Assisted reproductive technology (ART)
ART (Assisted Reproductive Technology) refers to all treatment used to assist in achieving a pregnancy and Includes fertility treatments that handle both a woman's egg and a man's sperm. In vitro fertilization (IVF) is the most common and most effective type of ART. ART procedures sometimes use donor eggs, donor sperm, or previously frozen embryos. It may also involve a surrogate or gestational carrier.
Intrauterine Insemination
IUI
Intrauterine Insemination
IUI is a fertility treatment that involves placing sperm directly into the uterus during the time of ovulation to facilitate fertilization. Before the insemination procedure, you may take fertility medicine to stimulate your ovulation period and increase the chances of fertilization. This process shortens the time and distance a sperm has to travel up the fallopian tube and makes it easier to fertilize the egg.
How does IUI work?
Before IUI takes place, medications may be used to stimulate ovulation, which requires careful monitoring to determine when the eggs are mature. The IUI procedure will then be performed around the time of ovulation, which is generally about 24-36 hours after the LH hormone increases, which indicates that ovulation will occur soon.
The lab washes a semen sample and separates the sperm from the seminal fluid and cellular debris. Then the sperm is inserted directly into the uterus with a catheter. This process improves the possibility of conception by increasing the number of sperm cells that are placed in the uterus.
The IUI procedure takes only a few minutes and involves minimal discomfort.
How Successful is IUI?
Several things play a part in the likelihood of IUI’s success. Success rates may reach as high as 20% per cycle if a couple has the IUI procedure performed each month. Individual success rates depend on the female’s age, the reason for infertility, and whether fertility drugs were used, among other variables.
Pregnancy rates for IUI are lower than those from IVF, but IUI is a less invasive and less expensive option. If you think you may be interested in IUI, you can call our office to set up a consultation and discuss with our doctors
In Vitro Fertilization
IVF
In Vitro Fertilization
IVF is a method of assisted reproduction that involves combining an egg with sperm in a laboratory dish. If the egg fertilizes and begins cell division, the resulting embryo is transferred into the woman’s uterus where it will hopefully implant in the uterine lining and further develop. IVF may be performed in conjunction with medications that stimulate the ovaries to produce multiple eggs in order to increase the chances of successful fertilization and implantation
Conventional IVF
For many patients, conventional IVF is the fastest route to a successful pregnancy. In conventional IVF, a woman receives individually tailored medications in order to stimulate many eggs to grow and develop. During this stimulation, she is monitored in our office every 2-3 days and the medications are adjusted on a daily basis to achieve the best outcome. When the eggs are ready, a procedure is performed in our office (“egg retrieval”) to collect the eggs and prepare them for fertilization. After retrieval, the eggs are fertilized with sperm and allowed to develop in our laboratory for 3-5 days. These resulting embryo (s) are ultimately transferred in the uterus at the optimal time, allowing for implantation and development of a pregnancy
While we are experts in a wide variety of treatments, conventional IVF remains a safe and effective method for the majority of people. In many patients, conventional IVF gives them the opportunity to create a larger number of eggs and therefore a larger number of healthy embryos, ultimately increasing the chances of pregnancy. Furthermore, many of our patients completing conventional IVF have “extra” embryos that can be frozen for future us.
Mild IVF
Mild IVF (low dose, minimal stimulation) is the best option for women who want a little more stimulation than a natural IVF cycle, but less than is required for a conventional fully stimulated IVF cycle.
Natural Cycle IVF
Natural Cycle IVF enables women to complete the IVF process with little to no medication at all. Using individualized protocols, our patients are monitored during their normal menstrual cycles. At the best time for the patient, a naturally selected egg (s) is retrieved, fertilized in our laboratory, and grown in our laboratory. The resulting embryo is then transferred back into the patient or frozen for future use.
Benefits of Natural cycle IVF:
• Improved outcomes in select patients – In many women, IVF using conventional methods fails. Without the use of high doses of medications, some women may have improved outcomes
• Less medication use – Fertility drugs can sometimes lead to unwanted side effects, including headache, gastrointestinal discomfort, nausea, breast tenderness, or hot flashes may occur. By avoiding these medications, a woman can complete the IVF process without worry about these side effects
• No risk of ovarian hyperstimulation syndrome – Some women taking fertility drugs experience a condition known as ovarian hyperstimulation syndrome (OHSS). Symptoms may include vomiting, diarrhea, pain in the area of the ovaries, dark urine, decreased urination, rapid weight gain, or shortness of breath. Severe cases can even require hospitalization and are associated with bad pregnancy outcomes.
• Less monitoring – Conventional IVF requires considerable monitoring through blood tests and ultrasounds. Although there will still be some monitoring with natural cycle IVF, Natural Cycle IVF requires >50% fewer visits.
In Vitro Maturation
IVM
In Vitro Maturation
In-Vitro Maturation is a safe unique alternative to IVF with more than 5000 healthy IVM babies born worldwide. Instead of requiring women to take hormones, the immature and undeveloped eggs are removed and developed outside the body. Once developed, the mature eggs are then fertilized in the lab and grow to be healthy embryos. Using IVM, women can create multiple viable embryos without using high doses of injectable hormones, limiting side effects, lowering the risk of overstimulation, and eliminating the inconvenience of taking multiple injections.
In contrast to many IVF Centers, we do not discard immature eggs. Instead, if immature oocytes are obtained at egg retrieval, our embryologists will mature those eggs in our labs, providing our patients with a better chance of getting pregnant.
How does IVM work?
