Treating Fertility Problems in the Chicago, Illinois Area — Polycystic Ovarian Syndrome, Male Infertility, and Other Conditions
Our Chicago, Illinois area private medical facility helps patients address a wide range of fertility problems. We help couples build or grow their families through the latest fertility treatments and techniques. With complete diagnostic evaluations, comprehensive medical and surgical treatments, and assisted reproductive techniques (ART) typically available only at major medical centers, the fertility specialists at Oak Brook Fertility Center are dedicated to helping you achieve the precious gift of a child.
To treat polycystic ovarian syndrome, male infertility, and other conditions, those who visit our Chicago, Illinois area facility address fertility problems with the help of our advanced endocrinology, andrology, and immunology laboratories. Our services include an in vitro fertilization/embryo transfer (IVF/ET) program that is backed by our advanced embryology laboratories. Our facilities are fully accredited and our staff is fully certified.
- Causes of Infertility
- What Are the Mechanisms of Infertility?
- Early Pregnancy Losses
- When and Where To Seek Medical Help
- Diagnostic Work-Up
- Unexplained Infertility
- Old vs. New Treatment Methods
- Old Treatment Methods
- Modern Management
- Conditions Causing Fertility Problems
- Irregular Ovulation
- Polycystic Ovarian Syndrome
- Secondary Infertility
- Infertility After Miscarriage
- Irregular Menstrual Cycle
- Pre Menopause
- Hormone Replacement with Bioidentical Hormone Therapy
Causes of Infertility
Infertility is caused by female factors in about 50 percent of couples experiencing fertility difficulties, male factors in about 40 percent, and a combination of male and female factors in about 10 percent. To determine the best course of action for each couple, we utilize the latest diagnostic equipment at our Chicago, Illinois area facility. Female factors include hormonal factors (such as polycystic ovarian syndrome), problems of ovulation, and abnormal embryo implantation. Tubal and uterine abnormalities may also cause infertility. Conditions such as endometriosis, uterine fibroids, or pelvic adhesions interfere with fertility, frequently through more than one mechanism. Our Chicago, Illinois fertility experts are also experienced male infertility treatment providers. Male factors are associated with low semen volume (oligospermia), decreased sperm motility (asthenospermia), lack of sperm production (azoospermia), or the production of abnormal sperm (teratospermia). Systemic diseases in both men and women may also impair fertility, either directly through the effect on the reproductive function or as a result of the treatment used.
What Are the Mechanisms of Infertility?
Even a minor alteration in the complex sequence of events needed to achieve pregnancy can lead to fertility problems. If there are not enough sperm in the fallopian tube when the egg gets there, there will be no fertilization; or if the sperm arrives late, the egg may be post-mature and the embryo will not develop. If the ovarian follicle is too small or the luteinizing hormone (LH) surge inadequate, the egg may not be released. In this case, the so-called luteinized unruptured follicle (LUF) may be detected by ultrasound — causing outward signs of ovulation, including an increase in progesterone, while the egg will be retained in the ovary, preventing conception. If preovulatory estrogen is low, decreased endometrial thickness may prevent embryo implantation. Alternatively, low progesterone after ovulation may result in a poor embryo implantation and either an early implantation failure or miscarriage. At Oak Brook Fertility Center, we work to determine the mechanism or mechanisms of infertility to ensure the most appropriate treatment is carried out for each couple.
Early Pregnancy Losses
The most common cause of early implantation failures and miscarriages is an abnormal number of chromosomes in the developing embryo. Both egg and sperm development involves a reduction in the number of chromosomes from 46 to 23. This process (referred to as meiosis) frequently becomes impaired with age, resulting in an abnormal chromosome number in the egg or sperm, and in the embryo conceived. Such an embryo does not develop normally and is typically miscarried. The risk of a miscarriage in a 20 year old woman is about 10 percent; it is 40 percent at the age of 40. Abnormal chromosomes have been identified in about 70-80 percent of miscarriages. Age-related changes in meiosis are a major factor responsible for the decline in fertility in women over 35, and a major cause of fetal malformations.
Some couples may conceive without treatment after attempting pregnancy for more than one year. While having experienced the great joy of conceiving, these couples are considered sub-fertile from a medical perspective. There are many causes of sub-fertility. Some women may ovulate infrequently (two to three times a year) or experience abnormal ovulation during most of their cycles. Similarly, a man may have variable sperm counts, occasionally normal but often in the infertile range (a condition known as oligospermia). While conception is of course possible for such couples, it can be more difficult. Many of these couples decide that, despite already having a child, fertility treatment is the best course of action.
