Fertility Treatments Articles

What does PGT test for?

Couples struggling with infertility may benefit from preimplantation genetic testing (PGT), which can increase the chances of having a successful pregnancy. Infertility clinics will perform PGT testing before implanting an embryo into the uterus for IVF. This article outlines what PGT is, discusses who could benefit from it, and explains the different types of PGT.

What is PGT? 

Preimplantation genetic testing (PGT) is an option for couples undergoing in vitro fertilization (IVF). This testing screens the embryos for potential genetic and chromosomal abnormalities before implanting them into the uterus. PGT plays a crucial role in selecting the embryos with the highest chance of success during fertility treatments, like IVF, for implantation. Only the unaffected embryos are transferred to the uterus for implantation to increase the success of implantation.

Is PGT for Me? Who Can It Help? 

There are many factors to consider when deciding to have PGT. Reasons to consider PGT include:

Previous pregnancy with aneuploidy (chromosome abnormality)
Two or more miscarriages
Couples at risk of having a child affected with an inherited genetic disorder
Previously failed embryo implantation
Women who are diagnosed with unexplained infertility
Women over the age of 35
Numerous unsuccessful fertility treatments

It is best to consult with a fertility specialist to make the best-informed decision. A fertility specialist will go over your health history, individual fertility journey and will be able to answer any questions.

Understanding the Different Types of PGT 

couple talking about pgt options with doctor

There are three different types of PGT. Preimplantation genetic testing-monogenic (PGT-M) testing targets a single gene disorder. Preimplantation genetic-testing aneuploid (PGT-A) is a broader test that screens for one or more extra or missing chromosomes, known as aneuploidy. Fertility clinics may recommend preimplantation genetic testing-structural rearrangements (PGT-SR) for concerns of translocations. Translocations are when two chromosomes break off and switch places.

Fertility specialists recommend conducting PGT during the blastocyst phase of an embryo, which is an early developmental stage of an embryo. Embryologists can also complete this testing at the embryo's later stages if needed. When performing PGT, embryologists will biopsy about 5-10 cells from the trophectoderm layer or the outer layer of an embryo that turns into the placenta. These cells do not require a biopsy of the inner cell mass, which turns into the developing fetus.

PGT-A (Aneuploidy Screening)

The PGT-A screens embryos for whole chromosome abnormalities. An embryo should have 46 chromosomes, of which half come from the egg and the other half from the sperm. PGT-A screens for any missing or extra chromosomes that may lead to failure of the embryo to implant, a miscarriage, or cause significant health issues for the child after birth. This screening counts the 46 chromosomes in an embryo to determine if there are any extra or missing chromosomes, a condition clinically referred to as aneuploidy. PGT-A screening can reduce the risk of having a child with genetic or chromosome abnormality, like Down syndrome, by identifying abnormal embryos so that transfer to a uterus can be avoided It can also help identify embryos with the greatest chance to implant during IVF, resulting in pregnancy.

Because PGT-A can identify embryos with high probability of implantation some fertility specialists recommended transferring only one embryo to avoid complications that may arise in pregnant patients with multiple fetuses.

Screening all 46 chromosomes means that the embryo sex is also available. This can benefit situations where a genetic disease is inherited based on embryo sex. Chromosomal abnormality in a developing fetus can lead to an increased risk of stillbirth, shortened lifespan, or cause significant medical problems after the child is born and is the leading cause of pregnancy loss. Screening the embryos for chromosomal abnormalities can avoid some of these situations and decreases the risk of miscarriage.

Additional testing of PGT-A adds extra cost to IVF. Insurance may not help cover the cost of PGT-A testing with the fertility treatment. Genetic screening tests also require embryologists to remove 5-10 cells from the trophectoderm, which are the cells that become the placenta. Testing is usually performed during the blastocyst stage of an embryo to decrease the risk of damage. The inner cells of the embryo that develop into the fetus are not disturbed. The risk of damage to the embryo is very low when performed in labs that routinely perform PGT screening.

