IVF Infertility Treatment Philadelphia

Having a baby isn’t always easy. Luckily, Philadelphia is full of doctors working on the forefront of infertility treatments. From Clomid to IVF, here are five local options that’ll help you give it your best shot

Many women grow up believing that, at some point, they’ll find a guy, settle down and have a family. But it doesn’t always work that way. “One in eight women has fertility problems,” says Gregory Fossum, M.D., director of reproductive endocrinology at Thomas Jefferson University.

[sidebar]And the more you delay pregnancy for career or social reasons, the harder it is to get a plus sign on that pregnancy test, says Michael J. Glassner, M.D., founding partner of Main Line Fertility and Reproductive Medicine and founding director of the Center for Reproductive Medicine at Bryn Mawr Hospital, who notes that a woman’s fertility peaks in her early 20s and starts to decline before she hits 30. “There is no magic formula that works for everybody, and it’s best to think of this as a process rather than as a simple solution,” advises Dr. Glassner. “That’s why it’s so important for women to know their options and to talk with their doctor about formulating a game plan that is right for them from day one.”

Though not every woman will walk away a success story, the odds are slanted in their favor. “Treatment has really changed in the last 10 years or so,” says Dr. Fossum. “It’s not 100 percent, but there’s so much we can do.”

Check out the best ways to beat whatever is standing in the way of you and a baby — they’re all available in the Philadelphia region.

BABY BOOSTER NO 1: CLOMID — FOR PCOS OR OTHER OVULATION PROBLEMS

BABY BOOSTER NO 1: CLOMID — FOR PCOS OR OTHER OVULATION PROBLEMS
Also known as clomiphene citrate, Clomid is often given to correct a hormonal imbalance or to help those with Polycystic Ovary Syndrome (PCOS), a condition that can affect women’s menstrual cycles and hormone levels.

How it works: “Clomiphene is an anti-estrogen,” says Dr. Fossum. “It makes your brain think you have lower levels of estrogen than you really do, which causes the pituitary gland to produce higher levels of the gonadotropin FSH, a hormone that stimulates the ovaries to produce eggs. It’s used to get the ovulation cycle to normalize, not with the intention to produce numerous eggs.”

How it will affect your life: Pop pills at varying doses for five days. Within a 14-day cycle, you’ll need to be seen by your doctor two or three times for checkups.

Success rate: “Eighty percent of patients ovulate and 60 percent of patients are pregnant after three or four cycles,” says Dr. Glassner.

Average local cost: $60 per cycle plus doctor visits

Possible side effects: Hot flashes, night sweats and mood swings. Though rare, it can impair fertility by making the lining of the womb too thin.

Octo-Mom risk: “Clomid has a 7 percent rate of multiples,” says Dr. Fossum. “And a 2 percent risk for triplets or more.”

Where it’s available: Jefferson University Hospital Center for Reproductive Endocrinology and Infertility, 834 Chestnut St.; Main Line Fertility, Bryn Mawr; Penn Fertility Care, 3701 Market St.; Abington Reproductive Medicine, Abington; The Crozer Reproductive Endocrinology and Fertility Center, Upland.

BABY BOOSTER NO 2: GONADOTROPIN INJECTIONS — WHEN CLOMID DIDN’T WORK OR YOU HAVE LOW NATURAL LEVELS OF THE BABY-FRIENDLY HORMONES LH AND FSH

BABY BOOSTER NO 2: GONADOTROPIN INJECTIONS — WHEN CLOMID DIDN’T WORK OR YOU HAVE LOW NATURAL LEVELS OF THE BABY-FRIENDLY HORMONES LH AND FSH
Two things you need to make a baby: Estrogen and the gonadotropins LH and FSH, hormones produced by the pituitary gland that are needed for egg and sperm production. Low levels are commonly seen in marathon runners with low body fat, patients with eating disorders or those under extremely stressful situations.

How it works: “Unlike Clomid, where the brain is stimulated to produce more FSH, these injections contain LH and FSH and stimulate the ovaries directly,” says Dr. Fossum. “They can also be used for men with a low sperm counts.” The goal? For women who weren’t ovulating on their own, a return to a normal cycle, and for men with low counts, a jump in their number. It can also be used to prompt the ovaries to develop multiple eggs prior to another fertility treatment, such as IVF, where eggs are harvested.

