Fertility Center of San Antonio

Monday, February 27th, 2006

Fertility Center of San Antonio

The Fertility Center of San Antonio is the first center to offer office-based assisted reproductive technology in Texas, and also the first intracytoplasmic sperm injection (ICSI) pregnancy in the southwest.

INFERTILITY TREATMENT AND FERTILITY EVALUATION OPTIONS INCLUDE:

  • Female and Male Fertility Evaluation
  • Financial Options-FCSA Shared-Risk Plans, Family Fee Plan by Capital One, ARC
  • IVF: In Vitro Fertilization-office-based ART procedure that involves the ultrasound guided removal of a woman’s eggs from her ovaries. The eggs are then fertilized with sperm. The resulting embryos are transferred to the woman’s uterus.
  • PGD: Pre-implantation Genetic Diagnosis-biopsy to analyze an embryo for severe inherited disease (Cystic fibrosis, Down syndrome, Turner syndrome, Hemophilia, and many more genetic diseases).
  • TESE: Office-based testicular sperm extraction-oocytes are injected with sperm extracted from testicular biopsy. TESE is indicated for men with vasectomy, blockage and other male factor conditions.
  • ET: Embryo Transfer-introduction of an embryo(s) into the uterus after IVF.
  • Blastocyst Transfer-ET utilizing an advanced stage blastocyst embryo. A blastocyst is typically seen 5 to 6 days post egg retrieval.
  • FET: Frozen Embryo Transfer-ART cycle in which frozen embryos are thawed and transferred to the uterus.
  • IUI: Intrauterine Insemination-procedure that places the sperm into the uterus to facilitate fertilization.
  • ICSI: Intracytoplasmic sperm injection-a treatment for male factor infertility whereby a single sperm is introduced directly into the egg. ICSI may be indicated for low sperm count, low motility, low morphology, high ASA levels, prior failed IVF or when using sperm from MESA, PESA or TESE.
  • Andrology and Embryology Laboratory

  • Hormone Assays
  • Semen Analysis with anti-sperm antibody testing
  • Induction of Ovulation
  • IVF with Egg Donor
  • Gestational Carrier/Surrogate
  • IUI or IVF with Sperm Donor
  • Tubal Reanastomosis
  • Advanced Laparoscopy and Hysteroscopy
  • Office Hysteroscopy
  • Egg Freezing
  • Assisted Hatching
  • Private, Office-Based Infertility Treatment and Research Program w/SART Affiliation: Fertility Center of San Antonio meets guidelines set by the American Society of Reproductive Medicine (ASRM). We are Accredited by American Institute of Ultrasound in Medicine (AIUM).
    Our laboratory now offers PGD services.

    Fertility Center of San Antonio
    4499 Medical Drive, #200
    San Antonio, TX 78229
    Phone: 210.692.0577
    Email: info at fertilitysa.com

    Desert Cryobank

    Monday, February 27th, 2006

    Desert Cryobank
    Desert Cryobank is a division of Southwest Fertility Center in Phoenix Arizona. Anonymous sperm donation is performed and samples are available for a nominal fee to infertile couples. the sperm bank offers a select number of donors to be chosen from for use by women for intrauterine insemination. Sperm cryopreservation for medical indications is also available.

    Services Offered

  • Sperm Cryopreservation

    Desert Cryobank specializes in both freezing and long term storage of donor and patient sperm samples. Cryopreservation (freezing), of human sperm is a long time practiced procedure which has proven to be safe and effective sperm storage method. A variety of special services are provided which are designed to assist patients with male factor infertility.
  • Therapeutic Inseminations using Donor sperm

    Patients choosing therapeutic inseminations using donor sperm will be evaluated by the healthcare provider and appropriate medical treatment will be determined. An intrauterine insemination using donor sperm will be performed at the optimum time during ovulation to maximize the possibilities of conception.
  • Sperm Cryopreservation for Individuals with Medical Indications

    Freezing and long-term storage (cryostorage) of semen is available for men with medical indications. These include patients who face chemotherapy, radiation treatment, or high-risk environmental exposure.
    Patients desiring cryostorage will have an initial semen analysis to determine the suitability of the sample for freezing. The amount of semen to be stored is up to the individual, however, a recommendation will be made by the staff at Desert Cryobank based on the initial analysis. The possibility of conception depends on a variety of factors such as the freezability of sperm, sperm count and the woman’s fertility. The more visits made to the cryobank for freezing, the more insemination samples available for later use. There is no guarantee that conception will take place using cryopreserved sperm. It is advisable to cryostore enough semen for at least six treatment cycles.
  • Donor Safety
    A general concern of people entering the therapeutic donor insemination program are the physical and health characteristics of the donor. While all donors remain anonymous, physical characteristics and background information are available to recipients. In addition, pertinent health information and a three generation family history is also available upon request. All sperm specimens used have been frozen and quarantined for at least 6 months to allow thorough screening for sexually transmissible diseases. All specimens out of quarantine have been found to be negative for HIV, Hepatitis B and C, syphilis, cytomegalovirus, gonococus, and chlamydia. When indicated by ethnic origin, genetic testing for tay-sachs, cystic fibrosis, and sickle cell anemia is performed.

