Reproductive Endocrinology

Reproductive endocrinology is a branch of medicine that identifies and treats infertility in both men and women. In the United States, 15 percent of all couples will face fertility issues, and many will be diagnosed with a reproductive disorder. Many infertile couples choose to see a reproductive endocrinologist when deciding upon fertility treatments. Your reproductive endocrinologist will identify factors involved in your infertility and select the appropriate methods to treat these factors.
Our team of passionate and committed reproductive endocrinologists showcases some of the most renowned fertility experts in the country. Consistently on the cutting edge of fertility treatments and technology, our physicians are committed to providing superior care to all patients facing reproductive issues.

Reproductive Endocrinology and Infertility

The infertility program at Mount Sinai is based on an affiliation with the Reproductive Medicine Associates of New York, which offers the most advanced services in assisted reproductive technology (ART) to help infertile patients who may require such approaches to achieve a healthy baby.

Treatments and Procedures

We customize treatment protocols to provide each patient with state-of-the-art techniques to optimize their care. Treatments include:

• In vitro Fertilization - Embryo Transfer (IVF-ET): Nearly five million babies have been born after use of IVF-ET, a procedure that involves retrieval of an egg directly from a ripe follicle in the woman's ovary then fertilized by sperm in a dish. The fertilized egg is then allowed to develop into an embryo in the laboratory prior to being transferred through the cervix into the uterus.
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• Blastocyst culture and transfer: A technique developed for in vitro fertilization (IVF) that improves likelihood of successful implantation of embryos while minimizing the risk of multiple pregnancy. Culture of the embryos for five days allows for growth to the blastocyst stage of development and provides a greater opportunity to assess viability and achieve a positive outcome.
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• Preimplantation Genetic Diagnosis (PGD): An advanced genetic technique which allows an individual embryo to be analyzed. PGD is a recommended procedure for patients who are carriers of a genetic anomaly or are affected by a genetic condition. Biopsy and selection of healthy embryos dramatically reduces the possibility of passing the condition to future offspring. Additionally, PGD can be used to select embryos that do not possess chromosomal abnormalities.
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• Comprehensive Chromosome Screening (CCS): A revolutionary technology involving thorough analysis, selection, and transfer of embryos that possess a normal genetic makeup. Assessment and selection of embryos that have a normal chromosomal make-up allows for higher implantation rates and fewer pregnancy losses.
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• Embryo cryopreservation: A procedure where embryos are frozen and placed safely in liquid nitrogen for future thawing and use in fertility treatments.
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• Egg freezing (oocyte cryopreservation): A fertility preservation treatment option for women interested in preserving current unfertilized eggs in order to attempt pregnancy in the future. Women who anticipate having children after the age of 35, are about to go under medical therapies such as chemotherapy or radiation treatment for cancer, or have a family history of endometriosis, premature ovarian failure, or early menopause may consider the treatment as a means to circumvent future reproductive complications.
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• Egg donation: Eggs are removed from the ovaries of a fertile donor for use in an infertile patient.
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• Intracytoplasmic sperm injection (ICSI): In cases where the male partner has abnormal or few sperm, mature sperm may be injected directly into the egg in the laboratory to achieve a normal pregnancy. A microscope and microsurgical equipment are used to insert the sperm into an egg.

In order to determine the proper course of treatment for each couple, we may perform a number of diagnostic tests:

• Preconceptual Counseling: Basic steps for a couple trying to conceive
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• Transvaginal Ultrasound: An internal ultrasound is used to evaluate a woman's uterus and ovaries
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• Semen Analysis: Test of the male partner's sperm count, shape, and motility to assess his fertility
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• Hormonal Testing: Tests of important hormones that give important information about a woman's reproductive system
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• Endometrial Biopsy: Evaluation of the uterine exposure and response to progesterone by taking a small sample of tissue
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• Post-coital Test: A test to evaluate the male-female interaction
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• Hysterosalpingogram: An X-ray of the uterus following injection of dye through the cervix used to evaluate the fallopian tubes and uterus
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• Basal Body Temperature Charting: By taking her temperature each morning, a woman can identify whether ovulation occurs and on what day it occurs.

The clinical and scientific teams at Mount Sinai and Reproductive Medicine Associates of New York were among the first to help women conceive using previously frozen oocytes (eggs) from egg donors. Effectively, this could halt the biological clock as these eggs could be successfully preserved before egg quantity and quality undergo their natural age-related decline in function.
 posted by

R.Rasa Prabakaran M.Sc,M.Phil,B.Ed,
Lecturer in Zoology.