Reproductive Treatments
ART, AI & IUI, and Reproductive Surgery
At the Center for Reproductive Health & Gynecology, we offer a full spectrum of fertility treatments tailored to your unique needs. Our services include Assisted Reproductive Technology (ART), Artificial Insemination (AI) and Intrauterine Insemination (IUI), as well as advanced reproductive surgeries. This comprehensive guide provides detailed information on each treatment option, helping you make informed decisions on your path to parenthood.
Assisted Reproductive Technology
ART Procedures
Patients trying to conceive for over a year, or those over 35 who have been trying for at least six months, should consult a fertility specialist. Issues like irregular periods, damaged fallopian tubes, recurrent pregnancy loss, or abnormal sperm analysis also warrant a specialist's advice. Talk to your gynecologist or contact us today. Assisted reproductive technology (ART) at our Beverly Hills and Los Angeles clinics has helped many couples achieve parenthood. While in vitro fertilization is the most common ART at the Center for Reproductive Health & Gynecology, Dr. Najmabadi and our team offer various ART options.
Assisted Reproductive Technology Procedures
There are a number of infertility treatments performed at our Los Angeles and Beverly Hills-area infertility centers that fall into the category of assisted reproductive technology (ART). Included in the list of assisted reproductive technology treatments at the Center for Reproductive Health & Gynecology are:
In vitro fertilization (IVF)
Intracytoplasmic sperm injection (ICSI)
Assisted hatching
Preimplantation genetic diagnosis (PGD)
Blastocyst transfer
Frozen embryo transfer
Cryopreservation Egg, Embryos, and Sperm
Egg Donation
Surrogacy
Candidates For ART Procedures
Assisted reproductive technology can help couples who experience the following infertility causes:
Sperm problems
Diminished ovarian reserve
Tubal disease
Ovulation problems
Endometriosis
Unexplained infertility
AI & UI Treatments
Artificial Insemination
Artificial insemination involves inserting sperm into the uterine cavity. This sperm can come from a partner or a donor sperm bank. Usually, this is performed on patients with a low sperm count and can dramatically increase the chances of pregnancy.
Artificial insemination (AI) at our Beverly Hills and Los Angeles-area fertility clinics is one of the most popular infertility treatments offered by Dr. Sam Najmabadi and the team at the Center for Reproductive Health & Gynecology. Artificial insemination (AI) involves collecting and processing semen and placing it directly into the woman’s vagina, cervical canal, or uterine cavity. Sperm may be from the husband, male partner (AIH), or from a donor (DI). The reasons for using artificial insemination include both male and female factors. Male factors include abnormal semen analysis (low count, motility, or % normal morphology), impotence, sexual dysfunction, and retrograde ejaculation. Female factors include hormonal deficiencies, sexual dysfunction and congenital abnormalities of the vagina and cervix.
Artificial Insemination Procedures
In preparation for and during artificial insemination treatment, doctors closely monitor the woman’s menstrual cycle. When her body is ready for implantation, the male participant provides doctors with semen. This semen is then “washed” to remove any harmful chemicals which may hinder conception. The semen is inserted into the woman in the hopes that she will conceive.
What is Intrauterine Insemination?
Intrauterine insemination (IUI) is a fertility treatment in which washed sperm are placed directly into the uterus. Intrauterine insemination bypasses the cervix and improves the delivery of sperm to the egg, thereby increasing the chances of pregnancy.
Intrauterine Insemination
In most cases, AI is performed by intrauterine insemination (IUI), where the semen is placed into the uterus through a catheter. In order to increase the number of eggs available, IUI is usually used in combination with controlled ovarian hyperstimulation. IUI can be a successful treatment for some forms of infertility and may be a good alternative to in vitro fertilization (IVF) for some couples. IUI is an option for couples with unexplained infertility and for couples where the male has sperm problems.
Intracervical Insemination
Intracervical insemination, the earliest form of artificial insemination, became popular in the 1970s. With intracervical insemination, sperm is deposited directly into the cervix. This relatively quick and painless procedure makes it easier for the sperm to travel through the uterus and fallopian tubes so that it can fertilize the egg.