    Desert Cryobank @ Southwest Fertility Center
    3125 N 32nd Street, #200
    Phoenix, AZ 85013
    Phone: 602.956.7481
    Email: swfertil at mindspring.com

    What are Donor Embryos?

    Monday, February 27th, 2006

    Donor Embryos
    Donation of an embryo by one couple to another who attempts to become pregnant by frozen embryo transfer.

    Who needs Donated Embryos?
    The following are some of the potential patients who are Donor Embryo Recipients:

  • Both partners have significant fertility issues
  • Couples are seeking a less expensive alternative compared to other technologies and adoption.
  • Couples are unable to adopt (i.e., cancer survivor, single, lesbian or in their 40’s).
  • Couples with a family history of genetic disease where direct reproduction is not recommended.
  • I’ve heard there is a high demand for embryos, is this true?
    Yes, in most cases this is VERY ture. Generally, due to the large demand for donor embryos and their extremely short supply, couples are not eligible to be placed on the Donor Embryo Recipient Waiting List if the female partner is aged 45 years or over. Also they are not eligible for treatment with donor embryos if the female partner is aged 50 years or over.

    I’ve heard about embryos getting rejected, what is this all about?
    Some couples are worried that if they use donor eggs or donor embryos, their body will “reject ” them, because these are genetically foreign. However, remember that all embryos are genetically foreign to the mother, because half the genetic material comes from the father ! The uterus is an “immunologically privileged” site, and donor embryos have as good a chance of implanting as normal embryos.

    Matching of Embryo Donors to Recipients
    Non identifying information about physical characteristics such as race, height, weight, hair colour, etc. of anonymous embryo donors will be provided to the recipients in advance of the embryo transfer. However, this does not ensure that any particular set of physical attributes will be conferred on the resulting offspring.

    What are Gonadotropins?

    Monday, February 27th, 2006

    Gonadotropins
    Gonadotropins are medications that will stimulate your ovaries to produce multiple mature eggs in a cycle. It is given via an intramuscular injection every evening for anywhere from 10-18 days (the average time is 12 days).

    There are several brand names of gonadotropins available like Pergonal, Repronex, Menogon, Fertinex, Follistim, Gonal F, Puregon, Pregnyl, Novarel, Profasi, Ovidrel.

    What is HCG (Human Chorionic Gonadotropin)?
    Human Chorionic Gonadotropin, or hCG, production begins approximately 8-10 days after conception when the embryo starts to burrow itself into the lining of the uterus. It is this hormone that is measured by early pregnancy tests and if present, will return a positive result. An hCG beta blood test is much more sensitive than an HPT, and can detect pregnancy as early as 10 days after fertilization.

    Are Gonadotropins right for you?
    Gonadotropins can help you conceive if you tried taking clomiphene (another fertility drug) but your body didn’t respond to it. Your doctor might also prescribe it if you have polycystic ovarian syndrome, luteal phase defects, or an unexplained fertility problem. If you’re undergoing an assisted reproductive technology (ART) treatment such as in vitro fertilization (IVF), gonadotropins can help you produce several eggs for the procedure.

    What is Donor Oocytes (eggs)?

    Monday, February 27th, 2006

    Donor Oocytes (eggs)

    This is the donation of an egg (oocyte) by one woman to another who attempts to become pregnant by In Vitro Fertilization.

    Anonymous oocyte donation is offered to women up to the age of 51 (the natural age of menopause). Once a donor recipient is close to being matched with a donor, she and her partner will need to go through a series of screening tests and appointments prior to starting a donor egg cycle.

    Donating eggs is not an easy process and will require a commitment of time and energy. Couples with whom you may be matched will be investing a large amout of money for each cycle.

    What does the screening process involve?
    The screening process will involve bloodwork, an ultrasound, and a psychological evaluation. For the psychological evaluation, you meet with a psychologist who will talk with you about why you want to be a donor, and her staff will administer a psychological test called the MMPI. The interview and test are not difficult or threatening. Additional tests may be required in certain circumstances.

    What does this Lupron drug do?
    Once you have been accepted as a donor it will be determined where you are in your menstrual cycle. You will utilize a medication called Lupron to help coordinate you and your recipients’ cycles. You will usually begin Lupron the week before your next expected period. If you are taking oral contraceptives you will overlap the Lupron and the pills for a few days then have you stop the pills.

