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IVF Treatment Program Description

Infertility Solutions, P.C. has been doing in vitro fertilization for since 1994.
We feel that our program offers patients some advantages over many programs in the United States.

Some of these advantages are derived from the fact that we are a small program and have a close integration between the laboratory and medical aspects of this procedure.
In many programs, physicians are not involved in evaluating laboratory issues.
Dr. Rose has extensive interest and experience in the laboratory aspects of IVF.

Small and Comfortable

We are not a large volume practice. As such, there are relatively few different people that patients will be working with and fewer different people will be working with their laboratory specimens. This provides a setting that is much more comfortable than a large program where patients may, at times, feel like a number. Our laboratory is located in our main office in Allentown. We do not contract out our embryology to another location, nor do we allow outside doctors to use our facility. This enhances our control over the quality of the laboratory. We also think that because of our size we can individualize our treatments to a much greater extent than a larger program.

Because we are a small program, there is potential for our results to vary more from year to year based on factors in the particular patients who we are taking care of. The most uniform subgroup of patients to look at are those under age 35. For women under age 35, our ongoing or delivered pregnancy rate per embryo transfer has been about 35%. We are confident that we can maintain this level of success and this confidence is the basis for our risk sharing IVF refund program. In this program, which is basically an insurance program for patients, we would lose money if we can not achieve this level of success with IVF treatment. Our current results are posted on-line to enable potential patients to assess our current effectiveness with this complex procedure.

Advanced Treatment Techniques

Intracytoplasmic sperm injection or ICSI is a process by which a single sperm is injected into an egg in order to cause fertilization. This procedure was primarily developed for those couples that had infertility on a male factor basis. It also also used in the many settings in which we are concerned that there might be an egg problem. With this procedure virtually any male factor problem can be overcome. It is a very dependable method for forcing fertilization to occur. We have been doing ICSI since 1996. All procedures are performed by Donna Lakey, our embryologist, who has extensive experience with this delicate procedure.

Today we can even treat some men who have no sperm by utilizing a testicular biopsy specimen (TESE). This harvesting procedure is also done in our office. We most commonly use this technique to help couples achieve pregnancy when the husband has had a prior vasectomy.

Based on research from Europe and Japan, we have developed two approaches to IVF treatment that are available in only a few other programs in the United States, IVM and Mini-stim IVF™. Both of these approaches are much easier for patients than traditional IVF and complement our traditional IVF program.

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Recent Treatment Innovations

The latest innovation in IVF treatment is PGD, which involves having DNA studies done on cells biopsied from the early embryo. This is available to our patients though one of the most established DNA laboratories in the country. We utilize an experienced outside embryologist for this procedure. PGD is useful in helping to decide which embryos to transfer in a patient who produces many normal appearing embryos, but has not gotten pregnant in several cycles. It has been shown to improve the delivery rate in patients with otherwise unexplained recurrent pregnancy loss. It can be used for sex selection (choosing a boy or girl) embryo. It can be used for embryo selection in patients with certain genetically inherited diseases.

A recent advance in laboratory procedures includes culturing embryos in reduced oxygen environments. Culturing embryos in a reduced oxygen environment increases the number of cells in a blastocyst's inner cell mass. Since each cell in the inner cell mass has the theoretical potential of becoming a baby, having more cells with this potential should enhance the pregnancy rate.

We have recently moved from programed slow freezing of blastocysts to vitrification of blastocysts. Vitrification is a process of more rapid freezing in an attempt to avoid damage of cells due to ice formation and long exposure to cryoprotectants. It is the preferred approach for freezing unfertilized eggs which contain a delicate chromosome spindle array. Embryos can tolerate repeated cycles of vitrification and defrost much better than repeated cycles of standard slow cryopreservation and defrost. Once embryos are frozen, they are stored in liquid nitrogen which is at a temperature below that required for chemical reactions. Once frozen, embryos essentially do not age.

Our professional society, SART, has issued a statement saying that egg (as opposed to embryo) freezing is an experimental procedure and should not be performed outside of research protocols. In part, this is because only a limited number of babies have been born after egg freezing and the safety of the procedure is difficult to assess. We are prepared to undertake egg freezing (vitrification) one it had been more adequately evaluated.

We are one of only a few programs to offer IVM and Mini-stim IVF. Our interest in these programs was the recognition that many patients could achieve pregnancy easier and much less expensively using one of these techniques. We likely have the first pregnancies with either of these techniques in Pennsylvania. It is an ongoing project to understand how best to integrate these programs with traditional IVF. However, our patients already have more options to achieve pregnancy than they have elsewhere.

We believe that we remain on the forefront of what is being done in IVF from a science viewpoint.