Infertility Treatment

The Center for Human Reproduction (CHR) has a world-wide reputation as a state-of-the art fertility center providing comprehensive infertility treatment options for both female infertility and male infertility problems. The CHR is seen as a "one-stop" fertility center with both diagnostic and therapeutic functions under one roof. We offer many different infertility treatment and financial options for those patients in need of infertility treatment.

Infertility Treatment

Ovulatory Dysfunction
This is the single most frequent cause of female infertility and denotes a problem with the monthly release of an egg (ovulation). There are varying causes for ovulatory dysfunction; the most frequent one is Polycystic Ovarian Syndrome (PCOS). CHR has extensive experience in treating women with all forms of ovulatory problems.

Tubal Infertility
This diagnosis denotes the presence of abnormal fallopian tubes. Most tubal disease is caused by an episode of tubal infections (pelvic inflammatory disease, PID) or a condition called endometriosis. CHR is known worldwide for having invented the treatment of tubal occlusions with trans-vaginal catheter techniques and has been a pioneer in treating tubal disease for many years. Reprints of a large number of published studies by Dr. Norbert Gleicher are available upon request in Scientific Publications.

Endometriosis
Some people believe that endometriosis, and not ovulatory dysfunction, is the single most frequent cause of infertility. Unfortunately, the diagnosis of endometriosis is not very reliable since it requires surgery (laparoscopy) and, even then, microscopic disease may be overlooked. Endometriosis can cause infertility by causing tubal disease. Endometriosis can affect the ovaries (and probably egg quality), can increase the risk of miscarriages and may cause infertility. Dr. Norbert Gleicher has been a pioneer in the research of immunological infertility and pregnancy loss and was the first to report on the significant autoimmune abnormalities associated with endometriosis. We encourage the review of his studies. Reprints are available upon request.

Surgical Infertility
This term denotes anatomic causes of female infertility that lend themselves to surgical repair. With the ascent of IVF (in-vitro fertilization), fewer indications for surgical infertility exist today than a decade ago. Nevertheless, there are still many occasions where competent surgery can make a difference. Examples are myomectomies (the surgical removal of fibroid tumors from the uterus), ovarian cystectomies (the surgical resection of ovarian cysts), tuboplasticies (the surgical correction of abnormal fallopian tubes) and many other procedures.

CHR physicians are all well trained as gynecological surgeons and are especially well versed in the performance of minimally invasive surgeries, such as operative laparoscopy and operative hysteroscopy. Under the leadership of our very renowned endoscopic surgeon, CHR's Division of Endoscopic Surgery can perform any endoscopic fertility surgery with the highest level of expertise.

Immunological Infertility
Whether abnormal female immune functions can cause infertility remains controversial. Based on research performed at CHR, primarily by Dr. Norbert Gleicher, and based on other recently published studies, we believe in the concept of immunological infertility and offer under experimental protocols, various treatment options.

Hormonal Infertility
Various hormonal abnormalities can lead to infertility. Examples are hypothyroidism (low thyroid function), hyperprolactinemia (high male hormone levels) and luteal phase defect (low progesterone levels). CHR physicians are experts in treating these and other endocrinological abnormalities.

Unexplained Infertility
This diagnosis denotes the fact that no obvious cause has been detected for a couple's infertility. Of course, this diagnosis is totally dependent on how extensive a diagnostic work-up has been performed: the more limited the work-up, the more frequent the diagnosis of unexplained infertility will arise. Largely based on our Unexplained Infertility Program's research, we have come to believe that many cases of unexplained infertility are nothing else but undiagnosed cases of endometriosis and immunological infertility. Our physicians always perform exhaustive diagnostic work-ups before reaching the diagnosis of unexplained infertility. However, once such a diagnosis is reached, CHR physicians are experts in offering up the appropriate empiric treatments.

Tubal Ligation
Many women who have had tubal ligations often opt to achieve pregnancy later in life. In-vitro fertilization (IVF) or tubal ligation reversal, are two options for these women. Tubal ligation reversals and IVF, after voluntary sterilization, are generally a non-covered service by most insurance companies. Therefore, CHR has developed the Shared Risk (Refund) Program in attempt to minimize the financial burden of infertility services. For those women who do choose tubal ligation reversals, CHR has accomplished laparoscopic surgeons to perform this procedure.

Other Conditions
Besides the above described major causes of female infertility, there are other, less frequent conditions that can lead to infertility. For example, premature ovarian failure (POF) can be caused by an autoimmune attack of the ovary or a genetic problem in the female. Genetic problems can cause infertility in a number of different ways. CHR has the expertise to treat infertility problems relating to genetics.

Repeated Pregnancy Loss as a Cause of Infertility
CHR is renowned worldwide for its research in the area of repeated pregnancy loss. Women who repeatedly miscarry are called habitual (or recurrent) aborters. There are a number of different possible causes for such losses. CHR physicians are experts in determining the cause of repeated pregnancy loss and in the various treatment options, if such options exist - even if experimental in nature. Finally, CHR is home to one of the nation's best known reproductive immunological laboratories. Since the correct diagnosis of repeated immunological pregnancy loss is dependent on the availability of a comprehensive immunology laboratory, CHR is uniquely equipped to diagnose and treat this condition. A female patient may suffer from more that one cause of infertility. A comprehensive diagnostic work-up is always essential.

Male Causes of Infertility

Like causes of female infertility, causes of male infertility can be multifaceted and deserve full investigation. In contrast to female infertility, all causes of male infertility affect only one target organ, the testes.

A semen analysis is the primary test used to determine male fertility. Semen analysis results can be normal, mildly, moderately or severely abnormal or may show no semen at all, a condition called azoospermia. Whatever the severity of semen analysis, CHR has the expertise to virtually guarantee fertility to almost all affected males.

CHR's urologist, has expertise in the following areas:

• Evaluation and treatment of male infertility
• Microsurgical vasectomy reversal
• Sperm procurement techniques
• Microsurgical varicocele ligation
• Management of testicular failure and hypogonadism
• Sperm cryopreservation/banking
• Evaluation and treatment of ejaculatory disorders
• General urology