FERTILITY CENTER OPTIONS
The Fertility Center conducts the complete in vitro fertilization process. Starting with ovulation induction to stimulate ovaries, eggs are harvested through an ultrasound-guided technique. The retrieved eggs are fertilized and grown in a laboratory for 3 to 5 days after which the embryos are transferred to the uterus.
For women who have had embryos frozen from a prior IVF cycle, the process of frozen embryo transfer is available during which thawed embryos are placed into the uterus.
Intracytoplasmic Sperm Injection (ICSI)
Intracytoplasmic Sperm Injection (ICSI) (pronounced "ICK-see") is a procedure used in conjunction with IVF in which a laboratory technician, using a microscope, attempts to inject a single sperm directly into each egg. ICSI is often used if the male partner has very low sperm count, low sperm motility, or poor quality sperm. If fertilization occurs after ICSI, the embryo may then be transferred into the uterus.
The use of ICSI and these sperm extraction techniques has greatly improved the ability of Reproductive Endocrinologists to treat male factor infertility. However, these treatments are not effective for men who do not produce any sperm at all. In these cases, donor sperm would be necessary.
Preimplantation Genetic Diagnosis (PGD)
Preimplantation Genetic Diagnosis (PGD) is a technique that can be used during in vitro fertilization (IVF) to test embryos for a variety of genetic disorders. PGD testing is done before the embryo is transferred to the uterus. This would allow you and your partner to decrease the risk of having a child with a serious inherited disorder.
When is PGD used?
PGD is generally used with couples who have lost pregnancies due to genetic disorders, who already have one child with a genetic problem, or who are carriers of a genetic disease. The procedure may detect Down syndrome, cystic fibrosis, hemophilia A, Tay-Sachs disease, and Turner syndrome, along with other disorders.
PGD is performed in the laboratory by removing a single cell from each embryo. This cell is then analyzed for the presence of genetic disorders. Once a diagnosis is made, which usually takes about a day, only unaffected embryos are transferred back into a woman's uterus.
Embryo Freezing
Cryopreservation, also known as "freezing," involves storing embryos at a very low temperature so that they can be thawed and used later. Many fertility clinics now offer patients this option.
There are many reasons for using cryopreservation. It is often done when there are more embryos than are needed for a single in vitro fertilization (IVF) cycle. The extra embryos are saved and potentially used during later cycles.
IVF success rates are generally lower with frozen embryos than with freshly fertilized embryos, although pregnancy rates with frozen embryos have been improving in recent years. The survival rate after thawing often depends on the quality of the embryos at the time of freezing.
Donor Egg Program
Egg donation provides a wonderful option for many couples who otherwise would have no hope of having a genetically related child. There are many reasons why a woman may not be able to use her own eggs including, premature ovarian failure, diminished ovarian reserve, her eggs may not fertilize and develop, advanced age, failed IVF cycles for unexplained reasons, and others.
Who Are the Egg Donors?
Egg donors may be "known", such as a sibling or family friend, or they may be anonymous. We currently use several agencies to provide donors. Donors are usually aged 21-35 years and they undergo careful screening including a complete physical, genetic screening to reduce the possibly of transmitting inheritable diseases, testing for sexually transmitted diseases including AIDS, psychological examination, and drug screening. If an anonymous donor is chosen, personal characteristics such as height, weight, hair and eye color, educational background, and sexual preference will be divulged.
Donor Egg Program Success Rates
Donor success rates are among the best. The pregnancy rate coincides with the donor's age group. For example, if a 21-year-old donor's eggs are transferred to a 37-year-old recipient, the success rates equals or exceeds that of the 21-year-old age group.
Donors undergo ovulation induction with follicle stimulating hormone to cause there ovaries to recruit numerous follicles each of which contains an egg.
Egg donors must regularly visit our center during the stimulation cycle for measurement of blood estradiol levels and ultrasound evaluations. Once the eggs are mature an injection of hCG is given and retrieval is scheduled 36 hours later.
The donor undergoes ovulation induction and the recipient receives hormones to prepare her uterus to accept a developing embryo, a process known as cycle synchronization. Her endometrium (lining of the uterus) must thicken and become more vascular to provide nourishment to the embryo.
What Happens the Day of the Egg Retrieval?
The couple arrives at our clinic on the day of egg retrieval. The male provides a semen specimen for use in the IVF cycle. Once the eggs are retrieved they are placed in petri dishes and exposed to the sperm. If the semen quality warrants it, individual sperm are injected directly into the eggs through a process known as intracytoplasmic sperm injection (ICSI). The inseminated eggs are placed in an incubator where they remain for 3-5 days.
The couple returns to the clinic where the physician discusses the number and quality of the embryos available for transfer or freezing. Since multiple pregnancies are highly likely with egg donation, we often recommend transferring two embryos to the uterus. The remaining viable embryos can be frozen for future use. The embryos are placed into the recipient mother's uterus using a small catheter in a painless procedure, using sonogram guidance.
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