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Infertility Care

At the AHN Center for Reproductive Medicine, we know that you want to be a parent, not a patient. We know that you are stressed and frustrated.  We want you to also know that when you choose Allegheny Health Network for your fertility care, you will be in the hands of a very experienced and caring team of fertility specialists.

Fertility practices come in all sizes. As a smaller program, you can also expect a more personalized experience at Allegheny Health Network, where everyone knows you and your specific circumstances.

If you have questions about our program or would like to schedule an appointment, please call our office at 412.847.1166.

Our office is located at:

9335 McKnight Road
Suite 240
Pittsburgh, PA 15237

Welcome New Patients

Dear Patient:

Welcome to the AHN Center for Reproductive Medicine.

The primary focus of our entire staff is on the evaluation and treatment of all types of reproductive problems. Our goal is to help you achieve a healthy pregnancy as safely, inexpensively and quickly as possible. We see patients with problems related to infertility, miscarriage, and prior sterilization. We also evaluate and treat patients of all ages, from puberty through menopause, with any of the following conditions: abnormal bleeding, excessive hair growth, breast discharge, pituitary disorders, polycystic ovarian syndrome, and/or endometriosis. In addition, we also evaluate and assist in the treatment of men with fertility disorders.

Many patients are referred by another physician. We work with your OB/GYN, urologist, family physician, or internist in handling all of your healthcare issues. We also see patients who are referred by another patient or who have heard about the office from another source.

We do not practice Obstetrics; we refer you back to your obstetrician or other healthcare provider after the first few weeks of your pregnancy. In general, the referring physician will resume care when the problems for which you were referred are resolved, and he/she will continue care and treatment for other unrelated problems while you are a patient with our practice.

If something arises that prevents you from attending your initial appointment, please call us as soon as possible in order to re-schedule. For couples with infertility, we encourage both husband and wife to attend the initial visit together, but if this isn’t possible, there is no need to cancel your appointment. Also, there is no need to cancel your appointment if you happen to be on your period.

In order to make your initial visit as productive as possible, we have enclosed a medical history questionnaire for you to complete and return to us prior to your first visit. We have also enclosed a release of healthcare information form. If you have previously undergone any evaluation or treatment that may relate to your fertility, please sign and send this form to your other physician(s) as soon as possible. We like to receive your records prior to seeing you, so that this information can be reviewed with you at your first visit as well.

The initial visit for a new patient consultation will last approximately one hour. Please be aware that your insurance may not cover some or all of the services provided, so please check with your insurance carrier. We will assist you with insurance issues in any way we can. Please be sure to bring all medical insurance cards with you to your first visit.

Seeing a new physician can be a stressful experience. We will do our best to make all your visits both productive and pleasant. We look forward to meeting you,

Dr. Lori Homa and the AHN Center for Reproductive Medicine Staff

Note: Please print and complete the Infertility History form and bring it with you to your first appointment.

Directions to AHN Center for Reproductive Medicine

We are located at 9335 McKnight Road, Suite 240, McCandless

 

From Points South (Pittsburgh):

  • Take I-279 North for approximately 3 miles to the McKnight Road exit
  • Proceed on McKnight Road for approximately 6 miles
  • Turn Left onto Arcadia Drive at the Outback Steakhouse
  • Make an immediate Left behind the restaurant and proceed to the last building on the Right

 From Points North (Cranberry and Grove City):

  • Take I-79 South to Rte 228 West toward Cranberry Township
  • Turn Left onto Rte 19 South/Perry Highway
  • Continue Straight for 7.3 miles
  • Merge Right onto McKnight Road/US-19 Truck S
  • Continue Straight for 1.9 miles
  • Turn Right onto Arcadia Drive at the Outback Steakhouse
  • Make an immediate Left behind the restaurant and proceed to the last building on the Right

 From Points West (Beaver County):