Testing can deliver a false negative or false positive result. Healthy embryos can remain unused or for an embryo transfer with chromosomal abnormalities to occur due to test results. The test uses cells from the placenta and not the fetus, so it is not considered a diagnostic test. However, early genetic screenings also test cells from the placenta. Testing on the DNA of the fetus is not available until 15 weeks of pregnancy through an amniocentesis.

PGT-M (Monogenetic/single gene disorders)

PGT-M tests for a specific genetic mutation associated with a known diagnosis or known predisposition within the family. PGT-M does not test for all single gene disorders at once and will not detect genetic alterations present for the first time in one family member due to a variant. This type of testing uses cytogenetic or molecular techniques for single-gene disorders, like Huntington's disease, cystic fibrosis, or Fragile X syndrome. This includes single-gene disorders that are autosomal dominant and recessive or X-linked. PGT-M testing can also test for hereditary cancer syndromes like breast and ovarian cancer and Lynch syndrome. Furthermore, PGT-M can assist in detecting embryos that are compatible with human leukocyte antigens. These embryos can then be gestated so that ill family members can receive bone marrow transplants or cord blood transfusions compatible with their immune systems.

PGT-M tests a few cells from the early embryo, usually in the blastocyst stage. Misdiagnosis is possible but rare. To confirm the results of PGT-M, fertility specialists may recommend chorionic villus sampling (CVS) or amniocentesis.

PGT-SR (Structural Rearrangements)

happy couple holding healthy newborn after IVF with pgt

Embryos at risk for chromosome rearrangement, when pieces of chromosomes are missing, duplicated, or rearranged, may consider having PGT-SR testing. It is important to consider genetic counseling and preimplantation genetic screening with the discovery of structural rearrangement in either parent. An individual with a chromosomal rearrangement is at an increased risk of experiencing recurrent pregnancy loss or having a child with a chromosomal rearrangement. If someone has experienced two or more pregnancy losses, fertility specialists may recommend a karyotype screening to check for any possible chromosomal rearrangement before beginning IVF. Testing for PGT-SR can lower the chances of experiencing another pregnancy loss or giving birth to a baby with a chromosomal abnormality.

It's important to note that PGT-SR testing has certain limitations. For instance, this type of testing cannot distinguish between an embryo with a typical karyotype and one with a balanced form of familial chromosome rearrangement. Individuals who carry balanced chromosome rearrangement involving imprinted genes are susceptible to irregularities related to uniparental disomy. This occurs when the embryo receives both copies of a chromosome from one parent instead of inheriting one from each parent. Uniparental disomy cannot be excluded from all preimplantation genetic testing analysis methods. A fertility specialist may recommend CVS or amniocentesis to confirm PGT-SR results.

Helping With Your Fertility Journey

Preimplantation genetic testing can help increase the chances of successful implantation for IVF patients. There are various reasons it may be considered. If you have been struggling with infertility, discuss your situation with one of our fertility specialists at Advanced Fertility Care to determine if PGT is right for you.

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Letrozole for Fertility

Infertility is a common problem for many people trying to get pregnant. Fortunately, many treatment options are available to help those struggling with infertility. Medications, such as letrozole, are often recommended as part of an infertility treatment plan.

What is Letrozole?

Letrozole is an oral medication that influences reproductive hormone balance in the body. Letrozole is an aromatase inhibitor, which reduces the hormone estrogen. It's widely used in breast cancer treatment, but it's also an effective treatment for infertility since its hormonal effects stimulate ovulation.

How Safe is Letrozole, and Does It Work?

couple discussing letrozole and fertility with reproductive doctor

Letrozole has been used to treat infertility for over twenty years. Success rates will always vary from person to person. Still, many studies suggest that letrozole is especially helpful for women dealing with polycystic ovarian syndrome (PCOS) or ovulation problems, like anovulation.

Luckily, letrozole is safe to take, but like any medication, it can have side effects. Some women may experience hot flashes, night sweats, headaches, tiredness, breast tenderness, dizziness, and spotting, to name a few. Letrozole's side effects are mainly related to how it affects estrogen levels.

