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Intrauterine insemination (IUI) is a fertility treatment that involves placing sperm inside a woman’s uterus to facilitate fertilization. The goal of IUI is to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of fertilization. IUI provides the sperm an advantage by giving it a head start, but still requires a sperm to reach and fertilize the egg on its own. It is a less invasive and less expensive option compared to IVF.

Before intrauterine insemination, ovulation stimulating medications may be used, in which case careful monitoring will be necessary to determine when the eggs are mature. The IUI procedure will then be performed around the time of ovulation, typically about 24-36 hours after the surge in LH hormone that indicates ovulation will occur soon.

A semen sample will be washed by the lab to separate the semen from the seminal fluid. A catheter will then be used to insert the sperm directly into the uterus. This process maximizes the number of sperm cells that are placed in the uterus, thus increasing the possibility of conception. The IUI procedure takes only a few minutes and involves minimal discomfort.
To find out if IUI may be a solution to your fertility problem, kindly contact us and we are more than ready to assist you.

Surrogacy is when another woman carries and gives birth to a baby for the couple who want to have a child. Surrogacy may be appropriate if you have a medical condition that makes it impossible or dangerous to get pregnant and to give birth. The type of medical conditions that might make surrogacy necessary for you include: absence or malformation of the womb recurrent pregnancy loss repeated in vitro fertilisation (IVF) implantation failures.

Full surrogacy involves the implantation of an embryo created using either: the eggs and sperm of the intended parents, a donated egg fertilised with sperm from the intended father, an embryo created using donor eggs and sperm.
Partial surrogacy (also known Straight or Traditional) – Partial surrogacy involves sperm from the intended father and an egg from the surrogate. Here fertilisation is (usually) done by artificial insemination or intrauterine insemination (IUI).

For more information about surrogacy services, please contact our helpdesk and we will be more than glad to assist you.

PGD can be used to test for virtually any genetic condition where a specific gene is known to cause that condition. It is currently approved to screen for over 250 genetic conditions. Some genetic diseases only affect one sex rather than the other. Examples include Duchenne muscular dystrophy, which affects boys but not girls. (Girls may still ‘carry’ the gene for the disease but they will not suffer from it). In these sorts of cases, the embryo is tested to find out its sex and only embryos of the non-affected sex are transferred to the womb.

Pre-implantation genetic diagnosis (PGD) enables people with an inheritable condition in their family to avoid passing it on to their children. It involves checking the genes and/or chromosomes of embryos created through IVF.
For more information on PGD services at City of Hope Hospital and Fertility Center, please contact our help desk.

Amniocentesis is a procedure in which amniotic fluid is removed from the uterus for testing or treatment. Amniotic fluid is the fluid that surrounds and protects a baby during pregnancy. This fluid contains fetal cells and various chemicals produced by the baby.

Though amniocentesis provides valuable information about your baby’s health, it’s also important to understand the risks of amniocentesis and to be prepared for the results.

Amniocentesis can be done for various reasons and some may are;

For genetic testing: which involves taking a sample of amniotic fluids and testing it for certain conditions like the Down syndrome.

For fetal lung testing, this involves taking a sample of the amniotic fluids and testing it to examine whether the baby’s lungs are mature enough for birth.

For the diagnosis of fetal infection, amniocentesis is used to evaluate a baby for infection or other illnesses. The process can also be done to evaluate the severity of anemia in babies who have Rh sensitization- an uncommon condition in which a mothers immune system produces antibodies against a specific protein on the surface of the baby’s blood cells.

For treatment where too much amniotic fluid is accumulated during pregnancy (polyhydraminios) amniocentesis might be done to drain excess amniotic fluid from the uterus.

The maternal and fetal medicine group cares for women who have a high risk pregnancy involoving obstetric, medical, surgical or genetic complication.

Our specialists complement obstetrical care providers, and co-manage complex conditions before or during pregnancy.

At City of Hope, we use imaging techniques to accurately diagnose babies with birth defects prenatally and then connect parents with a neonatologist and a pediatric subspecialist. The physicians and nurses help coordinate any necessary intrauterine therapy, plan the route and timing of delivery and also provide a smooth care transition for the newborn infant.

Laparascopy is done to examine the organs inside the abdomen.

Special surgical tools and a tiny video camera are inserted through four incisions in the abdomen. Your abdomen is inflated with carbon dioxide gas to give the surgical tools more room to work.

Myomectomy  is a surgical procedure that is done to remove  uterine fibroids also called leiomyomas. These common noncancerous growths appear in the uterus, usually during childbearing years, but they can occur at any age.

The surgeon’s goal during myomectomy is to take out symptom- causing fibroids and reconstruct the uterus. Unlike a hysterectomy, which removes your entire uterus, a myomectomy removes only the fibroids and leaves your uterus intact.

Women who undergo myomectomy have reported improvement in fibroid symptoms, including heavy menstrual bleeding and pelvic pressure.

Why do you need Myomectomy?

