Fertility Treatment Services at WVFC
Comprehensive Fertility Evaluation for both Partners/Fertility Work-up- Comprehensive Fertility Diagnosis
- Male Factor Evaluation and Treatment
- Comprehensive Semen Analysis with Kruger's Strict Morphology Evaluation
- Evaluation and Treatment of Ovulation Disorders
- Recurrent Pregnancy Loss Evaluation and Treatment
- Intrauterine Insemination (IUI) & other Non-IVF Treatment Options
- Therapeutic Donor Insemination (TDI)
- Operative Laparoscopy and related procedures
- Operative Hysteroscopy and related procedures
- Microsurgical Reversal of Female Sterilization
- Fibroid Tumor Treatment/ Abdominal Myomectomy for Fibroids
- In Vitro Fertilization (IVF)
- Intracytoplasmic Sperm Injection (ICSI)
- Assisted Embryo Hatching
- Pre-implantation Genetic Diagnosis (PGD)
- Family Balancing / Gender Selection (PGD)
- Embryo Cryopreservation
- Embryo Cryopreservation prior to chemotherapy
- Frozen Embryo Transfer (Cleavage Stage and Blastocyst)
- Sperm Cryopreservation
- Sperm Cryopreservation prior to chemotherapy or vasectomy
- Egg Donation
- Gestational Carrier (Surrogacy)
West Valley Fertility Center provides fertility services and treatment to single women and nontraditional couples.
First Step in Fertility Treatment: Consult & Evaluation
Fertility Work-Up
The goal of the infertility work-up (evaluation) is to answer four basic questions:
- Do we have sperm?
- Do we have eggs?
- Can the sperm and egg meet?
- Is there an adequate hormonal environment to achieve a pregnancy?
To answer these questions, specific tests are ordered.
1. Do we have sperm?
The semen analysis is a simple way of documenting the presence of adequate numbers of motile sperm. Because of its simplicity it is usually one of the first tests ordered. When abnormal results come from another facility, we will repeat tests in our lab to confer those results.
2. Do we have eggs?
A history of regular menstrual cycles is usually all that is needed to answer this question. By definition, women who have eggs and that ovulate in a predictable manner, have regular menstrual cycles. In the absence of ovulation menstrual activity is irregular and unpredictable. Additional evidence of ovulation can be obtained from (1) basal body temperature (BBT) charts, and (2) ovulation predictor (LH detection) kits.
3. Can the sperm and the egg meet?
For fertilization to take place an egg and a sperm need to be able to meet in the fallopian tube. In the presence of normal sperm function, damage or obstruction of the fallopian tubes would prevent fertilization from happening. Tubal damage is usually the result of a pelvic infection or previous pelvic surgery. A Hysterosalpingogram (HSG) is the test ordered to find out if the fallopian tubes are open or closed (blocked). The test involves the instillation of a contrast media (dye) through the cervix into the womb itself and from there into the fallopian tubes. A normal test demonstrates free flow of the dye through the fallopian tubes.
4. Is there an adequate hormonal environment to achieve
a pregnancy?
Normal progesterone levels are needed for the lining of the uterus to develop normally. Progesterone is a hormone produced after ovulation by the ovary. It is made in the same place in the ovary from which the egg was released (ovulated). Measurement of a progesterone level seven days after ovulation (in the middle of the luteal phase) is a simple way of answering this question. Normal progesterone levels are associated with normal ovulation and endometrial development. A blood sample to measure progesterone is obtained 7 or 8 days after the ovulation is detected with an ovulation (LH) detector kit.
We also measure: (1) TSH level - to assess thyroid gland function, (2) a prolactin level - elevated levels could cause abnormal ovulation, (3) a rubella titer - to assess immunity or protection against rubella, and (4) FSH and estradiol levels on the second or third day of the menstrual cycle to evaluate the egg quality or the "ovarian reserve". A Clomiphene Citrate Challenge Test (CCCT) is used to evaluate the egg quality when the female partner is 30 years of age or older, and when the infertility appears to be unexplained.
Additional studies
Actual testing performed may vary depending on your particular situation.
A diagnostic laparoscopy may be recommended as part of the evaluation to couples in which endometriosis or pelvic adhesions is suspected, or when the infertility is considered to be unexplained.
Diagnosis
In most cases, the work-up will pinpoint to an infertility diagnosis. Once the diagnosis is established, Dr. Troche will tailor a treatment path to suit your personal situation. We encourage patients to participate in the diagnostic phase of their treatment and discussion of your treatment options and alternatives. Dr. Troche’s recommended treatment plan will depend on your age, diagnosis, duration of infertility, any previous treatments, personal needs as well as the most cost effective treatment that leads to achieving a successful pregnancy.
Last updated:
June 4, 2008
Reviewed by Dr. Vladimir Troche and his medical staff