Infertility

Infertility is common, occurring in up to 11% of couples at some time in their reproductive lives. The American Society for Reproductive Medicine defines infertility as the inability to conceive after one year of regular unprotected intercourse. However, for women in their thirties the time frame is shortened to six months. This is because female fertility is directly related to advancing age and can decline rapidly.

A lot of media attention has focused on infertility, especially on treatment techniques such as in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Most of these news stories fail to mention that relatively few couples will need assisted reproductive technologies and most will become pregnant using "first level" treatments such as intrauterine insemination (IUI).

Couples should not delay consulting a board certified fertility specialist because of "fertility treatment cost concerns". Many studies demonstrate that treatment by a reproductive endocrinologist, fertility specialist results in lower overall cost and higher pregnancy rates. When more expensive techniques, such as IVF, are required, we help control fertility treatment costs through programs like our "IVF Refund Program". Our fertility specialists treat patients from Baton Rouge, New Orleans, and the surrounding regions.

One reason treatment costs are often higher when patients are treated by a non-specialist is that marginally effective therapies are used for too long. A good example is use of the first line ovulation inducing drug, Clomid. The literature clearly shows that Clomid will most likely be effective in the first three cycles yet we see patients who have taken Clomid for a year or longer. We also see women taking Clomid in the absence of a thorough male infertility evaluation. Clomid, and no other medication, will work in the absence of quality sperm.

Fertility specialists are highly trained in many areas including microsurgery. The reproductive endocrinologist is often able to treat diseases, such as endometriosis, during the diagnostic laparoscopy. If the laparoscopy is performed by a non-specialist, it is possible that a second laparoscopy may be required.

There are many biologic processes that must occur in the female and male for a successful pregnancy to result. Abnormalities in one, or more, of these processes can result in infertility.

1. Male Factor- The male must produce enough, high quality, sperm capable of fertilizing an egg. The sperm must be ejaculated into the female's vagina and swim through the cervical mucus to the uterus. Where moderate to severe male infertility is present, ICSI is the treatment of choice.
2. The cervical mucus must have the right consistency to facilitate the sperms transport. It must also be free of antisperm antibodies.
3. The female must produce an egg that can be fertilized and develop into an embryo. Women suffering from ovarian failure or other conditions making it impossible to use their own eggs, are candidates for our Louisiana donor egg program.
4. The egg must be transported from the ovary, through the fallopian tube, to the uterus. Fertilization must occur at the end of the Fallopian tube. Endometriosis can damage and obstruct the tubes.
5. Fertilization results when the chromosomes from the father and mother combine. Each parent contributes ½ (haploid) of the embryos genetic makeup.
6. The fertilized egg, now an embryo, must attach to the lining of the uterus (the endometrium) and receive nourishment.
7. The endometrium must be physiologically capable of supporting the developing embryo. Endometrial development is stimulated by estrogen and progesterone during the ovulatory cycle.
8. The uterus must support the developing fetus. It must be free of large obstructions such as fibroids and structural abnormalities.
   
9. The mother must be physically capable of caring the fetus to term and delivery.

Each of these infertility causes is discussed in detail on separate Web page. Our fertility clinic serves patients from Baton Rouge, New Orleans and the surrounding regions.

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