THE BOTTOM LINE IS THAT BECAUSE OF THE TRAUMATIC EFFECT OF FREEZING ON
EGG VIABILITY AND “COMPETENCY” THE STATISTICAL CHANCE OF EACH
FROZEN/ THAWED EGG ULTIMATELY RESULTING IN A BABY IS ONLY AT BEST
6-8%. SO, WHILE SUCCESS RATES FOLLOWING THE TRANSFER OF EMBRYOS
DERIVED FROM FROZEN EGGS HAVE INDEED IMPROVED SUBSTANTIALLY OVER THE
LAST 5-10 YEARS, THEY REMAIN SIGNIFICANTLY LOWER THAN WHEN EMBRYOS
DERIVED THROUGH FERTILIZATION OF FRESH (NOT FROZEN) EGGS, ARE
TRANSFERRED. …

Prolactin (PRL) is a protein hormone (closely related to human growth
hormone
[/blog/human-growth-hormone-administration-in-ivf-does-it-enhance-eggembryo-quality-and-outcome/])
that is secreted by specialized cells in the anterior part of the
pituitary gland. In addition, the hormone is also produced and
secreted by a broad range of other cells in the body, most prominently
variou…

…

Geoffrey Sher MD & Drew Tortoriello MD
Mini-IVF is a procedure that involves ovarian stimulation with oral
fertility drugs such as clomiphene or letrozole to promote the
development of follicles, for egg extraction. This is on the pretext
that Mini-IVF, involves the administration of oral low-dosage
medication, cuts down on cost, reduces the need for intensive
monitoring and is highly successful. Natural-cycle (NC)- IVF is an
extension of the same concept….

With the launching of Sher-Fertility Solutions (SFS), I will as of
April 1st, take on a new and expanded consultation role. Rather than
having hands-on involvement with IVF procedures I will, through SFS,
instead provide fertility consultations (via SKYPE) to the
ever-growing number of patients (emanating from >40 countries) who
have complex Reproductive Dysfunction (RD) and who seek access to my
input , advice and guidance. Subject to agreement on the part of their
personal RE’s, I hope…

SHER-FERTILITY SOLUTIONS (SFS)  Through SFS, I provide online
fertility consultations (via SKYPE and FaceTime) to an ever-growing
number of patients (from >40 countries) with complex Reproductive
Dysfunction (RD) who seek access to my input and services. I now
perform IVF and related procedures on a 3-monthly basis at Los Angeles
IVF Clinic (LAIVF) in Century city, Los Angeles. I no longer perform
hands-on IVF treatments at SIRM-Las…

This February 13th is the day you get closer to having the family of
your dreams. Join SFS Fertility Las Vegas for a patient-focused
seminar where you can: ✨ Win a Donated IVF Cycle ✔️ Schedule a
Free Consult to Review Your Records

* Meet The New SFS Fertility Team
* Learn About other Financial Opportunities for all Patients
…

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…

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…

Today, due to a myriad of factors, IVF is regarded as one of the main
thoroughfares for helping couples achieve the goal of creating a
family. However, no two IVF candidates are exactly alike and there is
no single approach that is applicable to every patient. In the final
analysis, success requires a careful analysis of the variables known
to affect outcome in combination with a very individualized and
customized approach to treatment, judicious and selective…

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 ploidy 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 (“competent”)
embryo tr…

[CASE REPORT]_THIS IS A RE-POST FOR PURPOSES OF FOLLOW-UP (SEE
POST-SCRIPT AT THE END)._BACKGROUND: Mary, 30 years of age and married
to a fertile male partner
[/blog/diagnosing-treating-male-factor-infertility/], presented to me
about four years ago with primary

Because of the emotional, physical, and financial toll
[/blog/cost-of-ivf-treatment/] exacted by IVF, it is preferable that
no one undertake a one‑shot attempt. If a couple can only afford one
treatment cycle, IVF is probably not the right course of action. 
After all, with conventional IVF there is only about one chance in
three that it will result in a live birth ‑and a tremendous letdown
if it fails. It is thus unreasonable to undergo IVF…

Polycystic ovary syndrome (PCOS)
[/blog/new-ivf-outcome-patients-polycystic-ovarian-syndrome-pcos/] is
a common hormonal system disorder among women affecting between 5% and
10% of women of reproductive age worldwide. Women with PCOS may have
enlarged ovaries that contain multiple small collections of fluid
(subcapsular microcysts) that are arranged like a “string of
pearls” immediately below the ovarian su…

