The first critically important step to becoming pregnant.
Why is it performed? Infertility has many causes. At Ferny, we endeavor to find out exactly why each couple or individual is not conceiving and base our fertility treatment on that diagnosis. We work carefully with patients to ensure that only the most needed tests are performed.
What is the process? We start with a review of your fertility history and a complete physical exam. Typically this includes an ultrasound and blood tests to get a complete picture of your reproductive health, to determine if infertility stems from the woman, partner (or donor), or both.
The basic infertility evaluation of all couples consists of:
Further testing may include genetic screen testing, antibody testing for both partners and a hysteroscopy of the uterus for the woman.
At Ferny, we work with you carefully to make sure only the most necessary and informative tests are performed. In some cases, no amount of extensive testing will reveal the exact cause of infertility, but all results are still enormously helpful in eliminating possible causes and tailoring your treatment.
This simple procedure can resolve various infertility issues.
Why is it performed? Intrauterine insemination (IUI) can resolve challenging fertility issues affecting both men and women. IUI alone is a useful technique for achieving pregnancy in couples with severe sexual dysfunction, low sperm count in the man, or damaged fallopian tubes in the woman as long as at least one fallopian tube is patent. It’s also an effective option for women in same-sex relationships and other patients opting to fertilize an egg with donor sperm.
What is it? In this minimally invasive procedure, healthy or “washed” sperm from the partner or donor is injected directly into the uterus just before ovulation. The increased numbers of sperm reaching the cervix greatly improves the likelihood of egg fertilization.
Additional Information: In some cases, Ferny will prescribe fertility drugs to enhance the ovulation cycle and boost your chances of getting pregnant. Although the drugs can cause temporary headaches, cramping and hot flashes, the actual IUI procedure has minimal side effects.
The last resort for those struggling with infertility.
Why is it performed? IVF can resolve challenging fertility issues affecting both men and women. Some of the situations that are best served by in vitro fertilization are low sperm count in the man, damaged fallopian tubes in the woman, or LGBT couples using donor eggs and/or sperm.
IVF can also help patients who haven’t been successful with artificial insemination.
At Ferny, we do a complete evaluation and IVF remains the last resort when counseling women with open fallopian tubes and without severe male factor infertility.
What is it? A procedure that brings together sperm and egg in a laboratory dish, then transfers the fertilized egg to the uterus.
IVF normally involves daily self-administered hormone injections to stimulate the ovaries to produce three to five eggs each cycle. When harvested, the eggs are fertilized in the lab and one or two of the most promising embryos implanted in the uterus. The process is quick and painless and no sedation is necessary.
Potential Side Effects: May include mood swings, hot flashes, breast tenderness and headaches, but subside when the injections are completed.
Additional Information: IVF can be useful in the following clinical settings of Sex Selection, Preimplantation Genetic Screening (PGS) and Preimplantation Genetic Diagnosis (PGD), prevention of mitochondrial disorders (either maternal spindle or via pronuclear transfer).
Natural IVF lets women forego the discomfort of daily injections.
Why is it performed? Unlike standard IVF, Natural IVF is a great option for women who want to avoid daily hormone injections because of the discomfort of ovarian stimulation, or the high cost of the medication.
What is it? In this alternative IVF, eggs are harvested from the woman’s natural cycle, sometimes induced to accelerate their arrival, without her having to experience the side effects of hormonal injections.
Any patient with a regular menstrual cycle is a good candidate for natural IVF, which is more comfortable, more affordable and has success rates comparable to conventional IVF.
Additional Information: We utilize all the same technologies as conventional IVF treatment to monitor a woman’s health throughout her cycle, and to check the health and viability of each egg she produces. Many women prefer the natural IVF treatment because it offers a more comfortable route to building their family, without side effects from medication and multiple-embryo production.
Nano IVF is another holistic alternative to standard IVF.
Why is it performed? Nano IVF is a more holistic alternative to conventional IVF. But it differs from natural IVF in that it involves some hormone stimulants and the production of multiple embryos.
What is it? The exact regimen a patient follows varies from case to case, but typically nano IVF includes taking daily Clomid pills supplemented with periodic injections and a nasal spray to encourage ovulation and the production of healthy eggs. As with all types of IVF, we carefully monitor the patient’s health throughout the process to achieve optimal results.
Additional Information: Nano IVF is a good option for patients with a fear of needles, or are seeking a financial middle ground between natural IVF and conventional IVF. At Ferny, we also give our IVF patients the opportunity to freeze remaining embryos through cryopreservation for future use, so you don’t have to repeat the ovulation and fertilization process.
