Your Care at NYP

Fertility & Reproductive Medicine

About Our Program

Innovative, Personalized Care to Meet Your Needs

A couple looking at pregnancy test in the bathroom after fertility treatments

NewYork-Presbyterian is at the forefront of fertility care with two leading centers that offer experts in reproductive medicine and infertility, groundbreaking technology, and proven treatments that help women and men become parents.

Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine at Weill Cornell Medicine provides world-class expertise and is a pioneer in the development and use of the most current, cutting-edge fertility treatments. The Center has a national and international reputation for successfully treating patients who have not had success with conventional treatments at other centers as well as those with complex fertility issues.

Learn more about the Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine at Weill Cornell Medicine.

Columbia University Fertility Center offers the personalized care of a boutique practice; the outstanding outcomes of a high performance, high volume laboratory; and the innovations and cutting-edge treatments that come from a leading academic medical center.

Learn more about the Columbia University Fertility Center.

These centers, together with NewYork-Presbyterian fertility doctors, offer patients the most evidence-based, cost-effective, and least-invasive treatments to achieve their fertility goals.

What is Infertility?

Infertility is a common condition that can affect men and women of reproductive age. In order to achieve a successful pregnancy, a remarkable sequence of events has to occur: A healthy egg has to develop and be ovulated, the sperm have to be of sufficient quantity and quality, the uterus and fallopian tubes have to function normally, and the timing has to be right.

Infertility is defined as not being able to achieve a pregnancy in a woman who has regular menstrual cycles after one year of trying (or six months if a woman is 35 or older). However, infertility is not always due to the female partner. In fact, when a cause for infertility is found, it is due to a male factor in about half of all cases.

Causes of Infertility

Age is one of the most important factors in determining a woman’s chance of achieving pregnancy. A woman is born with all the eggs that she will have in her lifetime and as she ages, the number and quality of eggs decline. Not having regular menstrual cycles usually means not releasing an egg every month and can be a cause of infertility. Other causes may include blockages of the fallopian tube (the tubes that capture the egg where fertilization occurs and bring the fertilized egg into the uterus where a pregnancy will implant), fibroids, or hormonal imbalances. It is important to emphasize that many systemic diseases can cause infertility.

Infertility in women can be caused by one or more of the following factors:

Advanced age. Couples in which the female partner is 35 years of age or older are more likely to report difficulty conceiving
Being overweight or obese
Smoking
Excessive alcohol use
Use of illicit drugs
Hormonal imbalances such as elevated levels of testosterone
Chemotherapy, radiation, surgery, or taking medications that should be avoided during pregnancy
Excessive physical or emotional stress or weight loss or weight gain that results in amenorrhea (absent periods)
History of pelvic infections
Systemic diseases (e.g., thyroid, diabetes, cancer, etc.)

Infertility in men can be identified by doing a semen analysis which evaluates the number (concentration), motility (movement), and morphology (shape) of the sperm as well as the volume of the ejaculate. In many cases, the cause of an abnormal semen analysis is unexplained but a thorough workup by a reproductive urologist can identify some causes that can be corrected.

Risk factors linked to male infertility include:

Smoking tobacco
Using alcohol
Using certain illicit drugs
Being overweight
Having certain past or present infections
Being exposed to toxins
Overheating of the testicles
Having experienced trauma to the testicles
Systemic diseases

When to See a Fertility Specialist

There are many conditions that can cause infertility — sometimes related to the woman, sometimes the man, and sometimes both — which is why it’s important for both partners to have a full evaluation by a reproductive specialist.

Women are typically advised to seek the care of a fertility specialist after unsuccessfully trying to conceive for one year if they are younger than 35 years old, or after six months if they are 35 or older. However, if there are risk factors for infertility, signs of infertility, or reasons to suspect other underlying conditions that can make it difficult to conceive or carry a pregnancy, a consultation with a reproductive endocrinologist earlier can be helpful.

Our Approach to Care

The complex nature of infertility requires a comprehensive and multidisciplinary approach. At NewYork-Presbyterian, Weill Cornell Medicine, and Columbia, reproductive endocrinologists closely collaborate with a wide range of specialists in Gynecology, Gynecologic Surgery, Genetics, and Urology to formulate an individualized plan of care that is tailored to a patient’s unique condition and reproductive goals.

Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine at Weill Cornell Medicine:

The Center is one of the oldest and most respected IVF programs in the country where many of the innovative techniques used by other centers were developed. Internationally recognized physicians and scientists have developed and refined many of the diagnostic and treatment modalities used in reproductive endocrinology and fertility treatments throughout the world. The Center’s physicians have been instrumental in developing medication protocols that have been adopted worldwide for ovarian stimulation, optimizing treatments for each patient undergoing this procedure to maximize the quantity and quality of eggs.
Our fertility experts place an emphasis on personalized medicine, focusing on each patient’s individual history and implementing the most appropriate and cost-effective treatment strategy focused on that particular patient’s needs and family-building desires. The Center also provides exceptional care for patients diagnosed with cancer or other conditions that would affect their future fertility.
The Center’s reproductive endocrinologists are also highly skilled minimally invasive surgeons who perform all necessary surgical procedures related to reproductive disorders (e.g., fibroids, uterine malformations, endometriosis, ovarian cysts, etc).
Comprehensive fertility services are provided in state-of-the-art facilities that include examination and consultation rooms, on-site blood testing, and laboratories that perform the most sophisticated clinical evaluations and procedures, including advanced semen testing, preimplantation genetic testing, and intracytoplasmic sperm injection. IVF procedures are performed in a dedicated operating room at NewYork-Presbyterian/Weill Cornell Medical Center with anesthesia provided by a board-certified anesthesiologist. The Center has the full benefits of care that a leading academic medical center provides.

Columbia University Fertility Center:

The Center provides the most innovative clinical approaches, cutting-edge technologies, and exceptional comprehensive care from leading, internationally recognized experts. Specialists provide personalized care that considers patients’ unique, individualized needs. Fertility test services are provided in state-of-the-art facilities that enable patients to receive testing and IVF lab services, evaluations, and advanced clinical procedures. A dedicated procedure room within the Center allows patients to undergo many of the necessary procedures in a welcoming, comfortable setting.
For more complex surgical cases, reproductive endocrinologists collaborate with Columbia’s Division of Gynecological Specialty Surgery to provide prompt access and care from some of the world’s more experienced gynecologic surgeons who perform the latest innovative, fertility-sparing, and fertility-enhancing minimally invasive surgery techniques to treat women with conditions such as tubal blockage, ovarian cysts, pelvic adhesions, uterine fibroids, or endometriosis.
The Columbia cross-disciplinary team collaborates to provide the best possible outcomes through detection of chromosomal abnormalities and genetic mutations in embryos, including those that are well known and those that are novel.
Working with urologists, the team provides coordinated and collaborative care for couples with male infertility.

The centers help patients navigate the complex issues surrounding infertility and its treatment. Our patients have seamless access to genetic counselors, psychologists, patient coordinators, and financial coordinators who help make the process as smooth as possible.

Infertility Evaluation and Treatments

Treatments

The evaluation and treatment of infertility requires a team approach with specialists who have expertise in providing comprehensive, personalized care that meets their patients’ individualized needs.

Infertility Evaluation

An infertility evaluation may include a complete history and physical to find out why you and your partner have not been able to become pregnant.

For Women:

Pelvic examination
Blood tests to determine hormone levels
Structural analysis of the uterus, fallopian tubes, and ovaries (these analyses include hysterosalpingograms, saline ultrasounds, and minimally invasive surgery)
Pelvic ultrasound to evaluate the uterus or to perform ovarian reserve testing to count the number of eggs available each month in the ovaries

For Men:

General physical exam
Semen analysis
Blood test to determine the level of testosterone and other male hormones

Treatments We Offer

Our fertility specialists carefully evaluate infertility symptoms to discover the cause of the infertility and determine the optimal course of treatment. Treatments may include:

Ovulation induction (OI): OI uses medications to release one or more follicles (eggs) from the ovaries. OI is used to treat women with unexplained infertility, ovulatory issues, polycystic ovarian syndrome, or other causes.

Intrauterine insemination (IUI): IUI is a treatment in which the ejaculate is washed to isolate the healthy sperm which is then placed in the uterus around the time of ovulation.

In vitro fertilization (IVF): IVF is a process in which the woman's eggs are surgically removed from the ovaries, mixed with sperm outside the body (in vitro), and allowed to fertilize and develop before an embryo is transferred back into the uterus. Excess embryos can be frozen and saved for future pregnancies, if desired.

Cutting-Edge Technologies

Our reproductive endocrinology and infertility specialists are committed to incorporating the latest evidence-based tests and treatment technologies into patient care. These include:

Pre-implantation genetic testing (PGT) to identify genetic defects in embryos created through in vitro fertilization (IVF). This can be performed to identify embryos affected with diseases that the parents may carry such as cystic fibrosis. It can also be performed to help identify potentially genetically normal embryos for transfer, thus increasing implantation rates for each embryo transferred and possibly reducing miscarriage rates.