Medication Alternatives to Letrozole

Medications are often the first-line treatment for women going through ovulation problems. Fertility drugs like letrozole impact hormones that affect ovulation and reproduction.

Clomiphene is one common alternative to letrozole. This oral drug works on the pituitary gland, promoting the release of hormones that encourage the growth of ovarian follicles containing eggs. Clomiphene may be more effective for women who don't have PCOS.

Human chorionic gonadotropin (hCG) is an injectable medication that may also help the body develop multiple ovarian follicles during an in vitro fertilization (IVF) cycle.

Letrozole and IVF

woman pregnant with ultrasound after letrozole IVF

Letrozole can be a valuable part of IVF and IUI treatments since stimulating ovulation can help increase the chances of conception.

Letrozole is also commonly used during an intrauterine insemination (IUI) cycle. Before IUI, you'll typically take either clomiphene or letrozole to stimulate your ovaries. Next, an injection of hCG is given, inducing ovulation. Then, sperm from a donor or a partner is collected, prepared, and placed into the uterus using a thin tube. An IVF cycle has several steps, including ovarian and pituitary suppression, ovarian stimulation, egg retrieval, egg fertilization in a lab, and the transfer of embryos into the uterus. Letrozole can be used in select patients as part of an IVF cycle to improve ovulation or impact the menstrual cycle to help make IVF as effective as possible.

Embracing Letrozole as an Effective Fertility Aid

Letrozole continues to be a safe and effective choice for many people struggling with infertility when used appropriately under the guidance of a fertility specialist. If you're coping with infertility, it's important to empower yourself with the knowledge to make the best decisions for your unique situation.

Our caring team of fertility experts at Advanced Fertility Care is always here to answer any questions. We strive to provide compassionate, individualized care to support you in building a family. Contact us today to schedule a consultation.

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Why Male Infertility Evaluations Are So Important

What is ICSI and Do I Need It?

What Is ICSI?

Intracytoplasmic sperm injection (ICSI) is a laboratory technique that offers a pathway to a successful pregnancy for couples with little hope of reproducing naturally or with IVF alone due to significant sperm issues. ICSI is the most used method that is a critical part of assisted reproductive technology. Its use accounts for 70% to 80% of the IVF procedures performed.

For sperm to fertilize an egg, the sperm's head must attach to the outside of the egg. It then must break through to the inside, where fertilization takes place. If the egg's outer layer has become hardened or thickened, or if the sperm is abnormal and cannot swim effectively, it will be difficult for the sperm to penetrate it.

Standard IVF vs. ICSI

In an IVF procedure, an egg is fertilized in a laboratory dish. Healthy sperm collected from the patient's partner or a selected donor is added to the dish to surround the egg. The sperm will naturally fertilize the egg by attaching itself to its outer membrane and breaking through into the egg. The fertilized egg (embryo) is transplanted into the uterus when it reaches a certain stage of development approximately five to six days after fertilization. If it implants into the lining of the uterus successfully, a pregnancy results.

There are times, however, when surrounding the egg with sperm in the dish may not result in fertilization. Based on the circumstances or results of a prior semen analysis, doctors may opt for ICSI to help improve fertilization success. This procedure can frequently solve the issue of male factor infertility or poor fertilization in IVF cycles. ICSI is essentially an extension of IVF that works to control some of the variables that affect fertilization and increases the chances of an embryo resulting in pregnancy.

How Is ICSI Performed?

ICSI is performed in conjunction with in vitro fertilization (IVF). Patients will undergo egg retrieval, and the egg will be injected with a single sperm in the lab through the process of ICSI with the hope of growing into a healthy embryo to be transferred to the carrying uterus.

Steps for Egg Retrieval

To prepare for egg retrieval, patients administer hormonal injections to stimulate the ovaries to produce multiple eggs for an average of 10 days, followed by an injection of human chorionic gonadotropin (hCG) or leuprolide acetate to assist in the eggs' final maturation.

