Tubal Factor (Damage to Fallopian Tubes) / Pelvic Adhesions
There are two options to treat patients with significant tubal damage and/or pelvic adhesive disease. The first option is to surgically repair the tubes and either get pregnant naturally or use Artificial Insemination or IUI to get pregnant. In many cases, however, surgery is not a good option as it may be very difficult to surgically fix the damaged tube(s) or the surgery may cause a high risk of an ectopic pregnancy. In these instances where the surgical option does not pose a high chance for success, the second option is to bypass the tubes completely by using IVF as the treatment plan.
Current scientific data about endometriosis show that mild to moderate forms of endometriosis may be effectively treated with a combination of surgical and medical therapy. For more stages of endometriosis, including the presence of endometriomas, IVF is the optimal first-line treatment and offers the highest pregnancy success rates.
Male Factor Infertility
One of the most significant advances in the treatment of infertility has been the ability for men with severe sperm abnormalities to achieve fertilization of the egg and successful pregnancy. IVF with the addition of ICSI (Intracytoplasmic Sperm Injection) has enabled couples suffering from abnormal sperm, who would not otherwise be able to conceive, to be able to start a family. ICSI is often recommended if there is any suggestion of a sperm issue, if sperm are obtained surgically, or if there has been a prior failure of fertilization.
Diminished Ovarian Function & Age-Related Infertility
Ovarian function decreases with age. In many cases, this reduced function can be overcome through the use of IVF alone, or in conjunction with techniques such as Assisted Hatching and ICSI. For some women, this decrease in ovarian function may start at earlier ages and may require aggressive treatment with IVF sooner.
Anovulation & Polycystic Ovarian Syndrome (PCOS)
The majority of patients with anovulation or PCOS often conceive using less aggressive treatments such as ovulation induction with IUI. For some patients who are “high responders” to gonadotropin therapy, IVF offers an excellent prognosis and reduces some of the risks of higher-order multiples.
Approximately 20% of couples will have no identifiable cause of infertility after completing a comprehensive evaluation. IVF is often successful even if more conservative treatments have failed, especially since some of these couples may have yet unidentifiable causes of infertility or sub-fertility.
Family Balancing (also known as Gender Selection or Sex Selection)
For families that wish to have additional children of a particular gender after already having a previous child, PGT-M allows for selection of embryos to transfer based on gender. While not perfect, embryo biopsy with genetic chromosome determination prior to transfer of embryos can allow families choice in how they expand the family. Read more about PGT-M.
Those looking to use preimplantation genetic screening (PGT-A or PGT-M)
Those wishing to utilizing preimplantation genetic testing will need to undergo IVF as IVF treatment makes it possible to administer genetic testing on embryos. One additional indication for IVF is to provide genetic testing on embryos prior to implantation. Preimplantation Genetic Testing (PGT) is the testing of embryos for genetic diseases and chromosomal disorders. There are three different types of PGT: PGT-A, PGT-M, and PGT-SR. Preimplantation Genetic Testing – Aneuploidy (PGT-A) is the most common and helps identify the embryos that are most likely to implant and result in a successful pregnancy and also reduces the chance of having a child with extra or missing chromosomes which could cause disorders such as Down syndrome During PGT-A, embryos created through IVF are biopsied and screened for all 46 chromosomes. PGT-A also identifies the chromosomal sex of the embryo (XX or XY) and this information is provided for those who wish to have it.