A doctor will surgically collect the patient’s immature eggs from small ovarian follicles with little to no stimulation medications. The immature eggs are then placed in cell culture, sent to our lab and cultured in special media containing follicle-stimulating hormone to improve their chance of reaching maturity. Generally, Intracytoplasmic Sperm Injection (ICSI) is used to manually fertilize the matured eggs with the sperm sample. Once the eggs are fertilized, the doctor will perform a minor surgical procedure to insert the embryos into the perspective patient.
Natural Cycle with IVM
Natural Cycle IVF with IVM is a type of IVF cycle that is similar to Natural Cycle IVF. A patient will be stimulated for approximately 3 days to mature the eggs. In addition to retrieving mature eggs, immature eggs from the smaller follicles will also be retrieved and matured in our labs.
Who can benefit from IVM?
• Women who want to take fewer medications when completing the IVF process
• Women with Polycystic Ovarian Syndrome (PCOS)
• Women in remission or recovery from hormone-sensitive cancers, such as breast cancer
• Women with a high risk of Ovarian Hyperstimulation Syndrome (OHSS)
• Women who have had severe side effects from hormonal medications
Elective Single Embryo Transfer
eSET
Elective Single Embryo Transfer
Elective single-embryo transfer (eSET) is when a woman undergoing IVF chooses to have a single embryo transferred when multiple embryos are available. The primary goal of eSET is to decrease the rate of multiple pregnancies associated with IVF. Transferring more than one embryo increases the chances of having multiple pregnancies. (twins, triplets, etc.)
How to choose the best embryo?
To pick the highest quality embryo, our lab will perform an assessment looking at the number and size of the cells, the rate of development, and other factors to determine if the embryos are strong enough to survive. After the assessments finished, the lab director will determine which is the highest quality embryo. While there is no reliable way of determining which embryo will produce a fetus, eSET allows us to determine which embryo has a relatively higher chance of growing.
Natural Cycle with IVM
Natural Cycle IVF with IVM is a type of IVF cycle that is similar to Natural Cycle IVF. A patient will be stimulated for approximately 3 days to mature the eggs. In addition to retrieving mature eggs, immature eggs from the smaller follicles will also be retrieved and matured in our labs.
Who can benefit from IVM?
• Women who want to take fewer medications when completing the IVF process
• Women with Polycystic Ovarian Syndrome (PCOS)
• Women in remission or recovery from hormone-sensitive cancers, such as breast cancer
• Women with a high risk of Ovarian Hyperstimulation Syndrome (OHSS)
• Women who have had severe side effects from hormonal medications
Fertility Preservation
Egg Freezing
Freezing eggs and egg banking, also called oocyte cryopreservation, is a relatively new method of fertility preservation where a mature, unfertilized egg is retrieved from a woman, frozen and stored for future use.
Women can potentially extend their fertility by preserving their eggs for future use. We offer this treatment using the most advanced technologies available, all within our small, personalized, boutique center.
How does it work?
Women who want to freeze their eggs take daily injections for 8-10 days and are monitored in our center every 2-3 days. When the eggs are ready, a procedure is performed in our office (“egg retrieval”) to collect the eggs and prepare them for freezing. Using the most advanced vitrification technique, the eggs are flash-frozen and stored in our center for future use. Patients may return to our office to use their eggs if, when, and how they choose to
Who should freeze their eggs?
1. Women who want to preserve their eggs at their highest quality.
2. Women who are single or married, with a partner or without a partner.
3. Women who will be receiving radiation and/or chemotherapy for cancer treatment.
4. Women who need to have their ovaries removed for any reason.
5. Women with a genetic history of early menopause, endometriosis, or premature ovarian failure.
Egg Freezing Process
1. Hormone Injections: Our nurses give you 1 on 1 instruction on how to administer these medications. Most women tolerate these shots very well, the main side effects being bloating and discomfort similar to a heavy period.
2. Monitoring: While taking hormone injections, our doctors monitor the growth of the eggs with ultrasounds and blood tests every 2-3 days. Typically, patients need 3-4 monitoring visits, each lasting about 10 minutes.
3. Egg Retrieval: When the eggs are ready to be frozen, our doctors perform the egg retrieval procedure. Under light sedation, the eggs are removed vaginally, without the need for incisions or stitches. The procedure lasts about 10 minutes and the patients go home in about an hour, resuming regular activities the next day.
4. Egg Freezing: After retrieval, the eggs are evaluated in our laboratory and frozen shortly after the procedure. Eggs are stored in liquid nitrogen tanks and can be stored, transported, or thawed at any time.
Our program includes:
Patient Screening
Patient Monitoring
Anesthesia
Egg retrieval
Egg freezing
Egg storage for 2 years
Our program excludes:
Patient cycle medications
Embryo banking
Embryo Freezing
Women can potentially extend their fertility by preserving their embryos for future use. We offer this treatment using the most advanced technologies available, all within our small, personalized, boutique center.
The ProcessThe procedure consists of retrieving the eggs from a woman’s ovary and transferring them to the embryology laboratory. The egg is then combined with sperm in the lab to form embryos. The embryos are then frozen and can later be thawed and placed in a woman’s uterus.
Ideal Patients
Embryo freezing may be useful for women with cancer who want to have children after having radiation therapy, chemotherapy, or certain types of surgery, which can cause infertility. This treatment cycle can be done with or without stimulation medications before the cancer treatments. It is known as one of the safest protocols for the individual. The patient is monitored for some time to determine the ideal time to retrieve her eggs to be inseminated, cultured in our lab, and frozen as embryos.
Our program includes:
Patient Screening & Monitoring
Anesthesia
Egg retrieval
IVF
PGS Biopsy & Testing
Embryo & Sperm storage for 2 years
Our program excludes:
Patient cycle medications
