Medications may be used to induce ovulation in those who are not ovulating or are ovulating irregularly. Additionally, hormone therapy can be used to alleviate other endocrine (glands that produce hormones) problems.
The causes of ovulation failure are numerous. The most common cause is polycystic ovary syndrome (PCOS). Learn more about Penn Fertility Care's dedicated PCOS Center and the excellent success rates seen at Penn.
In vitro fertilization (IVF) is the preferred or most common infertility treatment used when the fallopian tubes are severely damaged or absent, and for unexplained or male factor infertility. Due to its high success rate, IVF has been used more frequently in recent years as a first line of therapy for all causes of infertility.
The following steps are taken when performing in vitro fertilization:
- The ovaries are stimulated to produce multiple egg–containing follicles.
- Progression of follicular development is followed by evaluating hormone levels and performing ultrasounds at the appropriate times.
- A transvaginal ultrasound guides the retrieval of the eggs.
- The recovered eggs are immediately transferred to the laboratory where they are cultured and fertilized.
- On a predetermined date, the developing preembryos are inserted into the uterus.
These procedures involve a variety of carefully choreographed procedures to insure the best success. The procedure itself, including the laboratory work, is performed in Penn Fertility Care's central state–of–the–art facility.
Surgery is used to remove adhesions (scar tissue) or endometriosis, which block the fallopian tube or interfere with its ability to pick up an egg. Advanced techniques have improved our ability to do this, often with a non–invasive laparoscopic approach or with a microsurgical approach to reconstruct the fallopian tubes or the uterus.
Microsurgical repair is an option for reversing tubal sterilization and often provides a high success rate without the use of in vitro fertilization. When the fallopian tubes are extensively damaged, or when it is unlikely that they will respond to surgical treatment, in vitro fertilization is the most expeditious approach.
If there is extensive tubal damage, the affected fallopian tube is usually removed before proceeding to IVF. This helps to achieve greater success for the IVF procedure. For endometriosis, the laparoscopic approach with laser treatment is often effective.
Ovulation induction may be used in combination with intrauterine insemination (IUI). IUI is a relatively "low-tech" assisted reproductive technology (ART) in which washed sperm is deposited into the uterus and fallopian tubes, where fertilization occurs.
In addition, this process bypasses hostile cervical mucus and assists in overcoming sperm count and motility problems. Intrauterine insemination was pioneered by the Penn team and was extensively evaluated in a multi–center study published in the New England Journal of Medicine.
In rare cases with premature ovarian failure, the ovary is no longer releasing eggs because the supply of eggs has been exhausted. Although no treatment is available to reverse this process, it is important to recognize this condition. Some patients will seek counsel and advice to cope with this diagnosis.
When the patient is unable to produce a pregnancy with her own eggs, the use of donor eggs can be considered as an option.
Need an appointment? Request one online 24 hours/day, 7 days/week or call 800-789-PENN (7366) to speak to a referral counselor.