1. Ovulation induction Ovulation induction involves the use of medication to stimulate development of one or more mature follicles (where eggs develop) in the ovaries of women who have anovulation and infertility. These women do not regularly develop mature follicles without help from medication. Some women with anovulation have a condition known as polycystic ovarian syndrome. These women usually have irregular menstrual cycles, increased body hair, and infertility. Ovulation induction is somewhat different from controlled ovarian hyperstimulation which involves use of some of the same medications to stimulate development of multiple mature follicles and eggs in order to increase pregnancy rates with various infertility treatments. The medication comes in two forms: oral (Clomiphene Citrate; Clomid™, or Serophene™) and injectable (Follistim™, Puregon™, Merional™, Humegon™, Pergonal™, Gonal F™). 2. IVF-ET (In vitro fertilization and embryo transfer) Female patients are given medicine to stimulate development of multiple mature eggs on the ovaries. These eggs are then retrieved, placed in a special culture medium outside the woman's body, and combined with sperm. The resulting embryos are nourished in an incubator. At a predetermined stage of development, the embryos are replaced into the uterus to continue normal fetal development. 3. IUI (Intra uterine insemination) IUI is a relatively quick procedure that takes place in the clinic office. It is performed by passing a sterile catheter containing the sperm through the cervix and into the uterine cavity. The sperm are then injected directly into the uterus. Usually the insemination itself causes little if any discomfort. Following the insemination procedure, you will likely be asked to remain lying down with your hips elevated for about 45 minutes. Often, IUI is performed in conjunction with ovulation induction. 4. ICSI (Intra cytoplasmic sperm injection) Microsurgical fertilization, a form of micromanipulation, can be indicated in cases of severe male factor, where conditions such as abnormal sperm movement or low sperm numbers make it impossible for sperm to penetrate and fertilize the egg. One of the methods used to assist fertilization is Intracytoplasmic Sperm Injection (ICSI), which involves the use of very fine instruments to first pick up sperm and then injecting a single sperm directly into the cytoplasm of the egg. The cytoplasm is the area outside the nuclear cell of the oocyte that contains the physical elements or reproduction. ICSI also works well for cases of unexplained non-fertilization with conventional IVF. 5. AHA (Assisted hatching) Assisted Hatching is a procedure that "thins’ the outer coat (zona) of the embryo immediately prior to transfer to the uterus. This thinning helps the embryo "hatch" once it is placed back in the patient’s uterus. Hatching must occur prior to embryo implantation; pregnancy begins after the embryo implants in the uterus. AHA especially is useful on patients 35 or older because their thicker zonas make it more difficult for the embryos to hatch in the uterine cavity. AHA is also used in egg donation and gestational carrier programs. 6. Embryo cryopreservation Advanced cryopreservation techniques permit selected embryos that are not immediately returned to a woman's uterus to be frozen for the couples' later use. When thawed at a later date, these embryos can be transferred to the woman's uterus in a menstrual cycle with little or no premedication. The babies born after cryopreservation are just as healthy as babies conceived spontaneously. 7. Testicular / Epididymal sperm extraction Some men suffer a blockage or other abnormality that prevents the passage of sperm through ejaculation. A minor surgical procedure can be performed where sperm is retrieved from the epididymis or directly from the testicle itself. This sperm is then injected (ICSI) into the mature eggs obtained through IVF. Sperm from Testicular / Epididymal Sperm Aspiration can be successfully cryopreserved for future use. 8. Blastocyst transfer We already know that with natural conception, embryos arrive in the uterus at day 5-6 after fertilization. With present-day IVF, however, embryos are routinely transferred back to the uterus in 8-cell stage on day 3 after fertilization. Recent breakthroughs have been made in the science of nurturing embryos in the laboratory. These discoveries have allowed the embryos from select patients to benefit from an additional 2 to 3 days of growth prior to embryo transfer. By growing embryos to the blastocyst stage, we are able to transfer fewer embryos without lowering the chance that a patient will become pregnant. This breakthrough will help maintain the high pregnancy rates that patients have come to expect while decreasing the risk of conceiving a high order multiple pregnancy. 9. Operative laparoscopy A woman's reproductive organs lie in her pelvis. There are a number of conditions that can affect the fallopian tubes, ovaries and uterus that can be treated surgically. Operative laparoscopy refers to a minimally invasive technique whereby many debilitating or infertility causing conditions can be treated on an outpatient or "day surgery" basis. The physicians at Creation & Love IVF center are trained to perform both routine and highly complex operative laparoscopy. 10. Operative hysteroscopy The inside of a woman's uterus has a special lining called the endometrium. That lining is unique because it responds to the hormones estrogen and progesterone that are produced monthly. There are a number of conditions that disrupt the endometrium and can lead to heavy or irregular periods or infertility. Operative hysteroscopy refers to a minimally invasive technique whereby such conditions can be treated on an outpatient or "day surgery" basis. The physicians at Creation & Love IVF center are trained to perform both routine and highly complex operative hysteroscopy.