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Community Reproductive Endocrinology experiences success
We are pleased to share that Community Reproductive Endocrinology's ongoing clinical pregnancy rate is 75% (9/12; 2009-2010). The ultrasound gallery below showcases some of our success stories. Check back regularly for more new beginnings!
Congratulations Holly and Joey on the birth of your son!
Date: May 21, 2010
Weight: 7 pounds, 8 ounces
Length: 20 inches
Picture coming soon! Read their success story below.
Genesis and Gary
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Genesis and Gary were unable to get pregnant due to Genesis not having regular ovulation. She had conceived her first child after using injections of ovarian stimulating medication. Now, the couple wanted another baby. After trying on their own for six months, they saw Dr. Carnovale. He recommended trying clomiphene for ovulation induction before using the injectible medications again. At her baseline ultrasound before taking clomiphene, Genesis was found to have an ovarian cyst. Dr. Carnovale advised her to wait for the cyst to shrink on its own before using the clomiphene. After two months, the cyst had shrunk and Genesis was able to take the clomiphene. She developed two mature follicles and took HCG to induce egg release. Intrauterine insemination, or IUI, was added to improve the couple’s chances. After their first try Genesis was pregnant. They have been referred back to her ob/gyn for ongoing care.
Katie and Jason
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Katie and Jason (not their real name) had been trying for two years to have another child. At 35, Katie was concerned about her advancing age. Before seeing Dr. Carnovale the couple had tried two attempts at ovulation stimulation with injections of hormones. After Dr. Carnovale’s evaluation of Katie in May 2010, he recommended that she undergo a laparoscopy to look for and treat endometriosis. Later that month he performed a robotically-assisted laser vaporization of the endometriosis he found near and on Katie's reproductive organs. In July, the first month the couple tried again to conceive, Katie found out she was pregnant. She has a healthy pregnancy and is now back under the care of her ob/gyn.
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Endometriosis on Katie’s ovary. The ovary is also stuck to the side of her pelvis as a result of a scar due to endometriosis. |
Atypical endometriosis on the outside surface of Katie’s uterus |
Meredith and James
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Meredith was unable to conceive as a result of James being sterile after cancer treatment. At 32 years of age, Meredith was ready to have another child. Before seeing Dr. Carnovale in April 2010, she had undergone six donor insemination cycles without success. After evaluating her, Dr. Carnovale recommended that Meredith have a laparoscopy to look for and treat any pelvic abnormalities before additional donor insemination cycles were done. In May 2010, Meredith underwent the planned surgery at which time one of her tubes was repaired, endometriosis was treated and scar tissue was removed. After her second donor insemination following the surgery, Meredith found out she was pregnant. Happily, her first ultrasound showed a healthy baby developing as expected.
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Meredith’s left fallopian tube with scarring and damage |
da Vinci robot-assisted repair of Meredith’s tube |
Endometriosis and filmy scarring on Meredith’s right ovary |
Marita
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Marita went to Dr. Carnovale after not being able to get pregnant for more than fourteen months. At age twenty-five, she had been having heavy and painful menstrual cramps for quite some time. During Marita’s visit, Dr. Carnovale examined her and determined that she was at high risk for pelvic endometriosis. Dr. Carnovale suggested that she undergo a laparoscopy with laser treatment using the da Vinci surgical robot if endometriosis was found.
Marita underwent surgery in March 2010, at which time she was diagnosed with, and treated for, endometriosis. Dr. Carnovale had Marita wait until May to start trying to conceive again. In the first week of June, Marita found out she was pregnant! Marita is now under the care of a Community obstetrician and expects to deliver in February 2011.
