If you are among the millions of women and men who are struggling with infertility, you’re not alone. The experts at VCU Health Reproductive Medicine are here to offer real solutions and a variety of options to help you on your journey to parenthood.

As a starting point, this guide will provide you with solid information about our fertility services and answer many of your questions.

We invite you to come for a consultation with our reproductive medicine specialists.

So let’s get started.

Infertility: What is the definition?Simply stated, infertility means that a woman has not been able to get pregnant after one year of having intercourse without any birth control or protection, or six months if she is over the age of 35. Infertility can also apply to women who can get pregnant but miscarry in the first three months.

Pregnancy truly is miraculous when you consider the intricacy of the process. To have a baby:

• A woman must ovulate — release an egg from the ovaries• The egg must be fertilized by a man’s sperm• The fertilized egg must travel through the fallopian tube• The embryo must then attach — or implant — in the uterus• The hormonal and nutritional environment must be able to support the pregnancy to full term

Infertility can happen if a problem occurs in any of these vital steps.To schedule a consultation, call (804) 709-0276.

Guide to Fertility Treatment

Seeking the CauseDuring your consultation, we will discuss your history of periods, surgery or prior pregnancies. We will also discuss your partner’s history at this visit and he/she is encouraged to come but not required. The consultation helps to determine the next step in exploring why you may be having a difficult time getting pregnant.

About one-third of the cases of infertility are caused by factors that affect the woman, one-third by factors that affect the man. For the remaining one-third, the cause may be a combination of problems in both partners or it may be unknown. For many couples, not knowing is the hardest part.

Here are some of the most common causes of infertility:• Problem with ovulation, like polycystic ovary syndrome (PCOS) — a

hormonal imbalance that interferes with normal ovulation. If your periods are irregular or skip months, it may be a sign of an ovulation problem.

• Blocked fallopian tubes, which may be due to a pelvic infection, endometriosis or prior surgery, can affect the ability to be pregnant.

• Physical problems with the structure of the uterus and presence of uterine fibroids are associated with infertility and repeated miscarriages.

• Being overweight or underweight can affect a woman’s ability to get pregnant. Obesity is a problem found in about 50 percent of women with PCOS. Diet and exercise that result in weight loss are likely to improve the frequency of ovulation and enhance a woman’s ability to get pregnant. We will help you understand the best ways to optimize your weight for pregnancy.

• Male infertility may result from the absence of sperm, a low sperm count, abnormally shaped sperm or poor movement of the sperm (motility). The shape of the sperm — called morphology — can affect the ability of the sperm to fertilize the egg. Physical injury, infection or other damage to the reproductive system may block the sperm. In rare cases infertility in men is due to a genetic disease such as cystic fibrosis.

• Social changes have affected fertility rates in our country as more women choose to wait until their late 30s or 40s before starting a family. In fact, roughly 20 percent of women in the United States now have their first child after age 35. Age contributes to infertility in women in a variety of ways. Older women have fewer eggs and their eggs have poorer quality. With all these factors combined, about one-third of couples in which the woman is age 35 or older have fertility problems. We do see age-related fertility decline in men but usually not until their 50s.

We offer comprehensive testing and evaluation for both women and men — to help you understand why getting pregnant has been a challenge.

Some of the evaluations you may have include:

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Infertility Factors

affect women

affect men

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of both

• Blood tests for hormone levels• An ultrasound to check for follicles

or cysts• Semen analysis for the man

• A hysterosalpingogram (HSG) — an x-ray test to check the uterus and determine if the fallopian tubes are open

New Options, New HopeThe advances in reproductive medicine in the past 30 years are astounding, bringing new hope to couples who are struggling to get pregnant. The physicians and staff at VCU Health are on top of the latest changes and improvements in the field.

• Depending on the causes of infertility, a range of medications may be used to help infertile couples. Ovulation disorders are some of the easier problems to treat with medication.

• In some cases, when a structural problem exists, surgery can increase the chances of natural conception. Women may benefit from surgery to treat endometriosis or uterine fibroids or to repair the fallopian tubes. Men may have a vasectomy reversed or varicocele (varicose veins in the scrotum) repaired by a urologist.

• Most fertility cases can be treated with medication or surgery alone, but sometimes more advanced interventions are needed. One example is intrauterine insemination (IUI) — often called artificial insemination. IUI is a procedure in which sperm are processed in the laboratory, washed, concentrated and placed in a special culture fluid — then placed into the woman’s uterus at the time of ovulation to facilitate fertilization.

• Assisted reproductive technology (ART) or in vitro fertilization (IVF) refers to a whole class of fertility treatments that involve removing the eggs from a woman’s body, mixing them with sperm to create an embryo and then transferring the embryos back into the woman’s body. Sometimes assistive reproductive technology procedures rely upon eggs, sperm or embryos that were donated by others — allowing a woman to experience pregnancy and birth, even though the baby may not be her biological child.

• Women with ovaries but no uterus, or those who should not become pregnant due to health issues, may be able to use a surrogate or gestational carrier. Using IVF, the mother’s egg is fertilized by the father’s sperm and the embryo is placed in the gestational carrier’s uterus. The biological mother and father are the legal parents after the birth of the baby.

