Your Fertility Journey

Issues of male factor infertility represent approximately 30-50% of infertility cases. Therefore, the male partner must undergo evaluations as well as the female partner. His evaluations can be conducted at the same time as the female. The male evaluation also includes a thorough health history and semen analysis. The history includes questions about family history, chronic health problems, illnesses, injuries, and surgeries that could affect fertility. Your doctor might also ask about your sexual habits and your sexual development during puberty. The second evaluation is the semen analysis, performed at Adore Fertility’s laboratory to measure the concentration (number of sperm), motility (movement), and morphology (shape of sperm). Often, sperm concentration fluctuates significantly from one specimen to the next. In most cases, two semen analysis tests are required to ensure accurate results. Treatment options for male factor infertility range from intrauterine insemination (IUI) for mild cases to in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) for more severe cases. IVF with ICSI may be beneficial for those cases of severe male factor infertility because fewer sperm are needed for fertilization. For ICSI, the embryologist injects only one sperm into each egg. This form of treatment is also effective for those men with no sperm in the ejaculate (azoospermia), which can occur naturally or from a vasectomy. In those cases, a urologist obtains a small number of sperm from the testicle for ICSI. After fertilization, the resulting embryos are grown in an Embryoscope incubator for several days. An embryo can be transferred to the uterus (womb) to attempt pregnancy, while extra embryos are frozen for future attempts at pregnancy. Some patients opt to have their embryos biopsied and tested for chromosomal abnormalities. In these cases, the biopsied cells are sent to a genetics laboratory for testing while your embryos remain frozen at Adore Fertility. It takes approximately two weeks for the report to be released by the genetics lab. After that, an embryo that is chromosomally normal can be thawed and transferred into the uterus for implantation. This is called a frozen embryo transfer (FET) cycle. Hopefully, the baby journey begins! At Adore Fertility, our exceptional clinical team combines andrology, urology, endocrinology, and embryology to provide a variety of highly successful treatment methods.

Like male infertility, female infertility is common. The diagnosis is given for women <35 years of age who have tried to get pregnant (through unprotected intercourse) for 12 months without a pregnancy. For women >35, the diagnosis occurs if no pregnancy results after six months. Female infertility can be the cause or partial cause of infertility in approximately 30-50% of couples. When evaluating the causes of female infertility, Adore Fertility focuses on four factors:

• The ability to make quality eggs (ovarian reserve).
• The uterine environment.
• The condition of the Fallopian tubes.
• The overall health of the patient.

Ovarian reserve is the term used to describe the ability to make healthy eggs. The ovarian reserve is assessed by evaluating the patient’s age, ultrasound of the ovaries, and testing a blood sample for hormone levels. Age is the most critical factor affecting ovarian reserve. No new eggs are created after a woman is born, and the number of eggs within the ovaries decreases with age. Therefore, with increasing age, a woman has fewer eggs available with which to make a baby. The quality of the eggs within the ovary also decreases with age, meaning that the eggs present are less capable of creating a pregnancy as the woman ages. Ultrasound helps your physician visualize the size of the ovaries and the number of follicles in the ovaries. Follicles are fluid-filled structures within the ovaries that each contain an egg. This ovarian reserve evaluation is performed early in your menstrual cycle, and it is used to determine your antral follicle count, The antral follicle count helps your physician estimate the number of healthy eggs that can be produced during a cycle Blood tests measure hormone levels predictive of ovarian reserve. Two hormones that help predict ovarian reserve are follicle-stimulating hormone (FSH) and Anti-Mullerian hormone (AMH). The brain releases FSH to stimulate follicular development in the ovary and to mature the eggs within the follicles. The Anti-Mullerian hormone produced by the cells that surround the pre-antral follicles provides an idea of the number of eggs that remain in the ovary (reserve) and their quality. These two hormone levels help your doctor predict your ovarian reserve and your ability to produce healthy eggs capable of resulting in a pregnancy. The endometrial lining of your uterus (womb) is what allows the embryo to implant and continue to grow. We evaluate the uterus through ultrasound and hysterosalpingogram (HSG) studies. The ultrasound assesses the uterine wall and the endometrial lining of the cavity, which will support implantation. Abnormalities, such as fibroid tumors, are detected on ultrasound examination. A hysterosalpingogram study (HSG) fills the uterus cavity with contrast fluid to determine the shape of the uterine cavity, which is a critical factor for embryo implantation and continued growth. The Fallopian tubes are the route by which the sperm and the egg come together during fertilization. The Fallopian tubes must be open to conceiving naturally or by intrauterine insemination. The HSG procedure evaluates the Fallopian tubes. The contrast solution placed into the uterine cavity will hopefully enter, travel through, and exit each tube. This means that the fallopian tubes are open and capable of allowing for egg and sperm to meet.