Microscopic testicular sperm extraction (MicroTESE) is the microsurgical retrieval of sperm directly from the testicles in men who have no sperm identified in their ejaculate.

Intracytoplasmic sperm injection (ICSI) inserts a single spermatozoon directly into the cytoplasm of an egg to improve fertilization rates and is used when there is an identified abnormality of the sperm.

Assisted embryo hatching, performed in conjunction with an IVF cycle, is a fertility technique in which an embryologist uses a laser to thin the embryo’s outer shell, the zona pellucida, to make it easier for the embryo to “hatch” out of its protective shell and implant (attach to the uterus).

Frozen embryo transfer (FET) is a procedure in which frozen embryos from a previous IVF cycle are thawed and then transferred back into the woman’s uterus.

Fertility preservation uses state-of-the art cryopreservation technology to freeze eggs, embryos, sperm, or ovarian tissue before medical treatment that may cause infertility, such as radiation or chemotherapy. Egg freezing may also be used by women to freeze younger eggs because of the natural decline in fertility with advancing age.

Third-party reproduction helps individuals become pregnant by involving someone else in the reproduction process. It can include donated eggs, sperm, or embryos, as well as gestational carrier arrangements where someone else carries a pregnancy for a woman who is medically unable to do so for herself or for same-sex male couples.

Advanced IVF Techniques

The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine at Weill Cornell Medicine and the Columbia University Fertility Center offer a wide range of Advanced IVF Techniques.

Among their highlights and unique contributions to advancing these treatments:

Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine at Weill Cornell Medicine

EmbryoScope®: The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine at Weill Cornell Medicine was one of the first in the U.S. to offer this innovative time-lapse technology that takes pictures of the embryo every 20 minutes to identify those with the most potential for success.

IVF with endometrial cell coculture: Coculture is a process by which embryos develop on a layer of cells grown from the patient’s own endometrium (uterine lining) to promote normal embryo development. The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine was one of the first centers to publish research on the benefits of embryo coculture in conjunction with IVF for patients with prior unsuccessful treatments and poor embryo quality.

Intracytoplasmic sperm injection (ICSI): ICSI, which was developed by faculty at the Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, is the most frequently used advanced IVF technique. During this procedure, a single sperm is injected directly into the egg to achieve fertilization. The resulting embryos are then incubated for three or five days before they are transferred to the patient, or they may be cryopreserved.

The Andrology Laboratory at the Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine provides, in addition to routine semen analysis, sophisticated sperm testing including checking for DNA fragmentation, or damage. The laboratory has been at the forefront of using advanced sperm selection techniques such as micro-fluidic sperm separation, which separates sperm with low levels of DNA fragmentation, thus improving the chances of a successful pregnancy.

Microscopic testicular sperm extraction (MicroTESE): MicroTESE, developed at Weill Cornell Medicine, is the microsurgical retrieval of sperm directly from the testicles to improve the chances of extracting viable specimens in the most challenging male fertility cases. Physicians at the Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine are some of the best in the world for treating male infertility.

Third-party reproduction: Third-party reproduction encompasses techniques that enable individuals who cannot become pregnant with their own eggs or sperm to conceive using another individual’s gametes. It also allows couples to use a gestational carrier when the female partner cannot carry a pregnancy or when there is no female partner. One of the first comprehensive egg donation programs in the U.S. was established at the Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine.

Fertility preservation: The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine offers the full complement of fertility preservation procedures including cryopreservation (freezing) of eggs, sperm, embryos, and ovarian tissue to offset the risks of declining future fertility due to the natural aging process. Urgent consultations are performed within 24 hours for patients with medical conditions, such as cancer, to provide fast and efficient therapies to preserve the ability to have children using their own eggs and sperm in advance of treatments that would damage future fertility (e.g., chemotherapy, ovarian surgery). It is the leading center in the New York metropolitan area for providing ovarian tissue freezing for patients who do not have adequate time to undergo ovarian stimulation to collect eggs.

Preimplantation genetic testing (PGT): PGT involves the removal of a few cells from a developing embryo which is then cryopreserved while awaiting the results of testing. This can be performed to test for genetic conditions the parents carry or a chromosome imbalance such as Down syndrome. The first successful pregnancy and birth following an embryo biopsy in the U.S., now widely referred to as PGT, took place at the Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine.

