Female Infertility Services
Our comprehensive services for female infertility include:
For more information, read about the causes of female infertility.
Diagnosis
Diagnostic procedures can identify the causes of infertility. Sometimes, diagnosis can be easy – just a matter of conducting a few simple tests. Other times, pinpointing the cause requires time and patience. And, in some cases, no cause of infertility can be found.
A diagnostic evaluation often begins with a physical exam and a thorough health history. Afterward, the physician may further evaluate the following issues:
- Confirm ovulation
- A blood test can be performed to determine if there is normal ovulation physiology. Ovulation dysfunction can result from, hormonal deficiencies, congenital defects and age.
- Assess ovarian reserve – a physician evaluates the follicle stimulating hormone (FSH) level. A blood test is performed that can determine the number/quality of eggs remaining in a woman's ovary.
- Measure hormone levels - a common cause of infertility is polycystic ovary syndrome (PCOS). This syndrome is genetically linked to hormonal imbalances thereby causing a condition that prevents ovulation.
- Perform a post-coital test – after intercourse the cervical mucus is analyzed to see how well sperm survive in a woman's reproductive tract.
- Biopsy the endometrium (lining of the uterus) – this test further investigates problems with ovulation or hormones.
Depending on the patient's condition, additional detailed tests may be performed to determine the cause of the infertility. Penn Fertility Care understands that the process of diagnosis and treatment selection may be emotionally demanding and requires the most sympathetic of approaches, with attention to the emotional needs of the couple.
Hormone Therapy to Induce Ovulation
Medications may be used to induce ovulation in those who are not ovulating or are ovulating irregularly. Additionally, hormone therapy can be used to alleviate other endocrine (glands that produce hormones) problems.
The causes of ovulation
failure are numerous. The most common cause
is polycystic
ovarian syndrome (PCOS). Learn more about Penn Fertility Care's dedicated PCOS Center and the excellent
success rates seen at Penn.
In Vitro Fertilization
In vitro fertilization is the preferred or most
common infertility treatment used when the fallopian
tubes are severely damaged or absent, and for
unexplained or male factor infertility. Due to
its high success rates, in recent years, IVF is
increasingly used as a first line of therapy for
all causes of infertility.
The following steps
are taken when performing in vitro fertilization:
- The ovaries are stimulated to produce multiple
egg-containing follicles.
- Progression of follicular development is followed
by evaluating hormone levels and performing
ultrasounds at the appropriate times.
- A transvaginal ultrasound guides the retrieval
of the eggs.
- The recovered eggs are immediately transferred
to the laboratory where they are cultured and
fertilized.
- On a predetermined date, the developing preembryos
are inserted into the uterus.
These procedures involve a variety of carefully
choreographed procedures to insure the best success.
The procedure itself, including the laboratory
work, is performed in Penn Fertility Care's central
state-of-the-art facility.
Surgical Options
Surgery is used to remove adhesions (scar tissue)
or endometriosis
which block the fallopian tube or interfere with
its ability to pick up an egg. Advanced techniques
have improved our ability to do this, often with
a non-invasive
laparoscopic approach or with a microsurgical
approach to reconstruct the fallopian tubes or
the uterus.
Microsurgical repair is an option
for reversing tubal sterilization and often provides
a high success rate without the use of in vitro
fertilization. When the fallopian tubes are extensively
damaged, or when it is unlikely that they will
respond to surgical treatment, in
vitro fertilization is the most expeditious
approach.
If there is extensive tubal damage the
affected fallopian tube is usually removed before
proceeding to IVF. This helps to achieve greater
success for the IVF procedure. For endometriosis,
the laparoscopic approach with laser treatment
is often effective.
Learn more about our pelvic and reproductive surgery options >>
Intrauterine Insemination
(IUI)
Ovulation induction may be used in combination
with intrauterine insemination (IUI). IUI is a
relatively "low-tech" assisted reproductive technology
(ART) in which washed sperm is deposited into
the uterus and fallopian tubes, where fertilization
occurs.
In addition, this process bypasses hostile
cervical mucus and assists in overcoming sperm
count and motility problems. Intrauterine Insemination
was pioneered by the Penn team and was extensively
evaluated in a multi-center study published in
the New England Journal of Medicine.
Egg Donation
In rare cases with premature ovarian failure,
the ovary is no longer releasing eggs because
the supply of eggs has been exhausted. Although
no treatment is available to reverse this process,
it is important to recognize this condition. Some
patients will seek counsel and advice to cope
with this diagnosis.
When the patient is unable
to produce a pregnancy with her own eggs, the
use of donor eggs can be considered as an option.
Learn more about egg donation >>
Consultations for Women with Cancer
Penn Fertility Care has been a pioneer and today remains a leader in the treatment, services and programs offered to patients who have become infertile due to the effects of cancer. Learn more about how Penn Fertility Care meets the reproductive needs of cancer patients >>
Emotional support
and resources
Couples involved in infertility treatment frequently
feel emotional stress. Addressing these problems
is an important part of your treatment. Penn Fertility
Care offers counseling services for patients with
emotional support needs. Be sure to talk with
your doctor about these services.
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