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Infertility Treatments Texas Fertility Clinic
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Contrary to what is portrayed by the modern media, assisted reproductive technologies, such as IVF are not the most commonly employed fertility treatments. In fact, most couples (>80%) will become pregnant using technologies such as infertility medications and intrauterine insemination (IUI). It is estimated that less the 15% of couples seeking care from a reproductive endocrinologist, infertility specialist will eventually require IVF.
The most appropriate treatment depends upon the cause(s) of a couple’s infertility. At the Center for Women’s Medicine, each couple’s treatment is highly individualized.
If irregular, “poor”, or no, ovulation is identified as a cause of infertility, treatment with Clomid may be an appropriate first choice. This depends upon the patient’s treatment history and many of our couples have already failed multiple Clomid cycles.
Clomid is usually administered from three to six ovulatory cycles, depending upon female age and other factors. If the patient has reduced ovarian reserve (elevated FSH), then intrauterine insemination (IUI) after ovulation induction with FSH may be the treatment of choice. Most often, Clomid therapy is limited to three ovulatory cycles since the chances of pregnancy decline precipitously with extended therapy.
Diagnostic fertility tests such as day 3 hormones, androgen levels, prolactin levels, and others help determine the cause(s) of failed ovulation. If androgen levels are found to be elevated, the patient will be further evaluated for PCOS and if the disease is present Glucophage (metformin), or FSH may be the treatment of choice. Dr. Allon is a nationally recognized expert on the treatment of PCOS. PCOS patients must be managed by a fertility specialist because of their potential for exaggerated responses to FSH stimulation.
If hormone testing reveals that prolactin levels are abnormally elevated (hyperprolactinemia) than treatment with bromocriptine may be the first choice.
Some degree of male infertility is present in up to half of all infertile couples. For this reason, the semen analysis is mandatory before any treatment regimen begins. When mild male factor infertility is present, FSH stimulated IUI with washed and concentrated sperm may be the first treatment choice. When moderate to severe male factor is present in vitro fertilization employing the ICSI procedure is the treatment of first choice. The other option is to choose a sperm donor and attempt stimulated IUI. We are on of the few fertility centers with a male specialist on staff.
As with moderate to severe male factor infertility , there are other conditions where IVF may be the treatment of first choice. When the fallopian tubes are blocked or damaged, IVF usually produces the best per cycle success rates. In some cases, it is possible to surgically “reconnect” the tubes depending upon how and where they were tied and other factors such as scarring.
Older women with mildly elevated FSH levels may attempt IVF depending upon their ovarian reserve. As women age, their eggs loose their ability to fertilize and develop properly and miscarriage rates increase. We encourage women with significantly reduced ovarian reserve, or ovarian failure, to enter our donor egg program. This is also true for women who fail the “Clomid Challenge Test”. IVF success rates using donor eggs are exceptionally good.
There may be large polyps or fibroids in the uterus in which case hysteroscopic or laparoscopic surgery are the treatments of first choice. There may also be uterine structural abnormalities that can be surgically corrected.
Endometriosis can attach to and penetrate the reproductive organs causing serious damage. Dr. Allon can remove most endometrial implants surgically using the laparoscope and he often recommends therapy with Lupron.
Tests such as the ultrasound, or endometrial biopsy, may indicate that the lining of the uterus (endometrium) is not developing properly (in phase) to support a developing embryo. When this is the case, progesterone is often prescribed to stimulate endometrial development.
There can be many other causes of infertility and in most cases more than one defect is present. This is why Dr. Allon orders a complete workup on both partners even if the cause of their infertility is suspected or known. He often discovers concomitant conditions explaining why treatment at other centers may have failed.
Infertility Treatments
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