CRH provides leading technologies to facilitate the
success in fertility treatments for women. We
provide IVF but also provide many treatment programs
that are tailored for the individual patient. This
journey is chosen by our patients, and we know how
important it is to provide the best possible care to
prove that they made the right decision.
These treatments have been developed over decades of
research through ART (Assisted Reproductive
Technology). Let CRH be your guiding partner
towards the dream to be realized.
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Infertility is a common problem in the United
States, occurring in approximately 15% of couples.
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The World Health Organization (WHO)
task force on Diagnosis and Treatment of Infertility
described the frequency of conditions contributing
to infertility in developed countries as follows.1
Female infertility (37%), male infertility (38%),
ovulatory disorders (25%), hyperprolactinemia (7%),
pelvic adhesions (12%), tubal occlusion (11%),
endometriosis (15%), and many others. Infertility
factors can be broadly grouped into seven major
categories that influence fecundability.
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The
basic workup for infertility should begin 1 year
after discontinuance of contraception. The workup
includes a semen analysis, documentation of
ovulation, and uterine/tubal evaluation with a
hysterosalpingogram or sono-hysterosalpingogram.
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A
thorough history and physical examination of both
the man and woman may identify the etiology of
infertility and direct further testing to the most
likely cause of infertility.
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Treatment for male factor infertility includes
surgery, IUI, and IVF with intracytoplasmic sperm
injection (ICSI) with either epididymal or
testicular sperm extraction. Despite severe
oligoasthenospermia or azoospermia these techniques
allow couples to conceive. When all treatments with
husbands are doom to fail donor insemination can be
considered.
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Treatment of hypothalamic dysfunction includes the
GnRH pump and injectable gonadotropins.
Hyperprolactinemia is successfully treated with
dopamine agonists. Polycystic ovarian syndrome can
be treated with clomiphene citrate, surgery,
injectable gonadotropins, and insulin-sensitizing
medications. Premature ovarian failure can be
treated with donor oocytes.
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Uterine
and tubal factor infertility may be treated
surgically. Severe tubal factor infertility is most
successfully treated with IVF.
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Unexplained infertility can be treated with
clomiphene citrate/intrauterine insemination,
injectable gonadotropin/intrauterine insemination,
or IVF. Women with advanced maternal age are best
served by rapid workup and treatment.
