Reproductive Care Center Newsletter

In This Issue

FEATURE ARTICLES

  

IUI Success Rates

 

Insurance Update

 

When is IVF an Option

 

Volume 2, Issue 1

May, 2014

We hope you enjoy the RCC newsletter.  We try to pick topics of interest to current and past infertility patients. If you would like to suggest a topic please contact us at info@fertilitydr.com. You are receiving the newsletter because your e-mail address was given at RCC.  If you don't want to receive future e-mails please unsubscribe.
Announcing the 2014 Patient Party

We are excited to announce that the 2014 Reproductive Care Center Patient Party will be held on Saturday May 10, 2014 at the newly opened Loveland Living Planet Aquarium. You should have already received an invitation with details. Reproductive Care Center is providing up to four tickets for each family and additional tickets can be purchased online. Ticket prices are:  Adults (ages 13 or older): $15.95; Students (13-17), Seniors & Military: $12.95; Children (ages 3-12): $10.95.

 

Tickets can be used throughout the day of the event. We invite you to come during the Ice Cream Social being held in the Large Banquet Room from 1:00 to 3:00 PM and say hello to our physicians and staff.  We will have a separate entrance for all RCC patients starting at 12:30 PM. 
Intrauterine Insemination Success Ratesiui

 

IUI, Intrauterine insemination, is the oldest and most cost effective procedure available for many causes of infertility. IUI involves collecting and concentrating sperm to place high into the uterus, resulting in many more sperm reaching the egg in the fallopian tube. 

 

Success rates with IUI have increased dramatically over the decades, partly due to the process of preparing the sperm for IUI, and partly due to improving protocols to induce ovulation in the female. 

 

Many doctors offer IUI as a fertility treatment, but it is most likely to be successful when done by a doctor who specializes in the procedure, does it very often, and who has specialized staff who are formally trained and have a great deal of experience doing sperm preparations.

 

The lab staff at RCC has over 40 years combined experience doing sperm preparations for IUI. The process involves washing the sperm with special media, centrifuging the sperm, and collecting them in a catheter to transfer into the uterus. 

 

One reason an infertility specialist should be chosen to perform IUI is that high order multiple births can result if too many eggs develop and the cycles are not carefully monitored. When it is not safe to induce ovulation because of the risk of multiple births, the eggs can be retrieved for use in an IVF cycle. This can only be done at a fertility center that has an IVF program like Reproductive Care Center.

 

Another important factor contributing to success with IUI is the ovulation induction drug protocol used, if any, to prepare the female for the IUI. If there is no ovulatory dysfunction, IUI can be attempted without any medications, but if this doesn't work, or there is ovulatory dysfunction, then the protocol makes a big difference in the success rates. 

 

Clomiphene Citrate (Clomid) has been used for many decades to help women ovulate in preparation for IUI, and it is still used today. However, the proper use of Metformin, myoinositol and Femara has been shown to increase pregnancy rates in some women who don't ovulate regularly. Femara may produce fewer side effects in some patients.  

 

FSH (follicle stimulating hormone) is also used to facilitate ovulation, especially when oral medications don't work. At RCC, we have found that using a combination of oral medications and FSH injections actually doubles the pregnancy rates in women with ovulatory dysfunction, and is much safer and less expensive than using FSH injections alone.

 

In women under 35 years old, IUI using Clomid resulted in a pregnancy rate of 16% per cycle at RCC since 2009. This is similar to the success rates when using Femara with IUI. Sixteen percent is considered a normal success rate per month for fertile couples trying to get pregnant on their own. 

 

When FSH is added to the protocol for a few days at the right time, success rates jump to 23% per cycle. These numbers are very encouraging for couples who have a mild to moderate male factor and who are using their husband's sperm.

 

In cases when donor sperm are needed due to male sub fertility, the success rate using IUI with oral medications plus FSH injections was 40%, compared to about 20% using IUI with pills but without FSH injections. The benefit of using FSH can clearly be seen when using ovulation induction for IUI, but is not always used as first line therapy because of its increased cost and need the need for more monitoring.

 

IUI, either alone or in conjunction with various ovulation induction protocols, has proven to be the most cost effective form of therapy for many causes of infertility. When done at a center with extensive experience, success rates can meet or exceed the chances of a young fertile couple trying on their own. 