    What critia make a women eligible for egg donation?
    A woman is eligible to become a donor if she is a healthy non-smoker between the ages of 21 and 34. The process begins with an application, which includes detailed personal medical information about the donor and her immediate family.

    How do I know if I will be chosen as a donor?
    The process of selection as a donor is varied and is made by each recipient that is currently active in various programs. Generally every few weeks a list of the donors available will go out to each active recipient. They will consider their choice with many particulars in mind that will vary from recipient to recipient. The donor list will outline age, infertility type, height, weight, hair color, eye color, build, complexion, ethnicity, education, occupation, blood type, previous pregnancy, previous IVF, medical background for donor and family.

    What are the risks and side effects?
    Most donors generally do not have problems with blood sampling and hormone injections; however, some experience local discomfort, redness or bruising at the injection sites. Injections can be painful and the side effects of medications may include breast tenderness, fluid retention, a bloated feeling, moodiness and tenderness in the ovaries. Rarely, a donor may form ovarian cysts or hyperstimulation, a condition associated with enlarged ovaries and fluid in the abdomen. Also in extremely rare cases, clotting of the blood vessels may occur, cysts may rupture or ovaries may become twisted and require surgery.

    What else should be said about egg donation?
    Oocyte donation has become an extremely successful option for many women who have otherwise been considered hopelessly infertile. As the egg donation process has become more widely accepted and recognized by general public the number of women who are willing to donate oocytes has increased. Oocyte recipients are now able to experience pregnancy and childbirth, which allows many women to feel no different from other women who give birth to children.

    What is Assisted Hatching (AH) ?

    Monday, February 27th, 2006

    Assisted Hatching (AH)

    This is a microscopic procedure ( micromanipulation ) used to break up the zona pellucida (a thick protein coating surrounding the egg ).

    Early embryos are surrounded by a gel-like protective shell called the zona pellucida. When they are about 5-6 days old the embryos must hatch out of the zona pellucida so that they can attach to the wall of the womb and continue growing.

    As women get older, the zona pellucida may become harder or tougher making it difficult for the embryos to hatch. As a result, implantation and pregnancy may not occur.

    What demographic is best for Assisted Hatching?
    The most commonly used indications for assisted hatching with an in vitro fertilization case are:

    Zona factor – Couples having IVF with embryos that have a thick outer shell (zona pellucida).
    Age factor – Couples having IVF with the female partner’s age over 37.
    Embryo quality factor – Couples having IVF with poor quality embryos (excessive fragmentation or slow rates of cell division).
    Egg quantity and quality factor – Couples in which the female’s day 3 follicle stimulating hormone (FSH) level is elevated.
    Previous failures – Couples having IVF that have had one or more previous IVF cycles that failed.

    What are the risks of AH?
    There has been no reported increased incidence of birth defects in children born as a result of this procedure; some centers, however, have reported an increase in the number of identical twins. Also, rare side effects from the accompanying steroid treatment can include: salt or water retention, a higher susceptibility to infection, elevation in blood pressure, mood swings, osteoporosis, nausea, insomnia, and allergic reactions. The antibiotic used (usually doxycycline) may increase skin sensitivity to sunlight and may increase your risk for a vaginal yeast infection.

    What is Percutaneous Epididymal Sperm Aspiration (PESA) ?

    Monday, February 27th, 2006

    Percutaneous Epididymal Sperm Aspiration (PESA)

    PESA can be used for men with congenital absence of the vas and in lieu of vasectomy reversal. This procedure involves insertion of a small needle, under local anesthesia, directly into the epididymis for aspiration of a fewer number of sperm than would be necessary for fertilization by conventional IVF. However, in most cases there are more than enough sperm to fertilize all oocytes by ICSI. With newer cryopreservation techniques, there may even be sufficient numbers of sperm for freezing so that additional ICSI procedures could be performed in the future without the need to obtain more fresh sperm.

    What are the advantages of PESA?
    The advantages to this technique are that it can be performed without surgical scrotal exploration, it can be repeated easily and at low cost, and it does not require an operating microscope or expertise in microsurgery.

    How is PESA done?
    The procedure as described by Craft et al. has been performed under local or general anesthesia. After induction of anesthesia, the testis is stabilized and the epididymis is held between the surgeon’s thumb and forefinger.

    What is the success rate for PESA?
    PESA has the main benefits of being successful in most of the cases, while avoiding a skin incision. Costs are lower because an operating microscope, the skills of a microsurgeon, and the possibility of a general anesthetic are not necessary or likely. The most significant drawback is the blind nature of the procedure, often requiring multiple, potentially damaging needle insertions. The delicate, coiled anatomy of the epididymal tubules are easily damaged with such maneuvers. While PESA may be successful for someones first ICSI cycle, future cycles will require repeated procedures and the increased likelihood of progressive epididymal damage.

