In 2014, South Jersey Fertility Center’s IVF program will celebrate its 25th year of service to the region with over 2,000 babies born!! SJFC is the oldest continuously running IVF program in South Jersey, with a proven track record of success. We strive every day to bring this tradition of excellence to our patients to help them succeed.
Assisted Reproductive Techniques (ART) include various methods of aiding human reproduction through techniques that involve retrieving a woman’s eggs from her ovaries. These procedures are best known by their acronyms, such as IVF, ICSI, GIFT, and ZIFT. By far the most common of these procedures is IVF.
In-Vitro Fertilization/Embryo Transfer(IVF)
IVF is a process by which one or more eggs (oocytes) are fertilized outside the body. If the male partner has a very low sperm count then fertilization is achieved by injecting a single sperm into each egg in a process called Intra-Cytoplasmic Sperm Injection (ICSI). If the sperm count is normal, then the usual procedure is to place a droplet of washed sperm (50,000) onto each egg. Successfully fertilized eggs are called embryos. A select number of embryos are placed into the uterus for implantation and establishment of pregnancy. This process bypasses the fallopian tubes.
Indications for IVF
- Absence or occlusion (blockage) of the fallopian tubes
- Functionally damaged tubes
- Insufficient sperm
- Long standing infertility despite conventional therapy
- Unexplained infertility
The IVF cycle consists of four steps:
- Ovarian stimulation
- Collection of eggs
- Fertilization of eggs
- Placement of a select number of embryos into the uterus
Gamete Intra-fallopian Transfer (GIFT)
GIFT is a process by which eggs are removed from the woman via a vaginal aspiration or laparoscopy. The eggs and sperm are placed in a catheter and directly injected into the woman’s fallopian tubes during the laparoscopic procedure. Fertilization occurs in the fallopian tubes, not in a petri dish as in In-Vitro Fertilization. This process closely resembles the journey a fertilized egg would follow during a spontaneous cycle.
Zygote Intra-fallopian Transfer (ZIFT)
ZIFT is a process much like GIFT except that the eggs are fertilized outside the body. Then a select number of embryos are placed into the fallopian tube(s) via laparoscopy one or two days later.
Intra-Cytoplasmic Sperm Injection (ICSI)
In cases of sub-optimal sperm counts or poor sperm motility, Intra-Cytoplasmic Sperm Injection (ICSI) is used to increase the chance of successful fertilization. The procedure consists of injecting a single sperm directly into the egg. Manipulation of the eggs requires special equipment specifically designed to perform the very small, intricate movements used in this procedure.
Assisted Hatching is intended to benefit the patient by assisting the embryo to attach to the lining of the uterus. This procedure is performed just prior to transferring the embryos to the uterus by creating a small opening in the zona pellucida (egg shell) with the aid of a micro needle. The zona pellucida is opened in order to facilitate the normal hatching process, which must take place before the embryo is capable of contacting the endometrial lining of the uterus for implantation. Manipulation of the embryo requires specialized equipment, designed to perform these very small intricate movements. The risk of damaging the embryo from the Assisted Hatching procedure is exceedingly rare. Assisted Hatching is usually performed on all embryos being transferred to the uterus with the exception of embryos at the blastocyst stage.
Number of Embryos to Transfer
Increasing the number of embryos transferred into the uterus increases the chance for a resulting pregnancy, up to a point. The more embryos returned to the uterus, the higher the risk of multiple gestation. Your team of doctors, nurses, and embryologists will help you determine the best number of embryos to transfer in your individual situation. Our goal is to optimize the pregnancy rate while reducing the risk of high-order multiple gestation. The decision is based on your willingness to risk multiple gestation and your openness to the possibility of choosing selective reduction of fetuses in the event that there are triplets or more. Other important factors are your age, the reason for your infertility and the quality of the embryos to transfer. Patients under the age of 35 typically have only 2 embryos transferred if the embryos are of average or above average quality.
After 5 to 6 days of culture, healthy embryos usually reach the blastocyst stage. They contain more than 32 cells. When an embryo reaches this stage, it has proven itself to be quite viable. In January of 1999, we began extending the embryo culture in order to transfer many embryos at the blastocyst stage. By transferring blastocysts we are attempting to increase the pregnancy rates by transferring the best quality embryos. Our intention is also to decrease the high order multiple gestation by limiting the number of embryos we transfer. The embryo quality and stage of development will determine on which day the embryo transfer will be. This will not be known until the second or third day after the eggs are retrieved.
Embryo Cryopreservation (Freezing)
Many patients find that they have “extra” embryos beyond those needed for transfer into the uterus.The advance of embryo cryopreservation is to give the patients an added chance of achieving a pregnancy without having to undergo a complete stimulation IVF cycle. In the long run, embryo cryopreservation improves the likelihood of conception at a decreased cost.
Cryopreservation is performed on embryos between the second and sixth day of culture, thus it is done before you know if you have become pregnant from the fresh cycle. Thawing and transfer of the embryos is performed in a programmed cycle, which includes administration of Lupron, Estrogen pills and patches, and Progesterone supplements. Cryopreservation does not cause birth defects.