INFERTILITY

Infertility Care

Dr. Finberg specializes in infertility and is highly successful. Infertility is determined when a couple has been trying to become pregnant for a period of 12 months without results. In some cases, however, evaluation for infertility may be appropriate after six months of trying to conceive unsuccessfully. Once infertility has been verified, a medical evaluation will be necessary to diagnose the cause of the infertility and to decide on a treatment plan.

Causes of Infertility

There are many causes for infertility, but for women the problem is often related to an issue with ovulation or a condition affecting the uterus or fallopian tubes. For men, infertility is commonly due to an abnormal sperm count. According to national statistics, approximately 15 percent of couples struggle with impaired fertility and in about 25 percent of those cases, infertility is caused by more than one medical factor.

Medical Examination

If a couple is experiencing infertility they will need to be evaluated in order to identify the cause or causes of their fertility problems. At the evaluation, Dr. Finberg will require an in-depth personal medical history, including pelvic infections, abdominal surgeries, previous pregnancies, and any underlying health conditions or symptoms that may be contributing to infertility. Women will need to discuss the frequency of the menstrual cycles and associated pain or cramping as well. Men will also need to provide a detailed medical history, if he has fathered any children in the past, his occupation to exclude environmental influences, and if he is on any medications. Couples should also be prepared to discuss how often they are having sexual intercourse and how long they have been trying to conceive.

Testing and Treatment

After the initial evaluation, some tests may be necessary to further understand the reasons a couple is not able to conceive. Tests can include blood panels, semen analysis, ovulation kits, ultrasound, and hysterosalpingogram (HSG or X-ray of tubes and ovaries). Depending upon the test results, Dr. Finberg can determine an appropriate course of treatment(s). There are several options for treating infertility, including infertility medication, post-coital testing, and insemination (IUI), but each treatment should be decided on a case by case basis. Referral to a reproductive endocrinologist (REI) for advanced Reproductive Technology (ie. IVF-ET) may be required.

Infertility Medications: Ovulation induction medications such as Clomid or Femara may be used in an IUI cycle to encourage the development of mature eggs. Use of medications is dependent upon the cause(s) of the couple's infertility, their treatment history and many other factors. Patients undergoing fertility drug stimulation, also known as ovulation induction, are monitored through blood tests to measure hormone levels, and transvaginal ultrasounds, which allow Dr. Finberg to visualize the ovaries and follicles. IUI success rates using ovulation induction are usually higher than in non-medicated cycles due to increased egg production.
Post Coital Testing: The post coital (after intercourse) infertility test is sometimes used to evaluate how sperm interacts with the cervical mucus. The couple has normal intercourse, using no lubricants, and the female comes to office within 4 to 6 hours. A sample of her cervical mucus is examined under the microscope. Normal numbers of motile sperm should be seen in the sample. If numerous, inactive or "dead" sperm are seen, it could indicate; an infection or an antigen antibody reaction. Sometimes the female's immune system incorrectly identifies sperm as invading pathogens and seeks to destroy it in the same manner as bacteria or viruses. Rarely, a man may produce antibodies to his own sperm.
Insemination (IUI): Intrauterine Insemination (IUI) is a treatment for infertility in which sperm are washed, processed and concentrated at the outside laboratory prior to placement in the uterus. IUI is a first line treatment for women with cervical factor infertility. The cervical mucus may be too thick or thin or it may not be present in adequate quantities. Sometimes the woman's immune system mistakes sperm for invading germs. When this happens her body dispatches its natural defense mechanisms to destroy the sperm just as if it were a bacteria or virus. IUI is planned around the time of ovulation based on history and/or LH testing and ultrasound.

For Reproductive Endocrinology Infertility (REI) specialty advice link to: www.acaciofertility.com