As is true for virtually all problems we face in life, there is more than one way to approach solving them.
At Gen 5 Fertility, we believe that you should fully understand all of the infertility treatment options that are available to you before you decide. We respect the choice that you make and we work with you to maximize the chance that your choice will be successful. This is not about us, it’s about you.
Gen 5 Fertility has received many accolades on our science behind the treatments we offer. Our Doctors are global leaders in fertility. At Gen 5, you’re in good hands.
Sometimes called “artificial insemination,” IUI infertility treatment involves the placement of specially prepared sperm from the male partner (or donor) into the woman’s womb.
This usually is preceded by ovulation induction, which means taking fertility medications to ovulate or to ovulate better. When the plan is to do an IUI, almost always only an oral pill, either clomiphene citrate (Clomid) or letrozole (Femara), are used. Generally, only 1-3 follicles that can contain mature eggs are produced with these medications. For women who don’t normally ovulate, sometimes only the medication is needed, especially if her partner’s sperm is normal.
Ultrasounds are used as part of the infertility treatment to follow the growth of the follicles. When they get to the right size, they will either ovulate (release the egg) on their own or you will take an injection to cause ovulation. At a time or times based on the expected time of ovulation, the sperm sample is produced and prepared in a laboratory to select the best sperm, and then these are put into the uterus (through the cervix) using a special catheter.
We care very much about these types of cycles and have learned over the years of infertility treatment that outstanding pregnancy rates can be obtained if everything is done as it should be done. We do not pass these off to nurses. Instead a fertility specialist monitors each cycle to ensure that pregnancy rates are as high as possible.
IVF is perhaps the best known infertility treatment under the larger umbrella called “ART”. But what does ART mean anyway? The U.S. Centers for Disease Control & Prevention defines “Assisted Reproductive Technology” as all infertility treatments in which both eggs and sperm are therapeutically processed (or “medically handled”).
This means that for something to be classified as an ART procedure, it must involve surgically removing eggs from a woman, combining these eggs with sperm in a laboratory, and then placing the resulting embryo into the woman’s body—or donating the embryos to someone else. So, strictly speaking, ART does not include treatments where just sperm alone is processed/handled (i.e., intrauterine—or artificial—insemination), or procedures in which a woman takes medicine only to stimulate her egg production without the intention of having eggs surgically retrieved.
At G5F, the full range of fertility treatment options are available—from the simple to most complex.
The world’s first IVF baby, Louise Brown, was born in 1978. Since then more than five million IVF babies have been born worldwide.
IVF is actually a sequence of infertility treatments, involving a number of important steps. These include ovarian stimulation where a woman takes fertility drugs, usually in the form of daily injections, to stimulate her ovaries to produce multiple eggs. The woman is then sedated and the eggs are retrieved using ultrasound guidance. The goal is to collect a safe number of eggs, usually between 8 and 10. Once the eggs are collected, they are mixed with sperm in the lab and left to incubate. Usually, high percentages of the eggs will fertilize and form embryos. Hopefully, many eggs will fertilize properly and then go on to develop into embryos—this laboratory culture process usually takes about five days. Once an embryo has become mature (the “blastocyst” stage), each embryo is tested to see if it appears to be genetically normal. This is done by removing a few cells from each embryo and sending them to a reproductive genetics laboratory for preimplantation genetic screening (PGS). The embryos are then frozen until the results are back and the process of preparing the uterus to receive one of these normal embryos has been completed.
To prepare the uterus, the woman takes other fertility medications to build up the lining of her womb so it is ready to receive and accommodate the resulting embryos.
The embryo is then “transferred” to the woman’s womb. While it is up to individual clinics to decide how many embryos are transferred it is usually just one to two. The best practice is to limit the number transferred in order to avoid multiple pregnancies (twins and triplets) which are high-risk pregnancies. Any additional genetically normal embryos remain frozen so that they can be used later if that needs to be done.
At Gen 5 Fertility we almost always transfer only one embryo, because after genetically testing using PGS and then only transferring normal embryos, pregnancy rates are very high. Thus we almost always only do single embryo transfers (SET) because it is much safer to carry one rather than two (or more) fetuses and because there is a minimal increase in pregnancy rate rate by transferring a second embryo.
In very exceptional cases (usually in older women), up to two embryos may be transferred.
The infertility treatment, ICSI is a method of assisted fertilization which was originally used in cases where a man has a very low sperm count or poor sperm motility (movement). With standard IVF, approximately 100,000 sperm are put in with each egg and placed overnight in an incubator where the hope is that one sperm will fertilize each egg. With ICSI, a single sperm is injected directly into the egg. As time has passed, the use of ICSI has greatly increased so that now the majority of IVF cycles involve ICSI even if no sperm problems appear to be present.
Success rates for IVF drop considerably after a woman reaches age 40, so some couples turn to eggs donated from a younger woman. In IVF with donor eggs, the process is exactly the same as described above except that the donor undergoes ovarian stimulation and egg collection. The donor eggs are then mixed with the male partner’s sperm and the embryo transferred into the woman’s womb.
Because the young donors will produce young eggs, the success rate for IVF with donor eggs is far higher.
This is a special kind of x-ray “dye test” that is performed by a radiologist to gain information about the uterus and Fallopian tubes.
The HSG provides information about anatomical problems that might contribute to infertility
There is no specific cut-off age for IVF. All women are different. Some go through irreversible menopause at an early age while others remain fertile long after the average woman has entered menopause. We treat every woman as an individual and do not create meaningless artificial cutoffs.
There are several tests that may be needed prior to fertility treatment. The tests chosen are individualized for you. You may have already done some of these tests recently. If you are able to provide your recent test results, we are pleased to accept them. We don’t want you to repeat any tests unnecessarily. Contact us for detailed information.
In general, we do not do embryo transfers for women over the age of 59. Pregnancy is a challenging process and we want to do everything possible to make sure that both the pregnant patient and the baby remain healthy throughout the process.
At Gen 5 Fertility we assisted a patient at the age of 59 achieve pregnancy.
For cervical or intrauterine inseminations, fresh sperm has a much higher pregnancy rate than frozen. However, there is no difference between using fresh and frozen sperm for IVF/ICSI procedures and many of our patients choose to use frozen sperm
“Mini-IVF” means very different things to different fertility specialists. About the only commonality to these various definitions is that low (or lower) doses of fertility medication are used during treatment cycles. At some centers, anesthesia is rarely used and patients are seen less often. Gen 5 is well known for its novel approach to mini-IVF. Although studies indicate that in many cases, pregnancy rates are lower with min-IVF as opposed to standard IVF, Gen 5 is expert at determining which patients can do well with this type of treatment. In some cases, it is the patient that decides to do Mini-IVF because they feel more comfortable with a gentle approach to IVF. We would be happy to discuss this option with you.
Over the years Dr. Wood has developed a way of doing embryo transfers that is very different than almost any other fertility specialist. Everything from how the cervix is prepared prior the transfer to how the actual transfer is performed in unique to Gen 5. Virtually all of Dr. Wood’s transfers are done under vaginal ultrasound guidance while the vast majority of embryo transfers done around the work are still done using an older method that commonly involves an uncomfortable full bladder and an abdominal ultrasound. There is a better way to do embryo transfers and Gen 5 is pleased to be leading the way.
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