Many of Monterey Bay IVF’s patients are helped through basic and advanced infertility treatments. If you and your partner are having difficulty conceiving, then you may want to consider learning more about infertility treatments. One avenue to conception that Dr. Ramirez often begins his couples with is Intrauterine Insemination (IUI), which is sometimes referred to as “artificial insemination.” In addition to this method, there are other procedures that have allowed couples to experience the joy of pregnancy and childbirth after months, even years, of failed attempts to get pregnant. If deemed necessary, then In Vitro Fertilization is recommended. Here is a list and a brief overview of some of our most common infertility treatments:
- Natural Cycle Monitoring
- Ovulation Induction
- Intrauterine Insemination
- Laparoscopy and Hysteroscopy
- In Vitro Fertilization
- Egg Freezing
- Semen Analysis and TESA
Natural Cycle Monitoring
In some cases patients do not become pregnant because of difficulties related to ovulation timing. Dr. Ramirez will monitor these patients to determine when ovulation occurs, for timed intercourse or assist the patient by performing IUI’s.
Ovulation induction is one of the most common treatments for many causes of infertility. This process involves the stimulation of a woman’s ovaries through the use of fertility drugs. Ovulation induction is frequently used in conjunction with Intrauterine Insemination (IUI).
Intrauterine Insemination (IUI) is the placing of washed sperm in the women’s uterus when she is ovulating. IUI is especially useful when sperm has had difficulty reaching the egg(s). It is frequently used for the treatment of mild to moderate male factor problems such as poor sperm function. Dr. Ramirez typically does back-to-back IUI’s and will come in on weekends to do this unlike other clinics. This procedure can be used in conjuction with ovulation induction.
Laparoscopy And Hysteroscopy
Laparoscopy, sometimes referred to as “micro-surgery”, is performed in an out-patient surgery center with very low recovery time and minimal discomfort to the patient. It is mainly used to examine the abdominal wall or the female pelvic organs. It is a minimally invasive method of diagnosing problems such as cysts, adhesions, fibroids or infection. It is also used to confirm endometriosis, a condition which can cause infertility. Dr. Ramirez is a member of the American Association of Gynecologic Laparoscopy. He has performed hundreds of laparoscopies and was one of the first in Monterey County to perform this type of microscopic procedure. He has privileges at both the Salinas Surgery Center and Monterey Surgery Center for the convenience of his patients.
Hysteroscopy is performed in our comfortable, private surgery center. It is one of the necessary diagnostic procedures in an infertility evaluation used to inspect the inside of the uterus for fibroids, polyps, scarring and abnormal shape. During this procedure, a thin scope is inserted into the vagina and moved gently to the cervix and then into the uterus. If necessary, the doctor may take a small sample of tissue to perform a biopsy.
In Vitro Fertilization
In Vitro Fertilization (IVF) is a process by which the woman’s egg is fertilized outside the body in a laboratory setting. It is the treatment of choice when all other methods of assisted reproductive technologies have failed. The process involves monitoring a woman’s ovulatory process, priming the endometrium and synchronizing her ovulation days in order to remove mature eggs from her ovaries. The eggs are then fertilized in a special fluid medium in our embryology laboratory. After three to five days, the fertilized egg or eggs are then transferred to the woman’s uterus via ultrasound and allowed to implant naturally with the hope of achieving a successful pregnancy.
See more on the IVF Process.
Egg Freezing For Future Fertility
Women may choose to bank their eggs for a variety of reasons–career, haven’t found the right partner, medical reasons, to name a few. Success depends on the age of the woman at the time of egg freezing but for a woman who is less than 35 years old at the time of her egg freezing, the chances are good that her eggs will fertilize after thawing.
Although egg freezing has been available for over a decade the method of freezing has only recently changed from a “slow freeze” method, in which only a small percentage of eggs survived, to what is used now, a “flash freeze” method. Here at Monterey Bay IVF we utilize this newer vitrification method since studies have already shown that more than 90% of the eggs survive. The expectations are that pregnancy rates from frozen eggs will always depend on the women’s age at the time she freezes her eggs.
Semen Analysis and TESA
Male factor infertility occurs in 1/3 of all couples. At our center we are able to test for semen quality. We offer a private, comfortable collection room for our male infertility patients. After collection, the sperm is analyzed in our CLIA certified laboratory for morphology and motility. The physician is looking for sperm density (greater than 20 million/mL), motility (greater than 50%), and morphology (greater than 30%) as the baseline standard for optimal sperm fertilization. If there is a low count in any of these sectors, then IUI or intra-uterine insemination or IVF (in vitro fertilization) is considered. If there is an absence of sperm or “azoospermia”, we suggest either donor sperm or IVF (in vitro fertilization) with TESA (testicular sperm aspiration).
Some men have no sperm or “azoospermia” in their semen either because of vasectomy or illness. TESA is an open testicular biopsy performed under local anesthesia during which about 500 mgs of testicular tissue is aspirated through a needle placed in the testicle or epididymis. This procedure is typically performed in our surgery center by a board certified Urologist on the day of the couple’s IVF procedure. Sperm obtained by this method must be used in conjunction with ICSI (intracytoplasmic sperm injection) because they are too immature to fertilize the eggs on their own. This procedure is performed the same day as the oocyte aspiration (egg retrieval) in order to allow the use of fresh sperm for ICSI. The sperm extracted can also be frozen for future use in case the cycle is cancelled.
See more on Male Factor Infertility in our Understanding Infertility section.