Infertility affects people regardless of sex, and the causes of infertility in roughly one third of all cases result from issues with the female partner. Most of the obstacles facing women involve ovulation disorders, like polycystic ovary syndrome (PCOS) or premature ovarian failure (POF), or physical problems with the reproductive system, which can include damaged fallopian tubes or fibroids. When you come to Reproductive Medicine Associates of Florida (RMA-FL), our initial infertility consultation will explore the possible causes of your infertility.
Once we determine the root cause of your infertility, there are several possible treatments for you to choose, including:
Ovulation Induction(OI). This hormonal therapy stimulates healthy egg development and release. We use oral or injectable fertility medications to regulate or boost ovulation to produce a single healthy egg. We may also increase the number of mature eggs in a single cycle to increase the chance for conception.
Intrauterine Insemination(IUI). This procedure introduces sperm from the male partner or donor directly into the uterus to boost the chances of fertilization.
In Vitro Fertilization(IVF). We retrieve both the sperm and eggs from each partner and fertilize them outside the body. After some time for embryonic growth, the embryo is implanted into the woman’s uterus. IVF is a process that extends over several weeks and encompasses multiple stages, also known as a “cycle.”
Reproductive Surgery. For patients with uterine growths or damaged reproductive tissues, surgery may be the best solution.
Acupuncture. RMA-FL’s certified acupuncturists use this traditional Chinese treatment to stimulate healthy reproductive activity using traditional and modern methods.
Diet & Nutrition Counseling. A well-balanced, healthy diet is beneficial to reproductive health, and can play a pivotal role in managing infertility and achieving a successful pregnancy. Diet is also very important for managing PCOS.
Counseling. RMA-FL believes in providing compassionate, thorough patient care. Part of your treatment can include various types of counseling, such as specialized support groups, third-party reproduction counseling, couples counseling, and support networking with other patients.
When it comes to overcoming infertility, age is our biggest barrier to success. For example, at birth, a woman will have all the eggs she will ever have in her lifetime, nearly 1-million. But by the time she’s in her early 30’s her pool of eggs has decreased substantially to less than half that. A secondary challenge for women is one of egg quality: by the time a women is in her late 30’s nearly 40% of her eggs will be of low-quality due to genetic imbalances or other issues related to her age.
The American Society for Reproductive Medicine (ASRM) recommends seeing a reproductive specialist if you are a woman under 35 and trying to get pregnant for 12 months without success. If you’re over 35 ASMR recommends you see a specialists after 6-months of trying without success.
Hormonal evaluation studies help identify hormonal imbalances that may impair your fertility.
Hormones control every step in achieving pregnancy — from stimulating the development of an egg to ovulation and implantation of a fertilized egg in the uterus. Each hormone that plays a role in conception must be produced in a specific amount at a precise time in your menstrual cycle. Hormonal studies measure the levels of certain hormones produced by your body during your cycle. You are likely to have a series of simple blood tests at various points in your cycle. The tests your doctor orders may help determine your diagnosis as well as identify the best treatment options.
Hormones that control ovulation and implantation of the egg:
Estradiol – stimulates the growth of the follicles and the production of fertile mucus from the cervix, and prepares the uterine lining for implantation of a fertilized egg
Anti-Mullerian Hormone (AMH) – the level of AMH in a woman’s blood is generally a good indicator of ovarian reserve
Follicle-stimulating hormone (FSH) – stimulates the development of the egg
Luteinizing hormone(LH) – stimulates the release of the egg from the follicle (ovulation)
Progesterone – stabilizes the uterine lining for implantation of a fertilized egg and supports early pregnancy
Androgens – normally, small amounts of androgens — testosterone and DHEAS (dehydroepiandrosterone sulfate) — are produced in women; excess production may interfere with development of the follicles, ovulation, and cervical mucus production
Prolactin – stimulates milk production; blood levels may be higher than normal in certain disorders or if you are taking certain medications
Thyroid – underactive thyroid (hypothyroidism) can result in high prolactin levels
Ovulation induction with medications stimulate many follicles in your ovaries to develop multiple eggs. Your doctor will evaluate you frequently during this time to make sure your follicles (egg sacs) are developing properly and to evaluate the right time for egg retrieval. Once your follicles are developed, your doctor will retrieve the mature eggs.
What to expect during ovulation induction:
Ovulation induction involves treatment with medications to stimulate follicle growth. A GnRH analog may be used to control follicle growth. Your treatment will depend on your specific needs.
A few days after your period begins, you may start treatment with follicle-stimulating hormones (FSH) and/or human menopausal gonadotropins (hMG).
For the next week or so, your doctor will evaluate your hormone levels and examine your follicles by ultrasound frequently, to evaluate their development. Your doctor will also be monitoring you for potential medication side effects.
When your follicles are almost mature, your doctor will tell you when to take your human chorionic gonadotropin (hCG) injection. hCG causes the final maturation of the eggs. The hCG injection is usually given about 35 hours before egg retrieval is scheduled.
Please contact us for more information on female infertility treatment options in Florida.