RMA of Philadelphia offers a wide range of Non-IVF treatment options including Intrauterine Insemination (IUI), Fertility Medications, Laparoscopy, and Hysteroscopy.
Intrauterine Insemination (IUI)
Intrauterine insemination (IUI) is typically prescribed for patients with unexplained infertility, mild male factor infertility, or for women with cervical mucus problems. This treatment option often includes ovulation induction medications. Ovulation induction stimulates the growth of eggs within follicles, encouraging one or two of those eggs to reach maturity and become capable of ovulating (being released) in order to be fertilized by sperm. This can be done with oral or injectable medications.
IUI is performed at the time of ovulation, and can use sperm from a male partner or chosen donor. Prior to IUI, the woman should be evaluated for any hormonal imbalance, infection, or any other medical issues. IUI is brief, painless, does not require anesthesia, and is performed in our offices.
A semen sample is collected in a container, typically by masturbation either onsite or at home. If semen is collected at home it should be brought into the office within about an hour. The semen is then washed with special media and concentrated. A very thin, flexible catheter containing the prepared semen sample is placed through the woman’s cervix into her uterine cavity. This procedure places all of the motile sperm in the uterus, close to the fallopian tubes, where fertilization typically occurs.
Clomiphene citrate is an oral medication commonly used for ovulation induction. Approximately 80% of women who do not ovulate on their own will ovulate using clomiphene citrate.
Clomiphene citrate is also prescribed for patients with unexplained infertility. Clomiphene citrate is typically prescribed for two to three months before consideration is given to more advanced therapies. Clomiphene citrate has approximately a 7-8% risk for multiple gestations. Ovarian response to medication is monitored with blood work and ultrasound while on medication in order to individualize therapy. Commonly prescribed clomiphene citrate medications include Clomid and Serophene.
Intrauterine insemination (IUI) is often performed in conjunction with clomiphene citrate. Injectable medication to trigger the release of the egg(s) is often used with clomiphene citrate, including commonly prescribed medications such as Novarel, Ovidrel, Pregnyl, and Profasi.
Letrozole is an oral medication approved by the United States Food and Drug Administration (FDA) for the treatment of breast cancer. The medication has been used by reproductive endocrinologists since 2000 for its off-label use of ovulation induction. Letrozole is typically prescribed for two to three months before consideration is given to more advanced therapies. Letrozole has fewer side-effects than clomiphene citrate and less chance of multiple gestations. Ovarian response to medication is monitored with blood work and ultrasound while on medication in order to individualize therapy. Intrauterine insemination (IUI) is often performed in conjunction with Letrozole.
Fertility medications, such as follicle stimulating hormone (FSH), or a combination of FSH and luteinizing hormone (LH), allow women to safely produce multiple eggs during a single reproductive cycle. FSH and LH are known as gonadotropins.
These medications are typically used in conjunction with intrauterine insemination (IUI). FSH or FSH/LH medication is commonly started on the third day of a menstrual period and is continued for approximately 8-10 days. Ovarian response to medication is monitored with blood work and ultrasound while on medication in order to individualize therapy. Most patients are seen in the office every two to three days during the course of therapy.
Frequent monitoring of the patient while taking injectable infertility medications is designed to maximize the likelihood of pregnancy while minimizing the risk of multiples and hyperstimulation (when your ovaries become swollen and painful). Pregnancy rates with injectable FSH or FSH/LH and intrauterine insemination can be as high as 15% per cycle. Some couples undergo two to three cycles of injectable FSH or FSH/LH therapy prior to moving on to in vitro fertilization (IVF).
Commonly prescribed injectable infertility medications include Follistim, Gonal-F, and Menopur.
Laparoscopy is a minimally invasive surgical procedure that allows the physician to clearly view the condition of a woman’s reproductive organs. It is an effective way to diagnose or treat certain causes of infertility, including endometriosis, ovarian cysts, adhesions, uterine fibroids, ectopic pregnancy, or blocked or damaged fallopian tubes.
RMA of Philadelphia offers the latest and most advanced infertility treatment procedures, including robotic surgery for our patients requiring tubal surgery or other laparoscopic procedures. Robotics helps achieve maximum results while reducing recovery time and maintaining patient comfort and convenience. Robotic techniques help to optimize the outcome of many surgical procedures.
Hysteroscopy is the process of inserting a hysteroscope into the vagina and through the cervix in order to examine the uterine cavity. A hysteroscope is a thin, tube-like device equipped with a light and a camera used to produce real-time video of the uterus.
A hysteroscopy is performed to diagnose and/or treat problems of the uterus that may be the cause of infertility. A hysteroscopy can also be used to remove fibroids or polyps from the uterus.
For more information on infertility treatment options, please contact us today.