When and Where To Seek Medical Help
If the couple has not conceived after one year (six months if the woman is older than 35), it is recommended that an infertility specialist be consulted with. Traditionally, infertility diagnosis and treatment was the domain of gynecologists. During the past three decades, however, the development of new and complex treatment methods, advances in the science of reproductive endocrinology (RE), and an increased emphasis on specialization, prompted the establishment of the new subspecialty of reproductive endocrinology/infertility (RE/I). Basic infertility evaluation and treatment may still be performed by gynecologists with expertise in the field. However, if pregnancy is not achieved in four to six months the couple should seek help from a board certified reproductive endocrinologist. This is especially the case if the woman is over the age of 35. At our Chicago, Illinois areas facility, our specialists help address both male and female infertility problems to help couples obtain the beautiful gift of a child.
A comprehensive diagnostic work-up provides a more thorough understanding of a couple’s unique needs, and is an important element of any fertility treatment. Medical history and a physical exam may provide clues as to the cause of infertility. A basic evaluation should include tests to detect uterine anomalies and tubal pathology, the presence of eggs in the ovaries, ovulatory problems, and sperm abnormalities. Other causes of infertility, such as peritubal or periovarian scar tissue (adhesions), endometriosis, or uterine fibroids, may require laparoscopic surgery to diagnose and correct. Less common causes of infertility may be associated with gamete abnormalities, abnormal antibody production, immunological incompatibility, and congenital or acquired deficiencies — all of which require more specialized testing.
Unfortunately, many aspects of the reproductive function in both men and women cannot be tested. There are no tests, for instance, that can determine egg release from the ovary (ovulation) or evaluate tubal function (we can only test tubal patency). Testing also cannot determine the fertilizing potential of eggs and sperm, the adequacy of early embryonic development, or embryo implantation potential. As a result, infertility is frequently labeled as 'unexplained.’
At Oak Brook Fertility Clinic, we utilize the latest diagnostic technologies and techniques to determine, whenever possible, the cause or causes of fertility problems. Our Chicago, Illinois area clinic helps address polycystic ovarian syndrome, male infertility, and a wide range of other fertility-related conditions. If fertility problems remain unexplained, we will discuss measures that can, nevertheless, be taken in order to increase the likelihood of conception.
Old vs. New Treatment Methods
Old Treatment Methods
Treatment of infertility in the past was frequently empirical (based on trial and error). For instance, the wife, or sometimes the husband, was placed on a fertility drug called Clomid. This drug stimulates gonadal function (the organ that makes gametes) in both men and women. The wife in some cases was also given estrogens to improve the quality of the cervical mucous. Sometime, the couple would even be told to simply 'relax'.
How times have changed. Modern management of fertility problems relies on assisted reproductive techniques (ART) and requires extensive laboratory support. There are essentially two types of ART approaches: controlled ovarian hyperstimulation/artificial insemination (COH/AIH) and in vitro fertilization/embryo transfer (IVF/ET). Both methods are used to address fertility problems at our Chicago, Illinois area clinic.
Conditions Causing Fertility Problems
Endometriosis affects the fertility of women. It is present when the growth of the uterine lining (endometrium) extends outside the uterus. To learn about issues relating to the symptoms, diagnoses, and treatment of this disease, please read our educational information about endometriosis.
Fibroids are benign uterine tumors originating from the uterine muscle (myometrium). They begin as small seedlings in women with genetic predispositions and increase in size during reproductive life, and especially during pregnancy. A small percentage of fibroid tumors, usually those that grow rapidly, may become cancerous.
Size, Location, and Symptoms
Fibroid tumors may be very small, or as large as the head of a newborn. They may be located outside of the uterus (subserosal), in the wall of the uterus (intramural), in the uterine cavity (submucosal or intracavitary), or anywhere in between. The symptoms associated with fibroids depending upon the size and location of the tumor or tumors. Some women may be totally asymptomatic. Others may experience pelvic pain and pelvic pressure symptoms. Symptoms may also be experienced in the urinary or gastrointestinal systems. With submucosal or intracavitary fibroids, heavy menstrual bleeding, clotting, and/or hemorrhaging may be present.
Effect on Fertility
Fibroids prevent normal embryo implantation, resulting in infertility. Fibroids should be removed to improve the chance of pregnancy. In women of reproductive age, fibroids larger than 5 cm not only prevent pregnancy but may also increase the risk of a miscarriage, premature delivery, or other pregnancy complications.
