Mississippi Reproductive Medicine assists women and men with fertility problems as well as female endocrine disorders, uterine abnormalities, endometriosis, uterine fibroids, and a number of related health concerns. Call our office today to schedule an appointment and see how we can help you.
Infertility is diagnosed as the inability to successfully become pregnant after 12 months of unprotected intercourse or after 6 months of unprotected intercourse if 35 years of age or older. Mississippi Reproductive Medicine assesses your needs and provides treatment for those diagnosed with infertility.
Approximately 1/3 of infertility causes are related to female causes, 1/3 are related to male, and the remaining 1/3 are a combination of both male and female factors. Testing available at MRM includes ovarian reserve assessments (good for women of all ages), ovulation disorders including irregular or lack of ovulation, uterine disorders including irregular bleeding and uterine abnormalities, and the diagnosis and treatment of polyps and fibroids affecting the uterine cavity, and evaluation of the fallopian tubes.
Other testing of infertility may include chromosomal screening, genetic disorder screening, endocrine disorder screening, recurrent pregnancy loss screening, or anatomical anomaly screening.
Initial testing for the male partner includes a semen analysis performed in the clinic with same day results. The semen analysis is considered the Gold Standard for male evaluation. The semen analysis can determine the number of sperm, the motility and the morphology (shape) of the sperm.
We provide a private and comfortable area for this testing to occur onsite in the MRM laboratory.
Ovulation induction is done with oral and /or injectable medications. This treatment often corrects ovulation disorders and is a very common treatment for infertility and often used as a “first line” therapy. Oral ovulation medications (ie Clomid, Letrozole ) are generally well tolerated by most women.
Embryo Testing (PGS/PGD)
Preimplantation genetic screening (PGS) for aneuploidy (also known as PGT-A) and Preimplantation Genetic Diagnosis (PGD) is performed on the embryo to determine if the chromosomes of the embryo are normal, or euploid versus aneuploid (abnormal). Embryos with too few or too many chromosomes, if transferred, will most often result in a failure to achieve pregnancy, but may result in a miscarriage. In rare cases, abnormal embryos could result in the birth of a child with a chromosomal abnormality. By screening at the embryo stage of development (usually DAY 5 of development after an egg retrieval), these types of problems may be avoided. Transfer of an embryo with normal chromosomes does not guarantee a normal pregnancy. Most PGS cases at MRM involve screening or testing at the blastocyst stage, and then freezing the embryo(s) for later transfer (Frozen Embryo Transfer – FET). Preimplantation genetic diagnosis (PGD) is the term often used for testing the embryo for a specific genetic abnormality, such as cystic fibrosis or sickle cell disease.
When surgical intervention is deemed necessary, the staff of MRM provides these services without needing additional referrals. Surgical procedures often required for the treatment of infertility include laparoscopy, hysteroscopy, laparotomy, or a combination of the above. The majority of surgery cases are performed on an out-patient basis and the patient is able to return to normal daily activities within a few days. Surgery may include treatment for the ablation of endometriosis, resection or removal of uterine fibroids or polyps, removal of ovarian cysts often related to endometriosis, correction or repair of damaged fallopian tube(s), correction of uterine or vaginal septum (or other uterine abnormalities), or even the correction of previously ligated fallopian tubes (tubal anastomosis).
Endometriosis is a cause of both pain and infertility. Endometriosis is a common finding of patients affected with infertility. Endometriosis can be treated both medically and surgically. Depending on the patient’s future reproductive plans, the better treatment will be determined. Many patients benefit from the surgical evaluation and treatment of endometriosis prior to conception.
Intrauterine insemination is a common and relatively low-cost procedure that can help couples achieve pregnancy.
Sperm is collected and processed to obtain the best quality sperm from a semen sample and then placed into the uterus via a simple office procedure. IUI can be performed with fresh or frozen sperm. Sperm can be obtained from the male partner or from a sperm donor. MRM works with several sperm banks and once a sample is chosen, we can accept shipment to use whenever the patient is ready for an IUI.
IUI is one of the more common procedures performed in our clinic. There is little to no “down time” and the patient is able to return to daily activities without any limitations practically immediately after the procedure. An IUI generally requires one ultrasound, a “trigger injection” followed by the intrauterine insemination one to two days later.
Some patients will not be successful with IVF and may be candidates to receive donated embryos. These embryos are created during an IVF cycle at MRM by a couple that has completed their family. Embryo donation at MRM is primarily done in an anonymous fashion. A couple most likely to choose donor embryo may be one that requires both a donor egg and donor sperm, or possibly a couple that has failed IVF with their own gametes and would prefer a donor embryo.
Female Endocrine Disorders
While endocrine disorders account for a smaller percentage of infertility cases, the staff of MRM is knowledgeable in the management and treatment of a wide variety of disorders affecting the reproductive system, including delayed puberty, hyperprolactinemia, hirsutism, polycystic ovarian syndrome (PCOS), hypothalamic amenorrhea, and premature ovarian failure.
Fibroids or uterine myoma are causes of bleeding, pain, infertility and recurrent pregnancy loss. As with other uterine abnormalities, fibroids can be diagnosed with an SHG, office hysteroscopy, or even a complete gynecological ultrasound only. Depending on the size and location of fibroids, the MRM staff will decide if surgical, medical, or even no therapy is indicated or required.
Egg Freezing (Oocyte Cryopreservation)
Many women are considering oocyte cryopreservation. It may be recommended for a woman facing upcoming gonadotoxic therapy (ie cancer treatment) and if this is the case, the staff of MRM is available to evaluate a patient in this case 7 days a week. If you are facing a cancer diagnosis and subsequent treatment, time is of the essence and we are here to see you either same day or within one day of your diagnosis and treatment plan from your oncologist.
If considering elective oocyte cryopreservation for social/personal reasons (ie career, educational demands or relationship concerns) MRM provides this service as well. Elective oocyte cryopreservation is becoming more common as many women take a more proactive role in their future reproductive autonomy.
Ovarian Reserve Testing
Your ovarian reserve is your egg supply. Because we cannot count your eggs we use our testing to estimate your egg supply. This estimate is based on several factors, such as age and reproductive history. An ultrasound will be done to count the small (antral) follicles in the ovary.
Muellerian anomalies including uterine didelphys, bicornuate uterus, and septate uterus, can be causes of infertility. Often these anomalies are undetected until an infertility evaluation is completed.
The most common evaluation of uterine anomalies is through the use of an office sonohystogram (SHG) or an office hysteroscopy. Both evaluation options are available at MRM and are office-based procedures with no downtime, little to no discomfort, and both take less than 30 minutes to complete.
Recurrent Pregnancy Loss (RPL)
Approximately 5% of couples experience the loss of two or more pregnancies.
Recurrent pregnancy loss can be attributed to chromosomal disorders, endocrine disorders, coagulation disorders, luteal phase defects, and/or uterine anomalies. A complete RPL evaluation is started in the office through initial labwork and pelvic evaluation. The most reassuring news with RPL is that most couples who suffer from RPL will eventually maintain a successful pregnancy.