When the eggs are ready for actual retrieval, a transvaginal ultrasound guides a thin needle through the vaginal wall into the ovary, then suction draws out and collects the eggs. This is performed under anesthesia and is a relatively short procedure lasting 10-20 minutes.

Unless frozen sperm is used, it is collected on the same day that egg retrieval occurs. The person supplying the sperm must collect ejaculate into a lab-provided container and deliver it to the lab within 30 minutes. The semen is analyzed for volume, mobility, and quality.

The ICSI Procedure

The ICSI procedure is performed with these steps:

1. The embryologist holds the mature egg in a lab dish using a small glass tube equipped with a suction bulb.

2. Using a thin needle, a single sperm is immobilized and picked up.

3. The needle is inserted into the egg.

4. The sperm is injected directly into the egg.

5. The needle is withdrawn.

Now the waiting begins.

After the ICSI Procedure

Following the completion of the procedure, the embryology team monitors the embryos' progress to look for signs of successful fertilization. Cell division should begin within one day if the fertilized embryo is healthy. In many cases, the embryos are grown for five to six days, and at this point, if the patient elects to have preimplantation genetic testing performed (PGT) this is when the surviving embryos are biopsied (cells removed and sent for additional testing) and then frozen.

If a fresh embryo transfer is performed, the developing embryo will need to grow appropriately for at least three to six days. When it is ready to transfer, a long, thin tube (catheter) is inserted through the vagina into the uterus under ultrasound guidance to inject the embryo into the uterus. The embryo must implant in the uterine lining for pregnancy to occur. If PGT testing is being performed, a frozen embryo transfer will be performed at a later date.

Who May Benefit from ICSI?

woman pregnant after doing IVF with ICSI

Male factor infertility is one of the causative factors in over one-third of male infertility cases. It usually results from complications in the sperm's production or delivery. In such a case, ICSI would be high on the list of options to overcome infertility. A man who has undergone a vasectomy reversal would also be a candidate for this procedure, even if the sperm is healthy otherwise. Other examples of infertility that may be helped through the ICSI procedure include:

• Abnormal sperm motility. This references the sperm's ability to move effectively.

• Low sperm count. The male partner doesn't produce enough sperm for a successful attempt using artificial insemination or IVF.

• Infertility that cannot be explained.

• The semen lacks sperm because of a blockage in the reproductive tract of the male.

• The sperm is unable to attach to an egg.

• Traditional IVF has been unsuccessful, even with fit sperm.

• The eggs used were matured in vitro.

• The eggs were frozen before use.

Even when it isn't specifically indicated, some physicians may choose to use ICSI when appropriate.

What Are the Risks of ICSI?

Compared to conventional IVF, some studies of the ICSI procedure suggest a possible connection between ICSI and an increased risk for intellectual delays, autism, chromosomal abnormalities, and birth defects such as Beckwith-Wiedemann syndrome, hypospadias, Angelman syndrome, and sex chromosome abnormalities. These are rare, occurring in less than 1% of babies conceived through ICSI with IVF. Other possible risks include:

• Ovarian hyperstimulation syndrome in response to excessive fertility drugs

• Multiple births, either twins or triplets

• Increased risk of premature labor and low birth weight

• Slight increase in risk compared with IVF

• The need for a cesarean section for delivery is slightly increased

ICSI Success

On average, fertilization occurs through ICSI in 70% to 85% of cases. The rate of live births reflects the number of healthy children born following an IVF/ICSI cycle. These success rates are classified based on maternal age and will often vary due to additional factors affecting the eggs and sperm.

Take the First Step

If you'd like to learn more about IVF, ICSI, or other fertility treatments that may be a solution for you, contact the infertility specialists at Advanced Fertility Care to set up a consultation.

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Top Frequently Asked Questions About PCOS

What Is PCOS?

PCOS is a multi-system disorder affecting many women of reproductive age. The cause of the disorder is unknown, but people with PCOS commonly exhibit imbalances in certain reproductive hormones, such as androgens. As the name implies, people with PCOS often have large numbers of follicles which are the small egg-containing cysts found in the ovaries. During a normal menstrual cycle, your ovaries mature and release an egg every month. Due to the effects of PCOS, your ovaries may be unable to make or release an egg regularly. This can result in infertility issues.