As a rule, if you’re not conceiving after 6-12 months of well-timed unprotected sex, both partners should be tested for infertility.
For men, low sperm count or motility, or the absence of sperm, are common causes of infertility that can be detected readily through sample analysis. Men should also be concerned if they experience erectile dysfunction, low sex drive, lumps in their genital area, or have a family history of testicular or prostate cancer.
Once we identify the cause of male infertility, we offer treatment that can restore your ability to start a family:
In a small number of cases, hormonal imbalance is the cause of male infertility.
Disruptions in the pituitary gland, which produces the hormones that trigger the creation of testosterone and sperm, can be remedied by prescribing medications to stimulate testosterone and sperm production.
ICSI (intracytoplasmic sperm injection) is very effective in cases where sperm count is unusually low. In this procedure a small needle injects a single sperm into an egg that is then transplanted into the uterus. IUI and IVF are also good options for fertilizing eggs when sperm is low-count or abnormal.
An effective tool for men struggling with erectile dysfunction that isn’t rooted in physical or hormonal causes. In such cases, Ferny can refer patients to a professional counselor.
Varicoceles, or enlarged veins in the scrotum that can lead to infertility, can easily be corrected by microsurgery. Other surgical solutions include ejaculatory duct resection, which removes cysts, stones or other materials causing a blockage, and vasectomy reversal. (Yes, a vasectomy can be reversed.)
This supplemental infertility treatment has numerous benefits.
WHY IS IT PERFORMED? The Eastern medicine practice of acupuncture has proven to be effective in enhancing the prospects of those trying to conceive a child, including:
It can be especially useful for patients with unexplained infertility, for example, those experiencing undue levels of stress, further complicated by the anxiety of not conceiving.
WHAT IS IT? The procedure uses thin needles to stimulate specific points on the body and restore alignment along your meridians. It treats a host of health issues that affect infertility, including hypothyroid and hyperthyroid conditions, polycystic ovarian syndrome (PCOS) and imbalanced FSH levels.
Patients typically experience the most benefits if they begin acupuncture a few weeks or months in advance of their assisted reproductive treatments, but can be incorporated into your routine at any stage, including the first trimester of pregnancy.
Some infertility issues are best resolved with a surgical procedure.
For both women and men, surgery is sometimes the most effective solution for accurately diagnosing or correcting an infertility problem. Here are some of those situations:
Women usually benefit from one of two procedures:
HYSTEROSCOPY: A procedure that allows us to examine the uterus to identify the cause of abnormal bleeding, and remove uterine growths like polyps and fibroids that can contribute to implantation failure, leading to miscarriages.
LAPAROSCOPY/ROBOTIC SURGERY: In cases where invasive surgery is required, physicians at Ferny take the latest state-of-the-art approach with laparoscopic or robotic surgery.
Rather than the surgeon’s hands using instruments to make a large incision, robotic arms are used to make several small, less invasive incisions. The surgeon sits at a control console a few feet from the patient and views a highly magnified, three-dimensional image of the abdominal and pelvic interior structures.
All movements of the camera and robotic instruments are performed precisely in real-time using ergonomic finger controls to view, biopsy and remove unusual growths in the uterus, fallopian tubes, ovaries or the peritoneum. The tips of these instruments, which include miniature tweezers, lasers and scissors, can make any wrist-like turn the surgeon desires.
Benefits of robotic surgery are quicker patient recovery, less pain, true 3D view with increased surgeon control, and reduced blood loss compared with conventional surgeries. Dr. Radjabi is a certified robotic surgeon.
Men with certain types of infertility can be treated with:
Varicocele Repair This outpatient surgical procedure easily corrects enlarged veins in the scrotum that can cause low-count or poor quality sperm.
Ejaculatory Duct Resection A simple one-hour procedure that removes cysts, stones or other materials obstructing the volume of sperm flowing through the duct. The blockage is diagnosed with an ultrasound.
Vasectomy Reversal Reconnects the male reproductive tract that has been closed off by a vasectomy, even after a long period of time. The microsurgery procedure can also reverse blockages in a man’s reproductive tract.
Bringing more simplicity and certainty to IVF pregnancies.
WHY IS IT PERFORMED? To avoid some of the complications associated with carrying multiple embryos through traditional IVF treatments.
The procedure ensures the pregnancy will not result in multiple births, where babies are often born prematurely, have lower birth weights, or can experience more health issues than babies carried to term individually.
SET results in approximately the same number of successful births as multiple-embryo transfers, while increasing the chances of a safer, healthier pregnancy for both the woman and child.
