| Therapy: |
Recommended for: |
Procedure:
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In vitro fertilization (IVF)
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— Women with blocked tubes
— Women with severe endometriosis
— Couples with unexplained infertility
— Men with low sperm counts or abnormal sperm
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Involves giving medications to increase the number of follicles. Once the eggs are mature, a hormone, hCG, is administered and 34 to 36 hours later, the woman is taken to the operating room, where the eggs are removed from her ovaries and combined with sperm in a dish. Once the eggs have fertilized, they are placed in an incubator, and then placed back in the woman's uterus three to five days later. |
Cryoembryo Transfer
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— Patients who have undergone a cycle of IVF in which excess eggs were frozen and stored.
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In this procedure, the excess frozen fertilized embryos from the previous IVF may be transferred at a later time. The advantage of this procedure is that a repeat ovarian stimulation can be avoided. In addition, this procedure allows a woman who is older to use embryos that were fertilized with oocytes from when she was younger.
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| IVF with Donor Oocytes |
— Women with premature ovarian failure
— Women with perimenopause, or menopause
— Couples who failed IVF due to problems with the egg (accounts for 50 percent of IVF failures)
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The donor may either be anonymous or selected by the couple. A legal contract is needed between the donor and the recipient couple prior to initiation of the procedure. Insurers do not cover the payment to the donor and screening of the donor. |
| Intracytoplasmic Sperm Injection (ICSI) |
— Men with congenital abnormalities of the outflow tract for sperm
— Men with no sperm or very low sperm counts
— Men with previous vasectomy
— Women without a uterus
— Women with a medical condition that preclude carrying a pregnancy to term
— Male homosexual couples
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ICSI involves direct injection of a single sperm into the cytoplasm of an egg. Success has been reported even with non-motile and immature sperm. Success rates are the same as those reported for IVF, or about 35 percent per embryo transfer. |
| Gestational Carrier |
— Men with congenital abnormalities of the outflow tract for sperm
— Men with no sperm or very low sperm counts
— Men with previous vasectomy
— Women without a uterus
— Women with a medical condition that preclude carrying a pregnancy to term
— Male homosexual couples
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Involves IVF (see above) with transfer of the embryos to a gestational carrier, which is a woman with a uterus who will carry the pregnancy to term. To avoid custody lawsuits, when eggs are needed, use of a separate egg donor, (an individual who is different than the gestational carrier) is recommended. This is particularly important for male homosexuals or for women who lack functional ovaries or uterus, or who have a medical contraindication to pregnancy. At Brigham and Women's Hospital, surrogate carriers (women who are inseminated with the male partner's sperm, and who carry the pregnancy) are not used.
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Table of Contents - Infertility Patient Guide
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This page was last modified on 3/18/2008
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