• As more and more women opt to delay childbearing, egg freezing offers a solution to the rapid decline in fertility women experience after the age of 35. For example, a woman can have her eggs frozen at age 30 and saved for the future. Then, if she wants to start a family at age 42, she can have her frozen eggs fertilized and the embryos transferred back into her body. As far as her fertility is concerned, she will only be 30 years old.  

The specialists at VCU Health Reproductive Medicine will provide you with a personalized approach to addressing your fertility issues — from a complete evaluation to offering options for treatment — all delivered with respect and compassion. Most of our testing and treatment is performed at our state-of-the-art facility at Stony Point 9109.

Even with health insurance, the out-of-pocket expenses associated with infertility treatment can be significant. We will explore your insurance to determine what is covered for you. If you have no coverage, VCU Health Reproductive Medicine offers a variety of pricing options, refund programs and guarantees for patients who qualify. We’ll be happy to discuss financial options and work with you to make growing your family possible.

Meet Our Team of ExpertsRichard S. Lucidi, MD | Reproductive Endocrinologist and Infertility Specialist Dr. Lucidi, division director, completed his medical school training at St. Louis University, followed by his residency training in OB/GYN at the University of South Florida in Tampa. He then completed a fellowship in reproductive endocrinology at the University of Texas Health Science Center at San Antonio. He is board certified in OB/GYN and reproductive endocrinology and infertility. In 2010, Dr. Lucidi was named the first director of the newly established division of reproductive endocrinology and infertility at VCU Health. In addition to patient care, he enjoys teaching medical students and residents and engaging in clinical research in polycystic ovary syndrome and in vitro fertilization.

Nancy Durso, MD | Reproductive Endocrinologist and Infertility Specialist Dr. Durso completed her medical school training at the University of Virginia. She then went to St. Louis University for her residency in OB/GYN and to Washington University in St. Louis for her fellowship in reproductive endocrinology and infertility. She is board certified in OB/GYN and reproductive endocrinology and infertility. Dr. Durso was drawn to the field of infertility by her desire to help couples build their family. Over the past 25-plus years that Dr. Durso has practiced medicine, she has seen many exciting changes and improvements in IVF treatment.

Making Your Dream Possible

Jeannette Brown, MSN, WHNP-BC, RNC-OB, CEFM | Nurse PractitionerJeannette has over 30 years of experience caring for females from adolescents to women of reproductive age, and she has worked in both hospital and clinical settings. She received a diploma in nursing from Albany Medical Center School of Nursing in Albany, New York; a bachelor of science degree in nursing from George Mason University in Fairfax, Virginia; and a master of science in nursing from the University of Phoenix in Phoenix, Arizona.

Anil Dubey, PhD | High-Complexity Clinical Laboratory DirectorDr. Dubey completed his formal education in India where he received a PhD in reproductive physiology in 1977 from the Cancer Research Institute, University of Mumbai. He completed post-doctoral research at AIIMS New Delhi, Cambridge University and the University of Pittsburgh. He has been working in the field of medical-assisted reproduction and in vitro fertilization for over 25 years. 

Reem Khaldi, MS | Senior EmbryologistAt VCU Reproductive Medicine & IVF, Reem is responsible for all aspects of the Andrology & Embryology laboratories. She is a skilled embryologist and expert in ICSI, embryo biopsy and egg/embryo freezing. Reem enjoys working in the clinical and academic environment because it allows her to help couples achieve a positive outcome and gives her the opportunity to be part of future advancement in this dynamic and growing field.

Reece Watson, MS | EmbryologistReece is an embryologist in the VCU Andrology and Embryology lab. He began his career as an embryologist in 2015 in Connecticut before moving to Richmond in 2017. He is a graduate of The University of Alabama where he received both a bachelor’s and master’s degree in biology, focusing on genetics. Reece was drawn to the field of embryology because it gives him the opportunity to provide the ultimate gift of a healthy baby to patients struggling with infertility.

Christine Kroll, BSN | Clinical Nurse CoordinatorChristine has worked more than 28 years as a practicing nurse, and she loves all aspects of women’s health. She has worked in the areas of labor and delivery, newborn nursery, antepartum (high-risk pregnant patients), postpartum, OB/GYN emergency room and infertility. She attended VCU’s School of Nursing and is now proud to work for VCU Health.

Courtney Waltman, BSN | IVF Coordinator Courtney has a bachelor of science degree in biology and nursing from VCU. She holds a certification in ambulatory care nursing and has a background in medical-surgical nursing and enjoys working in her role as the IVF coordinator.

Wendy Lindsey, LPN | Infertility NurseWendy has been a nurse for 19 years and has enjoyed working in the OB/GYN field for her entire career, including the mother/infant unit, GYN surgery and ambulatory/outpatient women’s health. 

Kimberlyn Vaughan, NCP | Nursing Care Partner Kim has been a certified nurse assistant for 15 years. She has devoted her entire career to caring for women and children.

Tonya Porter | Business ManagerTonya grew up in Buckingham County and relocated to Chesterfield many years ago. She has been with VCU OB/GYN for 20 years but with Reproductive Medicine for almost two years. She is currently pursuing a bachelor of science degree with a concentration in health care administration.

Our new state-of-the-art facility is conveniently located at: VCU Health at Stony Point 9109Third Floor9109 Stony Point DriveRichmond, Virginia 23235Ample free parking is available.

To schedule a consultation, call (804) 709-0276.

Meet Our Team of Experts (cont.)