How do you pursue further fertility choices after completing the initial fertility evaluation?
Women and couple with unexplained infertility (no fertility factor detected) or mild male factor:Choices are timed intercourse (if not done before), followed by ovarian stimulation and IUI for 2-3 cycles followed by IVF. IVF with single embryo transfer may be preferred in women not accepting twins or fetal reduction.
Women who do not ovulate regularly:choices are ovarian stimulation with oral or injection medication with IUI for 2-3 cycles followed by IVF. IVF with single embryo transfer may be preferred in women not accepting twins or fetal reduction.
Women with blocked fallopian tubes.IVF is the best option for achieving a pregnancy. In some women laparoscopic surgery to correct the fallopian tubes can be considered.
Men with moderate to severe male factor:IVF with ICSI yields the best chances for pregnancy.
Women with prior unsuccessful fertility treatmentmay require careful evaluation of prior treatment to improve response to stimulation, mild stimulation IVF, PGD and other interventions.
Women with markedly diminished ovarian reservecan parent children through donor eggs with partner or donor sperm.
Single women interested in extending their fertilityusing egg freezing or embryo freezing using donor sperm.
Same sex female couplescan parent a child through donor sperm and IUI.
Same sex male couplescan parent a child through using a donor oocytes and a gestational carrier.
Women desiring to extend their fertilitycan use egg freezing or embryo freezing with partner or donor sperm. Eggs or embryos can be used years later to conceive.
Women at risk for reduced fertilitydue to a disease or disease treatment: options are egg freezing or embryo freezing using partner or donor sperm.
Women with recurrent pregnancy lossmay require surgery to correct the uterine cavity, ovarian stimulation and IUI or IVF with PGD.
Women desiring pregnancy with a specified sexfor family balancing requires IVF with PGD, embryos are tested for X and Y chromosomes to determine the sex of the embryo.
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