Infertility Treatments at NYU Langone Reproductive Specialists of New York
After identifying the cause of infertility, the doctors at NYU Langone Reproductive Specialists of New York develop a treatment plan that gives you the best chance of becoming pregnant. Treatment options include in vitro fertilization (IVF), intrauterine insemination, and timed intercourse.
In Vitro Fertilization
IVF is a commonly used treatment for infertility in women and men. It starts with fertility medications to stimulate ovulation, followed by harvesting eggs, combining them with sperm, and then placing the fertilized eggs into the uterus. This treatment can be used with fresh or frozen egg, sperm, or embryo.
In traditional IVF, sperm are placed in a laboratory dish with an egg until one of the swimming sperm penetrates the egg, fertilizing it. In some cases, sperm lack the ability to penetrate the egg. An embryologist then uses a micropipette, which is an extremely thin needle, to place a sperm inside the egg, thus triggering fertilization in a procedure called intracytoplasmic sperm injection (ICSI).
In Vitro Fertilization with Donor Eggs
Egg donation is an option for women who are unable to use their own eggs for medical or other reasons, and for individuals or couples who need a third-party egg donor to achieve pregnancy through a surrogate.
Donor eggs can come from a frozen egg bank or fresh from a donor. If you choose to use an egg bank, we can connect you with facilities that provide profile information of anonymous, medically cleared donors. We can also help facilitate a fresh egg donation from a donor agency or from a donor you know, such as a friend or family member. Fresh egg donors must also be medically screened before starting the IVF process.
Reproductive Specialists of New York also maintains our own egg bank, including eggs donated by patients who did not require them for their own IVF cycle.
Preimplantation Genetic Testing
After fertilized eggs have grown for five to six days, you can choose to have your embryos screened for potential genetic abnormalities or chromosomal conditions before implantation. There are four types of preimplantation genetic testing: aneuploidy, monogenic, structural rearrangement, and human leukocyte antigen (HLA) testing.
Preimplantation genetic testing for aneuploidy is the most common and can detect abnormalities that can point to an increased risk of miscarriage or indicate an abnormal number of chromosomes, which is associated with genetic disorders such as Down syndrome.
Preimplantation genetic testing for monogenic diseases may be used when one or both parents has a family history of certain genetic disorders, such as cystic fibrosis or sickle cell anemia. It can also be used to screen for genetic mutations associated with inherited cancers, such as the BRCA mutation associated with breast cancer.
Preimplantation genetic testing for structural rearrangement may be used to identify Robertsonian or reciprocal translocations, which have been linked to recurrent miscarriages. Preimplantation genetic testing for HLA can be done to identify an embryo that is a potential bone marrow donor for a sibling.
These tests are all performed in the same manner. After fertilization, an embryologist uses an extremely thin needle to remove a small number of cells from the growing embryo. This does not affect fetal development because the cells removed would have eventually become part of the placenta, and not the fetus. The DNA in those cells is then tested to look for chromosomal abnormalities or genetic disorders. This information helps your doctor to choose the embryos that have the greatest likelihood of resulting in a healthy and successful pregnancy.
During intrauterine insemination, your doctor uses a small catheter, which is a thin, hollow tube, to place your partner’s or a donor’s sperm inside the uterus during ovulation. This reduces the distance the sperm has to travel and increases the chances for fertilization.
Intrauterine insemination is recommended for couples who have male factor infertility that affects the quantity of sperm and their ability to travel through the female reproductive system, or when a man has erectile or ejaculatory dysfunction. It is also effective in women who have endometriosis, thick cervical mucus, or semen allergies, and is recommended for women using donor sperm.
Fertilization is only possible during a few days in the menstrual cycle. Identifying when a woman ovulates can help her become pregnant without medical intervention. Timed intercourse includes monitoring ovulation through blood or urine testing. We also may recommend an injectable medication to trigger ovulation and facilitate the correct timing for intercourse.