  • Take I-76 East/PA Turnpike toward Pittsburgh
  • Take US 19, Exit 28 toward Warrendale/Cranberry
  • Turn Left onto Rte 19 South
  • Proceed approximately 7 miles south on Rte 19--merge Right onto McKnight Road
  • Proceed 1.9 miles and turn Right onto Arcadia Drive at the Outback Steakhouse
  • Make an immediate Left behind the restaurant and proceed to the last building on the Right

 From Points East (Monroeville and Murrysville):

  • Take I-376 West/US 22 West toward Pittsburgh
  • Take Boulevard of the Allies, Exit 2B toward I-579/Liberty Bridge
  • Merge onto the Boulevard of the Allies/PA 885 North in downtown Pittsburgh
  • Immediately merge to the Left onto I-579 North
  • Merge again to the Left onto I-279 North
  • Take I-279 North for approximately 3 miles to the McKnight Road exit
  • Take McKnight Road for approximately 6 miles
  • Turn Left onto Arcadia Drive at the Outback Steakhouse
  • Make an immediate Left behind the restaurant and proceed to the last building on the Right

Patient Information

When you are dealing with a health issue, the more information you have, the better. In addition to extensive one-on-one consultations by our nursing staff, we also provide a comprehensive supply of written educational material for you to review at your convenience and to refer back to as needed throughout the duration of your care.

We provide the following Educational Packets (on paper or online) for all of the following treatments:

  • New Patient
  • Infertility
  • Fertility Medications
  • Insemination
  • IVF
  • Donor Insemination
  • Egg Donation

Become an Egg Donor

Our Donor Egg Program helps eligible women donate their eggs to other women who have been unable to conceive due to early menopause, ovarian damage or other issues related to egg quality. Over 10% of all of the IVF cycles in the country now involve the use of donated eggs, which indicates how much of a demand there is for women willing to be egg donors and what a precious gift this is to another woman in need.

What is involved in donating eggs?

Women interested in donating their eggs will first speak with our Donor Egg Coordinator to answer their initial questions and determine their eligibility. Women ages 21 to 32 years of age, who are and in excellent health and with no known genetic or infectious conditions, are eligible to be egg donors.

Once a woman is selected as an egg donor, she will receive a comprehensive physical exam, laboratory testing and genetic and infectious disease screening at no charge. Donors also receive $4,000 compensation.

For more information about the Donor Egg Program, please call 412.847.1166.

Tubal Reversal vs. IVF?

Tubal sterilization (having your “tubes tied” ) is a very common and successful method of permanent contraception. Due to life changes (such as divorce and a new partner) or simply changing your mind about wanting more children, some women regret having had a tubal sterilization and want to know what options they have for another pregnancy. Fortunately, there are two approaches to be considered: (1) tubal reversal surgery (also known as “tubal re-anastomosis” ) or (2) IVF (in vitro fertilization ).

There are pros and cons to each approach. To make the best choice of which approach, we also look for any other fertility issues that may affect the chance of a successful pregnancy (such as your age or an ovulation problem, and the fertility of your partner ).

Tubal Reversal Surgery

There are a number of different ways that the tubes are “tied”: tiny clips or rubber bands that permanently crush a small segment of the tubes, burning a portion of the tubes, or surgically cutting and removing a piece of each fallopian tube. The way in which your sterilization was performed will influence the chances for successful tubal reversal. It is important that you obtain a copy of the “operative report” so we know exactly what type of procedure you had. Reversal of tubal sterilization involves carefully re-connecting the tubes using microsurgical technique. The surgery takes a few hours and may be done as an outpatient or require an overnight hospital stay. Depending on the skill and experience of the surgeon, the surgery may be done laparoscopically or require a somewhat larger abdominal incision.

About three months after the surgery, an X-ray is done to show the flow of dye through the uterus and tubes to determine if one or both tubes are open. If so, pregnancy may occur immediately, or may take up to one to two years. Unfortunately, even if one or both tubes ARE open, pregnancy may still not occur — due to the fact that the tubes are abnormally short, scarred or otherwise not functioning properly to allow the sperm, egg or embryo to pass through normally. This is also the reason that there is an increased chance that if a pregnancy occurs following tubal reversal, the pregnancy may get stuck in the tube (a “tubal” or “ectopic pregnancy”).