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Close-up of endometriosis attached to pelvic side of uterus |
Endometriosis deep in pelvis behind cervix about to be vaporized with laser energy using the da Vinci robotic system |
Dewana and Sean
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Dewana had undergone a tubal ligation in 1999 after the birth of her last child. Since that time, she and her husband, Sean, decided they wanted more children. Dr. Carnovale reviewed the couple's history and discussed the options available to them to reverse or bypass Dewana's tubal sterilization. The couple needed to choose between an operation to put Dewana's tubes back together and in vitro fertilization (IVF) to bypass her blocked tubes. The couple decided on in vitro fertilization. Happily, after an unsuccessful fresh cycle, a later frozen embryo transfer of two blastocyst stage embryos resulted in Dewana becoming pregnant with twins. At thirty-seven years old, Dewana is excited to be expecting again!
Megan and Chris
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Endometriosis - endometrial tissue trapped under the pelvic lining |
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Endometrial tissue leaking out during laser treatment |
Megan and Chris had been trying to conceive for eighteen months without any success. At 28 years of age, Megan was eager to become pregnant. During the time they had been trying, the couple had used clomiphene (Clomid) two times to improve their chances of having a baby. In January 2010, the couple saw Dr. Carnovale for a fertility consultation. After carefully reviewing the couple’s history, Dr. Carnovale suspected that Megan might have pelvic endometriosis contributing to her infertility. Dr. Carnovale suggested that in addition to testing Megan’s ovarian health, that a laparoscopy be performed. At the time of the laparoscopy, Megan’s fallopian tubes would be tested, and any endometriosis found would be treated. Dr. Carnovale also recommended that Chris have his sperm tested to ensure that there was not a male factor contributing to the couple’s infertility.
In early March 2010, Megan underwent an outpatient laparoscopy, at which time her tubes were flushed and pelvic endometriosis around her reproductive organs was diagnosed and treated (see images at right). Two weeks later, Dr. Carnovale reviewed the couple’s testing and findings from the laparoscopy. At that visit, Dr. Carnovale recommended that Megan and Chris try on their own for three to six months before moving on to more intensive fertility treatments. Happily, in the second week of April, Megan discovered that she was pregnant. Megan and Chris are looking forward to the birth of their first child, expected in December 2010.
Nancy and Edward
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By age 29, Nancy had been pregnant twice, but unfortunately each time the pregnancy did not develop as expected. Nancy and her husband, Edward, consulted Dr. Carnovale in February 2010 for further advice on how they could improve their chances of having a successful pregnancy. Dr. Carnovale suggested testing to look for possible causes for the couple’s pregnancy difficulties. Soon after that visit, Nancy was pregnant again. Dr. Carnovale prescribed hormones and other medicine for Nancy to take in order to improve her chances of carrying the pregnancy to term. Happily, Nancy’s pregnancy is going well and she has been referred to her obstetrician for ongoing care.
Erin and Kevin
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Erin and her husband had been trying to have another child for a while. Erin had very irregular menstrual periods due to Polycystic Ovarian Syndrome. Her husband Kevin was told that he had a low normal sperm count, but had never had a full semen analysis. Erin had also tried getting her ovaries to produce better eggs with clomiphene a number of times with no luck. The couple met with Dr. Carnovale in October 2009. At that visit, Dr. Carnovale recommended that further testing be done to better direct the treatment plan. Erin was scheduled to have her tubes checked with a hysterosalpingogram and Kevin was scheduled for a semen analysis. Dr. Carnovale explained to the couple that if the testing results were normal, further ovulation induction would be appropriate. Before Erin had her hysterosalpingogram, Kevin’s semen report showed that his sperm had very poor morphology, or structure. This meant that there was very little chance for natural fertilization to occur. Dr. Carnovale canceled the tubal evaluation for Erin and advised the couple that in vitro fertilization (IVF) with direct sperm injection was recommended (with direct sperm injection, the sperm problem could be corrected). The couple decided to do in vitro fertilization with sperm injection in December 2009. After Erin’s eggs were removed from her body, Dr. Carnovale and Dr. Boldt met with the couple to discuss the number of embryos to be transferred. After discussion about the expected pregnancy and multiple pregnancy rate with one and two embryos replaced, single embryo transfer was recommended. This was suggested because Erin and Kevin had produced a good number of very healthy embryos, Erin was thirty years old, and the couple already had a child. The couple is now expecting their second child. At their first ultrasound, a single healthy developing baby was seen.
