What is it?
SOURCE is Stimulated Ovulation with Uterine Recovery of Capacitated Enhanced sperm. The procedure was developed in the In Vitro Fertilization (IVF or test-tube baby) process as a treatment for women with normal fallopian tubes. SOURCE is a combination of stimulated ovulation using Gonadotropins (Pergonal/Humegon/Repronex(HMG) and/or FSH (Follistim or Gonal–F) and and intrauterine insemination (IUI).
What does it involve?
SOURCE usually involves taking HMG/FSH injections starting on day 3 of the menstrual cycle and continuing for 5 to 10 days until the eggs are mature. Patients are taught how to give the injections of HMG/FSH at home each day. Starting on day 7-8 of the cycle, estrogen blood tests and vaginal ultrasound examinations are done each morning to follow development of the eggs in the ovaries. When the eggs are found to be mature, an injection of HCG (human chorionic gonadotropin) is given to induce ovulation. The intrauterine insemination with the washed sperm sample from the husband is then performed 24-36 hours later in the office.
How does it work?
SOURCE is thought to correct a number of fertility problems. Stimulation of ovulation with gonadotropins improves the development of the egg and often provides more than one egg per cycle for fertilization. Estrogen levels in SOURCE cycles are much higher than in an unstimulated or clomiphene cycle and may improve development of the endometrium (lining of the uterus). Stimulated ovulation may also correct luteal phase (ovulation) defects and improve the chances of successful implantation of the fertilized egg. Finally, intrauterine insemination of washed sperm provides a larger number of healthy sperm high in the uterus where they are closer to the eggs.
Who can SOURCE help?
SOURCE is recommended for couples with ovulation problems, unexplained infertility, male infertility problems, and endometriosis. The woman must have at least one normal fallopian tube. One to three cycles of SOURCE are now frequently recommended for couples before attempting I.V.F. or G.I.F.T.
Are there any problems with SOURCE?
SOURCE is a relatively expensive treatment because it uses gonadotropins and requires several visits and blood tests each month. The cost is much less than I.V.F. or G.I.F.T. but more than many other treatment options. HMG/FSH treatment is rarely associated with ovarian hyperstimulation syndrome (OHSS), a serious condition with multiple ovarian cysts and fluid imbalances. Up to 25% of SOURCE pregnancies are multiple pregnancies. The great majority of these multiple pregnancies are twins but triplets or more can rarely occur.
How successful is SOURCE?
Studies at the University of Washington and the University of Oregon Medical Schools as well as our center have shown a pregnancy rate of 15-18% per treatment cycle for the SOURCE procedure. This rate is close to the natural spontaneous rate for normal couples (18-20%) and compares favorably to the G.I.F.T. (30%) and I.V.F. (40%) pregnancy rates in large previous studies.