Ovarian Hyperstimulation Syndrome (OHS): Its Evolution & Reducing its Incumbent Risks.

Ovarian hyperstimulation syndrome (OHS) is a condition where a woman
receiving fertility drugs (usually gonadotropins) over-responds by
developing a large number of ovarian follicles which upon
administration of hCG, “triggers” a series of systemic events that
can place the woman’s health and even her very life at risk. The
development of OHS is linked to the effect of hCG and thus does not
arise until the “hCG trigger” is administered. In fact, the woman
is not at risk until t…

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Sher-IVF Success Rate

Given rapidly changing practices in the IVF arena, it is becoming
increasingly implausible to reliably interpret current national
reports expressing IVF outcome statistics as birth rate per initiated
treatment cycle, per egg retrieval procedure or per embryo transfer
procedure performed…AND here is why:

* There has with good justification been a strong move to perform
embr…

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IVF SUCCESS RATE EXPRESSED AS VIABLE PREGNANCY RATE PER EMBRYO TRANSFERRED (PRPE): A PROPOSED NEW PRADIGM FOR IMPROVED AND VERIFIABLE REPORTING OF IVF STATISTICS

Given rapidly changing practices in the IVF arena, it is becoming
increasingly implausible to reliably interpret current national
reports expressing IVF outcome statistics as birth rate per initiated
treatment cycle, per egg retrieval procedure or per embryo transfer
procedure performed.  …AND here is why:

* There has with good justification been a strong move to perform
embryo transfers on day 5-6 (blastocyst-ET) rather than on day 3. Such
practice has inevitably resulted in…

IVF SUCCESS RATE EXPRESSED AS VIABLE PREGNANCY RATE PER EMBRYO TRANSFERRED (PRPE): A PROPOSED NEW PRADIGM FOR IMPROVED AND VERIFIABLE REPORTING OF IVF STATISTICS Read More »

Genetically Testing IVF Embryos

Preimplantation genetic testing (PGT) involves testing
pre-implantation embryos for chromosomal numerical abnormalities
(aneuploidy). Preimplantation genetic diagnosis (PGD) involves genetic
testing of embryos for specific genetic conditions. The objective of
both PGT and PGD is to identify embryos that are aneuploid or
genetically defective so as to selectively transfer the most
“competent” so as to improve embryo implantation potential, reduce
the risk o…

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Management of Immunologic Implantation Dysfunction (IID)

In the United States, effective treatment of NK/CTL activation
associated with either alloimmune or autoimmune implantation
dysfunction requires the administration of primarily Intralipid (IL).
Such treatment is much more likely to be successful in the case of`
autoimmune implantation dysfunction where the NK/CTL activation is
present in advance of the uterus being exposed to the embryo. It is
not nearly as effective for the treatment of alloimmune implantatio…

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Management of Immunologic Implantation Dysfunction (IID) 2

In the United States, effective treatment of  natural killer cell
/cytotoxic lymphocyte (NK/CTL)-activation associated with either
alloimmune or autoimmune implantation dysfunction requires the
administration of primarily Intralipid (IL) or Intravenous
gamma-globulin (IVIg). Such treatment is much more likely to be
successful in the case of` autoimmune implantation dysfunction where
the NK/CTL activation is present in advance of the uterus being
exposed to the embryo. It is not nearly a…

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Does Frozen Embryo Transfer (FET) Improve IVF Success?

_“I AM IN FULL AGREEMENT WITH RESEARCHERS AT__ CAMBRIDGE UNIVERSITY
IN THE UNITED KINGDOM WHO FOLLOWING A RECENT PUBLISHED A REPORT ON
THEIR OBSERVATION THAT FET ENHANCES IVF OUTCOME, STATED THAT THIS
COULD REPRESENT ONE OF THE MOST “EXCITING” IVF REVELATIONS OF THE
LAST  25 YEARS.”_ I am often asked by patients whether there is a
benefit in doing frozen embryo transfers over fresh embryo transfers
and how this decision impacts IVF…

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Performing Embryo Transfer: The “Process”

Embryo transfer (ET) is undoubtedly a rate limiting factor in IVF. The
IVF doctor’s expertise in performing ET is one of the most important
factors determining IVF outcome. It requires the dexterity, skill, and
gentle touch that can only truly come through experience. Of all the
procedures in IVF, this is the most difficult to teach. It is a true
“art” and there is little doubt that many women will fail to
conceive following IVF from a suboptimal transfer technique. Good
quality em…

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IVF: Selecting the Best Quality Embryos to Transfer

The numerical chromosomal configuration of a cell is referred to as
its karyotype or ploidy. A cell with an irregular chromosome number is
referred to as aneuploid while one with a normal karyotype, as
euploid. It is predominantly (but not exclusively) the chromosomal
configuration of the embryo that determines its subsequent ability,
upon reaching a receptive uterine environment, to propagate a normal
pregnancy, also referred to as its “competence.”  A “euploid
(“co…

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