Uterine fibroids can be detected with pelvic ultrasound, computerized tomography (CT) scans, and magnetic resonance imaging (MRI). Submucosal or intracavitary fibroids can be evaluated using hysteroscopy, hysterosalpingogram, or sonohysterogram. Laparoscopy allows visualization of the size and location of intramural and subserosal fibroids. With the latest technologies, our fully equipped Chicago, Illinois area medical facility is equipped to diagnose and treat fertility problems related to fibroids.
Although non-surgical fibroid treatment is available, these measures provide only a temporary removal of fibroid tissue. Surgical excision is the only way to permanently remove fibroids. In addition, fibroids that rapidly increase in size are suspected of being cancerous and should be removed without delay. Treatment of fibroids depends on their size, location, and associated symptoms. Small and asymptomatic fibroids in a woman who is approaching menopause may be observed without specific treatment. These fibroid can be expected to decrease in size after menopause sets in. Symptomatic fibroids in a woman who wants to preserve her uterus for future childbearing should be removed by myomectomy, the surgical removal of uterine fibroids. This leaves the uterus in place and its anatomy restored. In a woman who has completed her family, fibroids may be removed along with the uterus (hysterectomy).
Myomectomy Through Laparotomy
Laparotomy is a surgical procedure that gains access to the abdominal cavity through an incision in the abdominal wall. It is a traditional approach to myomectomy that is still used if fibroids are multiple, large, vascular, difficult to resect, or are attached to other organs. However, laparotomy may result in the development of pelvic and abdominal adhesions which can compromise fertility. About ten percent of myomectomy procedures are performed through laparotomy. The great majority — about 90 percent — are performed laparoscopically.
Laparoscopic surgeries are performed through small incisions, and are therefore less invasive than more traditional forms of surgery. With advanced laparoscopic techniques, fibroid-related fertility problems can be addressed non-invasively at our Chicago, Illinois fertility clinic. Myomectomy is a much more involved procedure than myomectomy through laparotomy, and takes an experienced fertility specialist to perform. Advanced laparoscopic skills are needed not only to remove the fibroids without damage to the uterus, but also to reconstruct the uterus so it can carry a child. At Oak Brook Fertility Center, 90 percent of myomectomy procedures are performed laparoscopically. There are also a number of potentially beneficial modifications to laparoscopic myomectomy that have been developed.
Modifications of Laparoscopic Myomectomy
Laparoscopic myomectomy, reconstruction of the uterus, and removal of fibroid tumors through small incisions are technically difficult and require advanced surgical skills. Several modifications to laparoscopic myomectomy have been recently advocated. Using various energy sources, the laparoscopist can destroy fibroid tumors without removing them from the uterus. This can be achieved with very low temperatures (cryo-myolysis), lasers (laser-myolysis), or electromagnetic waves. Another method not requiring laparoscopy that is used by interventional radiologists is based on embolization of the arteries providing blood supply to the fibroids. However, none of these methods have been tested extensively and several patients required emergency hysterectomy after myolysis because of uterine necrosis and life-threatening sepsis. At Oak Brook Fertility Center, we eagerly await further research in this area to determine the safety and efficacy of these treatments. We always stay up-to-date on the latest clinical developments to provide couples with the latest treatments and techniques.
Fibroids are estrogen-dependent tumors. They decrease in size with a decrease in estrogen levels. Medications such as GnRH agonists or GnRH antagonists (GnRH analogs) decrease the size of the fibroids by suppressing estrogen levels. However, within six months after the end of treatment with GnRH analogs, fibroids grow back to their original size.
Our Approach to the Management of Uterine Fibroids
The principle of our approach is to preserve the uterus and a woman's reproductive function, to remove fibroids by the least invasive method possible, and to addressing fibroids-related fertility problems. At our Chicago Illinois area medical facility, for more than 10 years now, we perform 90 percent of myomectomies through laparoscopy while only about 10 percent require laparotomy. To facilitate the laparoscopic surgery, we pretreat most of our patients with GnRH analogs for three to four months. GnRH analog, or gonadotropin-releasing hormone analog, is a synthetic peptide drug that is designed to modify the release of follicle stimulating hormone (FSH) and luteinizing hormone (LH) to increase fertility.
After the fibroids are removed, the uterus is reconstructed laparoscopically. This allows our patients to conceive, have normal pregnancies, and in most cases normal deliveries. If the fibroids are multiple, which would make reconstruction of the uterus difficult, or if they are not accessible to laparoscopic resection, we may perform laparotomy and myomectomy and use adhesion-preventing methods to preserve the patient's fertility. We remove intracavitary or submucous fibroids hysteroscopically under laparoscopic control.
