An X-ray examination of the uterus and fallopian tubes.
insemination (IUI): This is
an in-office procedure that involves exposing the patient
to sperm, either vaginally, intra-cervically, or intrauterinally.
Sperm can be from the husband or frozen donor semen.
If sperm is placed inside the uterus it must be washed
several times to remove substances that can cause severe
cramping or shock. Once the sperm are washed, they can
remain active and viable for 24-48 hours. Intrauterine
insemination involves washing and condensing the sperm
into a small volume of less than 1.0 cc. The aim is
to get sperm beyond the cervical barrier and enable
them to find the egg. The soft plastic catheter is threaded
through the cervical canal into the uterine cavity before
injecting the semen. Insemination optimizes your chances
of achieving pregnancy within a cycle, thereby bringing
you up to potential 20% pregnancy rate/cycle.
vitro fertilization (IVF):
The letters IVF stand for In-Vitro Fertilization,
otherwise known as test-tube baby. These days, fertilization
takes place in a dish, not a test tube. Due to improvements
in ultrasound imaging, surgery is no longer necessary
for most In Vitro Fertilization patients. A technique
for recovery of eggs from the ovary is described below.
It uses a sonographically-guided needle to replace the
surgical procedure which previously was used to recover
oocytes (eggs). This procedure requires neither hospitalization
nor general anesthesia.
order to prepare a proper environment in the woman and
to increase the chances of recovering several healthy
and mature eggs, the woman will undergo about two weeks
of intensive preparation. This will include hormonal
therapy with fertility drugs (clomid, metrodin, pergonal).
Blood tests and ultrasound scans of the ovaries are
used to determine the optimal time to retrieve the eggs
from the ovary. This optimal time is just before ovulation
when the oocytes are almost ready for fertilization.
the proper time, an outpatient procedure under local
anesthesia will allow the wife's eggs to be visualized
by ultrasound and retrieved from the ovary by placing
a needle through the vaginal wall. After a short rest,
the wife will be able to go home and resume normal activities.
fluid from the follicles is examined under the microscope
by the embryologist, who locates the eggs and keeps
them in the laboratory under physiologic conditions.
The embryologist will place the sperm with the eggs
when they are ready for fertilization. The fertilized
eggs are maintained in laboratory dishes in a nutrient
mixture which acts as a substitute for the environment
that would otherwise have been provided by the fallopian
tubes. After two days, the fertilized eggs have divided
2 to 4 times and are ready to be transferred back into
the woman. Using a special catheter, 3 to 6 of the couple's
pre-embryos will be passed through the vagina and into
the uterus. After the pre-embryo placement in the uterus,
the wife will lie quietly in a bed for about an hour,
and then will return home. The chance of implantation
and pregnancy is up to about 25% per cycle of treatment.
The remaining pre-embryos can be frozen for future use.
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