INTRAUTERINE INSEMINATION - IUI
Intrauterine insemination with partner's sperm can be used as a potentially effective treatment for infertility of all causes in women under about age 45 except for cases with tubal blockage, severe tubal damage, very poor egg quantity and quality, ovarian failure (menopause), and severe male factor infertility. In vitro fertilization with the woman's eggs or IVF with donor eggs are alternatives for couples that are not candidates for artificial insemination.

It is most commonly used for infertility associated with endometriosis, unexplained infertility, anovulatory infertility, very mild degrees of male factor infertility, cervical infertility and for some couples with immunological abnormalities.

It is reasonable initial treatment that should be utilized for a maximum of about 3-6 months in women who are ovulating (releasing eggs) on their own.

IN VITRO FERTILIZATION - IVF
There are five major steps in the IVF and embryo transfer sequence:
- Monitor the development of ripening egg(s) in the ovaries.
- Collect eggs
- Obtain sperm
- Put eggs and sperm together in the laboratory, and provide
   correct conditions for fertilization and early embryo growth.
- Transfer embryos into the uterus.
The retrieval of the eggs is performed transvaginally using a hollow needle guided by the ultrasound image, a method completely comfortable under adequate sedation and local anesthesia.

INTRACYTOPLASMIC SPERM INJECTION - ICSI
If the sperm are considered less likely than usual to achieve fertilization, intracytoplasmic sperm injection (ICSI) into each egg is performed using special micromanipulation equipment. The sperm and eggs are then placed into incubators and examined carefully at intervals to ensure that fertilization and cell division have taken place; the fertilized eggs are now called embryos.

Embryos are ready to be placed in the wife's uterus 2 to 5 days after egg retrieval. Transfer of embryos at about 5 days post-retrieval is often referred to as blastocyst transfer. A speculum is inserted into the entrance of the uterus and the embryos, suspended in a tiny drop of fluid, are very gently introduced through a catheter into the womb, often under ultrasound guidance. The embryo transfer is followed by a brief period of rest. Subsequent blood tests and ultrasound examinations are used to determine if pregnancy has been successfully established.

Indications for intracytoplasmic sperm injection
- very low numbers of motile sperm
- severe teratospermia
- problems with sperm binding to and penetrating the egg.
- antisperm antibodies thought to be the cause of infertility
- prior or repeated fertilization failure with standard IVF methods
-Frozen sperm limited in number and quality
- Obstruction of the male reproductive tract not amenable to repair. Sperm
  may then be obtained from the epididymis by a procedure called
  microsurgical epididymal sperm aspiration ( MESA ), or from the testes by
  testicular sperm aspiration (TESA)

Patients from outside Lebanon
Numerous patients from abroad have obtained IVF and ICSI treatment at the PMC. During a treatment cycle, the female member of an IVF couple must generally be in area for approximately one week. We will help with the arrangement of suitable accommodations as required. The husband must be available the day of egg recovery (unless special arrangements are made for prior sperm cryopreservation), and is welcome to be present for the embryo transfer.