What Are the Symptoms of PCOS?

Woman talking to doctor about PCOS signs and symptoms and risk level

PCOS symptoms vary between individuals and can range from mild to severe. Many people may experience irregular periods, erratic ovulation, infertility, oily skin, extra hair on the face or body, hair loss on the scalp, and weight gain. More recently, PCOS has been linked with depression or mood disorders. Some people with PCOS are overweight, although people who are not overweight can have it also. Being overweight can make the signs and symptoms of PCOS worse.

A common problem in people with PCOS is insulin resistance (more on this below). People with insulin resistance can often find darkening of the skin along creased areas like the groin or neck can occur, as well as the development of skin tags.

Who is at Risk for PCOS?

The condition affects women of all ethnicities and can develop at any time during reproductive years or any time after puberty. The precise cause of PCOS is unknown. However, you may be at higher risk if you have a family history of the disorder.

As noted above, people with PCOS often have insulin resistance. People with insulin resistance can make insulin, but their cells don't respond to insulin as they should. As a result, insulin levels in the body may increase. This can cause the ovaries to produce higher levels of a group of hormones known as androgens which causes some of the symptoms of PCOS like unwanted hair growth.

In addition to PCOS, other factors can contribute to insulin resistance such as being overweight, having an unhealthy diet, or a family history of diabetes. These people can see a worsening of their symptoms of PCOS. It's important to take action if you have high insulin or blood sugar levels since this may increase your risk of developing diabetes.

How Is PCOS Diagnosed?

Since PCOS is a syndrome with many different signs and symptoms, not all experts agree on the criteria to diagnose PCOS. The three most commonly used criteria are seen here.

As you can see, some criteria rely on blood tests, others rely on ultrasound, and still, others emphasize signs and symptoms. Therefore, your doctor may perform an exam and discuss your medical history to diagnose PCOS. They may perform a pelvic ultrasound to examine your ovaries and do blood tests to determine your hormone levels. These exams and tests will help rule out any other possible causes of your symptoms.

How Is PCOS Treated?

There is no total cure for PCOS. But fortunately, you can take steps to manage or improve your symptoms. Getting adequate exercise, managing your weight, and eating a healthy diet can all help. You may also be able to take medication to lessen physical symptoms, like hair growth and acne. Making lifestyle changes can lower your long-term risks like type 2 diabetes.

It's not easy to hear that you may have PCOS, but you can talk to your doctor about how to lessen your symptoms. Some simple lifestyle changes may improve things.

Can You Get Pregnant if You Have PCOS?

Woman with PCOS with positive pregnancy test smiling

It's possible to get pregnant if you have PCOS. While PCOS can cause infertility struggles, there are a few things you can do to increase your chances of pregnancy.

Having irregular ovulation will make it harder to track the fertile phase of your menstrual cycle. Even so, you could still be able to get pregnant naturally. If this doesn't happen, there are fertility treatment options available.

Can Fertility Treatments Help You Get Pregnant With PCOS?

Absolutely! If you're having trouble getting pregnant, one possible option is in vitro fertilization (IVF). During this advanced fertility treatment, a doctor extracts your eggs, fertilizes them in a laboratory with collected sperm, and transfers the fertilized egg into your uterus. IVF bypasses the fallopian tubes, enabling a fertilized egg to be placed directly into your uterus, where it can implant. IVF can be an effective choice for many people, including those with PCOS, endometriosis, or damaged fallopian tubes.

However, many patients don't require IVF to get pregnant.

Reducing insulin resistance by lifestyle changes or medication can often result in more regular ovulation and pregnancy. Another alternative is ovulation induction with intercourse or intrauterine insemination (IUI). For this procedure, you take fertility drugs to induce ovulation before having intercourse or undergoing artificial insemination so that your eggs can become fertilized.

Does Having PCOS Increase Your Risk of Pregnancy Complications?

