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General Fertility Program
The General Fertility Program of the RGI's Institute for Human Reproduction involves
all clinical services associated with human reproduction, which do not
pertain to ART, including ovulation induction, artificial
insemination and gynecoradiology. Until a few years ago, this represented
a large majority of all human reproductionservices provided at RGI.
However, in recent years, pregnancy rates with IVF
(in-vitro fertilization) have greatly improved. As a consequence of our
learned ability to select high quality embryos, we now can transfer fewer embryos
without affecting pregnancy rates. Consequently, IVF gives us much better
control over the risk of high order multiple births. Non-ART
related fertility treatments seem to be decreasing in utilization and importance
in the field of human reproduction. However, they will always
have a role within a comprehensive infertility treatment program and are offered
by RGI in all of their detail.
Ovulation Induction
Ovulation Induction involves the administration of either oral or injectable fertility medications, to either establish ovulation (where a woman otherwise does not ovulate), improve the ovulation process or convert the usually unifollicular, monthly ovulation process into a polyfollicular process, to enhance conception chances. Whatever the indication for ovulation induction treatment, a conversion to a polyfollicular response will always take place. The woman has a greater chance of getting pregnant, but, consequently, any form of ovulation induction will be characterized by an increased risk of multiple births.
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Intrauterine Insemination(IUI)/Artificial Insemination
Artificial insemination, also known as intrauterine insemination, is usually recommended to accompany ovulation induction cycles to increase pregnancy chances. When an IUI is performed, the partner's semen, after its seminal plasma has been washed off, is directly injected into the uterus. IUIs empirically improve pregnancy rates over regular intercourse, when male infertility is a factor. They also improve pregnancy rates if cervical factor infertility is present (i.e. the cervical mucus inactivates semen motility) and in the presence of mildly abnormal semen, which can constitute a case of general male infertility .
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Donor Insemination
Artificial insemination is also performed through donor insemination,
which involves the same process as described for IUI, except that the semen sample
comes from a donor. RGI/IHR works with reputable sperm banks from which such
donor semen samples are procured by the patient for artificial insemination.
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Gynecoradiology
Gynecoradiology is an acronym that denotes the use of x-ray equipment to diagnose
and treat causes of infertility. Investigators at RGI have been leaders in
the
field of gynecoradiology since its
inception. RGI is currently the only fertility center in the nation with dedicated
x-ray equipment at most locations. Most other fertility centers refer patients
to radiology departments.
The principle advantage of gynecoradiology lies in its superior diagnostic
capabilities, which virtually replace the utilization of diagnostic laparoscopy as a diagnostic
tool. In doing so, the patient is saved a surgical procedure, general anesthesia and cost. In
addition, gynecoradiology allows for immediate intervention in a minimally invasive fashion, again
replacing major surgical procedures.
For example, based primarily on research at RGI, proximal tubal occlusions are now routinely treated
by transvaginal tubal catheterisation procedures rather than, as used to be the case, major abdominal
surgery. Similarly, intrauterine adhesions (Asherman's syndrome), uterine septae and other uterine as
well as tubal pathology can be treated in an ambulatory fashion, with the patient observing the
procedure on a screen.
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Ultrasound Services
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Ultrasound Services are an integral part of any infertility treatment. Every RGI center is
equipped with state-of-the-art ultrasound equipment and offers all relevant services.
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Laboratory Services
Laboratory Services are crucial for any infertility center. While many fertility
programs outsource all of their laboratory work, RGI strongly believes that
key
laboratory tests should be
performed in-house. RGI maintains its own andrology laboratory services, which
are also available to physicians outside of RGI. We also maintain our own endocrinology
laboratory and one of
the leading specialty laboratories in reproductive immunology.
All of RGI's laboratory services are primarily meant to benefit RGI patients
but are available to
patients of other physicians as well.
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