Houston Reproductive Center

Assisted hatching creates a small opening in the zona pellucida, the outer shell surrounding an embryo, to help it attach more effectively to the uterine lining. Physicians most often recommend this micromanipulation technique for patients with multiple failed cycles, those over 39, or individuals with diminished ovarian reserve.

A blastocyst represents the final developmental stage an embryo must reach before attaching to the uterine wall. Roughly 40% of human embryos achieve this milestone after five to six days inside a laboratory environment. Transferring at this stage on day five has helped lower multiple birth rates while maintaining strong live birth outcomes across IVF cycles.

This approach uses screened eggs from an anonymous or known source, provided the donor shares no genetic relationship with the intended father. Retrieved oocytes are fertilized with the partner's sperm, and resulting embryos are transferred into the recipient's uterus. Success is predicted by the age of the donor rather than the recipient, and all screening follows FDA and American Society of Reproductive Medicine guidelines.

Embryo freezing allows surplus embryos from a single IVF cycle to be stored for potential future use. Not every cycle will produce candidates suitable for preservation. Outcomes from previously frozen transfers have improved considerably and now approximate those achieved with fresh embryos.

Infertility is defined as the inability to conceive after 12 months of unprotected intercourse when the female partner is under 35, or six months if she is older. Time spent in a sexual relationship without contraception counts toward these limits, regardless of whether a couple actively pursues conception.

Several factors can contribute to infertility in both partners:

• Ovulation disorders such as PCOS disrupt regular egg production.
• Fallopian tube blockage prevents sperm from reaching the egg.
• Diminished ovarian reserve reduces egg quantity and quality.
• Uterine abnormalities such as fibroids can block implantation.
• Endometriosis affects surrounding reproductive organs.
• Male factor infertility covers low count, motility, or morphology.
• Age naturally reduces egg quality over time.
• Unexplained infertility occurs when no single cause is found.

Evaluation typically begins with a sperm quality assessment for the male partner and a review of fallopian tube function, ovulation, and ovarian reserve for the female. Further workup is individualized based on those initial findings and each couple's specific medical background.

ICSI (Intracytoplasmic Sperm Injection) is a microscopic procedure in which a single sperm cell is injected directly into an egg to assist with fertilization. This technique is particularly effective for severely low counts and produces comparable pregnancy outcomes to standard IVF when used in appropriate clinical situations.

IUI (Intrauterine Insemination) places washed sperm directly into the uterine cavity on the day of ovulation. Washing removes seminal plasma and concentrates motile cells into a small volume, significantly increasing the number that can reach the fallopian tubes and successfully fertilize an egg.

IVF (In Vitro Fertilization) begins with ovarian stimulation to produce multiple mature eggs, which are retrieved and fertilized with sperm in a laboratory. After three to five days of incubation, an embryo is placed into the uterus, where it must implant to establish a successful pregnancy. 

This treatment offers the highest success rate of all fertility therapies at this Houston Reproductive Center, regardless of age.

Ovulation induction uses fertility medications to stimulate egg production and release, or to support irregular cycles. A number of options exist depending on diagnosis and patient needs:

• Metformin is an insulin-sensitizing drug used for patients with polycystic ovarian syndrome.
• Clomiphene citrate is an oral medication that triggers ovulation with a low risk of multiple births.
• Letrozole and anastrozole are aromatase inhibitors that produce outcomes similar to clomiphene.
• Gonadotropins are injectable hormones and the most potent stimulators available; they carry a 20% chance of twins and a 5% chance of triplets or more.

Reserve testing measures a woman's remaining egg supply through blood work including AMH (anti-Mullerian hormone), FSH, LH, and estradiol. These results help predict how a patient will respond to stimulation medications and guide treatment decisions at this Houston Reproductive Center.

PCOS (Polycystic Ovarian Syndrome) is diagnosed when a patient shows at least two of three features: irregular cycles, signs of excess androgens such as acne or facial hair, and a distinctive follicle pattern visible via ultrasound around each ovary. Insulin resistance plays a significant role in this condition, and combining metformin with fertility medications often benefits women managing this diagnosis.

PGD (Preimplantation Genetic Diagnosis) tests an embryo for specific single-gene disorders such as Cystic Fibrosis, Sickle Cell Anemia, or Huntington's disease before any transfer takes place. Physicians recommend this when a known inheritable condition runs in the family or when genetic screening of the couple returns a positive result.

PGS (Preimplantation Genetic Screening) examines all 23 chromosome pairs within an embryo prior to transfer. This technology proves most beneficial for patients with a history of recurrent miscarriage or for older individuals seeking to reduce chromosomal risk before implantation.