Many infertile patients, are erroneously advised by their physicians
to first try IUI
[/blog/reflecting-upon-use-misuse-intrauterine-insemination-iui-time-serious-reality-check/]
several times before resorting to IVF. Additionally many misguided
insurance providers often, purely for economic
[/blog/ivf-the-economic-realities/] reasons, req…

It is primarily the egg (rather than the sperm) that determines the
chromosomal integrity (karyotype) of the embryo, the most important
determinant of egg/embryo competency
[/blog/ivf-factors-affecting-egg-embryo-competency-during-controlled-ovarian-stimulation-cos/].
A “competent” egg is therefore one that has a normal karyotype and
has the best potential to pro…

Polycystic ovary syndrome (PCOS)
[/blog/understanding-polycystic-ovarian-syndrome-pcos-and-the-need-to-customize-ovarian-stimulation-protocols-sfs/]
is a common hormonal system disorder among women affecting between 5%
and 10% of women of reproductive age worldwide. Women with PCOS may
have enlarged ovaries that contain multiple small collections of fluid
(subc…

Mini-IVF is a procedure that involves ovarian stimulation using low
dosage medications (often oral drugs like clomiphene
[/blog/clomiphene-induction-ovulation-use-misuse/] and letrozole)
under the premise that it is a “safer” and less expensive than
conventional gonadotropin stimulation regimes while yielding
comparable success. Nothing could be further from the truth. The fact
is that success rates per fresh mini-IVF cycl…

Advanced endometriosis is often associated with ovarian endometriotic
cysts, known as endometriomas. The cysts contain decomposed menstrual
blood that looks like melted chocolate – hence the name
“chocolate cysts.” They are space occupying cystic lesions within
the ovarian connective tissue (stroma/theca) and if sizable (>1cm)
often will activate the surrounding tissue to produce excessive
amounts of male hormones (androgens) such as testosterone and
androstenedione that can compr…

Staggered-IVF involves the use of Preimplantation Genetic Testing
[/blog/preimplantation-genetic-sampling-pgs-using-next-generation-gene-sequencing-ngs-method-of-choice/]
of advanced embryos (blastocysts) to identify those that are euploid
(“c…

Endometriosis [/blog/endometriosis-and-infertility-sfs/] is a complex
condition where, the lack or relative absence of an overt anatomical
barrier to fertility often belies the true extent of reproductive
problem(s). All too often the view is expounded that the severity of
endometriosis-related infertility is inevitably directly proportionate
to the anatomical severity of the disease itself, thereby implying
that endometriosis causes …

All multiple pregnancies pose a risk to both mother and offspring.
Pregnancy induced maternal complications such as miscarriage
[/blog/recurrent-pregnancy-loss-rpl/], pre-eclampsia, antepartum and
post-partum hemorrhage become progressively more prevalent the higher
the

Most pregnancy induced placental complications that compromise
placentation and intrauterine development have their origin in
conditions that present prior to conception. As such, a patient
requiring IVF presents her RE with a golden opportunity to
preemptively identify and address such factors in order to optimize
the quality of life after birth. IVF conducted with the sole objective
of pregnancy as the end-point ignores the opportunity to set one’s
sights higher….and take aim at ac…

Oscar-nominated director Amanda Micheli’s provocative documentary,
Vegas Baby followed several aspiring parents, who desperately wanted
to have a baby but were struggling w…

About 1/3 of infertility is caused by a male factor
[/blog/male-infertility/], one third by a female factor and another
third is due to a combination of both male and female factors. Thus,
in more than 50% of cases, a male factor causes or contributes to the
problem. Today, with very few exceptions, in the case of moderate or
severe male infertility (unless it can be reversed medically or
surgically) in vitro fertilization (IVF) with

In 2005, my associate Levent Keskintepe PhD and I introduced
Preimplantation Genetic Testing (PGT) with the ability to identify all
chromosomes in the embryo’s cells, into the fiel…

Neither sex contributes more heavily than the other to infertility
problems. Roughly one‑third of all infertile couples can trace their
infertility to the woman, one‑third to the man, and one‑third to
both partners. In practice this means that in >50% of cases there is
both a male and a female factor involved. Understanding this reality
before embarking on a strategic plan of treatment is in my opinion
essential to optimizing outcome.

