| See Also the Donor Egg FAQ's at our NY Donor Egg Program Web Site. |
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What made you become a reproductive endocrinologist? |
My sister had infertility for over 10 years. I went with her through the anguish in her and our entire family and understood from her point of view as well as parents, who could not become grandparents, the anguish of not being able to conceive of a child. These were the early days before IVF. When I came out of my army service, it was 1981. Louise Brown was the first IVF baby born in 1978. That was followed by a long hiatus and finally in 1981, the same year that I finished my army service as a physician, the first IVF baby, Elizabeth Carr, was born in the United States. From afar, back in Israel, I followed with great anticipation the development of in vitro fertilization, which at the beginning of the 1980’s was considered to be a scientific miracle. It was only three years later that I decided to make a change in my career and leave a surgical residency in Israel in favor of an OB/Gyn residency in the United States aiming to become a subspecialist in infertility. I realized that IVF was not a random occurrence, but was rapidly becoming a reproducible and reliable method of helping women become pregnant, who would have otherwise remained childless. I decided at that point that I had to be a part of this amazing field and have never regretted it since.
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How common is infertility? |
About 15% of couples trying to conceive do not achieve a pregnancy within a year.
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When should I see a fertility specialist? |
If you are under 35 years of age and have been trying to conceive on your own for a year but have been unsuccessful, we recommend that you see a fertility specialists. Women over the age of 35, should seek help from an infertility specialist after 6 months. Should you have any concerns prior to this time you are welcome to see our physicians to discuss your concerns. Our Long Island infertility specialists' biographies are available on line.
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What can be done about infertility? |
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Treatment has to be tailored to a couple's specific situation. Fertility treatment has evolved dramatically in the past two decades, especially in IVF (In Vitro Fertilization), allowing the great majority of patients to become parents.
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What is the incidence of male infertility? |
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Male infertility is identified as the primary cause of infertility in 30% of. In 20% of cases both partners are sub fertile.
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Why should the man be evaluated? |
First - because in 50% of infertile couples the male is involved. Second, because some of the male fertility problems are treatable. And last - in a small minority of males with an abnormal sperm test - an underlying, serious disease is found.
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What is the most common cause of male infertility? |
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Varicocele, or an abnormal widening of a vein in the testicle is the most common finding in infertile males. It is thought that varicocele causes sperm abnormalities by warming the blood in the testis. Some, but not all men with varicocele may benefit from surgery.
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What is polycystic ovaries? |
Polycystic ovary syndrome (PCOS) is a health problem that can affect a woman's hormone levels, periods, and ovulation. This can affect fertility and pregnancy. It can also cause male-type body changes. Typical symptoms include irregular periods, acne, and abnormal hair growth. If you have PCOS with irregular periods, it is likely that you are not ovulating, and your physician at the Center can provide options for you to induce ovulation.
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How successful are infertility treatments? |
With improvements in technology and the availability of
IVF, a large number of couples will conceive. In fact, at our Center, more than 15,000 babies have been born as result of fertility treatment. Your physician at the Center will review with you the statistics that apply to your particular situation.
Review our NY fertility center's IVF success rates.
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What are the different types of fertility medications that I might be given? |
Typically, when a woman ovulates, she release one egg in a menstrual cycle. Clomiphene citrate (brand name Clomid) is a pill that is most often used to stimulate ovulation. More aggressive fertility treatments involve the use of natural hormones (gonadotropins FSH and LH) which are given by injection. The FSH and LH stimulate the ovaries to produce multiple eggs in one cycle. These medications can be combined with intrauterine insemination (IUI) or used in IVF.
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What is intrauterine insemination (IUI)? |
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IUI is insemination of your husband's sperm into your uterus in order to enhance fertility. Your husband collects a semen specimen in a sterile container, and the sperm are washed under sterile conditions in the laboratory. The concentrated motile sperm are then deposited directly within the uterine cavity.
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What is in vitro fertilization (IVF)? |
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IVF is the process whereby fertilization of the egg by a sperm occurs in the laboratory. The woman takes medications to stimulate the ovaries to produce multiple eggs. The eggs are then removed from her body while she is under intravenous sedation. The eggs and sperms are combined in the laboratory, where fertilization is allowed to take place. The highest quality embryos are then placed into the woman's uterus. Pregnancy success rates are influenced strongly by the woman's age.
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What is ICSI? |
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As part of the IVF process, in the laboratory, micromanipulation of the sperm and egg is sometimes required to achieve fertilization. A single normal-shaped sperm is injected into a mature egg. This procedure is called intracytoplasmic sperm injection (ICSI).
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Is there a way to make sure that I have a normal child? |
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Preimplantation genetic diagnosis (PGD) is a very early form of prenatal diagnosis whereby embryos are screened genetically prior to transferring them into a woman's uterus, in order to minimize the risk of a pregnancy with a particular disease. PGD is an adjunct to assisted reproductive technology and requires IVF to obtain embryos for evaluation. Potential candidates for this technology include couples with a high risk of transmitting an inherited condition and couples that undergo IVF treatment and whose embryos are screened for chromosome aneuploidies (PGS) to increase the chances of an ongoing pregnancy. The main indications for PGS are an advanced maternal age, a history of recurrent miscarriages or repeated unsuccessful implantation.
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Does fertility treatment cause birth defects? |
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It is important to recognize that the rate of birth defects in humans in the general population is about 3% of all births for major malformations and 6% if minor defects are included. Fortunately, 20-plus years following Louise Brown's birth (the first IVF baby), we now have ample data that children conceived through IVF have no increase in these rates of birth defects. Further follow-up on older children indicates that IVF children have done as well or better than their peers in academic achievement (probably a social bias) and have no higher rates of behavioral or psychological difficulties.
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Will the hormones cause long-term health risks, such as cancer? |
The only suggested long-term health risk of IVF is medications, and a possible association between these drugs and the risk of cancer, specifically ovarian cancer.
An important fact to keep in mind is that women who suffer from infertility and never conceive appear to have a slightly increased risk of ovarian cancer as compared to the general population (about 1.6 times the rate). As these are the women who use fertility medications, the medications themselves have been implicated in the cancer risk but have never been proven to be a cause of cancer . At this time, we can say that there is no direct evidence that fertility drugs play a causal role in increasing a woman's risk of invasive ovarian, breast or uterine cancer.
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Is there an option for women who have failed multiple cycles of IVF or women with ovarian failure? |
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We offer a donor egg program, designed for women who cannot conceive from their own eggs. Most commonly, such women include women with premature ovarian failure, women with repetitive IVF failures, and women with ovarian failure prior to their fifty-first birthday. Because the donor egg is harvested from a young donor, pregnancy success rates are high.
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What are my options if my partner had a vasectomy? |
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1)Vasectomy reversal: This procedure would be preformed by your urologist. Success rates vary dependent on the timing of the vasectomy, be sure to discuss success rates with your urologist.
2)TESA/MESA, surgery to retrieve sperm sample: Can be done during the vasectomy reversal.
3)Donor sperm: This can be a good option as a back up to the vasectomy reversal treatment.
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