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The new, simplified
techniques of IN VITRO FERTILIZATION (IVF)
include OFFICE BASED IVF, TUFT and "EMBRYO
IMPLANTATION".
Because there are many causes of infertility, not
every procedure is right for everyone. Each
couple's history and situation must be carefully
evaluated to determine the most appropriate
procedure for them.
Who is a
candidate for the office based IVF?
Couples with a variety of infertility
disorders, such as tubal disease, endometrioses,
male factor, unexplained infertility, immunological
infertility, hormone inbalance and uterine
fibroids.
How is it
done?
In the office based IVF, the egg(s) is removed
by vaginal ultrasound aspiration from both ovaries
in the doctor's office. The egg (s) is mixed with
sperm and placed in a small dish which is then kept
in the incubator for 2-5 days. At that time, the
fertilized egg(s) is then transferred to the uterus
through a small catheter.
This method is applied to both the unstimulated and
the stimulated cycles. The stimulated cycle has a
higher yield. For some women, TUFT, or
"EMBRYO
IMPLANTATION",
is better.
How did the
advances come about?
In-Vitro Fertilization, now referred to as
Standard IVF, was one of the great medical
breakthroughs of our time. However, the original
procedure has some serious drawbacks. It put the
mother and baby (or babies) at high risk by
utilizing large quantities of hormones.
Additionally, Standard IVF requires the use of
sophisticated equipment and hospital based
procedures, which make the procedure too expensive
for most couples.
A few years ago,
those high risks were discussed at length at the
World Congress on Infertility. Reproductive
specialists from around the globe expressed their
deep concern over the problems associated with IVF.
They made a commitment to cooperate and collaborate
in finding new ways of making IVF safer and less
expensive. Shortly after, experience with natural
cycle In-Vitro Fertilization was renewed. This has
enabled us to provide a full spectrum of Assisted
Reproductive Technologies (ART) at a lower cost
than the standard IVF while maintaining the same
efficiency.
How do the costs
compare?
The evolving procedures cost about one half the
average cost of Standard IVF, and some insurance
companies are covering this cost.
How do the
success rates of the Office Based IVF compare with
the success rates of standard IVF?
Success rates compare very favorably. With standard
IVF, the success rate is globally approximately
15%. The Office based IVF is 20% (not statistically
significantly different) and we hope that with the
use of "EMBRYO
IMPLANTATION"
this will be even higher with elimination of
ectopic pregnancies.
What are the key
factors in the Office Based IVF?
To begin with, each woman is individualized as
to the dosage requirements for stimulation of the
ovaries. This will depend upon the woman's age,
diagnosis, and male factor. Once the egg(s) is
ready for ovulation, it(they) is removed under
local anesthesia and light sedation in the doctor's
office. The egg(s) is then mixed with sperm, or the
sperm is injected microscopically into the egg and
left in a small dish in the incubator. After two
days they are evaluated as to the degree of growth.
If too many embryos with potential viability are
obtained by day two (based on a multifactorial
computer generated analysis), they are then
incubated three extra days to let nature help us to
better differentiate the true potential of those
embryos (All eggs/embryos do not have the same
potential to become true viable pregnancies) i.e.
the apparently two days old and growing embryos
with no potential for a viable pregnancy will not
make it to five days. This is how long it takes in
nature for the embryos to get to the uterus anyway.
They are then transferred to the uterus in the
office through a small catheter and
glued
into the uterus. In some of these situations the
extra embryos are then frozen.
What are other
advantages of the Office Based IVF?
- While
maintaining a relatively high successful
pregnancy rate with minimal cycle cancellation
rate.
- No
hospitalization is necessary for any part of
this procedure. Therefore, you will save the
cost of general anesthsia, surgery room and
post-anesthesia recovery.
- Recovery after
the procedure is faster as no general anesthesia
is given.
- The procedures
are accomplished in short office visits, so
patients are able to follow a normal daily
routine throughout the IVF period.
- There is no
need for use of any further blood components in
these processes.
- Patients
benefit psychologically because they are able to
participate actively in the process.
- With the use of
"EMBRYO
IMPLANTATION"
ectopic pregnancies from IVF is
eliminated.
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