If you have PCOS, there can be some increased risk of certain complications like gestational diabetes and preeclampsia during pregnancy. However, this does not always happen, and you can reduce your risks by maintaining a healthy weight and making sure your blood sugar levels are normal before trying to become pregnant.

No matter your situation, the team of caring professionals is here to support you on your fertility journey. We would be glad to answer any questions you may have about PCOS, infertility, and fertility treatment options. Explore our website or schedule a consultation with our experts today if you'd like more information.

How to Decide Between IUI and IVF

Millions of Americans are impacted by fertility challenges each year. The National Institutes of Health (NIH) estimates that roughly 9 percent of men and 11 percent of women have had fertility problems of varying severity. These fertility struggles may get in the way of people’s dreams, and they can have a devastating impact, if left unaddressed, on both individuals’ and couples’ mental and emotional health. Fertility challenges may not be the only reason people consider fertility treatments. For example, many people who are single by choice, as well as LGBTQ+ couples, may see fertility treatments as their best road to building their family.

Fertility Treatments Are Available To You

If you’re struggling to conceive, the good news is that there are treatment options available that could help you realize your dreams of parenthood. Two of the most common treatment choices are intrauterine insemination and in vitro fertilization. In this article, we discuss these two fertility treatment options in greater detail and compare the pros and cons of each one while recognizing that patients’ ultimate decisions are highly personal.

What is IUI?

Intrauterine insemination, also referred to as IUI, is an increasingly popular fertility treatment that can be used as an initial intervention when people have trouble trying to conceive. One of the selling points of IUI is that it is dramatically less expensive than a treatment like IVF. Even though IUI treatments often include medications, like Clomid, to encourage ovulation, many see it as a less intensive or invasive treatment than IVF. You may find yourself wondering what happens in IUI. The answer is quite simple. Washed sperm from a partner or a donor will be inserted directly into the uterus. This means that the sperm will have less distance to travel to meet a released egg, and hopefully, it means that the likelihood of a pregnancy increases. IUI is a common first step for many couples struggling to get pregnant, single parents by choice, or others using donor sperm.

Fertility Specialist consultation for IUI and IVF

Although you may not need a highly qualified reproductive specialist for a successful IUI, there are many reasons why you might consider working with one. This way, you will have an established relationship with a fertility physician if you need to consider other interventions down the road. A reproductive specialist can also provide any necessary testing to help you determine why you may be experiencing challenges on your fertility journey. Many find that an initial evaluation from a fertility specialist can provide a fuller picture of their fertility status and better understand their best options to move forward.

What is IVF?

IVF, or in vitro fertilization, is a well-known type of assisted reproductive technology (ART) that’s helped thousands of people worldwide have the family of their dreams. IVF involves fertilizing eggs in the laboratory and transferring created embryos to a uterus. The process involves extracting eggs, retrieving a sperm sample, and combining an egg and sperm in the laboratory to help fertilization and embryo creation.The first step in an IVF cycle is ovarian stimulation, which is where synthetic hormones are injected to stimulate the ovaries so that they can produce multiple eggs. Once the eggs mature, it’s time for follicular aspiration, also known as egg retrieval, when a needle is inserted into one or both ovaries to retrieve the eggs. After that, the egg is fertilized with sperm provided by a partner or donor. Once this has happened, medications are administered to the person planning to carry the pregnancy to prime the environment for a healthy pregnancy. The embryo is then transferred into the uterus. If any other embryos were created, they may be frozen and kept in storage for future use.

What Are the Main Differences between IVF and IUI?

There are multiple differences between in vitro fertilization and intrauterine insemination. A few of the most significant differences are highlighted below:

#1 The Extensiveness of the Process

IVF is considered more involved and has more stages in the process than IUI. This includes egg retrieval, which can be uncomfortable or painful for the patient. Many of these steps happen in a laboratory before the embryo is transplanted back into the uterus.

