Our fertility doctors and specialists understand that, for some, it can be challenging to conceive. Through the Columbia University Fertility Center and The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine of Weill Cornell Medicine, our fertility care teams provide world-class services to help you become pregnant. Both centers are nationally respected for providing exceptional infertility and reproductive medicine services.
Our programs feature the most advanced fertility treatments, renowned fertility doctors, in vitro fertilization (IVF) success rates at or above national levels, a team approach that includes specialists in emotional support, and treatment for male infertility.
What is Infertility?
Infertility is the inability to become pregnant after at least one year of unprotected intercourse (six months for women age 35 and older). Infertility can have both male and female causes.
Causes of infertility in women may include:
- Irregular ovulation due to conditions such as polycystic ovary syndrome or premature menopause
- Advanced age (35+)
- Blocked fallopian tube(s) due to endometriosis, previous pelvic surgeries, or sexually transmitted diseases such as chlamydia
- Anatomical abnormalities of the uterus, such as fibroids
- Weighing too little or too much
- Excessive alcohol use
Our infertility teams conduct various fertility tests to evaluate both you and your partner. You will each have a physical exam to assess your overall state of health. Additional tests may include:
- Semen analysis to assess sperm count, shape, and motility
- Tests of the ovarian reserve (the number of eggs in the ovaries) including blood tests for follicle stimulating hormone (FSH), estradiol, and antimullerian hormone (AMH)
- Tests of a patient's thyroid-stimulating hormone (TSH), prolactin, dehydroepiandrosterone sulfate (DHEAS), 17-α hydroxyprogesterone, and total testosterone levels to identify conditions that may cause irregular menstruation or recurrent miscarriages
- Hysterosalpingogram, an X-ray to check the opening of the fallopian tubes and the shape of the uterus
- Transvaginal ultrasound to evaluate the uterus and ovaries
- Hysteroscopy- placing a small camera through the cervix to look in the uterus
What are Fertility Treatments?
Fertility treatments are procedures or medications that can help the female reproductive system increase the chances of pregnancy. These include drugs and procedures to aid with ovulation and hormone production.
Many infertility cases can be treated with medications and in some cases, surgery. Each patient will have a specific fertility treatment plan that is formulated for their unique needs.
Fertility Treatment Options
There are several fertility treatment options, and your care team will match you with those that are best for you based on the results of your fertility evaluation. Our fertility treatments include:
- Oral medications to stimulate ovulation, including clomiphene citrate (Clomid®) and letrozole (Femara®)
- Injections to stimulate the development of mature eggs in the ovaries, such as human menopausal gonadotropin (Menopur®, Repronex®, Pergonal®) or follicle-stimulating hormone (Gonal-F®, Follistim®)
- Medications to treat diabetes, insulin resistance, polycystic ovary syndrome, and high prolactin levels
- Intrauterine insemination (IUI) places sperm into the uterus, sometimes after the women have received medications to stimulate ovulation.
- Surgery to restore fertility may be performed using minimally invasive laparoscopy to treat conditions such as blocked fallopian tubes, ovarian cysts, pelvic adhesions, uterine fibroids, or endometriosis. Our surgeons often perform these procedures using robotic surgery.
Assisted reproductive technology
Fertility treatments in which eggs or embryos are handled outside of the body are called assisted reproductive technologies (ART). The most common ART is in vitro fertilization (IVF). This can include the use of donor eggs, donor sperm, and donor embryos. About 2.1% of all babies born each year in the United States are conceived using ART. Types of ART include:
- IVF where eggs and sperm are combined in a laboratory to create embryos. Fertility medicine is used to stimulate the development of mature eggs, which are then retrieved through a transvaginal surgical procedure. The eggs are placed in a glass dish with sperm so the sperm can "swim" to and fertilize the egg(s). One or more embryos is implanted in the woman's uterus. Embryos can also be frozen for transfer in the future.
- If a couple has infertility due to a problem with the function of the sperm, intracytoplasmic sperm injection (ICSI) may be used during IVF. Instead of sperm fertilizing eggs on their own, a single sperm is injected directly into a mature egg.
- Assisted embryo hatching may be performed in conjunction with IVF before the transfer of an embryo. The doctor uses a laser to thin the outer shell of an embryo to make it easier to implant itself in the uterus.
- Donor eggs and donor sperm are sometimes used if a patient cannot produce eggs on their own, for couples where a parent has a genetic disease they do not wish to pass on to their child, and for a parent who wants to become pregnant without a male partner. A couple may also choose to have a donor embryo implanted in the uterus. Donor eggs, sperm, and embryos can also be used in same-sex couples who wish to become parents.
- A gestational surrogate is an individual who carries a pregnancy for someone else. The embryo may have been created using a couple's eggs and sperm or from a combination of a couple's eggs or sperm with donor eggs and sperm.
- Egg and sperm freezing is available for people who are not ready to become pregnant but may wish to do so in the future. This includes individuals undergoing cancer treatments that may impair their fertility.
Possible Risks of Fertility Treatment
Like most medical procedures, infertility treatment carries some risks. Our fertility teams provide care to ensure the best outcomes for our patients and educate you about the possible side effects of each treatment.
Fertility medications may cause:
- Mild bruising and soreness at the injection site
- Mood swings, fatigue, and nausea
- Increased vaginal discharge
- Tender breasts
- Painful and swollen ovaries from stimulation
Individuals undergoing IVF may experience:
- Pain in the pelvic region and abdomen
- Rarely, an injury to the bowel or blood vessels that require emergency surgery
The transfer of embryos into the uterus may cause:
- Mild cramping
- Vaginal spotting
- Rarely, an infection that requires antibiotic treatment
Get Fertility Treatments at NewYork-Presbyterian
Our fertility doctors are nationally and internationally recognized for their expertise in all areas of reproductive medicine. Using basic fertility treatments and advanced approaches, we can dramatically boost your chances of becoming pregnant.
We embrace people from all walks of life, with special programs for those seeking to use donor eggs and for LGBTQ+ parents-to-be. Our participation in several large managed-care health insurance plans helps make infertility treatment affordable.
We also participate in the New York State Infertility Demonstration Program, which helps subsidize infertility treatment for people who live in New York who have limited or no insurance coverage for IVF treatment. Give us a call today to make an appointment so we can help you get started on your journey to parenthood.