maternal age, premature menopause, or genetically defective eggs. Like sperm donation, egg donation is preferably anonymous. In choosing an egg donor, couples consult a list with identifying physical characteristics. Egg donation is done in conjunction with IVF.
Donor sperm has been utilized for many years for couples in which the man does not have sperm, or his sperm does not fertilize eggs. It is also an option for single women who want to have a child without a partner. Donors are chosen from a list of physical and personality characteristics. Fertilization with donor sperm can be accomplished through AI, IUI or IVF.
Sperm banks have been maintained for many years, however egg banking is relatively new due to technical problems involved in the freezing of unfertilized eggs. Both egg and sperm donors are evaluated for their physical and psychological suitability as gamete donors.
Cryopreservation of Sperm, Embryos and Oocytes
Freezing of embryos and sperm is possible for either short or long term storage. Sperm have been successfully frozen for many years. Embryos can be successfully frozen and thawed approximately 80-90% of the time. A similar procedure for immature eggs has recently been developed and is currently available. Excess eggs removed at the time of IVF or GIFT procedures are fertilized and then frozen. These embryos can be transferred at a later date. Sperm can be stored ahead of time and thawed for use during treatment cycles. Ovarian cryopreservation can be used to store large numbers of immature eggs for future use.
Arizona Center for Reproductive Endocrinology and Infertility
Caring for you, Caring for your heath & Caring for your future
5190 E Farness Drive #114 Tucson, Arizona 85712