Although our main focus is on infertility treatments, at PREG we also offer many other services to diagnose other gynecological challenges. We also offer evaluation and treatment of pubertal disorders, menopause, and other complicated gynecological problems. For more information about available services, please review the list below, explore our website, or contact us today to schedule an appointment.
- Female Infertility
- Male Infertility
- Female Reproductive Tract Abnormalities
- Premature Menopause or Early Ovarian Failure
- Recurrent Miscarriages
- Polycystic Ovarian Syndrome (PCOS)
- Menopausal Hormone Replacement Therapy
- Pubertal and Sexual Development Disorders
- Abnormal Uterine (Menstrual) Bleeding
- Abnormal or Excessive Hair Growth/Loss (Hirsutism)
Saline Infusion Sonohysterogram
A vaginal probe ultrasound test using warmed water and a small catheter to evaluate the inside of the uterine cavity to check for any abnormalities such as polyps (benign tissue growth), fibroids (benign uterine muscle tumor) or scar tissue.
- Semen Analysis
Anti-sperm Antibody Testing
Antibodies against sperm that can interfere with the normal function of the sperm such as motility and fertilization. Antibodies can be from either the male (against his own sperm) or the female (against her partner's sperm).
Cycle day 3 Follicle stimulating hormone (FSH) and Estradiol levels. Day 3 FSH and Estradiol levels can give an indication of how well the ovaries are working, especially in older women. Generally, levels of FSH should be <10 mIU/ml and Estradiol <50 pg/ml on cycle day 3 (depending on the reference lab). An elevated day 3 FSH/Estradiol level may signify that the ovary is struggling and showing signs of advanced ovarian aging.
Clomiphene Citrate Challenge Test (CCCT)
A series of blood tests to measure how well the ovary responds. Clomiphene Citrate (Clomid, Serophene) 100 mgs (two pills) is taken on cycle days 5 through 9. A cycle day 3 and a cycle day 10 FSH and Estradiol levels are obtained to evaluate the response of the ovary before and after stimulation by a fertility medication (Clomid).
- Ovulation Induction
- Clomiphene Citrate
Usually taken daily for 5 days beginning on cycle day 3 through 7. Can also be started on cycle day 4 or 5 for a total of 5 days. Doses range from 2.5 mgs (one pill) up to 5 mgs (two pills). Letrozole works through the brain as well to cause release of FSH. Side effects include hot flashes, mood swings, decreased cervical mucus and possible thinning of lining of uterus (endometrium). Monthly pregnancy success rates with the use of Letrozole ovulation induction/ IUI is 5-12% per cycle. Multiple birth rates is approximately 10% with the majority of multiple pregnancies being twins. Medication costs: 5 day course at 2.5 mgs/day; $40 to $60 depending on place of purchase.
Minimal Stimulation Protocol
Combination of either Clomiphene Citrate (CC) or Letrozole (LT) and injectable gonadotropins. Usually recommended if failure to ovulate with CC or LT alone, no pregnancy after 3-6 cycles of CC or LT, or persistently thin (<6 mm) uterine lining (endometrium). CC or LT for 5 days usually beginning on cycle day (CD) 3. Gonadotropins (usually use Repronex due to lower cost) 2 ampules on IM on CD 7 and CD 9. Follicle scan on CD 12. If follicles are not of appropriate size (>18 mm) a repeat follicle scan may be ordered 2-3 days later. hCG (Pregnyl) to be given when appropriate to trigger or boost ovulation. Can be done with timed intercourse or intrauterine insemination. Monthly pregnancy success rates; 8-15% per cycle. Multiple birth rates is approximately 10% with the majority of multiple pregnancies being twins.
- Stimulated Ovulation Induction Protocol
Follicle Scans (transvaginal ultrasound)
Vaginal probe ultrasound performed to evaluate the ovaries' response to fertility medications and the development of follicles (egg sacs). Usually scheduled on cycle day 12 and may be repeated 2-3 days later if needed. Also used to evaluate the thickness of the uterine lining (endometrium). Generally, a endometrial thickness >8 mm is considered to be adequate for implantation and pregnancy. A persistently thin lining (<6 mm) could be detrimental for implantation of a developing embryo.
hCG injections for ovulation triggering
hCG (human chorionic gonadotropin; Pregnyl, Profasi, Ovidrel) is an injectable medication given intramuscular (IM, in the muscle, usually thigh or buttocks) that can trigger or boost ovulation to better time intercourse or intrauterine insemination (IUI). hCG is usually given when there are mature ovarian follicles (egg sacs) seen on vaginal ultrasound (size >18 to 22 mm) or in conjunction with a positive urine LH surge detection kit. Usually given in a dose of 10,000 units of hCG per vial. You will be instructed on how and when to give hCG.
- Intrauterine Inseminations (IUI)
- Donor Inseminations (D-IUI)
- Assisted Reproductive Technologies (IVF) (A Guide for Patients) ASRM 2008
- In Vitro Fertilization (IVF)
- Minimal IVF
- Donor Egg IVF Program
- Intracytoplasmic Sperm Injection (ICSI)
- PGD (Pre-Implantation Genetic Diagnosis) or PGS (Pre-Implantation Genetic Screening)
- Microsurgical Tubal Reversal (Anastomosis)
- Laparoscopic and Hysteroscopic Surgery
- Laparoscopic and Abdominal Myomectomy (Removal of Fibroids)
- Acupuncture and Oriental Medicine is available at PREG provided by Acupuncture Center of Greenville, Cassandra Nelson, L.Ac.
- Individual and Couples' Therapy Sessions are available with Amy Wood, MMFT, LMFT-I, CC of Upstate Family Solutions
- Fertility Counseling - Click here to read more.