Dr. Nicole Noyes

Reproductive Endocrinologist
Specializing in Infertility,
In Vitro Fertilization (IVF)
and Egg Freezing

Treating Infertility

 

Fertility-enhancing treatments are used to help a woman achieve pregnancy more often and more quickly after unsuccessful attempts on her own. If you have been trying for more than 6 months and are age 38 or younger, or if you have been trying for more than 3 months and are over age 38, you should come in for a consultation.

 

Ovulation Induction with Insemination

 

Ovulation induction with intrauterine insemination (IUI), also commonly referred to as artificial insemination, is offered when someone has unsuccessfully tried to get pregnant on their own, whether it be due to lack of ovulation, mild sperm deficiencies, advanced age (over age 35) or no definable cause. This modality involves approximately one week of fertility medication (often administered by subcutaneous injection) along with frequent ovarian-response monitoring, including blood tests and ultrasound exams. All monitoring takes place at NYU Fertility Center before the workday begins (7-9 AM) and daily instructions are chosen based on your body's response to medication.

 

In Vitro Fertilization (IVF)

 

IVF is an "assisted reproductive technology" (ART) used to help women become pregnant in the setting of:

 

  • No or suboptimally functioning fallopian tubes
  • Prior ectopic pregnancy (meaning a pregnancy that implanted outside the uterus, usually in the fallopian tube)
  • Failure to achieve pregnancy using ovulation induction with sperm insemination
  • If a male partner exists, low semen parameters (low sperm count or sperm motility)
  • Unexplained infertility

 

IVF usually involves several weeks of injectable medications administered to cause multiple eggs to develop in the ovaries, and also requires frequent monitoring of the egg development through blood tests and sonogram exams. All monitoring takes place at NYU Fertility Center before the workday begins (7-9 AM) and daily instructions are given based on your body's response to medication.

 

An egg harvest procedure is performed when the oocytes are mature. This procedure is accomplished under light anesthesia where the eggs are aspirated out of the ovaries through the vagina. Embryos are created by combining sperm and individual eggs in a petri dish and allowing them to grow and divide in an incubator that mimicks the conditions of the female body. Several (3-5) days later, embryos are placed into the uterus through the vagina using a thin plastic catheter. This is a relatively painless procedure for most women.

 

NYU Fertility Center is state-of-the-art and has been ranked third in the nation by Child Magazine. The most recent pregnancy rates for IVF are available on the NYU Fertility Center website, www.NYUFertilityCenter.org.

 

Reproductive Surgery (including congenital anomalies)

 

There are times when surgery is the appropriate next-step in the evaluation or treatment of infertility. Some procedures are also indicated in a non-infertility setting. In general, surgery will be avoided when possible, but certain conditions warrant this modality:

 

  • Large fibroids, particularly those that involve the endometrial cavity or womb (the part of the uterus where pregnancy is carried) or those that cause significant symptoms, particularly bleeding
  • Polyps in the endometrial cavity
  • Dilated fallopian tubes, especially those large enough that they can be visualized on ultrasound examination
  • Ovarian cysts of undetermined origin or those large enough to warrant surgical exploration
  • Congenital uterine or vaginal abnormalities such as a uterine septum, bicornuate uterus, or vaginal hemi-septum
  • Significant signs of endometriosis or pelvic adhesions

 

Surgery is accomplished through one of three approaches: laparoscopy, hysteroscopy or open abdominal surgery. The approach that allows the best outcome with the least amount of invasion to the body will be selected.