Infertility Treatment

You may want to seek care from a fertility specialist if you and your partner:

• Have been unable to get pregnant after 12 months of unprotected sex
• Are over age 35 and have been unable to conceive after six months of unprotected sex
• Have infertility risk factors including:
  • Concerns about your reproductive health
  • A medical condition such as polycystic ovary syndrome (PCOS), endometriosis or fibroids
  • You have undergone cancer treatment
  • Repeated miscarriages
  • Suspected or known male infertility

If you are part of an LGBTIQ couple, you may want to meet with a fertility specialist to understand your options for starting or growing your family.

If you are single and want to start a family, we help create an individualized plan to help you reach your goal.

Our team of fertility specialists can evaluate your situation, conduct tests to determine if there is an underlying cause of your infertility, and recommend a range of infertility treatments to help you conceive and have a baby. At the same time, because infertility can cause anxiety and put stress on relationships, our psychologist can help you with this process through consultations, individual and couple support groups, and more.

The first step is a consultation with one of our fertility specialists. They will evaluate your medical history, conduct a physical exam, and get a better understanding of your circumstances. They will also recommend tests to identify whether a medical condition is causing your infertility.

Fertility Testing

Initial fertility testing may include semen analysis, ovulation testing, hormone testing, and tests to estimate your egg count.

Pelvic Ultrasound

Your uterus, fallopian tubes, and ovaries can be safely and painlessly evaluated using a vaginal ultrasound probe. Ultrasounds are performed throughout the fertility testing and treatment process.

Hysterosalpingogram (HSG)

A hysterosalpingogram uses X-rays to evaluate your fallopian tubes and the inside of your uterus. A contrast dye is injected into the uterus through a thin tube that is threaded through the vagina and cervix. The dye helps show the outline of the fallopian tubes and can identify a blockage or abnormality. This test is performed in the comfort of our clinic by one of our doctors.

Sonohysterogram (SHG)

This procedure uses ultrasound to evaluate your uterus and the shape of your uterine cavity. A saline solution is put in the uterus through a thin tube that is inserted through the vagina and cervix. The solution fills the uterus and allows your doctor to see any abnormalities in the uterine cavity, such as fibroids, polyps or scar tissue.

Our surgeons can perform one of the following outpatient procedures to confirm a diagnosis, or to correct a condition that may be related to infertility.

Hysteroscopy

This procedure is used to diagnose or treat a problem within the uterus. A tiny camera in the hysteroscope allows your doctor to view the inside of your uterus.  Your doctor can correct polyps, scar tissue or a uterine or cervical defect at the same time.

Laparoscopy for Infertility

Laparoscopy allows your doctor to visualize your uterus, fallopian tubes, and ovaries by looking inside your abdominal cavity. It uses a laparoscope with a camera at its tip that is inserted through a small incision in your belly button. It can be used to look for endometriosis, scar tissue, ovarian cysts, ectopic pregnancy and other concerns in your pelvic area. If a condition is identified, your doctor can perform a corrective procedure at the same time.

We encourage you to explore all available fertility treatment options to determine which helps you achieve your goal.

Nature Cycle Monitoring

We monitor your cycle using blood tests and vaginal ultrasound to determine the best time for intercourse.

Ovulation induction with Fertility Medications

If you have an irregular menstrual cycle or ovulate infrequently, ovulation induction combined with fertility medications can stimulate egg production and regulate ovulation.

Fertility Medications

Oral and injectable medications are used to stimulate ovulation. Fertility drugs may be used alone or in combination with artificial insemination or in vitro fertilization (IVF). Our trained nurses teach you how to use these drugs effectively.

Artificial Insemination/Intrauterine Insemination (IUI)

The sperm are separated from the rest of the semen, then inserted directly into your uterus using a small catheter. This process is called intrauterine insemination (IUI). It 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.

In Vitro Fertilization (IVF)

IVF is a multi-step process. First, fertility drugs will be prescribed to stimulate the maturation of several eggs. The eggs are retrieved from the ovaries using a long needle under ultrasound guidance. To avoid discomfort, an anesthesiologist provides intravenous sedation.

The eggs are then fertilized in a lab by combining them with sperm, or by injecting a single sperm into each egg using a process called intracytoplasmic sperm injection.

Embryos are cultured in the laboratory for up to five days. At that time genetic testing can be performed or the embryos can be transferred to the woman’s uterus. The embryos are transferred into the uterus through a catheter using ultrasound guidance.

A blood test will confirm pregnancy about 14 days after the initial egg retrieval.

Fertility Preservation

You may choose to freeze eggs, sperm or embryos for transfer at a later date.

• Women can undergo egg harvesting followed by egg or embryo freezing prior to chemotherapy or radiation, or to preserve their fertility options as they age.
• People can freeze their sperm, eggs or embryos before transitioning.
• Men can consider sperm cryopreservation if they are being treated with chemotherapy or radiation or need to undergo testicle removal.
• Sperm cryopreservation can also be used to assist in conception when a man is frequently unavailable due to business or military commitments.

Male Infertility Evaluation and Treatment

We work closely with Duke male infertility specialists because evaluating and correcting male infertility at the same time as the female evaluation can expedite the process of achieving a successful pregnancy.

Egg Donation

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.

Gestational Carrier Counseling and Screening

If you want to work with a surrogate – meaning another woman carries and delivers a child for you -- we will 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.

We Offer Affordable Infertility Treatment Options
We routinely recommend the least expensive, least invasive treatment options available. If more expensive treatments are required, such as IVF, our financial representatives can help you understand your options, and help you with financial assistance through our partnership with an organization called the ARC Fertility Network.

We Offer Options for Every Person
We help everyone who wants to grow their family, whether you are a heterosexual couple, single person, lesbian, gay or transgender couple. We tailor our recommendations to your needs.

We Have a 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 the next steps.

You May Benefit from On-Site Acupuncture
We identify targeted strategies and tools that help you cope and feel better while you are trying to conceive.

Our High-Tech Clinic Is Built for Comfort
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.