#2 What Is Treated

As we will explore in more detail below, there are some situations in which IUI may be appropriate, and there are others where providers may recommend IVF. Remember, everyone’s fertility journey looks different, depending on numerous factors, and there is no single perfect answer for everyone.

#3 How Much It Costs

The price of IVF and IUI may vary depending on where you live and various factors. IVF is usually costlier than IUI. Depending on the clinic you are using and the accompanying treatments you may need, IUI may cost less than $1,000 per attempt, and IVF is estimated to cost between $15,000 and $30,000 per attempt. This price differential explains, at least in part, why some doctors recommend starting with intrauterine insemination as an initial fertility treatment.

#4 The Length of the Process

There is no easy or perfect answer for how long it will take someone to get pregnant. Some medical experts suggest that your success rate with IUI will be about 15 to 20 percent per try. However, your odds jump significantly if you decide to go the IVF route. In this case, your likelihood of a successful overall outcome is between 30 and 60%, depending on the woman's age. The chance of a successful pregnancy from one round of IVF can vary depending on the underlying source of infertility. For example, advanced maternal age, which describes people over the age of 35 during pregnancy, may be one factor that significantly lowers the success rate. Although these factors impact many people's decisions when discussing their treatment options and plan, there is also a psychological and emotional toll to every cycle without a successful pregnancy to be carefully considered.

When Is IUI a Better Choice than IVF?

As stated above, IUI is less expensive than IVF treatment. However, there are two caveats here. First, the budget should never be the sole determinant of your reproductive health. It is important to talk to skilled fertility practitioners and see what they recommend for your unique circumstances. Second, the attractive prices quoted above were for a single round of IUI. However, given the relatively low success rate per cycle, many patients need to undergo multiple treatment rounds, and the cost can accumulate cycle after cycle.In addition to very valid cost considerations, some other factors could nudge you to consider IUI. If, after testing, doctors are still unsure about the source of your infertility, then this treatment option could be a good starting point. If it does not work, you can always move to another option, like IVF. It may be a good idea to discuss how many cycles you are willing to try before changing your approach with your provider ahead of time. This can help with future decision-making when in the midst of fertility treatment. Also, IUI can be a great option if the fertility challenges you're experiencing have been determined to be caused by sperm motility issues. The IUI process puts the sperm and the egg in much greater proximity, upping the likelihood of success. However, this may only be effective if the motility reduction is mild or moderate. More severe cases of sperm motility issues may require a greater amount of intervention, such as IVF or ICSI.

When Is IVF a Better Choice than IUI?

Even though IUI is an excellent choice for many people, especially those with unexplained infertility, it may not help everyone achieve the family of their dreams. In these cases, it might be time to consider IVF. For instance, if fertility testing shows that the source of infertility is fallopian tube scarring, IVF might be a better choice. This creates an issue because the egg cannot make it to the uterus for fertilization. IVF treatment bypasses this issue by uniting the sperm and egg in the controlled environment of a laboratory dish. IVF treatment also allows for the opportunity to utilize genetic testing. With Preimplantation genetic testing (PGT), medical professionals can test embryos for a wide range of genetic and chromosomal conditions and only implant the healthy embryos. In many cases, undergoing IVF with PGT can significantly increase the chance of having a healthy baby. Another reason why IVF may be a better choice is if sperm quality and/or motility are very low. The controlled environment of a lab with IVF may be the only way to achieve fertilization. However, even placing the sperm closer to the egg, like with IUI, may not be enough to achieve fertilization. In some cases, it may be recommended to utilize intracytoplasmic sperm injection or ICSI. During ICSI, a single sperm is directly injected into the egg, which can greatly improve the fertilization rate. IVF may also be recommended for someone dealing with endometriosis or if the patient has experienced multiple miscarriages at any stage of pregnancy.

Reach Out to Advanced Fertility Care

At Advanced Fertility Care, our highly qualified team of medical specialists prides itself on being the best at helping people realize their dreams of parenthood. Set up your initial consultation today to learn how our team can guide you in this journey. We understand that everyone’s fertility journey is unique, and we will work with you to set up a treatment plan that transforms your dreams into reality.

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