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James S. Heiner, MD
Reproductive Endocrinologist
Reproductive Care CenterSandy, Utah
Exploring Family Building Options
801-878-8888
Topics to Discuss
Exploring
Exploring Family Building
Options - help is available!
Exploring
The Goal The Plan The Experience
Discovery– so much to learn Surprises – so much can happen
The End Result
Exploring Family Building
It can be daunting Overwhelming
Where do you start?
Frightening Will it work?
Exciting Maybe it will work!
Exploring Family Building
It can be challenging Time Money Emotions Learning Uncertainty Persistence
Exploring Family Building
A good guide can help in the journey Board Certified Reproductive
Endocrinologist
Three years of formal training in infertility after 4 years of OB/GYN training
Two years to gain experience and pass examinations
Exploring Family Building
As you begin or continue your exploration, remember:
Be optimistic
Be realistic
Be together and unified
Be determined and persistent
Be satisfied that you have done your best
Exploring Family Building
Examples of two couples who had the experience of exploring family building.
Couple 1-unsuccessful but kept a positive attitude and had a good experience
Couple 2-persistent and succeeded in an unexpected way
Exploring Family Building
Learning from others can help make your own exploration easier and more enjoyable, even though the journey is different for every couple.
Options
Sex Fertility pills Injections Inseminations In vitro fertilization Other advanced techniques
Options-Sex
SEX You should keep having sex!
Many couples seem to forget this one while they’re so busy looking at other options. Worse yet, they learn to dread it!
Sex is good for fertility, for togetherness, for unity, and for fun!
Good therapy after a hard day at the clinic (or after a good day at the clinic!)
Options-Fertility Pills
Pills to help the woman ovulate Clomid Femara
Injections to help the woman ovulate more FSH to stimulate more egg development hCG to trigger ovulation
Options-Injections
Injections to help stimulate ovulation
FSH is a natural hormone
FSH requires close monitoring
FSH is expensive
FSH can be used with or without ovulation induction pills
hCG can be used will pills or injections to help assure and time ovulation
Options
IUI - Intra Unterine Insemation IVF - In Vitro Fertilization ICSI - Intracytoplasm Sperm Injection
TESE -Testicular Sperm Extraction AH - Assisted Hatching PGD - Pre Implantation Genetic Dx.
Options- IUI
IUI- Intrauternine Uterine Insemination Minimal increase in the chance of pregnancy,
but cost effective
Increases the chance of conception from 8% to 11% per cycle, in a typical couple with unexplained infertility
It can be used with or without medications for ovulation induction
Options- IUI
IUI
Takes of couple of hours to prepare the sperm for the IUI
Usually costs a few hundred dollars
Simple and relatively painless
Options- IVF
IVF-- In Vitro Fertilization
More expensive than basic treatments but also much more likely to result in a pregnancy in each cycle attempted
Pregnancy rate typically >50% in young women in good centers
Options- IVF
IVF
Eggs are stimulated with FSH, and retrieved under sedation using a transvaginal, ultrasound guided needle
Eggs are fertilized with sperm and the resultant embryos are incubated for 2-6 days then transferred into the uterus
Options- ICSI
ICSI- Intra cytoplasmic Sperm Injection
Revolutionized the ability to fertilize eggs using sperm with problems
Greatly increases chance of pregnancy when moderate to severe sperm problems exist
Options- Assisted Hatching
AH- Assisted Hatching
Laser is used to put a small slit in zona pelucida (egg shell)
This makes it easier for the embryo to hatch out later on
Used primarily when the zona is thicker than normal, after embryo freezing, in cases of advanced maternal age, or when prior IVF cycles have failed
Options- TESE
TESE- Testicular Epididymal Sperm Extraction
Used in cases where no sperm come out in the ejaculated semen
Male hormones and other tests done to be sure TESE is appropriate
Options- PGD
PGD- Pre implantation Genetic Diagnosis
Used primarily to prevent the transmission of genetic diseases to the next generation
Cystic fibrosis, Sex potential of embryo, Help gender balancing in a family
Options- Third Party
Third party options for building your family Donor Sperm Donor Eggs Donor Embryos Gestational Surrogates Traditional Adoption
It usually works– but what if it doesn’t?
Was it still worth the journey?
Can you still keep exploring?
Can you still be happy?
Conlusions slide
Mountain view with name, phone number of clinic
Reproductive Care Center
801-878-8888
Sandy, Utah