I am very proud to be featured in a new documentary film, VEGAS BABY,
which follows several of my patients gambling on infertility treatment
and the emotional, physical and financial costs involved.  Amanda
Micheli, the director, has struggled with infertility herself, so
in addition to being an Oscar-nominated filmmaker, she brings an
empathetic eye and a passion for raising awareness. The film will be
available on iTunes on Mother’s Day, this Sunday May 14th at this
link: 

_ Everything Has its Season_

GEOFFREY SHER MD
Dear Patients and Friends, After some 35 years in the field of
Assisted Reproduction (AR), having founded the First Private
(non-university based) IVF program in the United States in 1984, and
having been influential in the births of over 18,000 babies, the time
has finally arrived for me to prepare for my retirement. I, therefore,
wish to take the …

It is important for patients/couples contemplating IVF with their own
eggs, to be aware that usually, in more than 50% of cases a single
attempt will not result in a live birth and furthermore that the
chance of success declines with advancing age of the egg provider.
 Thus, given the emotional, physical, and financial toll exacted by
IVF, it is preferable that no one undertake a one‑shot attempt. If a
couple can only afford one treatment cycle, IVF is probably not the
right course o…

There is a great deal of confusion when it comes to defining egg
“quality.” Most people interpret terms such as
“mature/immature/post-mature” eggs as implying that the timing of
egg retrieval was off. This is, at best, a gross over-simplification
and at worst, dangerously misleading.

Embryo transfer (ET) is undoubtedly a rate limiting factor in IVF.
Unquestionably, the IVF doctor’s expertise in performing ET as one
of the most important factors that will determine IVF outcome. It
takes confidence, dexterity, skill, gentility and above all,
experience to do a good transfer. This having been said, 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 simpl…

It is only through propagation of our biological offspring that we as
humans can leave a lasting legacy of our existence. Perhaps this
explains why the desire to have children is a basic human instincts
and why an inability to achieve this goal (infertility) often leads to
considerable psychological and social difficulties. Infertility evokes
a strong sense of failure, loss and helplessness leading to one of
life’s most distressing crises. Seven out of ten children and young
adults wit…

The conventional way of conducting IVF treatment is to provide
patients with opportunity to undergo treatment any time they are ready
to do so. But such delivery of services in fact often falls short of
affording access to the most efficient and best quality of treatment
because it fails to allow much needed opportunities for clinical and
laboratory staff to take much needed breaks in order to implement
optimal quality control and to recover from the pressure resulting
from uninterrupted…

It is hard for me to believe that more than three decades have flown
by since I first introduced intrauterine insemination into the
clinical arena (Journal of Fertility & Sterility, April, 1984). At
that time and for more than 2 decades thereafter, I held the strong
belief that IUI would provide a less expensive, safe and equally
successful alternative to  IVF in cases where the woman had at least
one patent Fallopian tube… How wrong I was! In my defense however,
let me say that in th…

Unless tests for immunologic implantation dysfunction (IID) i
[https://blog.drgeoffreysherivf.com/endometriosis-immunologic-implantation-dysfunction-iid-ivf/]mmunologic
implantation dysfunction [/blog/endometriosis-and-infertility-sfs/]are
performed correctly and conducted by a one of the few reliable
reproductive immunology reference laboratory in the United States,
treatment will likely be unsuccessful. . In this regard…

All multiple pregnancies pose a risk to both mother and offspring.
Pregnancy induced maternal complications such as miscarriage,
pre-eclampsia, antepartum and post-partum hemorrhage become
progressively more prevalent the higher the multiple gestation. For
the babies, it is an escalating risk of premature birth and
intrauterine growth retardation that places the offspring at risk.

