Over the past 25 years there have been enormous scientific advances in the care of infertile couples. These advances have come through the development of new and better medications for ovulation induction, technological advances in surgical techniques including microsurgery and minimallly invasive surgery, and in-vitro fertilization technology. Innovative new treatments have enabled us to treat couples who would have had no options available to them in the past. For example, in-vitro fertilization techniques now allow the possibility of pregnancy when the male has an extremely low sperm count or no sperm at all in his ejaculate. Women with irreparably damaged fallopian tubes may now achieve pregnancy readily through in-vitro fertilization technology. The use of tiny, telescopic instruments has allowed us to evaluate and treat parts of the reproductive tract previously inaccessible.

Newly developed medications enable us to control and support the hormonal events of the menstrual cycle, stimulating and supporting where necessary to improve the prospects for a successful pregnancy. We now have the capacity to freeze embryos for use in future treatment cycles, allowing additional opportunities for pregnancy following a single in-vitro fertilization cycle. Through the use of “egg donors”, women who have experienced “early or premature menopause” or had their ovaries surgically removed may become pregnant and carry successfully. Even women who have had a hysterectomy may be able to have their own biological pregnancy through the use of a “gestational carrier”.

In spite of all these marvelous technological advances, most infertile couples achieve success through simple office based “low tech” procedures. The goal of treatment is to achieve a successful pregnancy as quickly as possible using the safest, simplest, most effective approach to treatment. When necessary, scientific and technological advances allow us a wide variety of treatment options with excellent prospects for success in almost all couples!