Evaluation and Treatment Options
Evaluation
If you and your partner are struggling to conceive, a comprehensive fertility evaluation can help identify underlying causes. The evaluation process includes:
New patient consultation
The first stop along your journey is a detailed consultation to review your personal and family medical history, menstrual cycles, previous pregnancies, fertility history and any known reproductive health concerns.
Transvaginal Ultrasound
A transvaginal ultrasound is an essential diagnostic tool to assess the structure of the uterus and ovaries as well as to check for any other abnormalities such as fibroids or ovarian cysts. An ultrasound provides valuable information about ovarian reserve, giving an overall estimate of the egg count at that given time.
Laboratory Testing
Blood tests are performed to measure several hormones crucial for fertility. These include:
Saline Infusion Sonogram (SIS), Hysterosalpingogram (HSG) or Office Hysteroscopy (OHS)
The HSG and SIS are vital tests for evaluating the health of the fallopian tubes and the uterus. Depending on the indication, one may be preferred over the other. They both help identify issues such as tubal blockages, fibroids, polyps, and uterine scarring (Asherman syndrome). Although they can impact reproductive success, many of these conditions can be treated surgically. Office hysteroscopy is a procedure done in our center and used to take a real-time, in-depth view of the uterine cavity to identify any sort of issues such as fibroids, polyps or adhesions. Dr. Bazzi has conducted numerous surgeries to identify and treat abnormal anatomical changes.
Semen Analysis
Semen analysis is the primary test used to evaluate male fertility. Several factors are assessed, including:
Treatments Options
Ovulation Induction Medications
Medications such as Clomid, Letrozole, or injectable Gonadotropins can stimulate ovulation, increasing the chances of conception for those with ovulation disorders. Depending on one’s evaluation, these medications can be used with timed intercourse (TIC), intrauterine insemination (IUI), and in vitro fertilization (IVF).
Timed intercourse (TIC)
TIC involves strategic planning of intercourse to better time the patient’s most fertile window in order to maximize the chance of successful conception. Initial evaluation and assessment can help determine if this is an appropriate option before advancing to more complex interventions such as intrauterine insemination (IUI) or in vitro fertilization (IVF).
In Vitro Fertilization (IVF)
IVF is a highly effective treatment where eggs are retrieved, fertilized in a laboratory, and then transferred into the uterus to achieve pregnancy. IVF and associated procedures have continued to advance and have resulted in the highest pregnancy success rates amongst the available infertility treatments to date.
Intracytoplasmic Sperm Injection (ICSI)
ICSI is an advanced technique utilized during IVF where a single sperm is injected directly into a mature egg to help facilitate fertilization. It is strongly considered the treatment of choice in cases of male factor infertility and with a prior history of fertilization failure. The procedure may be recommended and offered during genetic testing of the embryos and based on individual patient needs.
Preimplantation Genetic Testing (PGT)
PGT is an advanced technique utilized during IVF to help assess and screen for genetic abnormalities in the developing embryo. It can help identify whether embryos have the correct number of chromosomes (PGT-A for aneuploidy), detect structural chromosomal abnormalities (PGT-SR) or screen for specific inherited genetic, monogenic disorders (PGT-M). Although the aim of PGT is to select the healthiest embryos and improve successful pregnancy, it does not guarantee implantation nor does it eliminate the possibility of genetic issues.