Q&A Topic: Infertility and Reproductive Endocrinology, with Dr. Jeffrey Russell, M.D., F.A.C.O.G.
The world-renowned Delaware Institute for Reproductive Medicine (DIRM) is a leading Infertility and IVF Center specializing in state-of-the-art treatment for all aspects of male and female infertility as well as other reproductive health issues. DIRM truly is a place where dreams, through science, become reality.
What is infertility and when should I seek professional help?
Infertility is the inability to conceive after 12 consecutive months of unprotected intercourse. Infertility affects approximately 1 in 8 couples of reproductive age. Professional help from a board-certified reproductive endocrinologist and infertility specialist should be considered after 12 months without conception. Other conditions may prompt an earlier infertility evaluation: If you are over 35 years of age, if you have had more than one miscarriage, have irregular menstrual cycles, painful menstrual periods, have had previous gynecological surgery or a pelvic infection, or a family history of endometriosis and/or other fertility-related diagnosis.
What should I expect from my visit with a reproductive endocrinologist and infertility (REI) specialist?
First, it is essential to understand the cause or causes of your infertility.The initial visit will focus on education, followed by a thorough explanation of what it takes to conceive and the testing to help determine the cause of your infertility. The vast majority of infertility problems are easily treatable and knowing the reason why helps to focus on cost-effective treatment options.
What are the routine tests to determine my cause of infertility?
The causes of infertility can be broken down into several areas:
- The first and easiest area to check is the presence of sperm, which is done by semen analysis. The sperm is counted and different parameters are required for conception.
- The next is the ability of the sperm to travel through the cervix. Something as simple as an infection can stop you from getting pregnant.
- The third test is the “HSG,” or hysterosalpingogram, to evaluate the patency of the fallopian tubes. Fallopian tubes that are not functioning properly or are closed will hinder your fertility.
- The next area to evaluate is if you are ovulating. We study the entire ovulation process and confirm ovulation is occurring and intercourse is timed appropriately.
- The last area is to confirm normal anatomy. We make sure the uterus and the internal reproductive organs are functioning properly, allowing an opportunity for sperm to fertilize an egg.
What treatments are available to help me conceive?
There are multiple treatments to help you conceive. Simpler treatments might include treating an infection with antibiotics, fertility medications to assist or initiate ovulation, advancing slow-moving or a decreased sperm count closer to the opening of the fallopian tubes at the time of ovulation (IUI), opening the fallopian tubes so the sperm can reach the egg or taking medications to eliminate the endometriosis or pelvic pain interfering with conception. A more advanced option is to place the sperm with the egg to fertilize, forming an embryo, and then placing the embryo inside the uterus to implant (IVF).
What is IVF and how does it work?
IVF is a treatment where the ovaries are stimulated with safe fertility medications to “recruit” available eggs for that particular month. The eggs are removed with ultrasound guidance in the office prior to their release from the ovary or ovulation. Later that day, sperm are placed near or in the egg to initiate fertilization. The following day the eggs are checked for fertilization. The fertilized eggs (now embryos) are allowed to grow in the incubator for the next five days. At the end of the five days, the embryo(s) can be transferred back to the uterus, tested for any chromosomal abnormalities, or frozen for transfer in subsequent months.The ability to genetically test the embryos prior to their transfer back to the uterus, called pre-genetic screening or PGS, has many benefits. PGS allows for only one normal embryo to be transferred back to the uterus, increasing the ultimate success rate of IVF, while eliminating the risk of multiples. It also reduces the miscarriage rate and provides the ability to know the gender of the child, if that information is requested.
For over 30 years, Dr. Russell has been helping thousands of couples (with 6,000+ babies) realize their dreams of starting or increasing their family. He is double-board certified in Obstetrics and Gynecology and Reproductive Endocrinology and is Yale University trained. He has always been on the cutting-edge of reproductive technology, from the first IVF pregnancy in Delaware to the first ICSI pregnancy in the region. He continues to break ground, being the first to provide genetic testing on embryos (PGS/D) for both genetic disorders and family balancing. Dr. Russell practices in both Newark and Milford, Del.
The Delaware Institute for Reproductive Medicine
Christiana Care Health System & Nemours Children’s Health System
4745 Ogletown-Stanton Road, Suite 111
Medical Arts Pavilion I
Newark, Del., 738-4600
556 S. DuPont Blvd., Suite H
Milford, Del., 424-6645