Ovarian hyperstimulation syndrome (OHSS) is a life-endangering
condition that occurs following ovarian stimulation
[/blog/ovarian-stimulation-for-women-with-diminished-ovarian-reserve-dor-and-in-older-women-undergoing-ivf/]
for the treatment of infertility. It occurs due to overstimulation of
the ovaries with the development of numerous follicles in susceptible
women. S…

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”
(compet…

Male factor problems as a contributing cause of infertility are very
common. Male infertility is reported as a factor in 30-50% of
infertility cases. In fact, many fertility specialists will recommend
a semen analysis as one of the very first tests that should be done.
It is relatively simple, inexpensive and yields much information. The
two main causes of male factor infertility can be divided into either
problems in manufacturing sperm or problems in getting sperm outside
of the body (…

The objective with In Vitro Fertilization is to consistently transfer
competent embryos into a receptive uterine environment. This requires
a very individualized and meticulous approach to evaluating and
addressing those factors that can influence IVF outcome
[/blog/fundamental-requirements-achieving-optimal-ivf-success/]: All
patients/couples should learn what they can reasonably expect before
committ…

I have all too often heard it said that medical providers knowingly
place unsuspecting infertile women at risk of developing cancer
through the fertility injectable drugs and treatment they administer
and that we knowingly place patients at risk by understating medical
risks associated with the use of fertility treatments
[/blog/ivf-pregnancies-bear-greater-risk/]. To me this is both
offensive and untrue. It is true that the indiscrim…

Implantation dysfunction [/blog/endometriosis-and-ivf/] is
unfortunately often overlooked as an important cause of IVF failure.
In the pursuit of optimizing outcome with IVF, the clinician has a
profound responsibility to meticulously assess and address this
important issue if IVF success is to be optimized. This is especially
relevant in cases of “unexplained …

With cervical Incompetence (CI) the cervix starts to shorten (efface)
and dilate too early in the pregnancy giving rise to late (2nd
trimester) miscarriage or premature birth. It can occur with first
pregnancies (“Primary Cervical Incompetence”) or after a prior
pregnancy (“Secondary Cervical Incompetence”). CI often occurs in
women who give a history of cervical insufficiency in one or more
prior pregnancies; late miscarriages or premature deliveries of
unknown cause; cervical i…

About a decade ago, I, along with my associate, Levent Keskintepe PhD
were the first to introduce full chromosome Preimplantation Genetic
Testing (PGT)
[/blog/preimplantation-genetic-sampling-pgs-using-next-generation-gene-sequencing-ngs-method-of-choice/]
into the IVF clinical realm to try and identify euploid embryos whose
cells contained the required 46 chromosomes…

CASE REPORT: **For the purposes of anonymity, I will be referring to
the patient as RL throughout this blog.** RL, a 31-year-old woman,
presented with a 7 year history of inability to conceive, in spite of
2 prior fresh and 1 frozen IVF attempts
[/blog/frozen-embryo-transfer-fet-versus-fresh-et-make-decision/],
where a total of six

Hi Dr Sher, I’m 42 years of age. Until very recently, I knew nothing
about IVF, and I now find myself in a scramble to optimize my chances
with it. Despite a lifelong dream of having a healthy baby and happy
family, it has taken me this long to find a great man/dad I can
believe in for my unborn kids, so prior, I always used protection and
never tried to get pregnant. Since my mom got pregnant naturally at
40, I grew up thinking that was normal-or at least normal for my
family. And, I …

Following ovulation, what remains of the ruptured follicle transforms
itself into a structure called the Corpus Luteum (CL) which produces
progesterone. The purpose of progesterone is to prepare the uterus to
accept and support an early pregnancy until it is able to sustain
itself at around 8-10 weeks of gestation.
The life span of the CL is predetermined to be 12-13 days, unless
rescued by a signal from the early pregnancy. If no pregnancy occurs,
the CL …

Consider the fact that between 40 and 43 of age, the success rate per
cycle of treatment with injectible fertility drugs
[/blog/fertility-drugs-for-ivf-how-safe-are-they-and-do-they-cause-cancer/]
alone, with or without intrauterine…

For about 10% of all infertile couples, the cause of the infertility
cannot be readily determined using conventional diagnostic methods.
Such cases are often referred to as “unexplained infertility.” The
truth however is that in most such cases, the diagnosis of
“unexplained infertility is in fact presumptive because a more
in-depth evaluation would have revealed a cause. This having been
said, people diagnosed with so called “unexplained infertility”
fall into two broad groups: a)…

Tubal damage is one of the commonest causes of infertility. It is most
often due to pelvic inflammatory disease (PID)
[/blog/pelvic-inflammatory-disease-pid-tubal-damage-hydrosalpinx-preparing-ivf/]
caused by sexually transmitted bacterial infection with chlamydia
trachomatis and Neisseria gonorrhea. Acute PID caused by such usually
are associated with severe clinical manifestations such as rapid …

