About Infertility Treatment at Oak Brook Fertility Center — Chicago, Illinois Infertility Specialists
Infertility can be cause by many factors. At Oak Brook Fertility Center we use the latest in diagnostic techniques to determine, whenever possible, the cause of fertility difficulties. We understand the pain and frustration couples can feel when unable to conceive, and we are dedicated to helping these couples achieve their dreams. At our state-of-the art infertility clinic serving Chicago, Illinois and surrounding areas, an infertility specialist can help determine what infertility treatment, or other course of action, may be best.
Controlled ovarian hyperstimulation/artificial insemination (COH/AIH) and in vitro fertilization/embryo transfer (IVF/ET) are two infertility treatments provided at Oak Brook Fertility Center. If you would like to learn more about infertility treatment, and the steps our infertility clinic will take to help you conceive, contact our Chicago, Illinois area fertility center today to speak with an infertility specialist.
- Controlled Ovarian Hyperstimulation/Artificial Insemination (COH/AIH)
- In Vitro Fertilization/Embryo Transfer (IVF/ET)
- Additional Gamete and Embryo Procedures
About Controlled Ovarian Hyperstimulation/Artificial Insemination (COH/AIH) Treatment
This approach consists of ovarian stimulation using fertility drugs and artificial insemination with the husband's semen. To stimulate the development of ovarian follicles, injections of a follicle stimulation hormone (FSH) are used. Luteinizing hormone (LH) may or may not also be included in treatment. When the leading follicle is mature, an injection of human chorionic gonadotropin (hCG) is administered. The result is a release of the egg or eggs from between 36 and 48 hours later. Insemination is then performed with washed and processed sperm from the husband. Sperm is injected into the uterus via intrauterine insemination (IUI), or into the fallopian tube on the side of ovulation via intratubal insemination (ITI). The choice between IUI and ITI depends on the number of sperm in the specimen. The objective is to provide an adequate number of normal sperm in the fallopian tube where fertilization takes place.
What are the Benefits of COH/AIH Treatment?
COH/AIH can correct several infertility problems such as anovulation (decreased menstrual periods), ovulatory dysfunction, hormonal dysfunction, oligospermia (low semen volume), asthenospermia (reduced sperm motility), or teratospermia (abnormal sperm morphology — or it’s form, structure, and configuration). This approach will help in the development of a healthy ovarian follicle, which will then produce adequate estrogen levels to prepare the reproductive system for pregnancy. COH/AIH infertility treatment at our Chicago, Illinois area infertility clinic will also facilitate the release of the egg from the ovary and will assure an adequate number of sperm in the reproductive system.
What are the Requirements of COH/AIH Treatment?
To be effective, COH/AIH requires at least one patent (unobstructed) and normally functioning fallopian tube, a normal uterus, and normal eggs and sperm. If there is evidence of abnormal tubal function, abnormal gamete function, or of diseases such as endometriosis, COH/AIH may be ineffective and IVF/ET may be selected as the initial approach. An infertility specialists at our clinic serving Chicago, Milwaukee, Oak Brook, and other areas, can help you determine if you and your partner meet the requirements for COH/AIH treatment and, if not, what other option would be best.
What are the Results of COH/AIH Treatment?
The fecundity rate per cycle (that is, the potential for pregnancy) one could expect with COH/AIH is less than the normal age-dependent cycle fecundity of 15 to 20 percent. This is because many couples with unrecognized fertility problems not correctable by COH/AIH are typically included in the treatment. These couples are included because there are no tests to recognize tubal function, fertilizing potential of the gametes, or quality of embryonic development, but COH/AIG is nevertheless a viable starting point. A cumulative three to four cycle fecundity rate with COH/AIH is about 30 to 40 percent and there is little, if any, increase in pregnancy rates after the third or fourth cycle. While COH/AIH is an effective fertility treatment for many couples, if there is no pregnancy after three to four cycles of COH/AIH at our Chicago, Illinois area clinic, the couple should proceed to IVF/ET infertility treatment.