The Impact of Age on Success

In addition to the way in which your tubal sterilization was performed, your age is an extremely important predictor of successful tubal reversal. The older you are, the lower the success rate for both tubal reversal surgery and IVF. As a woman ages, the number and quality of her eggs gradually decline. By age 40, there is already a sharp decrease in fertility for most women, even though your periods are continuing normally. If you are older when you start this process, and are anxious to conceive as quickly as possible, IVF is often favored over tubal surgery, since pregnancy can often be achieved much more quickly with IVF. Finally, if your partner has decreased or abnormal sperm quality, even if tubal reversal surgery is successful, the chance for a naturally occurring pregnancy is reduced. In this situation, IVF (which can overcome sperm issues) is the recommended approach. The ideal candidate for a tubal reversal is a younger woman who may want more than one additional child and had a tubal sterilization that blocked only a very short segment of both tubes.

In Vitro Fertilization (IVF )

IVF allows a pregnancy to occur by completely bypassing the blocked fallopian tubes. IVF involves first being placed on medications for about two weeks to stimulate your ovaries to simultaneously produce multiple mature eggs. The eggs are then removed from your ovaries through a brief and minor surgical procedure in which a needle is carefully passed through the vagina and into the ovaries under ultrasound guidance. These eggs are then fertilized in the lab. Three to five days later, one or more embryos will be placed into your uterus. A pregnancy test is obtained two weeks after the embryo transfer. If any extra embryos are left over, they can be frozen for another try later.

Pros and Cons

Some of the advantages of IVF over tubal reversal surgery include:

  • pregnancy may be achieved very quickly
  • no need for an abdominal surgery
  • lower risk of a tubal ( “ectopic” ) pregnancy
  • no need for either you or your partner to undergo future sterilization once you have achieved your desired family

 Because women who have had a tubal sterilization are usually otherwise normally fertile, they may have a better chance of successful IVF than most patients who are doing IVF since they have an underlying fertility problem that is preventing pregnancy. If you are somewhat older and only want one more child with your new partner, IVF may be the best and fastest option for a pregnancy.

IVF is usually more expensive than a tubal reversal surgery. Also, since success rates with IVF increase when more than one embryo is replaced at a time, the chance of twins is increased. The fertility drugs used to stimulate the ovaries for IVF can produce temporary side effects, but there is little or no evidence for any long-term risk from these medications.

Success Rates

IVF statistics are now collected and reported annually for almost every fertility practice in the country. Visit SART.org to see IVF success rates, specific for your age category and for over 400 individual IVF programs throughout the country. For tubal reversal, published studies from several large medical centers over the last three decades report success rates ranging from 25 to 83%. Tubal reversal surgeries are much less common today and most fertility surgeons no longer do a high volume of these procedures. The individual expertise and success of each surgeon may vary widely. Due to the low volume of procedures and the fact that fertility programs do not publish annual success rates for tubal reversal surgery like they do for IVF, age specific and program specific success rates are not readily available for tubal reversal.

Conclusion

As you can see, the choice between tubal reversal surgery and IVF involves many factors and can come down to a matter of personal preference. Overall, you should view your expectations for a successful pregnancy as good. We will do our best to help you make the right choice to achieve a pregnancy as quickly, safely and inexpensively as possible.

What Causes Miscarriage

Miscarriages are a disappointing but normal part of the process of human reproduction. Just as a healthy and successful professional baseball player occasionally strikes out at bat, young, healthy couples may occasionally experience a miscarriage, without any underlying problem being present.

It is well known that in the process of creating human eggs or sperm, the development of genetically abnormal eggs or sperm is fairly common. This is thought to be responsible for the majority of all miscarriages. In most cases, a miscarriage arising from a genetically abnormal egg or sperm is a random, occasional and non-recurring problem, although this risk does increase as women and men age. It is very often hard to prove the cause of an early pregnancy loss, since the pregnancy may be lost before there is any possibility of doing genetic testing.