 

If initial attempts at IUI with oral medications, or no medication fail, then adding FSH injections can boost the odds of success significantly, providing another good option with IUI before moving on to more advanced treatment options.

 

 
IVF (in vitro fertilization) is the most powerful fertility treatment currently available. The first baby born from IVF tre
atment was delivered on July 25, 1978, and the scientist who developed it, Robert Edwards, was awarded the Nobel Prize in 2010  for his work.

Since 1978, over 5 million babies have been born using IVF worldwide, and more than half of these have been in the past 5 years as the stigma surrounding infertility has lessened and technology has improved. In the USA, over 61,000 babies were born as a result of IVF in 2012, and this number continues to increase. Between 1.5 - 2% of all babies born in the US are results of IVF.

 

Why is IVF so Powerful and Popular?

 

IVF can overcome many of the causes of infertility at the same time, such as ovulation disorders, pelvic adhesions, endometriosis, and male factors. With IVF treatment, the ovaries are typically stimulated to produce multiple eggs. Once the eggs mature they are retrieved in a simple office procedure under sedation.  Next, the eggs are fertilized; the embryos are grown, then placed in the uterus 2 to 6 days later.

 

Because many embryos are available at one time for transfer, those that are growing best can be selected and those that fail to grow can be discarded, improving the chance that one of the transferred embryos will implant in the uterine wall. In a fertile couple attempting natural conception, only about one in 6 embryos grows normally to the point of implantation, and some of these abort after implantation due to genetic anomalies. Having several embryos to work with in one cycle greatly improves the success of IVF. 

 

Any excess number of growing embryos can also be cryopreserved (frozen) for use in a later cycle.  This means a future pregnancy can be attempted without having to go through the ovarian stimulation and egg retrieval processes again.  The cost and time required for frozen embryo cycles is much less.

 

Can All Patients Pursue IVF? 

 

There are limitations even with IVF, and it doesn't make sense for all patients. Certainly, simpler and less expensive options should be considered before resorting to IVF. The success rate for standard IVF drops drastically after the age of 40 but in these cases, using donor eggs from a younger woman may allow an older woman to conceive and deliver a baby. 

 

For mild to moderate male factor infertility, inseminations (IUI) are more cost effective than going straight to IVF. With ovulation disorders, medications can be given to induce ovulation, without needing IVF. Unexplained cases of infertility should also be treated with basic therapies before resorting to IVF. 

 

Cases where IVF should be used as first line treatment include tubal disease and severe male factor. In appropriate aged women where other treatment modalities have failed, IVF is a great next step. So the answer to the question about all patients pursuing IVF is "Yes"; they can and should, if other therapies haven't worked or don't have a good chance of working. IVF is the gold standard treatment.

 

insuranceInsurance Update

Governor Gary Herbert signed house bill 347 into law on April 1, 2014.  The bill was sponsored by Representative LaVar Christensen and sponsored on the floor by Senator Curtis S. Bramble.

 

This bill amends the original bill that required indemnity coverage of $4,000 to be paid to adopting parents who have maternity coverage. The amended bill does not change the adoption indemnity coverage but it allows it to be used for infertility treatments instead of only for adoption costs.   

 

However, it is up to the discretion of the insurers to allow this interchangeIt is not known how many insurers will offer the optional infertility benefit. Infertility treatments can be very expensive and Utah couples often have to pay "out of pocket'. This prevents many couples from having the family they desperately desire. It is hoped that most insurance companies will provide the fertility indemnity benefit to couples who prefer treatment over adoption.

 

Managed care providers have denied coverage for infertility for years.Given the comparatively small pool of infertility patients, coverage cost for insurers would likely be very low. In addition, the Obamacare plan does not include infertility coverage.

 

We advise patients to lobby their representatives and join local advocacy groups. Public pressure is needed to require insurers to provide the coverage infertility patients deserve.

We Appreciate Patients' Comments

If you have  positive comments about our services, we would appreciate your sharing them at the following Websites:Vitals.com, Google.comHealthgrades.com, Ratemds.comFacebook.com  ,Linkedin.com.

 

Reproductive Care Center Locations
Sandy Office
10150 Petunia Way
Sandy, UT 84092
Tel: (801) 878-8888
Fax: 801-878-8890


Clearfield/Layton Office
1725 East 1450 South
Suite 300
Clearfield, UT 84015
Tel: (801) 784-5484
Fax: (801) 784-5480


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