Today’s technology can greatly reduce the risk of genetic diseases.
Advances in DNA testing for genetic abnormalities are bringing untold peace of mind to couples and aspiring single parents, especially those with a family history of genetic diseases and other pregnancy concerns.
Ferny can test an embryo before it’s implanted into the uterus, a safe and easy way to ensure the pregnancy and birth will be free of genetic complications. There are two types of genetic testing:
PGD (Preimplantation Genetic Diagnosis)tests for disorders that the patient, partner or donor might be carrying, including cystic fibrosis, Tay Sachs, sickle cell, spinal muscular atrophy, and others.
PGS (Preimplantation Genetic Screening)focuses on chromosomes rather than genetic disorders, verifying that the embryo has 23 pairs. Missing or extra chromosomes can result in pregnancy loss or a child born with serious health issues.
Gender Selectionis available to those who conceive through IVF and opt for PGS testing. After lab fertilization, we draw a single cell from each viable embryo to identify the gender, then implant one or two embryos of the gender you choose.
Planning a family today gives you more choices and opportunities than ever before. And Ferny’s knowledgeable professionals are happy to meet with you to discuss your fertility goals.
Choosing when to have a baby on your terms.
WHY IS IT PERFORMED?
Career goals, personal circumstances or an illness can all influence the timing of your pregnancy, so it’s encouraging to know there are options available to safely put off conceiving until your situation is more favorable to having a child.
The younger you are when you freeze your eggs the better quality they’ll be when thawed for insemination.
WHAT IS IT?
Egg harvesting and freezing usually takes four to six weeks. After discussing your fertility goals, we conduct a physical exam to ensure you’re in good health and to determine how many eggs are available for retrieval.
Next comes ovary stimulation to retrieve as many as eggs as possible. Ferny closely monitors your progress with ultrasounds and blood work throughout the process.
In a typically painless 30-minute procedure your eggs are harvested. Immediately after retrieval, the eggs are cryopreserved or vitrified, the most effective method of preservation.
Finally, when you’re ready to become pregnant, the eggs are thawed, fertilized in the lab and the embryos transferred into the uterus.
At Ferny, vitrification is an approach to oocyte freezing. It is based upon the principle that metabolically active cells can be cooled so rapidly that ice does not have time to form. During vitrification, permeating cryoprotectants are added at high concentrations, a very short time is allowed for equilibration, and an extremely rapid rate of cooling is used.
Embryo cryopreservation is a proven method of fertility preservation offered at Ferny. It requires the use of sperm, making it applicable only to women who have a participating male partner or are interested in using donor sperm.
Ferny’s development of the most up-to-date cryopreservation methods for our patients, and our continuous improvements in protocols and techniques, have achieved the highest levels of success in pregnancies from oocyte cryopreservation over the last decade.
WHY IS IT PERFORMED? Cryopreservation or the freezing of sperm is the most frequently used technique to preserve male fertility.
For men facing chemotherapy, radiation or other medical treatments that could cause infertility, as well as vasectomy patients, this method allows you and a partner to start a family in the future.
WHAT IS IT? The process is quick and easy. The patient’s sperm is washed and frozen in small vials that can be thawed and used at a later date in IUI or IVF procedures.
Shielding the testes during radiation or chemotherapy also can markedly increase fertility retention.
Microsurgery: Another option that can improve fertility for men with no sperm in their ejaculate. Performed by a urologist, the procedure retrieves sperm that is then washed and frozen to be available when needed.
Donor eggs bring new hope to women in special situations.
WHY IS IT PERFORMED? Women past the age of 40 face greater risks during their pregnancy, as does the health of the baby. Ovarian decline can also occur at an earlier age due to illness, chemotherapy, a genetic predisposition, or surgical removal of the ovaries.
In all of these instances, using a donor egg can ensure a safe, healthy and successful pregnancy. And for women in same-sex relationships, donor eggs allow both partners to participate in the birth, one as the donor and the other to carry the child.
HOW IS IT DONE? Patients either can opt for a private donor, for example a family member’s eggs to keep their gene pool intact, or select an anonymous donor through a qualified agency. These donors are carefully vetted for personal, family and medical history, and undergo psychological screenings, medical evaluations, substance abuse tests, and follicle health tests before starting IVF.
Many recipients prefer donors who have previously conceived or donated eggs that have resulted in pregnancies, indicators that the donor has healthy eggs suitable for fertilization, transplanting and cryopreservation.
At the Ferny fertility clinic, we can guide you through the entire egg donor process, giving you the greatest chance of bringing a pregnancy to term with donated eggs