For couples who experience two or more miscarriages, there are a number of possible causes and tests to try to determine the underlying cause. However, more than half of the time, we are unable to pinpoint a definite cause. Fortunately, in spite of the absence of a specific cause, the majority of couples go on to have a successful pregnancy! Some of the causes and testing for recurrent miscarriages include:

  • uterine abnormalities, such as a birth defect of the uterus that can be detected with ultrasound, X rays, or surgery;
  • genetic disorders that can be detected by examining the chromosomes of the mother, father, or tissue from the miscarriage;
  • certain medical conditions in the mother, such as diabetes or lupus, can increase the risk of miscarriage;
  • there are many other controversial causes of miscarriage, as well as rare conditions known to be associated with an increased risk of miscarriage.

If you have experienced one or more pregnancy losses, we will carefully review your history, medications and lifestyle looking for any potential causes for miscarriage. Once again, even if complete testing fails to find an explanation, your expectations for a successful pregnancy remain generally very good!

For Single Women

The staff at the AHN Center for Reproductive Medicine recognizes that there are many different types of families, including those made up of a single woman and her children. If you are a woman without a male partner and you feel that the time has come to consider being a parent, we welcome you and want to help you achieve your goals and dreams.

Some women will seek to achieve a pregnancy by using sperm from a friend or acquaintance and will do insemination at home. This approach raises concerns about health risks, such as infectious diseases, which can be transmitted from sperm used for insemination, even if you are not sexually intimate with the provider of the sperm.

Our approach involves careful screening to evaluate your overall health and fertility. We only use semen samples that have been thoroughly screened and quarantined to minimize the risk of infectious disease. We can also help you consider the legal, financial and social aspects of single parenthood by choice.

We keep your semen samples frozen on site and your (intrauterine) insemination is timed to optimize your chances of conceiving. We will sometimes recommend additional treatment with fertility medications if needed during your insemination cycles to help with egg development.

If you are considering becoming a single parent by donor insemination, please schedule an appointment for an in depth discussion to help get all of your questions answered. We work at the pace you are comfortable with, and we look forward to meeting and helping you become a parent.

Fertility Options for Same Sex Couples

Becoming a parent is a natural desire for most people, whether gay or straight. At the AHN Center for Reproductive Medicine, we provide the same quality medical care to all of our patients in the most friendly, inclusive way possible. If you feel that the time has come to consider becoming parents together, we welcome you and want to help you achieve your goals and dreams.

A successful pregnancy for a lesbian couple can be achieved a number of ways, from the relatively simple process of insemination using donor sperm to reciprocal IVF, where it is possible for one partner to provide the eggs and the other partner to carry the pregnancy and give birth. Our program offers all aspects of assisted reproductive technologies to fit the needs of a same sex couple who has decided to pursue the joy of parenthood.

Some gay men build their family by using an egg donor to obtain healthy eggs and a gestational surrogate to carry the pregnancy. Eggs can be obtained from anonymous or known donors. In addition to our own egg donors, personally evaluated and screened by our team, we also work with outside donor egg banks so that you can obtain the donor that works best for you.

If you are a same sex couple and are now considering becoming parents, we hope that you will schedule an appointment at the AHN Center for Reproductive Medicine for an in depth discussion to help get all of your questions answered. We work at whatever pace you are comfortable with, and we look forward to meeting you and helping you build your family.

Egg Freezing (Cryopreservation)

Since 2007, an ultra rapid freezing process known as “vitrification” has dramatically improved the success of freezing human eggs. There are several situations in which it may be appropriate to collect and freeze a woman's eggs (oocytes):

  • Egg freezing can be done for women newly diagnosed with cancer before they begin chemotherapy or radiation that might result in egg damage or early menopause;
  • Fertility preservation for women that are concerned that they are aging but not yet ready to have children; their eggs can be frozen and stored for use sometime in the future;  this process can help avoid the reduced ability to conceive as a woman gets older and her egg quality declines;
  • Couples undergoing conventional IVF who prefer not to freeze and store a large number of embryos can freeze some of their excess (unfertilized) eggs instead.