How it will affect your life: Injections every day for 8 to 10 days. During each 14-day cycle, expect to be at the doctor’s office three to five times.

Success rate: “It’s about 18 percent per month, which is right around the natural conception rate,” says Dr. Fossum.

Average local cost: $1,000 per cycle plus doctor visits

Possible side effects: Surprisingly, very few. “Women who’ve been on Clomid are especially fearful of symptoms when we tell them we’re going to put them on something stronger,” says Dr. Fossum. “But because you’re stimulating the ovaries directly and not affecting estrogen in the brain, those hot flashes and other symptoms don’t occur.”

Octo-mom risk: “There’s a 15 percent chance of multiples, with a 5 percent chance of triplets or more,” says Dr. Fossum. “Out of all fertility treatments, gonadotropins have the highest risk. We can control the dosing to some extent, but some women are very sensitive and produce numerous eggs, which can lead to multiple births.”

Where it’s available: Jefferson University Hospital Center for Reproductive Endocrinology and Infertility, 834 Chestnut St.; Main Line Fertility, Bryn Mawr; Penn Fertility Care, 3701 Market St.; Abington Reproductive Medicine, Abington; The Crozer Reproductive Endocrinology and Fertility Center, Upland.

BABY BOOSTER NO 3: SURGERY — WHEN THERE’S A PLUMBING ISSUE, WHETHER IT’S FROM FIBROIDS, A TUBAL LIGATION OR SOMETHING ELSE

BABY BOOSTER NO 3: SURGERY — WHEN THERE’S A PLUMBING ISSUE, WHETHER IT’S FROM FIBROIDS, A TUBAL LIGATION OR SOMETHING ELSE
You had your tubes tied (but now you want them untied), you have fibroids — noncancerous growths, on, in, or inside of the uterus that increase the risk of miscarriages or can prevent pregnancy — or you have a blockage in your fallopian tubes. “A blockage can be secondary to an infection like gonorrhea or due to scarring from an ectopic pregnancy, ovarian cyst removal, or appendicitis,” says Dr. Fossum. “It can also be due to endometriosis, a condition where the tissue lining the uterus begins to grow outside of it.”

Front-line treatment: Precise, minimally invasive surgery using the da Vinci machine, a state-of-the-art, doctor-controlled, robotic system. Formally only used for prostate operations, da Vinci surgery has only been available for women’s health issues in the tri-state area within the last three years.

How it works: “We go in through the belly button,” says Dr. Fossum, one of the first doctors in the area to begin using da Vinci. “We’re able to do big things on the inside while doing small cuts on the outside.” What this means for you? Less pain, less blood loss, and less scarring.

How it will affect your life: “It’s a really fast recovery,” says Dr. Fossum. “Patients recover in a day or two as opposed to six weeks.”

Success rate: “It’s about 70 percent for patients without any other infertility factors that are under age 36,” says Dr. Fossum.

Average local cost: $10,000 to $25,000

Possible side effects: Less complications than with traditional open surgery, but a greater number of larger incisions than in laparoscopic procedures.

Octo-mom risk: N/A

Where it’s available: Jefferson University Hospital Center for Reproductive Endocrinology and Infertility, 834 Chestnut St.; Abington Reproductive Medicine, Abington; The Crozer Reproductive Endocrinology and Fertility Center, Upland.

BABY BOOSTER NO 4: IUI — WHEN YOUR PARTNER HAS LOW SPERM COUNT OR LOW MOTILITY

BABY BOOSTER NO 4: IUI — WHEN YOUR PARTNER HAS LOW SPERM COUNT OR LOW MOTILITY
“Normally, there are about 20 million moving sperm in an ejaculation," says Dr. Fossum. A low count, between 10 to 20 million moving sperm, or low motility, the number of sperm that are actively swimming, can keep sperm from hitting its desired target: your egg.

How it works: “We insert the sperm into the uterus using a small plastic tube,” says Dr. Fossum, who says intrauterine insemination (IUI) especially beneficial when your partner has between 10 to 20 million moving sperm. "We put the sperm right near the fallopian tube so it only has a short time to travel to reach the egg.” Also, because you’re removing the need to perfectly time when you and your guy get it on, women have about a 2 percent higher chance of getting pregnant with IUI when using gonadotropins than if they had sex at home, says Dr. Fossum.