Myomectomy might be recommended for fibroids causing symptoms that may interfere with your normal activities. If surgery is needed, reasons to choose a myomectomy over hysterectomy for uterine fibroids may include;

• Where you plan to bear children
• Where you might want to keep your uterus
• Where your doctor may suspect uterine fibroids may be interfering with your fertility

Sickle cell is related to anemia. Anemia is a condition where you don’t have enough healthy red blood cells to be able to carry adequate oxygen to the various body tissues.

Anemia makes you feel tired and weak. Anemia has many forms and each comes with its own causes. It can be temporary or long term and it also ranges from mild to severe.

Treatment for anemia is available, and it can be by simply taking supplements or undergoing medical procedures.

Whatever your condition may be, treatment is available for you to get cured permanently.

A couple may decide that they may want a method of gender selection that offers them an almost 100% chance of obtaining the desired gender.

In Vitro Fertilization with biopsy of a resulting embryo has been shown to be effective and a reliable method of gender selection.

To achieve this, In Vitro Fertilization (IVF) can be used in conjunction with embryo testing (Pre-implantation Genetic Diagnosis or PGD) where only embryos of the preferred gender are placed back in the uterus.

PGD is the testing process that can provide the answer. With PGD, one to two cells are removed from these early embryos, and then DNA based genetics analysis is performed in our highly-specialized laboratories. Upon completion of the analysis which takes about 24 hours, couples can select which embryos they will like to use.  If pregnancy results, there is almost a 100% chance it will be of the desired gender.

This method or procedure is particularly helpful for couples where the risk of having a male child with an X-linked genetic disease is significant. It is likely that the method of separating and selecting sperm will evolve in the future, making this science more reliable. However, even at the present time of using IVF with PGD for sexing each particular embryo and then only replacing those of “the desired” gender, this affords close to 100% certainty for desired sex.

Cryogenic storage is the process where organelles, cells, tissues, or genetic materials are collected and stored with the intension of conservation or preservation.

• Semen preservation; semen are stored, used for sperm donation, also for preserving fertility for men undergoing vasectomy or treatment that may compromise their fertility such as; chemotherapy, radiation therapy or surgery.
• Embryo preservation; this is used in In Vitro Fertilization (IVF), where the embryos taken are much more than needed. Children born from frozen embryos or “frosties”, the results have been positive with no increase in birth defects or developmental abnormalities.
• Ovarian tissue preservation; the preservation of ovarian tissue is of best interest to women who want to preserve their reproductive functions beyond the natural limit; or one whose reproductive  potential is threatened by a cancer therapy just like in hematologic malignancies or breast cancer. This procedure is to take a part of the ovary, perform slow freezing before it is stored in liquid nitrogen whilst therapy is ongoing. The tissues can be thawed and then implanted near the fallopian tube either by orthotropic; on the natural location or heterotypic; on the abdominal wall where it then starts to produce new eggs, then allows normal conception to occur.
• Oocytes; this is a new technology where a woman’s eggs are extracted, frozen and stored. Later on, when she is ready to become pregnant, the eggs can then be thawed, fertilized and transferred to the uterus as embryos.

Pre – implantation Genetics Diagnosis (PGD) is a procedure used prior to implantation to help identify genetic defects within embryos.

This serves to prevent certain genetic diseases from being passed on to a child.

Embryos used in PGD are usually created during the In Vitro Fertilization (IVF) process.

Getting from the egg retrieval process to the final results of PGD can take several weeks. The processes are collection, fertilization, three to five (3-5) days of development, one to two (1-2) weeks testing and scheduling an appointment for the discussion of results with our doctor.

PGD can also be used for the purpose of gender selection.

Sickle cell anemia is a hereditary genetic condition where a mutated form of haemoglobin distorts the red blood cells from a normal disc shape to a crescent shape.

This disease is associated with a number of acute and chronic health problems.

This involves the testing for specific genetic defects in the DNA code prior to embryo implantation. Targeted testing of a known genetic abnormality in the couple is what’s normally done.

This is the diagnosis of a genetic condition prior to achievement of a pregnancy.

Pre-implantation Genetic Diagnosis (PGD) is the method used. DNA samples from the direct family members (nuclear family) are taken mostly and not from the extended family.

The oocytes retrieval; the female partner is given medication to create multiple follicular development and ovulation. Once these follicles are well developed, they are retrieved from the patient under conscious sedation using a special ultrasound guided technique. The oocytes are then isolated from the follicles, and then allowed to rest in the incubator for about three to four (3-4) hours before insemination. It is used to prepare the sperm for In Vitro Fertilization (IVF).

Today, most sickle cell carrier couples now have the ability to screen their embryos before conception thereby avoiding a sickle cell baby.

Many parents have a strong desire to complete their families with the addition of a son or a daughter.

Family balancing is the term for gender selection done for the purposes of achieving a more balanced representation of both genders in a family.

Gender selection can be done by using Pre-implantation Genetics Diagnosis (PGD), a technology involving the testing of the chromosomal make-up of an embryo.

Pre- implantation Genetics Diagnosis (PGD) must be done in conjunction with In Vitro Fertilization (IVF).

Once the test results are known, only the embryo(s) of the desired gender X or Y are returned to the patients uterus, thereby ensuring a nearly 100% accuracy rate for gender when the pregnancy is achieved.