Lindsay and Doug
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Lindsay and Doug had been trying for four years to have another child. When Lindsay saw Dr. Carnovale, she was 32 years old. Over the preceding year she had been through numerous cycles where she had been taking injections to stimulate egg development within her ovaries. This was combined with intrauterine insemination with her husband's sperm. Twice she became pregnant, but both times the pregnancies were abnormal. The first pregnancy had taken hold in her fallopian tube and was causing Lindsay to bleed internally. Fortunately, she underwent surgery and the bleeding was stopped and the abnormal pregnancy was removed. The second pregnancy, about a year later, was lost as a result of a miscarriage. Lindsay and Doug met with Dr. Carnovale in October 2009. At that time he suggested that, based upon Lindsay’s history, the best approach would be in vitro fertilization (IVF). He further discussed with them that he would place the embryo a little lower into her uterus to decrease the chance of it floating up into her fallopian tube from the uterine side. This would help reduce the chances of another ectopic pregnancy. Dr. Carnovale and Dr. Boldt met with Lindsay and Doug after Lindsay’s eggs were removed from her body and fertilized with Doug’s sperm. Based on the high quality of her embryos, the number of embryos that were developing well, Lindsay’s age, and the fact that they had a child, it was recommended that only a single embryo be transferred. Lindsay and Doug knew that transferring one embryo would decrease their chance of a pregnancy slightly with that attempt. The couple also knew that the benefit of this approach was a much lower chance for a multiple pregnancy. The day after her 33rd birthday, Lindsay had one beautiful blastocyst embryo put back into her uterus. Happily, she is now pregnant with a single, well-developing baby.
Jessica and Kristopher
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Jessica and Kristopher had been trying to have a child for a little less than a year. Jessica had been told she had Polycystic Ovarian Syndrome, or PCOS. This caused her not to ovulate on a regular or predictable time schedule. The couple had tried a cycle of clomiphene ovulation induction without success prior to their visit with Dr. Carnovale at Community Reproductive Endocrinology. After reviewing their history, Dr. Carnovale reassured Jessica and Kristopher that their chances of becoming pregnant were very favorable. Dr. Carnovale recommended that Jessica undergo a test to ensure that her fallopian tubes were open. Dr. Carnovale further explained that sometimes the process of passing dye through the fallopian tubes during the test clears them out and improves fertility. After it was confirmed that Jessica’s tubes were open, Dr. Carnovale prescribed ultrasound monitored clomiphene ovulation induction. Once a mature follicle was developed, Jessica took a shot of medication to release the egg into the tube, and an insemination with Kristopher’s sperm was performed thirty-six hours later. Happily, the procedure worked on the first attempt. Surprisingly, despite having only one follicle, Jessica had a twin pregnancy. Dr. Carnovale explained to Jessica and Kristopher that it is likely that the egg that was fertilized had split after 2-3 days and resulted in identical twins in two separate sacs.
Linda and William
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Linda and William had been trying to have a child for more than three years. Linda had been treated with multiple clomiphene cycles without success. She also tried the more powerful injectible medications to stimulate her ovaries, which unfortunately did not work despite more than seven attempts. In September 2009 she consulted Dr. Carnovale for another opinion about what her options were to have a child. At the age of 41, Linda knew her chances of having her own child were rapidly diminishing. After reviewing her past treatments and performing some tests to determine Linda’s ovarian reserve, Dr. Carnovale recommended in vitro fertilization (IVF). In November 2009, Linda and William completed their IVF cycle and were elated to find out that they were expecting twins.
