Infertility Treatment Process at East Bay Fertility Center
This section describes our infertility treatment processs:
- Initial Consultation
- Pre-cycle Evaluation
- Ovarian Stimulation
- Ovulation Induction with Clomid
- Ovulation Induction with Injectable Gonadotropins
- In-Vitro Fertilization with Embryo Transfer (IVF-ET)
1. Initial Consultation
Infertility is a condition that affects upwards of 12% of the population attempting to achieve a pregnancy. It can be emotionally and financially draining. It is often impacted significantly by the fragmented and piecemeal medical care a patient receives in our current healthcare system. And though there are many programs that provide the process—they often cannot provide the service that the patients need and deserve. This, in turn leaves you, the patient, dealing with inefficiency and impersonal care.
At East Bay Fertility Center, our approach to infertility is to provide the most comprehensive infertility treatment services available—services that start from your initial evaluation to offering the most advanced forms of treatment available, namely, in-vitro fertilization.
Our commitment to you is very specific—we will properly diagnose the cause of your infertility and in a very detailed and personalized fashion, outline all of your available infertility treatment options. We will clearly outline the pros and cons of each procedure and/or treatment so that you will have all facts you need, right in front of you, to make the decision that is right for you. We will then customize a plan of care for you to follow that guides you step-by-step and helps you feel less overwhelmed.
Please e-mail East Bay Fertility Center to set up your initial consultation.
2. Pre-Cycle Evaluation
This phase of your journey will depend largely on your particular situation.
Patients undergoing an initial evaluation may be asked to have some preliminary tests such as hysterosalpingogram (HSG), hormone testing (FSH, Estradiol (E2), TSH, Prolactin), or semen analysis.
Prior to a patient undergoing ovulation induction and/or intrauterine insemination(s), some additional tests may be required based on the legal requirements for infectious screening.
Patients who have undergone infertility treatment such as IVF or previous infertility work-ups should request a copy of their medical records to be sent to East Bay Fertility Center for Dr. Snowden to review and assess. This may minimize both the need to repeat certain tests and the time involved in getting a patient into cycle.
3. Ovarian Stimulation
A woman’s body is designed in such a way that each month her body will produce a certain number of follicles which contains eggs. Left alone, the brain and ovaries will work together to produce one mature egg per month. However, there are women who have problems with this process and thus they are diagnosed with ovulatory dysfunction. Once this diagnosis is reached, one encounters words such as controlled ovarian hyperstimulation ("COH"), ovulation induction ("OI") and ovarian hyperstimulation. There are three levels of infertility treatment, which depend on the individual’s situation and history. They are:
LEVEL I: Ovulation Induction with Clomid
LEVEL II: Ovulation Induction with Injectable Gonadotropins (E.G. Gonal F, Follistim, Bravelle, Menopur, Repronex, ETC.)
LEVEL III: In-Vitro Fertilization with Embryo Transfer (IVF-ET)
4. Ovulation Induction with Clomid
This mode of infertility treatment is the least invasive intervention for infertility treatment and is timed with your menstrual cycle. This form of fertility therapy uses a tablet called Clomiphene citrate (Serophene® or Clomid®), which is usually prescribed in a 100 mg. dose to be taken orally for a period of 5 days. The use of this medication may cause one or more follicles to develop in the ovaries and is timed to your menstrual cycle. This treatment can be combined either with artificial insemination or timed intercourse.
5. Ovulation Induction with Injectable Gonadotropins (E.G. FOLLISTIM, BRAVELLE, REPRONEX, GONAL-F, MENOPUR, etc.)
Like the Level I treatment, this form of fertility therapy is timed to your menstrual cycle. However, it introduces the use of injectable medications, which should cause more than one follicle to develop in the ovaries. These injections are subcutaneous ("SUBQ"). The patient is taught how to measure the dosage and give the injection(s). This treatment also involves ultrasound examination of the patient. When timing is determined to be optimum, the patient will come to the clinic for artificial insemination or pregnancy can be attempted through timed intercourse.
6. In-Vitro Fertilization with Embryo Transfer (IVF-ET)
A cycle of in-vitro fertilization involves several steps. The first step is hormonal control of the female patient’s menstrual cycle (usually achieved through the use of birth control pills). Then a hormone called lupron is introduced which works at keeping the pituitary gland suppressed. This will make the ovaries and endometrium more receptive to the next step of the infertility treatment, , which is the introduction of the follicle stimulating hormones ("FSH"). Most commonly these hormones are injected SUBQ for a period of 9–12 days. After 5–7 days on the FSH medications, clinical monitoring is required which involves both a blood test and ultrasound examination. The monitoring allows Dr. Snowden to watch the follicular development and most optimally set the stage for the next step, which is the egg retrieval. The egg retrieval takes place 36 hours after the injection of HCG (human chorionic gonadotropin) is given. HCG works at maturing the developing eggs in preparation for the retrieval and the timing of the injection is critical. Once the eggs are retrieved they are inseminated with sperm (either from the male partner or from donor sperm) in the IVF lab. The embryologists culture the fertilized eggs which have now become embryos. The transfer of the embryos to the uterus by use of a catheter through the cervix, usually occurs 3 days after the retrieval. Unlike a natural cycle where the follicle which released the egg produces progesterone, in an IVF cycle the progesterone needs to be replaced in the form of injections and/or vaginal suppositories.