The use of GnRH antagonists, as currently prescribed in ovarian
stimulation cycles
[/blog/optimizing-response-ovarian-stimulation-women-compromised-ovarian-reserve-personal-approach/],
i.e. the administration of 250mcg daily from the 6or 7th day of
stimulation with gonadotropins, is in my opinion problematic when used
in women who have

Ever since January 1993 when a study was reported by researchers at
Stanford University suggesting that the use of fertility agents
increased the risk of ovarian cancer,
[/blog/fertility-drugs-for-ivf-how-safe-are-they-and-do-they-cause-cancer/]
there has been tremendous concern and anxiety among women who use

Intralipid (IL)
[/blog/intralipid-ivig-therapy-treatment-immunologic-implantation-dysfunction/]is
a solution of small lipid droplets suspended in water. When
administered intravenously, IL provides essential fatty acids,
linoleic acid (LA), an omega-6 fatty acid, alpha-linolenic acid (ALA),
an omega-3 fatty acid. It is made up of 20% soybean oil/fatty acids
(comprising linoleic acid, oleic acid, p…

A hydatidiform molar pregnancy [/blog/molar-pregnancy-treated/]
happens when tissue that normally forms the placenta instead becomes a
growth, that triggers symptoms of pregnancy. A hydatidiform mole is a
benign tumor of the root system (trophoblast) of the embryo which
under normal conditions develops into the placenta which connects the
baby to the mother. About 1 out of 2,000 women with early pregnancy
symptoms will have a molar pregnancy. I…

Today, in first world environments where there is ready access to
advanced medical technology, many women undergo ultrasound diagnosis
of pregnancy as early as 5-6 weeks after their last menstrual period.
As a result, multiple pregnancies
[/blog/how-many-embryos-should-be-transferred-a-critical-decision-in-ivf/]
are often recognized very early on. Serial ultrasound follow-up
examinations performed in su…

Older women, and those who have diminished ovarian reserve (DOR)
[/blog/diagnosing-and-treating-infertility-due-to-diminished-ovarian-reserve-dor/]
with resistance to ovarian stimulation
[/blog/controlled-ovarian-stimulation-cos-for-ivf-selecting-the-ideal-protocol/]
(…

While most IVF pregnancies will progress normally and without any
increased risk to mother or baby, there is little doubt that women who
conceive in this manner as well as their babies are potentially at
increased risk. In fact, women who give birth after IVF treatment are
several times as likely to suffer from significant complications such
as miscarriage [/blog/first-trimester-bleeding-serious/], pregn…

For more than three decades, about 70% of the patients that I have
performed IVF on, have journeyed to see me from out state or out of
country. Over the years, I have been repeatedly asked how, given the
distance separates us from our patients, we are able to provide
optimal, efficient, and congenial services. This blog represents an
attempt to describe how we accomplish this. It will outline the
processes involved, and explain how the system we have put in place
allows us to fully prepa…

Two main factors determine the quality of a woman’s eggs
[/blog/ivf-factors-affecting-egg-embryo-competency-during-controlled-ovarian-stimulation-cos/]
at ovulation or egg retrieval. First is her age…

Cytomegalovirus (CMV) belongs to the Herpes group and, like Herpes,
can remain dormant in the body for long periods of time (even for
life). CMV infection is very common, such that by age 40Y >50% of
adults will bear evidence of previous infection (i.e. test IgG +…see
below). Acute infection most commonly is seen in developing babies, in
those who care for or work with children and in people who are HIV
positive. CMV infection rarely causes a significant illness or
symptoms. People wh…

Clomiphene citrate (Clomid)
[/blog/case-study-prolonged-clomiphene-citrate-therapy-can-cases-reverse-male-factor-infertility-avoid-need-ivficsi/]is
by far the most commonly used fertility drug
[/blog/fertility-drugs-for-ivf-how-safe-are-they-and-do-they-cause-cancer/]
in the…

  Vaginal bleeding occurs in about 25% of all pregnancies. When it
happens, it almost invariably raises the concern of pregnancy loss
(miscarriage) [/blog/recurrent-pregnancy-loss-rpl/]. Bleeding can also
be a sign of a tubal ( [/blog/ectopic-tubal-pregnancy-ivf/]ectopic)
pregnancy…

After 1 year of unsuccessfully trying to have a baby, it is time to
have a basic infertility evaluation. And the urgency increases the
older the woman is.

