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James S. Heiner, MD Reproductive Endocrinologist

Exploring Family Building Options. James S. Heiner, MD Reproductive Endocrinologist. Reproductive Care Center Sandy, Utah. 801-878-8888. Topics to Discuss. Exploring Exploring Family Building Options - help is available!. Exploring. The Goal The Plan The Experience

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James S. Heiner, MD Reproductive Endocrinologist

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  1. Exploring Family Building Options James S. Heiner, MD Reproductive Endocrinologist • Reproductive Care Center • Sandy, Utah 801-878-8888

  2. Topics to Discuss • Exploring • Exploring Family Building • Options - help is available!

  3. Exploring • The Goal • The Plan • The Experience • Discovery– so much to learn • Surprises – so much can happen • The End Result

  4. Exploring Family Building • It can be daunting • Overwhelming • Where do you start? • Frightening • Will it work? • Exciting • Maybe it will work!

  5. Exploring Family Building • It can be challenging • Time • Money • Emotions • Learning • Uncertainty • Persistence

  6. Exploring Family Building • A good guide can help in the journey • Board Certified Reproductive Endocrinologist • Three years of formal training in infertility after 4 years of OB/GYN training • Two years to gain experience and pass examinations

  7. Exploring Family Building • As you begin or continue your exploration, remember: • Be optimistic • Be realistic • Be together and unified • Be determined and persistent • Be satisfied that you have done your best

  8. Exploring Family Building • Examples of two couples who had the experience of exploring family building. • Couple 1-unsuccessful but kept a positive attitude and had a good experience • Couple 2-persistent and succeeded in an unexpected way

  9. Exploring Family Building • Learning from others can help make your own exploration easier and more enjoyable, even though the journey is different for every couple.

  10. Options • Sex • Fertility pills • Injections • Inseminations • In vitro fertilization • Other advanced techniques

  11. Options-Sex • SEX • You should keep having sex! • Many couples seem to forget this one while they’re so busy looking at other options. Worse yet, they learn to dread it! • Sex is good for fertility, for togetherness, for unity, and for fun! • Good therapy after a hard day at the clinic (or after a good day at the clinic!)

  12. Options-Fertility Pills • Pills to help the woman ovulate • Clomid • Femara • Injections to help the woman ovulate more • FSH to stimulate more egg development • hCG to trigger ovulation

  13. Options-Injections • Injections to help stimulate ovulation • FSH is a natural hormone • FSH requires close monitoring • FSH is expensive • FSH can be used with or without ovulation induction pills • hCG can be used will pills or injections to help assure and time ovulation

  14. Options • IUI - Intra Unterine Insemation • IVF - In Vitro Fertilization • ICSI - Intracytoplasm Sperm Injection • TESE -Testicular Sperm Extraction • AH - Assisted Hatching • PGD - Pre Implantation Genetic Dx.

  15. Options- IUI • IUI- Intrauternine Uterine Insemination • Minimal increase in the chance of pregnancy, but cost effective • Increases the chance of conception from 8% to 11% per cycle, in a typical couple with unexplained infertility • It can be used with or without medications for ovulation induction

  16. Options- IUI • IUI • Takes of couple of hours to prepare the sperm for the IUI • Usually costs a few hundred dollars • Simple and relatively painless

  17. Options- IVF • IVF-- In Vitro Fertilization • More expensive than basic treatments but also much more likely to result in a pregnancy in each cycle attempted • Pregnancy rate typically >50% in young women in good centers

  18. Options- IVF • IVF • Eggs are stimulated with FSH, and retrieved under sedation using a transvaginal, ultrasound guided needle • Eggs are fertilized with sperm and the resultant embryos are incubated for 2-6 days then transferred into the uterus

  19. Options- ICSI • ICSI- Intra cytoplasmic Sperm Injection • Revolutionized the ability to fertilize eggs using sperm with problems • Greatly increases chance of pregnancy when moderate to severe sperm problems exist

  20. Options- Assisted Hatching • AH- Assisted Hatching • Laser is used to put a small slit in zona pelucida (egg shell) • This makes it easier for the embryo to hatch out later on • Used primarily when the zona is thicker than normal, after embryo freezing, in cases of advanced maternal age, or when prior IVF cycles have failed

  21. Options- TESE • TESE- Testicular Epididymal Sperm Extraction • Used in cases where no sperm come out in the ejaculated semen • Male hormones and other tests done to be sure TESE is appropriate

  22. Options- PGD • PGD- Pre implantation Genetic Diagnosis • Used primarily to prevent the transmission of genetic diseases to the next generation • Cystic fibrosis, Sex potential of embryo, Help gender balancing in a family

  23. Options- Third Party • Third party options for building your family • Donor Sperm • Donor Eggs • Donor Embryos • Gestational Surrogates • Traditional Adoption

  24. It usually works– but what if it doesn’t? • Was it still worth the journey? • Can you still keep exploring? • Can you still be happy?

  25. Conlusions slide Reproductive Care Center Sandy, Utah • Mountain view with name, phone number of clinic 801-878-8888

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