At StarCare, we provide comprehensive fertility testing and treatments. We start by performing a complete review of our patients' medical records and a careful assessment of their individual fertility status.
Depending on her individual situation, tests for a female patient may include blood tests, an endometrial biopsy, a hysterosalpingogram, a hysterosonogram, a hysteroscopy, and a laparoscopy to evaluate, the uterus, the fallopian tubes and the pelvis. Infertility testing includes the following:
- Male Factor - Semen Analysis
- Ovulatory Function - Serum hormone levels of FSH, LH, Estradiol and Progesterone
- Ovarian Reserve - AMH (Anti-Mullerian Hormone), Day 3 FSH and Estradiol
- Tubal Disease - HSG or Hysterosalpingogram, or Laparoscopy
- Cervical Disease - Post-coital test
- Uterine Disease - HSG, Sonohysterogram, or Hysteroscopy
- Endocrine Abnormalities - Serum hormone levels (above), Testosterone, Prolactin, and thyroid hormone tests, or Endometrial Biopsy
Many causes of male and female infertility can be successfully overcome using a range of treatment options. Once your infertility testing has been completed, we will review the results and recommend a treatment plan. This plan may include one or more treatment alternatives including ovulation induction to enhance the production of healthy eggs, minimally invasive surgery to correct or improve anatomical abnormalities, intrauterine inseminations (IUI) to enhance sperms ability to fertilize the egg. If the assisted reproductive technologies such as in vitro fertilization (IVF) are needed, we will refer you to specialized fertility centers for further treatment.
Some causes of infertility can be effectively treated with ovulation induction. During ovulation induction, the woman is treated with medications that increase the number of eggs she ovulates each month. At the appropriate time, IUI or timed intercourse can be performed. Causes of infertility that can be treated with this therapy include ovarian dysfunction, infertility associated with endometriosis, cervical factor infertility, and infertility in which the exact cause cannot be identified.
How ovulation induction works
The first step in ovulation induction is to administer medications aimed at increasing the number of mature eggs produced by the ovaries. During the normal reproductive cycle, two hormones - follicle-stimulating hormone (FSH) and luteinizing hormone (LH) - are required to initiate and complete the process of egg maturation. Medications are administered to women either orally or by injection to increase levels of both LH and FSH.
Fertility is then further enhanced by performing an appropriately-timed intercourse, or intrauterine insemination with semen from your partner or a donor. The semen sample is prepared in a way that allows an enriched, highly motile concentration of sperm to be placed directly into your uterus through the cervix. The result is an increase in the number of mature eggs, as well as motile sperm, within your reproductive tract, which enhances the likelihood that you will become pregnant.
Commonly used medications
Clomiphene citrate can be taken orally to promote the process of egg maturation. The progress is monitored with ultrasounds or the use of home ovulation-predictor kits. Once ovulation is impending, an appropriately-timed intrauterine insemination is performed. There is a more aggressive approach that uses injectable medications, containing FSH with or without LH, results in a higher likelihood of conception than when clomiphene citrate alone is used. To assess the process of egg maturation while you are being treated with FSH with or without LH, several ultrasounds are performed. Blood sampling of your estrogen levels is also performed. Once the eggs have matured adequately, ovulation is induced using a hormone medication HCG (Human Chorionic Gonadotropin) to trigger the final stage of egg maturation and ovulation, like LH does in a natural cycle. Then, just prior to ovulation, an intrauterine insemination or timed intercourse is performed.
To learn more about infertility testing and treatment, or to set up a consultation, please call Dr. Pei’s office at (703) 698-9668.