Intrauterine insemination (IUI) at our Los Angeles-area fertility clinics is the most popular form of artificial insemination. If it is decided that an intrauterine insemination (IUI) is appropriate for you and you decide to proceed with treatment, Dr. Najmabadi will help you plan your IUI cycle. There are different types of IUI cycles: an un-medicated IUI, an IUI with the addition of Clomid (CC) and an IUI that utilizes a combination of injectable medications (hMG). There are many steps involved in this process, but try not to become too overwhelmed, that’s why we are here. Together, we will discuss what you can expect throughout the treatment process.
The IUI Procedure
A semen sample is provided one to two hours before intrauterine insemination is to be performed. Intrauterine insemination can be performed with the partner’s sperm or with donor sperm. The semen is then washed (sperm is separated from the seminal fluid) and the sperm quality is analyzed. Now it is ready to be inseminated, which only takes a few minutes and causes little to no discomfort.
During the intrauterine insemination procedure, a small catheter is inserted into the uterine cavity and the sperm is injected directly into the uterus. The patient should be able to resume normal activity immediately after the intrauterine insemination procedure. If the intrauterine insemination is unsuccessful, it may be repeated during the following cycles.
When Is Intrauterine Insemination Recommended?
Intrauterine insemination is often recommended for couples that have been trying to conceive for at least one year with no explanation for their infertility. Intrauterine insemination may also be recommended for any of the following:
A low sperm count (but no less then 10 million/ml)
While going through a Clomid cycle (Clomid/IUI)
When being treated with injectable fertility drugs (hMG or FSH/IUI)
Bad sperm mobility
Same sex couples
Single women
When donor sperm is used
The couple has been diagnosed with sexual dysfunction
Cervix conditions, such as cervical mucus that is too thick
Reproductive Surgery
Reproductive Surgery
Most procedures we perform are done at our ambulatory surgical center, located next to the Beverly Hills office. Some of the procedures included would be tubal reversal, tubal cannulation, hysteroscopy, and laparoscopy. Reproductive surgery and diagnostic procedures such as laparoscopy and hysteroscopy, can help Dr. Najmabadi diagnose possible causes of infertility during a fertility work-up, and he can also use reproductive surgical techniques to correct tubal obstruction, uterine fibroids, endometriosis, and scarring.
Diagnostic Laparoscopy
Minimally Invasive Surgery
During laparoscopy, a telescope-like instrument is inserted into the abdomen through a small incision so the doctor can visualize the abdominal cavity. During the procedure, the surgeon asks himself several questions, including:
Do the tubes pass dye easily without becoming swollen?
Is the tubal wall structure normal?
Is there evidence of scar tissue?
Does the tube appear normal, and does it make contact with the ovary?
Are there adhesions between the tube and the ovary?
Is there evidence of endometriosis?
Tubal Reversal
Tubal ligation, or “tube tying”, is a common form of contraception; however, life circumstances change, and many women wish to become pregnant again. Fortunately, tubal reversal surgery can help a woman regain her fertility and gives her the chance of achieving the pregnancy she desires.
Tubal reversal can be performed through laparoscopy (placing a small scope through the naval) or through a small incision (mini-laparotomy) just above the pubic bone. In most cases, a laparoscopy is done first to evaluate the tubes’ reversibility. If the conditions of the tubes are appropriate, the tubal reversal will be performed by laparoscopy. If not, a small incision is made just above the bikini line and the separated ends of the fallopian tubes are rejoined with fine suture material. The tubal reversal procedure takes two to three hours and can be performed under general anesthesia. Most patients are able to return to normal activities within two weeks of the tubal reversal procedure.
There are several factors that determine the success of the tubal reversal surgery, including the length and health of the fallopian tube sections to be rejoined, the woman’s age at the time of tubal reversal, and pelvic scar tissue.
There are risks associated with every surgery, and tubal reversal is no exception. Complications of the tubal reversal surgery include bleeding, infection, or damage to surrounding organs. However, these risks are extremely rare, and most patients are satisfied with the procedure. In addition, it is important to note that the risk of ectopic pregnancy, or tubal pregnancy, increases from 1 in 100 to 5 in 100 pregnancies after tubal reversal.