Fertility

What causes fertility problems?

Many factors that affect both men and women contribute to fertility and conception delay. Women need to produce and release viable eggs. Those eggs must be able to travel through the fallopian tubes where they need to combine with a sperm cell, then the fertilized egg or zygote needs to travel to the uterine cavity and implant in the uterine wall, or endometrium.

Female problems occur when the ovaries don’t produce or release eggs; if there are structural blockages in the fallopian tubes, or distorted pelvic anatomy from previous surgery, infection, or endometriosis; or if there’s a problem in the uterus that prevents implantation. Male factor fertility occurs when men either don’t produce enough sperm or their sperm shows reduced motility, or sperm binding, and thereby can’t successfully reach or fertilize an egg.

How is fertility tested?

Dr. Moomjy offers both male and female fertility testing. Her practice is licensed by the New York State Department of Health as a Tissue Bank providing Sperm Testing and Insemination Services. Some of the available fertility tests for men and women include:

• Hysterosalpingogram (HSG) testing detects blockages or abnormalities in the fallopian tubes, and uterine problems including fibroids, septum, and adhesions.
• Saline sonograms reveal uterine polyps, submucous fibroids, and septum.
• Endometrial biopsies provide a tissue sample that is tested for abnormalities of the endometrium, including chronic infection (endometritis) and hormonal insufficiencies.
• Ovarian reserve testing reveals your remaining supply of eggs, in comparison to your age group.
• Semen analysis shows the concentration and motility of the sperm. Semen and urine cultures test for silent infections which do occur with men

When should I talk to a doctor about my fertility issues?

If you’re under the age of 35, you should schedule an appointment with a fertility expert like Dr. Moomjy after 12 months of having unprotected sex without becoming pregnant. If you’re 35 years or older, you should make an appointment after six months of trying to conceive.

If you have a risk factor for infertility such as previous surgeries, or infections, or abnormal or irregular menstrual cycles, or a miscarriage, or a previous complicated pregnancy, you should schedule an appointment prior to or at the time of trying to conceive so you have relevant information much sooner.

What are the available fertility treatments?

Dr. Moomjy recommends fertility treatments based on the results of your fertility testing, personal medical history including past pregnancies, and your long-term family goals. For example, if your body isn’t releasing eggs, Dr. Moomjy can prescribe a medication to stimulate ovulation. Other available fertility treatments include:

• Intrauterine insemination (IUI): Dr. Moomjy instills sperm directly into your uterus at the optimal time for fertilization in your cycle. The semen specimen undergoes a density gradient preparation to isolate and concentrate the motile sperm on the morning of the IUI procedure.
• In vitro fertilization (IVF): Dr. Moomjy, in collaboration with NYU Fertility Center, stimulates the ovaries to produce extra mature eggs that can be harvested  and combined with a sperm sample outside of your body, in a Petrie dish under the microscope; then, with the assistance of an embryologist, the embryos are cultured to a developed blastocyst stage;  and then, the best quality embryo is transferred to your uterus once it has been hormonally primed and synchronized to the developmental stage of the embryo.
• Donor eggs or sperm: Dr. Moomjy has 20 years of experience in helping patients achieve families with the assistance of Donor Egg/IVF or Donor Sperm as medically indicated when severe ovarian dysfunction of lack of motile sperm has occurred. Dr. Moomjy, in collaboration with the NYU Fertility Center, provides counseling and can help you find an appropriate donor match.
• Egg freezing: Dr. Moomjy can provide a medication protocol matched to your ovarian reserve, monitor and medically prepare you for egg retrieval (egg harvest) that will be performed at the NYU Fertility Center for their expert embryology and egg freezing services. The monitoring services provided by Dr. Moomjy are organized to provide you the most amount of privacy with time to ask questions and best understand your medication protocol and ovarian response.

If you’re concerned about your fertility or have been trying to conceive without success, call Dr. Moomjy’s practice to make an appointment today.