Reproductive endocrinologists in Duke’s nationally ranked gynecology program provide the broad scope of compassionate care to help individuals and couples become pregnant. Whether you experience fibroids, endometriosis, polycystic ovarian syndrome, recurrent miscarriages or other hormonal problems, we can help diagnose the cause, and choose from an array of treatments. We do our best to help you achieve a successful pregnancy.
Compassionate, high-tech fertility care
Our nationally recognized fertility specialists combine compassionate care and counseling with a robust offering of comprehensive fertility services. We understand that infertility can be a challenging time, and that it may heighten stress and anxiety, which can lead to physical or emotional turmoil. We use the latest diagnostic and imaging tests to determine the cause of your infertility, and correct it with appropriate treatment options. We help you make choices that balance risk and costs. Our goal is to help you achieve success in the shortest time possible but also to take the time to carefully consider the nuances of your decisions in order to minimize the chances of regret.
Choose Duke for your fertility treatment because we offer:
- Top ranked care. Our reproductive endocrinologists are part of Duke’s gynecology program, which is ranked among the best in the country by U.S. News & World Report.
- High-tech, comfortable setting. Our ultra-sterile in vitro fertilization (IVF) laboratory is designed to maintain air of the highest quality. A sophisticated positive pressure filtration system eliminates airborne toxins and pathogens that can impede the chances of a successful pregnancy after IVF. At the same time, we offer a comfortable, convenient location just off I-40. Sophisticated imaging is available onsite and wide screen monitors allow you to view your embryos before transfer.
- Nationally renowned experts. Our reproductive endocrinologists are recognized leaders in the field of fertility. They conduct and publish research, speak internationally, and educate future doctors on the latest in vitro fertilization techniques.
- More fertility treatment options. We encourage you to explore all available fertility treatment options, including a less aggressive option called mild/minimal-stimulation ovulation induction. It combines oral fertility drugs and low-dose injectable hormones. The approach reduces both the cost and the risk of multiple pregnancies compared to using injectable hormones alone.
- Comprehensive stress reduction program. Fertility diagnosis and treatment is often emotionally draining. To address the stress, our clinical psychologist provides individual and couple support groups and therapy. She is also available for consultations if you need support deciding which path to take, or if you and your partner are not in agreement about next steps.
- Onsite acupuncture program. We identify targeted strategies and tools that help you cope and feel better while you are trying to conceive.
- Fertility preservation. Individuals and couples may choose to freeze their embryos, eggs or sperm in order to attempt pregnancy at a later date. Women can undergo egg harvesting followed by egg or embryo freezing (cryopreservation) prior to chemotherapy or radiation, or in an effort to preserve their fertility options as they age. Men can consider sperm cryopreservation if they are being treated with chemotherapy, radiation or require testicular removal. Sperm cryopreservation can also be used to assist in conception when a man is frequently unavailable due to business or military commitments.
- Affordable options. We routinely recommend the least expensive and invasive treatment option available. If more expensive treatments are required, such as IVF, we encourage you to consider financing your fertility treatment using a national service called Advanced Reproductive Care (ARC) Family Building Program.
- Egg donation program. Individuals or couples who need a donor egg because of age or other factors can arrange to have a friend or relative donate her eggs, or apply to be matched with a young woman from the local area who has volunteered to be an anonymous egg donor.
- Egg donor volunteers. Women who volunteer to be anonymous egg donors go through a confidential and comprehensive screening process, including medical and psychiatric evaluation as well as testing for infectious diseases and certain genetic disorders. There is no cost to potential egg donors for this testing. Women interested in volunteering as egg donors should call 919-572-4673. Choose option 2, then option 2 again.
- Gestational carrier counseling and screening. If you and your reproductive endocrinologist determine that you need a gestational carrier, we perform medical and psychological screening to verify your gestational carrier is appropriate and well-prepared for this experience. We also help you contact local legal resources to handle all the appropriate legal arrangements.
- Treatment for all medical conditions related to infertility. If you have fibroids, endometriosis or polycystic ovary syndrome, our reproductive endocrinologists will recommend the appropriate treatment to decrease your pain and improve your fertility. We can also help you experience relief if you have troublesome symptoms during the hormonal transition to menopause.
Oral and injectable medications are used to stimulate ovulation. Fertility drugs may be used alone or in combination with intrauterine insemination (IUI) or in vitro fertilization (IVF). Your doctor will recommend the combination of fertility drugs and other treatments that are right for you. Our fertility nurses will teach you how to effectively use these drugs.
After semen is carefully washed to remove irritating substances, concentrated sperm is inserted directly into your uterus in a process called intrauterine insemination (IUI). IUI has been found to improve fertility in men with low sperm counts, and in women with unexplained infertility, even if the sperm count is normal.
Washed sperm is placed directly on the eggs to achieve fertilization. If sperm problems are suspected, your doctor may recommend intracytoplasmic sperm injection injection (ISCI) where a single sperm is injected into each egg.
Injectable hormones stimulate the maturation of several eggs, which are retrieved through the vagina using a long needle. To avoid discomfort, monitoring and intravenous sedation are administered by an anesthesiologist.
Embryos are transferred into the uterus through a catheter using ultrasound guidance three to five days after fertilization.
Embryos that have been frozen during previous IVF cycles may be thawed and transferred into the uterus during a subsequent cycle. Estrogen patches and vaginal progesterone are administered to optimize the uterine lining and timing of the transfer to maximize the chances for the embryo to implant and develop into a pregnancy.
Women who have had their “tubes tied” can often regain fertility by surgically reconnected. This is performed microscopically through a very small abdominal incision as same day surgery.
In special cases, embryos can be biopsied and tested for genetic abnormalities prior to implantation. Only embryos that appear normal are transferred into the uterus.
Several tests are performed prior to pursuing fertility treatment. They may include a physical exam, infectious disease screening, genetic screening, semen analysis, hormone levels in your blood, and tests to estimate the quality and quantity of your eggs.
Your uterus, fallopian tubes and ovaries can be safely and painless evaluated using a vaginal ultrasound probe. Ultrasonography is performed by our doctors and nurse practitioner throughout the fertility screening and treatment process.
Your tubes and the inside of your uterus are examined using X-ray imaging and an opaque dye injected through your cervix. This test is performed in the comfort of our clinic by one of our doctors.
Our andrology laboratory examines semen samples using up-to-date procedures to detect subtle causes of infertility.