There is a wide range of conditions that can affect fertility and lead to a couple having difficulty getting pregnant. These problems include issues with ovulation (egg production), age (egg quality and numbers), blockage or other problem within the reproductive track (a structural problem within the uterus or fallopian tubes), and male factor infertility (issues with sperm quality or numbers). The workup includes hormonal imbalances of the thyroid, adrenal or pituitary gland and commonly polycystic ovary syndrome (PCOS). The accurate diagnosis of what is causing infertility is crucial for deciding on the appropriate treatment options. Thoroughly evaluating and understanding the cause of a person’s infertility is the key to improving fertility and achieving pregnancy.
Dr. Neil Goodman is board certified medical endocrinologists specializing in reproductive endocrinology and are experts in the diagnosis and treatment of the causes of infertility.
Our unique approach to fertility treatments
Dr. Goodman prioritizes understanding the cause of infertility and ensuring it is fully understood and addressed in a logical and appropriate way.
Many couples do not need Assisted Reproductive Technology (ART) or surgery such as in vitro fertilization (IVF) in order to get pregnant. Furthermore, IVF comes with very high costs and still does not guarantee that couples achieve pregnancy. Ovulation induction with medications and close monitoring is another approach to infertility treatments that can succesfully achieve pregnancy.
At Reproductive Health Physicians, Dr. Goodman focuses on the stimulation of egg growth (ovulation induction), possible treatment with intrauterine insemination (IUI), and then the optimization of the lining of the uterus (endometrial lining) to prepare the uterus for implantation and pregnancy.
Our doctors are extremely thorough in their approach, and recognize that IVF has high cost and is not necessary for most couples experiencing infertility.
Infertility In Men
Up to 40% of fertility problems in couples can be due to an underlying issue with the sperm, or male factor infertility. These problems can be due to a wide range of issues including hormone problems such as disrupted pituitary hormones (LH and FSH), diabetes, and low testosterone production from the testes.
Dr. Goodman will perform a semen analysis and appropriate blood tests. A semen analysis involves the collection of a semen sample and determination of the quantity, movement and shape of the sperm. This is done expertly and conveniently in our certified andrology lab located at the office.
Depending on the underlying cause of the problem, medications can sometimes help improve sperm and fertility potential. Treatment can include intrauterine insemination (IUI) either in a natural cycle or combined with ovulation induction using fertility drugs. It is extremely important to evaluate the underlying cause of sperm abnormalities in order to determine the best treatment option.
Infertility In Women
Often, ovulation issues or ovulation dysfunction can be corrected by carefully discovering the underlying problem and fixing it. Thyroid, pituitary and adrenal problems must be sought out and corrected as needed. In other circumstances including PCOS, early menopause, and advanced age, women may need medications to help them ovulate more normally in order to get pregnant.
Using medications to stimulate normal egg ripening and ovulation is Dr. Neil Goodman’s expertise. Ovulation medications include clomiphene and letrozole which are taken by mouth as well as injected medications such as FSH hormone injections. Often these treatments are combined with intrauterine insemination (IUI) to place the sperm directly into the uterus through a thin tube. The type and combination of medications and treatment will depend on the underlying problems and individual circumstances.