What are the Risks and Complications?
The major disadvantage of COH/AIH is the risk of multiple pregnancies because more than one egg can be released at the time. To prevent this complication, careful ultrasound examinations to determine the number of ovarian follicles and an on-site laboratory capable of rapid hormone determinations are mandatory. High-order multiple pregnancies (publicized by the media) have been conceived exclusively during the COH/AIH cycles. Ovarian hyperstimulation syndrome (OHSS) is another potential complication. When several follicles develop at the same time, the ovary increases in size. This may cause pelvic pain, peritoneal irritation, and fluid and electrolyte imbalance. In extreme circumstances, the patient may have to be hospitalized. OHSS is also preventable through careful sonographic and hormonal monitoring.
In Vitro Fertilization/Embryo Transfer (IVF/ET)
In vitro fertilization/embryo transfer (IVF/ET) is an assisted reproductive technique (ART) provided at our Chicago, Illinois area infertility clinic. The technique involves the fertilization of human eggs in the laboratory (in vitro) rather than in the fallopian tube (in vivo). The eggs are removed from the woman's ovaries and, after maturing in the laboratory, are fertilized with the husband's sperm. The divided embryos are then transferred to the woman’s reproductive system.
What are the Indications of In Vitro Fertilization/Embryo Transfer?
IVF/ET was introduced in the late 1970's and early 1980's, originally to bypass diseased fallopian tubes. It has now revolutionized the management of infertility. IVF/ET provides couples who would otherwise remain childless a good chance of having a biological child. Indications for the procedure, in addition to diseased fallopian tubes, include: endometriosis, pelvic adhesions, male factor infertility, unexplained infertility, and other irreversible causes of infertility.
What Factors Might Prevent Success with IVF/ET?
IVF/ET will not be successful if the uterus is unhealthy or there are factors preventing embryo implantation. Endometrial polyps, intrauterine adhesions, uterine fibroids, uterine infections, and other congenital or acquired uterine anomalies can prevent the implantation of healthy embryos. Careful evaluation of the uterus is therefore mandatory before the IVF/ET procedure. Occasionally, abnormal expression in the endometrial molecules that participate in embryo attachment/implantation (such as integrins) can prevent embryo implantation. If uterine problems cannot be corrected, use of a gestational surrogate may be required. Diseased fallopian tubes may also occasionally accumulate fluid which is toxic to embryos. Such a condition is referred to as hydrosalpinx. If hydrosalpinx is present, chances for pregnancy with IVF/ET are decreased by about 50 percent. It is generally recommended that dilated and occluded fallopian tubes, known as hydrosalpinges, be removed before the IVF/ET attempt.
What are the Procedures Involved in IVF/ET Treatment?
IVF/ET consists of several phases, each of which our infertility specialists serving Chicago, Illinois are highly experienced at carrying out. During the suppression phase, a hormone (GnRH agonist) is administered to suppress ovarian function and to allow for the development of several eggs at the same time. During the stimulation phase, follicle stimulation hormone (FSH), or FHS with luteinizing hormone (LH), is administered. This helps stimulate development of ovarian follicles. When the follicles reach maturity, a human chorionic gonadotropin (hCG) injection is given. About 36 hours later, oocyte retrieval is performed. The eggs are then aspirated transvaginally under ultrasound control. The procedure is performed under conscious sedation with intravenous medication and with local anesthesia. After a brief maturation in the laboratory, the eggs undergo in vitro fertilization with specially prepared husband's sperm. Fertilized eggs or pre-embryos are cultured in the laboratory for three to five days. Then, embryo transfer (ET) of between one to three healthy embryos is performed. Uterine embryo transfer (UET) is a simple office procedure performed under a mild sedative. Ultrasound guidance is used to properly place the embryos in the uterus. A pregnancy test is performed about 10 to 14 days later.
