Fertility

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. This approach reduces both the cost and the risk of multiple pregnancies compared to using injectable hormones alone.

Fertility Drugs

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's right for you. Our fertility nurses will teach you how to use these drugs effectively.

Artificial Insemination

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.

Egg Fertilization

Washed sperm is placed directly on the eggs to achieve fertilization. If sperm problems are suspected, your doctor may recommend intracytoplasmic sperm injection (ISCI), where a single sperm is injected into each egg.

In Vitro Fertilization (IVF)

Injectable hormones stimulate the maturation of several eggs, which are retrieved through the vagina using a long needle. To avoid discomfort, an anesthesiologist provides monitoring and intravenous sedation.  

Embryo Transfer

Embryos are transferred into the uterus through a catheter using ultrasound guidance three to five days after fertilization.

Frozen Embryo Transfer

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 help optimize the uterine lining and timing of the transfer to maximize the chances for the embryo to implant and develop into a pregnancy. 

Tubal Ligation Reversal

Women who have had their “tubes tied” can often regain fertility by having them surgically reconnected. This outpatient surgery is performed microscopically through a very small abdominal incision.

Pre-Implantation Genetics

In special cases, embryos can be biopsied and tested for genetic abnormalities prior to implantation.

Fertility Screening

Several tests are performed before you pursue 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.

Ultrasounds

Your uterus, fallopian tubes, and ovaries can be safely and painless evaluated using a vaginal ultrasound probe. Ultrasounds are performed by our doctors and nurse practitioner throughout the fertility screening and treatment process.

Hysterosalpingogram

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.

Sperm Evaluation

Our andrology laboratory examines semen samples using up-to-date procedures to detect subtle causes of infertility.  

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.  Sophisticated imaging is available on-site, and widescreen monitors allow you to view your embryos before transfer.

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.

On-Site Acupuncture
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 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.

Affordable Options
We routinely recommend the least expensive, least invasive treatment options available. If more expensive treatments are required, such as IVF, you may wish to consider financing your fertility treatment using an organization called Advanced Reproductive Care, Inc. (ARC).

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 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. 

Medical Treatment for Infertility-Related Conditions
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.

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