Men with no sperm in their ejaculates (azoospermia), whether due to
non-obstructive or obstructive (usually post-vasectomy) causes, can
have their sperm accessed surgically and still propagate pregnancies.
There are 2 methods by which this can be achieved. : 1) TESE
(testicular sperm extraction), where a biopsy of the testis is done
or, 2) TESA (testicular sperm aspiration), which involves introducing
a needle into the testis and aspirating fluid and tissu…

Embryo transfer (ET)
[https://blog.drgeoffreysherivf.com/frozen-embryo-transfer-fet-involve/]
is undoubtedly a rate limiting factor when it comes to IVF outcome
[/blog/fundamental-requirements-achieving-optimal-ivf-success/]. In
fact, in my opinion, it is the single most important procedural step
in IVF. Optimal performance of ET takes practice, confidence,
dexterity, timing, gentility and skill. Out o…

Intracytoplasmic Sperm Injection ICSI, which began in 1992 as a
treatment for severe male factor infertility
[/blog/male-infertility/], involves the direct injection of a single
sperm into each egg under direct microscopic vision.Soon after the
turn of the 20th century, it was reported that while the diag…

Until less than a decade ago, most women undergoing IVF would have
their embryos transferred to the uterus in the same cycle that the egg
retrieval was performed (“Fresh” Embryo Transfer). This was
because embryo cryopreservation (freezing)
[/path-to-parenthood/egg-freezing/]was a hazardous undertaking. In
fact it resulted in about 30% not surviving the freezing process and
those that did, having about one half the pot…

About a decade ago, we, (Sher, and Keskintepe, L; et al) introduced
full chromosomal karyotyping for preimplantation genetic sampling –
(PGS) to assess egg/embryo “competency”
[/blog/human-growth-hormone-administration-in-ivf-does-it-enhance-eggembryo-quality-and-outcome/]
for IVF. We performed and reported on 3 separate studies that served
to herald transformation in the fi…

Pelvic inflammatory disease (PID) is a condition where inflammation of
pelvic structures occurs, as a result of one of the following: sexual
transmission via the vagina and cervix, contamination from other
inflamed structures in the abdominal cavity (appendix, gallbladder,
kidneys, etc.), a foreign body inside the uterus (i.e., the
intrauterine device – IUD), contamination of retained products of
conception following abortion or child birth, or, rarely, as a result
of blood-born bact…

The precise mechanism by which ovarian endometrioma causes infertility
is unknown. In women with ovarian endometriomas, infertility is
potentially associated with a decreased oocyte retrieval rate, reduced
oocyte quality and reduced embryo quality. I personally believe that
it is local irritation caused by the cystic space occupying lesion
within the ovary that irritates surrounding connective tissue
increasing ovarian testosterone production which in turn…

The Sampson Theory for the pathogenesis of endometriosis
[/blog/endometriosis-and-ivf/] is the oldest, but remains the most
widely popular and accepted hypothesis. It is based on observations
made as early as in 1938, that that endometriotic implants in the
pelvis arise from retrograde (reversed) menstruation of endometrial
tissue through the fallopian tubes. The finding that women with
endometriosis have larger volumes of retrograde material…

In 1 to 2 percent of cases, male infertility [/blog/male-infertility/]
is the result of problems in an area of the brain (the hypothalamus)
and or in a small gland situated just below the base of the brain
known as the pituitary gland. The pituitary gland produces two
gonadotropin hormones: The first is FSH that controls production of
sperm (spermatogenesis) by Sertoli cells…

Older women [/blog/old-old-ivf/], as well as those who (regardless of
age) have diminished ovarian reserve (DOR)
[/blog/diagnosing-and-treating-infertility-due-to-diminished-ovarian-reserve-dor/],
tend to produce fewer and

 Dehydroepiandrosterone (DHEA), is steroid hormone produced by the
adrenal glands and ovary. It is involved in producing the male
hormones, androstenedione testosterone and also estrogen. DHEA blood
levels tend to decline naturally with age. Under the effect of
luteinizing hormone (LH), DHEA is metabolized to testosterone in
ovarian connective tissue (theca/stroma). Thereupon the testosterone
is transported to the granulosa cells that form the innermost layer of
the ova…