There may be several modifications to this infertility treatment, as determined by the specialists at our Chicago, Illinois area infertility clinic and discussed with you in detail. The suppression phase may be omitted or combined with the stimulation phase using GnRH antagonist. In some patients, the ovaries may not be accessible transvaginally and laparoscopic retrieval of the eggs may be necessary. After embryo transfer, various protocols may be used for support during the later stages of menstruation to increase the chances of embryo implantation.
What are the success rates of IVF/ET Treatment?
As recommended by the Society for Assisted Reproductive Technology/Center for Disease Control (SART/CDC), treatment success rates are reported as the number of live births per number of attempted IVF/ET cycles. The probability of pregnancy and live birth during the first cycle of IVF/ET is over 40 percent in the leading centers, as reported by SART/CDC. Cumulative probability of pregnancy after three IVF cycles exceeds 70 percent.
Additional benefits of IVF/ET
IVF/ET is not only a therapeutic procedure, but also a diagnostic one. Data from the embryology laboratory can provide important information about the quality of a woman's eggs, fertilizing potential of her husband's sperm, and the quality of the resulting embryos.
Risks and complications
Multiple pregnancy and ovarian hyperstimulation syndrome (OHSS) are two potential complications of IVF/ET. Multiple pregnancies can be prevented by limiting the number of embryos transferred. It is a common misconception that IVF/ET leads to high-order multiple pregnancies. In general, the number of fetuses cannot be larger than the number of embryos transferred, and most IVF programs transfer no more than two to three embryos. By transferring two embryos in the blastocyst stage when chances for implantation are higher, and by cryopreserving the supranumerary embryos, high success rates with low risk of a multiple pregnancy can be achieved. It is quite likely that with further advances, only one or two embryos will be transferred during each IVF/ET attempt. OHSS can be prevented by using less aggressive stimulation protocols and through other preventive measures. The infertility treatment specialists at our clinic serving Chicago, Oak Brook, Milwaukee, and surrounding areas are highly experienced providers and will take all necessary precautions to prevent these complications from occurring.
Additional Gamete and Embryo Procedures
If more than two or three healthy embryos are available for transfer, cryopreservation of the additional embryos can be performed. Cryopreserved/thawed embryo transfer during a subsequent cycle gives the couple another chance for pregnancy or the possibility for two or more consecutive pregnancies from the same IVF attempt. If the sperm have low or no fertilizing capacity or if their numbers are low, fertilization can be achieved through micromanipulation and intracytoplasmic sperm injection (ICSI). To improve embryo quality and the chance of for pregnancy, embryo co-culture with endometrial cells to the blastocyst stage may be recommended. Healthy blastocyst transfer increases the chance for implantation and pregnancy and lowers the risk of multiple pregnancy. Assisted zona hatching (AZH), another micromanipulation technique, facilitates embryo hatching from sometimes overly thick or hardened zona pellucida, the structure that binds sperm. Prior to transfer, embryos can be analyzed for abnormal chromosomes or adverse genetic traits and only healthy embryos of either male or female sex are then transferred. The procedure is referred to as preimplantation genetic diagnosis (PGD).
Gestational surrogacy can also help some couples have a biological child. If a women has healthy ovaries, but has experienced a disease of the uterus or the surgical removal of the uterus, gestational surrogacy may be the only way to have a biological child. In gestational surrogacy, a woman's eggs can be removed and fertilized with her husband's sperm. The resulting embryos can then be transferred to the uterus of a gestational surrogate. Regardless of your reproductive health, a consultation with an infertility specialist at our clinic in the greater Chicago, Illinois area will help you understand your options and make the decision that is right for you.
Contact an Infertility Specialist at Oak Brook Fertility Center
At Oak Brook Fertility Center, we understand the difficulties couples experience when unable to conceive. Each infertility specialist at our Chicago, Illinois area clinic is dedicated to helping couples make their dreams come true by building or growing their families. Take the first step and contact our fertility center today.