How it will affect your life: It takes some timing, so be prepared to plan your schedule around it, says Dr. Glassner. That’s because when an egg is released during ovulation, it only remains fertilizable for 12 to 24 hours, and when sperm is deposited inside the reproductive tract of a woman, it only has a 24-72 hour window where it can fertilize an egg. “The woman is monitored closely for ovulation, as a well-timed insertion is important for pregnancy,” says Dr. Glassner.

Average local cost: $300 to $400 per IUI

Possible side effects: Mild cramping during the procedure and vaginal bleeding a few hours following the procedure. Though rare, some patients develop an infection or an allergic reaction to the sperm. Signs of infection include fever, chills, and lower abdominal pain. If you experience these symptoms within four or five days of the procedure, tell your doctor asap.

Octo-mom risk: Zero. “Unless the patient is also on fertility drugs, IUI does not stimulate the ovaries to produce eggs,” says Dr. Fossum.

Where it’s available: Jefferson University Hospital Center for Reproductive Endocrinology and Infertility, 834 Chestnut St.; Main Line Fertility, Bryn Mawr; Penn Fertility Care, 3701 Market St.; Abington Reproductive Medicine, Abington; The Crozer Reproductive Endocrinology and Fertility Center, Upland.

BABY BOOSTER NO 5: IVF (IN VITRO FERTILIZATION) — WHEN NOTHING ELSE HAS WORKED

BABY BOOSTER NO 5: IVF (IN VITRO FERTILIZATION) — WHEN NOTHING ELSE HAS WORKED
IVF is commonly used if you have unrepairable fallopian tubes or if your partner has less than 10 million active sperm. You may also be nearing 44, the age when most fertility treatments start to have less of a success rate, and you’re afraid of wasting time on less-effective options.

How it works: A needle is passed through the vagina into the ovaries to retrieve multiple eggs. “Usually the patient has already undergone a round of gonadotropins to stimulate more eggs than she regularly produces,” says Dr. Glassner. “The hope is to get about 12 to 16 healthy eggs.” The eggs are then fertilized by sperm in a dish outside the woman’s body, creating living embryos. “We either put sperm on the egg or, if sperm count is extremely low, we can inject it right into the egg,” says Dr. Fossum. Then, the embryos grow for a few days. “We put one or two of the healthiest embryos back inside the uterus,” says Dr. Glassner. “The excess embryos can be frozen and used later if the cycle doesn’t work or of the patient decides they want another baby later.”

How it will affect your life: “It’s time consuming,” says Dr. Fossum. “Generally, each patient needs about five visits within a two-week time period. During egg retrieval, the patient is fully sedated, and after embryo transfers we recommend 24 hours of bed rest. So that’s another two days to plan on being out of work.”

Success rate: “The lab is extremely important in determining the success of IVF,” cautions Dr. Glassner, who advises comparing IVF success stats at www.sart.org before committing to a doc. “On average, for women under age 35, the take-home baby rate is in the 40 to 50 percent range,” says Dr. Glassner. “For women in their 40s it drops into the teens.”

Average local cost: $9,000 to 13,000 per cycle, not including fertility drugs, which run about $3,000. “It’s blood tests, medications, ultrasounds, and then the actual procedures,” says Dr. Fossum in regard to the high cost. “It’s a lot of different things all together.” Keep in mind, however, that the first round is usually the most expensive. “If you are on a second cycle and already have frozen embryos, it’s only about $3,000 or $4,000 because you don’t need to go through egg retrieval,” says Dr. Glassner.

Octo-mom risk: “It’s very low because we can control how many embryos we place,” says Dr. Glassner. “Depending on how healthy they are, we do anywhere from one to three embryos per cycle.”

Where it’s available: Jefferson University Hospital Center for Reproductive Endocrinology and Infertility, 834 Chestnut St.; Main Line Fertility, Bryn Mawr; Penn Fertility Care, 3701 Market St.; Abington Reproductive Medicine, Abington; The Crozer Reproductive Endocrinology and Fertility Center, Upland.

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  • Heather

    I would like to raise awareness about the disease of infertility and its effects on every 1 in 8 couples trying to have a baby. Please visit http:www.resolve.org/takecharge to learn more.