Ovulation occurs within 38-42 hours of initiation of the spontaneous
luteinizing hormone (LH) surge (which can be detected in the blood or
urine prior to this event) and/or hCG administered
following controlled ovarian stimulation (COS)…

Antisperm antibodies (ASA) are immunoglobulins that attach to sperm.
They are most commonly encountered in semen, blood, cervical mucous
and follicular fluid. Not all ASA bind to sperm; however, those that
do so can inhibit fertilization. The current methods of detecting
the presence of SAs in blood, in the seminal plasma of the ejaculate
or in the cervical mucus only measure those immunoglobulins that bind
to sperm components. ASAs are related to the …

Ideal egg development sets the scene for optimal egg maturation that
occurs 36-42h prior to ovulation or egg retrieval. Without prior
optimal egg development (ovogenesis), egg maturation will be
dysfunctional and most eggs will be rendered “incompetent” and
unable upon fertilization to propagate viable embryos. In IVF, optimal
ovogenesis requires the selection and implementation of an
individualized approach to

Approximately 1 out of every 100 embryos will implant and grow outside
of the uterine cavity, almost always in a fallopian tube. This is
defined as an ectopic pregnancy. Infrequently, an ectopic pregnancy
attaches to an ovary or to one or more other pelvic organs. On very
rare occasions (1:1,000), one twin attaches and grows in the uterine
cavity with the other growing outside the uterus (i.e. a heterotopic
pregnancy). There is an ever present risk that a tubal (ectopic)
pregnancy might …

Given the considerable emotional, physical and financial investment
associated with IVF treatment
[/blog/confronting-the-real-cost-of-ivf-treatment/], it is essential
that factors known to affect success be identified and regulated in
advance of initiating treatment and to always thoroughly and
meticulously “plan the trip before taking the ride.” This article
addresses the most important considerations in this regard:…

An ovarian cyst [http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024724]
is any collection of fluid, surrounded by a very thin wall, within an
ovary [http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0022599]. An

What is a varicocele? The testicles are housed in the scrotum, a
skin-covered sac that houses the two testicles as well as blood
vessels that deliver blood to these glands, nerves, and lymphatics. An
abnormality of the plexus of veins (the pampiniform plexus) that carry
blood away from the testicles can result in their distention,
proliferation and enlargement within the scrotum. We refer to this as
the development of varicosities similar to varicose veins…

About seventeen years ago, after reporting on the benefit of vaginal
Sildenafil (Viagra) for women who had implantation dysfunction due to
thin endometrial linings, I was proud to announce the birth of the
world’s first “Viagra baby.”  For those of you who aren’t
familiar with the use of Viagra in IVF, allow me to provide some
context.

There is an ever growing realization, recognition, and acceptance of
the fact that uterine immunologic dysfunction can lead to immunologic
implantation dysfunction (IID)
[/blog/diagnosing-and-treating-immunologic-implantation-dysfunction-iid/]
with “unexplained” infertility, IVF failure
[/blog/unexplained-ivf-failure/], and…

More and more women are deciding, based upon personal preference and
professional necessity, to postpone having a family to a later age. In
fact, very recently Janet Jackson (49Y) was in the news stating that
she was cancelling her tour to prepare for treatment needed to have a
baby. This event prompted me to write this article on IVF in women of
a more advanced age The truth is that hardly a day goes by when I am
not asked the question of, “How old is too old to do IVF?” The
standar…

The prevalence of obesity in Western societies is on the rise, which
has a profound effect on the reproductive performance of women who are
trying to have a baby. Recent evidence suggests that obesity in women
of reproductive age is associated with decreased birth rates,
increased miscarriage rates, lowered IVF success rates, higher rates
of premature delivery and a marked increase in pregnancy
complications. We use two parameters to measure height-weight …

Patrick Steptoe and Robert Edwards were responsible for the birth of
the world’s 1st IVF baby, Louise Brown, in 1978. Since then about 4
million babies have been born worldwide, and the number is growing
fast. The introduction of this Assisted Reproductive technology (ART)
which comprises IVF and associated procedure has literally
revolutionized the treatment of infertility and Reproductive failure
b…