By David R. Meldrum, M. D.

Traditionally, most women desiring fertility after tubal sterilization have been advised to have major surgery to repair the tubes. Since the success rate with surgery is higher than with one cycle of IVF, it is more cost-effective despite having required “open” major surgery. Surgery also avoids the risks associated with multiple pregnancy, which are more common with IVF.
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By Denise L. Cassidenti, M. D.

The use of third party reproduction has increased dramatically over the last several years. The term third party reproduction is used when another person (i.e., egg donor, surrogate or gestational host) is involved in the process of conceiving or carrying the pregnancy. Medically, the idea of using either an egg donor or a gestational or traditional surrogate is not novel. Although in our minds it is obvious who the “parents ” are and to whom the child belongs, the legal system doesn’t necessarily recognize our common sense approach. Legally the concept of parentage is not as clear as it may seem. This article will discuss some of the legal issues regarding third party reproduction.
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by David R. Meldrum, M. D.

GnRH agonists have been routinely used for IVF cycles since they prevent ovulation before egg retrieval, improve the ovarian response, and increase the success rate approximately two-fold over IVF cycles without use of a GnRH agonist. These benefits are produced by suppression of luteinizing hormone (LH). Leuprolide acetate (Lupron) has been the most common GnRH agonist used for IVF, although Synarel (a form given by nasal spray) has been tried with similar success. Lupron is given by injections under the skin, sometimes overlapping with an oral contraceptive, but often given starting about one week after ovulation.
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An Update
by I. Lane Wong, M.D.

Chances are if you have irregular periods, you have heard of the term “Polycystic Ovary Syndrome (PCOS).”

The goals of this article are to define PCOS, describe how it causes infertility, and outline its treatment. PCOS is truly a syndrome because its specific cause is not well understood, known or agreed upon. In contrast to a specific disease, a syndrome is a group of symptoms and signs that are recognized to be associated with each other but without a common specific cause.
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