Fertility Treatment Services at Troché Fertility Centers
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Overview Of Fertility Treatment
- 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, ICI)
- Ovulation Induction
- Therapeutic Donor Insemination (TDI)
- Operative Laparoscopy and related procedures
- Operative Hysteroscopy and related procedures
- Microsurgical Reversal of Female Sterilization (Tubal Reversal)
- 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 (PGS)
- 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)
Troché Fertility Centers provides fertility services and treatment to single women and nontraditional couples.
First Step: 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.-
Fertility Testing
We will perform the following fertility tests:
(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. Troché 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. Troché’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.
In Vitro Fertilization - IVF
A brief outline of the steps involved in IVF and related procedures, also referred to as Assisted Reproductive Technologies (ART). Due to individual needs, some steps may be changed for you, but the basic flow of steps remains the same for most patients. Read more...
Fibroids and Fertility
Fibroids or leiomyomas are benign smooth muscle tumors of the uterus. These tumors are very common and approximately one out of every five women over the age of 30 years has a fibroid. Read more...
Fertility Treatment Cost Information
At Troché Fertility Centers, we understand and are committed to providing our patients with the most compassionate quality care possible at the most competitive price available. Compare and see. When you're ready to take the first step, we're here and ready to help. Read more...
Fertility Financing and Insurance Information
We offer assistance with understanding your insurance benefits and provide financial options to assist you in seeking treatment. All patients considering fertility treatment at Troché Fertility Centers are offered a financial consultation. Read more...
Last updated:
January 31, 2012
Reviewed by Dr. Vladimir Troché and his medical staff