Reproductive Endocrinology

Reproductive endocrinology and infertility is a subspecialty of obstetrics and gynaecology that trains physicians in reproductive medicine addressing hormonal functioning as it pertains to reproduction as well as the issue of infertility. While most reproductive endocrinology and infertility specialists primarily focus on the treatment of infertility, reproductive endocrinologists are trained to also evaluate and treat hormonal dysfunctions in females and males outside of infertility. Reproductive endocrinologists have specialty training in obstetrics and gynaecology (ob-gyn) before they undergo sub-specialty training (fellowship) in reproductive endocrinology and infertility.

Assisted reproductive technology (ART) uses special methods to help infertile couples. ART involves handling both the woman's eggs and the man's sperm. Success rates vary and depend on many factors. ART can be expensive and time-consuming. But ART has made it possible for many infertile couples to have children.

• In vitro fertilization (IVF) is a procedure made famous with the 1978 birth of Louise Brown, the world's first "test tube baby." IVF is often used when a woman's fallopian tubes are blocked or when a man has low sperm counts. A drug is used to stimulate the ovaries to produce multiple eggs. Once mature, the eggs are removed and placed in a culture dish with the man's sperm for fertilization. After about 40 hours, the eggs are examined to see if they have become fertilized by the sperm and are dividing into cells. These fertilized eggs (embryos) are then placed in the woman's uterus, thus bypassing the fallopian tubes.
• Gamete intrafallopian transfer (GIFT) is similar to IVF, but used when the woman has at least one normal fallopian tube. Eggs are placed in the fallopian tube, along with the man's sperm, for fertilization inside the woman's body.
• Zygote intrafallopian transfer (ZIFT), also called tubal embryo transfer, combines IVF and GIFT. The eggs retrieved from the woman's ovaries are fertilized in the lab and placed in the fallopian tubes rather than the uterus. ART procedures sometimes involve the use of donor eggs (eggs from another woman) or previously frozen embryos. Donor eggs may be used if a woman has impaired ovaries or has a genetic disease that could be passed on to her baby.