Learn more about the Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine at Weill Cornell Medicine.

Columbia University Fertility Center

Coral-IVF (Columbia Oral IVF): Columbia University Fertility Center now offers a novel, low-cost IVF fertility treatment for patients and couples who have not achieved success through IVF injections. Coral-IVF uses pills instead of hormone injections to cause the same effect.

Enhanced Implantation Protocols: Specialized protocols, developed at Columbia University Fertility Center, are used to increase the implantation rates of embryos. Using novel medical approaches and interventions such as intrauterine infusion of platelet-rich plasma (PRP) and natural (unmedicated) protocols, the Center’s fertility specialists can offer new treatments to increase the chances of conceiving using IVF.

Enhanced Sperm Transport: While sperm samples have traditionally had to be produced in the fertility clinic itself or produced at home and then quickly brought to the fertility clinic, scientists and andrologists at Columbia University Fertility Center have developed a method to allow sperm to be stored for hours after production so that samples can be produced in the privacy and comfort of home and then brought to Columbia University Fertility Center without any rush. This service is available to all of the Center’s patients at no cost.

Microfluidic sperm-preparation: Scientists and embryologists at Columbia University Fertility Center have developed a new method of preparing sperm for use with ICSI/IVF that uses microfluidics to gently isolate sperm and avoid the harsh and damaging centrifugation steps conventionally used in order to improve embryo development in older eggs and sperm that have increased DNA fragmentation/damage.

Innovative technology to store eggs and embryos: A team at Columbia University Fertility Center has developed a first-of-its-kind technology that provides additional monitoring and protection for tanks that store embryos and eggs. Columbia offers the most advanced egg and embryo freezing procedures available.

Fertility preservation: A dedicated and highly experienced team at Columbia University Fertility Center coordinates fertility preservation treatments due to cancer, medical conditions, and natural aging. Due to the often time-sensitive nature of this care, the team is able to expedite thorough and expert consultations and treatments, usually with minimal or no delays.

Third-Party Reproduction: With one of the most experienced third-party reproduction programs in the country, the Columbia University Fertility Center team can often quickly match women and couples with the appropriate egg, sperm, or embryo donor or gestational carrier.

Pre-Pregnancy Genetics Program: The Pre-Pregnancy Genetics Program at Columbia University Fertility Center brings together a multidisciplinary team of specialists to help couples have a healthy child without the risk of severe genetic diseases. By combining the most advanced approaches in genetics and reproductive medicine, couples can safely and effectively conceive with almost no risk of having a child affected by common or rare genetic diseases. Experts in genetics and reproductive medicine work closely with the couple to develop an individualized treatment plan. Eggs and sperm from the couple are then combined in the Center’s lab. The resulting embryos are tested for specific diseases using preimplantation genetic testing, and a healthy embryo is then placed in the uterus.

Learn more about the Columbia University Fertility Center.

Comprehensive Care

Reproductive genetics: Genetic counseling, preconception screening, prenatal screening, and prenatal diagnosis for a variety of birth defects and genetic disorders are available. Genetic counseling for infertility and other problems with conception and pregnancy is also available to patients.

Care for endometriosis and polycystic ovarian syndrome: These conditions can cause infertility in women.

Fertility surgery or medications to correct an underlying abnormality. Our expert gynecologic surgeons use minimally invasive and robotic approaches to:

Repair blocked or damaged fallopian tubes
Treat endometriosis, which is commonly associated with infertility
Remove polyps or fibroids in the uterus
Remove ovarian cysts

Male infertility: Our experienced urologists provide evaluations and medical or surgical treatments that address male infertility.

Why Choose Us

Leaders in Infertility Treatment

At NewYork-Presbyterian, affiliated physicians from Weill Cornell Medicine and Columbia University, all board-certified in reproductive endocrinology and infertility, are nationally and internationally recognized for their expertise in infertility and recurrent pregnancy loss. These highly trained specialists address the entire spectrum of reproductive issues and work with patients to create a customized, evidence-based treatment plan that gives them the best chance to conceive. Patients with some of the most challenging conditions — many of whom have been unsuccessfully treated elsewhere — have found success with our specialists. At the leading edge of fertility care, our clinician-researchers continue to develop and pioneer novel reproductive treatments and technologies to help patients realize their dreams of building a family.

Advancing the Field through Research

Our Weill Cornell Medicine and Columbia University clinician-investigators remain at the forefront of research related to fertility and reproductive medicine, including new therapies and approaches. Our patients benefit from treatments based on the most up-to-date research and findings.