Jennifer and George
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Before coming to Community Reproductive Endocrinology, Jennifer and George had been trying for three years to have a child. During that time, Jennifer had been treated with six cycles of clomiphene citrate ovulation induction. With two of those cycles, intrauterine insemination, or IUI was added to increase the likelihood of success. Unfortunately, those efforts were unsuccessful. During the couple’s evaluation, it was determined that there was a problem with fertilization. In 2006, the couple decided to undergo in vitro fertilization (IVF). Unfortunately, that attempt was also unsuccessful. In July 2009, Jennifer and George met with Dr. Carnovale for an initial consultation, at which time it was recommended that the couple try another IVF cycle. Based on the concern that there were problems with fertilization, intracytoplasmic sperm injection (ICSI) was planned to be part of the procedure. In November 2009, Jennifer had recently turned 37 years old, and the couple underwent in vitro fertilization combined with ICSI. The ICSI procedure was performed in the Assisted Fertility lab under the direction of Dr. Jeffrey Boldt. Following a discussion on the likelihood of pregnancy and multiple gestation with one or two embryos transferred back into Jennifer’s uterus, the couple decided on two. Happily, they conceived, and Jennifer’s first ultrasound seen here shows the couple’s twins. Jennifer and George are thrilled with how everything turned out!
Holly and Joey
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Holly and Joey had been unable to have a child because of poor semen quality. It was unlikely that without in vitro fertilization (IVF) the couple would ever conceive. The couple decided that instead of IVF, they would adopt an embryo from the National Embryo Donation Center. After being accepted into the embryo adoption/donation program, the couple was ready for the embryo transfer process to begin. Dr. Jeffrey Boldt, director of Assisted Fertility Services at Community Hospitals of Indiana, has worked very closely with the National Embryo Donation Center for many years. Holly and Joey met with Dr. Boldt and Dr. Carnovale to arrange for the embryos from Knoxville, where the NEDC is based, to be shipped to the Assisted Fertility lab in Indianapolis. Under Dr. Carnovale’s direction, Holly was given medication that developed the lining of her uterus to allow her to receive an embryo and carry a pregnancy. Happily, Holly is now pregnant and under the care of her OB/GYN.
Kelly and Justin
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Kelly and her husband, Justin, had been trying for more than three years to have a baby. Before seeing Dr. Carnovale, they had undergone multiple cycles of ovulation induction and one IVF. Unfortunately, despite getting pregnant after the IVF cycle, Kelly had a miscarriage. Luckily, they had a number of eggs frozen as a result of the IVF cycle. The eggs were frozen in the Assisted Fertility Center laboratory under the direction of Jeffrey P. Boldt, Ph.D., a leading authority in the worldon this technology. After meeting with Dr. Carnovale and Dr. Boldt, Kelly and Justin decided to undergo a frozen egg embryo transfer cycle, or FEET. By doing a FEET cycle, Kelly did not need to undergo another complete IVF cycle. Her eggs were thawed and inseminated with Justin’s sperm. Coordinated with the egg thaw and insemination, Kelly took medications so that her uterus would be prepared to receive the embryos formed. Happily, the FEET worked, and Kelly and Justin are now expecting their first child.
Kimber and Adam
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Kimber was unable to get pregnant after seven years of trying with her husband, Adam. Before seeing Dr. Carnovale they had undergone an unsuccessful IVF and subsequent frozen egg cycle. After carefully reviewing their history and examining Kimber, Dr. Carnovale recommended that they try another IVF cycle. Suspicious that Kimber also had endometriosis, Dr. Carnovale suggested that she undergo a laparoscopy to treat her pelvic pain and painful menstrual periods. Dr. Carnovale told them that treating endometriosis before the IVF would also improve their chances of having a baby. Happily, after her endometriosis was treated in August 2009, and before the IVF was needed, Kimber found out she was pregnant in October. The pregnancy is progressing well and Kimber has returned to her OB/GYN for ongoing care.