 If you think egg freezing might be right for you, please contact us to schedule an appointment to discuss this process.

Evaluation and Treatment of Male Patients

For couples experiencing difficulty conceiving, evaluation of the male partner is essential because many fertility problems arise from issues related to the man’s sperm quality. When a couple seeks fertility evaluation, the male partner will undergo a complete history, followed by a semen analysis. Sperm testing should be done early in the assessment, so no time is lost and a sperm issue contributing to infertility is not overlooked.   

Sperm testing is conducted in the Andrology Laboratory, adjacent to our office. A semen sample can be collected on site in a private collection room or delivered to the Lab by the man or his partner. One or more semen samples may be required to evaluate a man’s fertility.

Today, we can treat almost any type of sperm disorder, including low sperm counts, decreased sperm motility, or hormone, anatomic or genetic problems affecting male fertility. We work closely with urologists who conduct the medical and surgical aspects of fertility care for men.

Potential treatments for male infertility include hormone therapy, surgery, or artificial (intrauterine) insemination of sperm into their partner’s uterus. In vitro fertilization (IVF) with direct injection of a single sperm (known as Intracytoplasmic sperm injection or ICSI) in eggs that have been collected from the woman has proven to be extremely effective in overcoming problems with decreased sperm quality. In certain cases in which men produce few or no sperm at all, sperm may be successfully retrieved directly from the testes ( known as testicular sperm extraction or TESE ) or from the man’s epididymis. These procedures can also be done to obtain sperm from men who have undergone a previous vasectomy and now wish to again father a pregnancy.    

Our lab also provides sperm cryopreservation and storage (“sperm banking”) for men planning to undergo treatment that could affect sperm quality (such as cancer treatment), for couples undergoing fertility treatment when the man will be out of town for extended periods of time, or prior to a man undergoing permanent sterilization by vasectomy.

Guidance on the Financial Aspects of Your Fertility Care

Insurance coverage for fertility treatments - as well as the financial aspects of your care - can sometimes be very confusing and frustrating. Sometimes, even fairly simple medical care can result in sizable charges and complicated billing statements. Since financial obstacles may pose a bigger challenge to your ability to achieve a successful pregnancy than the medical problems being treated, we have developed some guidelines that may be helpful to you regarding these issues.

You will almost certainly have questions about your financial statements at some point in your treatment. For example, due to the nature of medical billing “cycles,” your most recent billing statement may not always accurately reflect your current balance. Given the complexity of insurance coverage and the way in which medical care is “coded” for processing and payment, mistakes can happen. Don’t panic if you see something that appears to be incorrect. When you have questions about your financial statements, please let us know right away. If there are errors, they can often be easily corrected.

Our financial counselor is here to help you with all the financial aspects of your care and will guide you before, during and after your treatment. In addition to helping you understand your insurance coverage, we will review your insurance benefits, do any necessary pre-certifications, and can address any problems with insurance claims that occur after submission.

While we can’t make the expenses associated with your medical care disappear, we do want to try to minimize the confusion and frustration associated with the billing and insurance reimbursement issues. Please call us if you have questions or concerns.

Preserving Fertility for Women Facing Cancer Treatment

Imagine being a woman who has not yet started her family and being told you require cancer treatment that might permanently damage your ovaries, making a future pregnancy difficult or impossible.

The good news is that many women in this situation can undergo fertility treatment that will allow them to store their eggs or embryos before being exposed to cancer treatment. However, treatment can be expensive and many patients in this situation have no way to pay for this emergency therapy. Allegheny Health Network’s “Fertility Preservation Fund” pays for this treatment for women that qualify.

If you have been diagnosed with cancer and want to determine if fertility preservation is appropriate for you, please call the AHN Center for Reproductive Medicine at 412.578.5588 to schedule an immediate appointment.