Ovulation irregularities are incredibly common. These irregularities are found to be present in up to 30 percent of infertility cases. To address this fertility problem, the specialists at Oak Brook Fertility Center use the latest diagnostic techniques and equipment. A lack of ovulation is termed “anovulation.” Ovulation that occurs irregularly is termed “oligoovulation.” Regardless of your unique circumstances, our fertility specialists will work with you to help provide the best possible chance of obtaining the precious gift of a child.
Polycystic Ovarian Syndrome Treatment in the Chicago Area
Polycystic ovarian syndrome is characterized by an unusual hormone balance in women. The condition is very common, affecting as many as 1 in 15 women. Polycystic ovarian syndrome can cause ovulation issues, and thus fertility problems. At our state-of-the-art Chicago Illinois area fertility clinic, polycystic ovarian syndrome treatment begins by stabilizing the hormones at more normal levels. Medications recommended by our fertility experts, many times in combination with a diet and exercise regimen, can help regulate hormones in order to address polycystic ovarian syndrome. Not only can the treatment of polycystic ovarian syndrome at our Chicago, Illinois area fertility clinic help increase your chance of achieving pregnancy, but normalizing hormone balances may also reduce the likelihood of serious health problems, including diabetes and heart disease.
Secondary infertility refers to a couple’s inability to conceive after the couple has naturally and successfully given birth to one or more children. Like fertility problems in general, secondary infertility may be the result of male factor infertility, female factor infertility, or a combination of the two.
Secondary infertility can have any number of causes, including ovulation problems, endometriosis, weight gain, changes is egg quality, changes in sperm count, or other factors. Unfortunately, since couples with secondary infertility already have one or more children, they sometimes do not receive the same medical attention or personal support from family and friends. At Oak Brook Fertility Center, this is far from the case. The specialists at our fertility clinic understand the pain a couple can experience when unable to conceive, regardless of how big their family is. Our caring staff will provide you with thorough information and support, all the while working hard to provide you with the best possible chance of conceiving.
Infertility After Miscarriage
A miscarriage can be devastating to couples hoping to have a child. For many, infertility problems after a miscarriage can be equally devastating. This form of female factor infertility can be the result of hormonal, environmental, or immunological problems. In some cases, psychological trauma can also be a factor. If you have experienced a miscarriage, and are now having trouble conceiving, the specialists at Oak Brook Fertility Center will help you analyze the causes of, and develop solutions for, the fertility problems you are experiencing.
Irregular Menstrual Cycle
When a woman’s menstrual cycle varies in length by more than a day or two from month to month, it is considered irregular. While many women with irregular menstrual cycles can achieve pregnancy with little or no issue, others have more serious difficulties. Irregular cycles account for 30 to 40 percent of fertility problems. At Oak Brook Fertility Center we work to help women normalize their cycles, making it easier to become pregnant.
Pre menopause, or perimenopause, is the stage of a woman’s life when the first signs of menopause begin to appear. Women can enter perimenopause as early as their mid-thirties, but it is more common in women in their forties and fifties. Because perimenopause affects the regularity of ovulation, it can make pregnancy more difficult. It should be said, however, that many women in the perimenopause stage of their reproductive lives can become pregnant. Modern fertility drugs can help induce ovulation in perimenopausal women. Other treatments, such as IVF treatment or egg donation, can also help couples build families.
Hormone Replacement with Bioidentical Hormone Therapy
During menopause, the production of the hormones estrogen and progesterone decrease. This decline in hormone production leads to an end to menstruation, and thus fertility. Hormone replacement is used to replace the female hormones that are lost as a woman nears menopause, helping to extend reproductive abilities and lessen the negative effects of menopause — including hot flashes, mood swings, and vaginal dryness, among others.
At Oak Brook Fertility Center, we utilize advanced bioidentical hormone replacement techniques. This involves the development of natural hormones that are designed specifically for you, as opposed to synthetic hormones. Bioidentical hormones, as the name implies, are identical to those already in your body. This provides women with a natural means to address fertility and other issues related to early menopause.
Contact Oak Brook Fertility Center to Learn More
At Oak Brook Fertility Center serving Chicago, Illinois and surrounding areas, fertility problems — including male infertility, polycystic ovarian syndrome, and many more — are addressed with care and compassion. If you would like to speak with our specialists, contact Oak Brook Fertility Center today. We are here to help couples fulfill their dreams.