    What is Intracytoplasmic Sperm Injection (ICSI)?

    Monday, February 27th, 2006

    Intracytoplasmic Sperm Injection (ICSI)

    Direct injection of a single sperm into an egg under microscope (micromanipulation). This procedure is used when there is a severe male factor such as a very low sperm count or poor quality sperm.

    How it’s done
    The woman is given fertility drugs to stimulate her ovaries to develop several mature eggs for fertilisation. (As you know from sex education, women normally release only one egg a month.)

    Once the eggs are ready, the man and the woman undergo separate procedures. The doctor retrieves sperm from the man, in most cases from a testicle with a needle under anaesthetic (the procedure is called percutaneous epididymal sperm aspiration). If this technique doesn’t remove enough sperm, the doctor will take a biopsy of testicular tissue, which sometimes has sperm attached. After giving the woman a local anaesthetic, the doctor will remove her eggs using a fine, hollow needle. (An ultrasound helps the doctor locate the eggs.)

    A lab technician then isolates individual sperm and injects them into individual eggs. Two days later the fertilised eggs become balls of cells called embryos. The doctor transplants two or three embryos into the woman’s uterus through her cervix using a thin catheter. (Extra embryos, if there are any, may be frozen in case this cycle isn’t successful.) One embryo may attach to the uterine wall and continue to grow. (In a third of ICSI pregnancies, more than one embryo will implant.) After about two weeks, the woman can take a pregnancy test.

    What are the known risks of ICSI?
    ICSI is a relatively new treatment, the first children having been born in 1992. Although information to date suggests that it is safe, couples considering ICSI should be made aware of several issues including the possibility of unknown risks.

    What are the advantages?
    ICSI gives men with a very low sperm count a chance at conceiving their genetic child. The treatment also helps men who are missing their vas deferens, the pair of tubes that carries seminal fluid from the testes to the penis, and men who are unable to reverse a vasectomy.

    What is the success rate of ICSI?
    The success rates for all IVF treatments vary between patients, however ICSI produces similar live birth rates to standard IVF treatments. Slight differences in ICSI fertilisation and pregnancy rates with different causes of infertility have been observed.

    What is In Vitro Fertilization (IVF)?

    Monday, February 27th, 2006

    In Vitro Fertilization (IVF)

    In Vitro Fertilization is used when a woman has blocked or absent fallopian tubes, irreparable fallopian tube damage, severe endometriosis, history of failed infertility treatment (i.e. ovulation induction with medications and/or Artificial inseminations), or unexplained infertility.

    IVF is also indicated when there is a severe male factor (i.e. very low sperm count/quality). The success rate of IVF is 3-4 times higher than that of artificial insemination. A woman is prepared for IVF with a series of injectable medications and ultrasounds followed by an office procedure that will retrieve all available eggs.

    The partner’s sperm is then put with the woman’s eggs in a small plastic dish in the laboratory where the progress of the embryo is watched for 3-5 days. The resulting embryos are then placed in the woman’s uterus.

    In Vitro Fertilization Pre-Embryo Transfer (IVF-ET) is a fertility procedure which first succeeded as recently as 1978 by Dr. Edwards (an embryologist) and Dr. Steptoe (a gynecologist) in England. Since then the technology has been further refined and developed by physicians and embryologists, with over 20,000 babies born worldwide.

    Q: Will IVF damage my ovaries?
    A: There is no evidence to suggest that either ultrasound egg retrieval or normal laparoscopy damages the ovaries. In fact, some reports in the medical literature suggest that following ovarian biopsy, pregnancies occur in couples with a long-term history of infertility.

    Q: How soon will the IVF work and I’ll know I’m pregnant?
    A: Pregnancy can be confirmed using blood tests about 13 days after egg aspiration. Pregnancy can be confirmed by ultrasound 30 to 40 days after aspiration.

    Q: How many times can IVF be done per couple?
    A: This is determined by the couple together with the physician. Sorry, There is no specific number.

    Q: Is IVF covered by most standard insurance companies?
    A: It is unlikely that IVF coverage is provided, unless your health insurance policy specifically provides infertility coverage . Frequently insurance policies will cover infertility but exclude IVF. This has been successfully challenged in the legal system. Consultation with your lawyer may be necessary to review you insurance companies refusal to provide IVF coverage. If, however, IVF is combined with surgical procedures used for diagnosis, insurance carriers may pay for much of the procedure. For infertility alone, most insurance policies will not provide coverage. However, coverage will depend on the terms of your policy.

    Arizona Reproductive Medicine Specialists

    Monday, February 27th, 2006

    The Arizona Reproductive Medicine Specialists mission is to provide the most successful, highest quality, medical care available, in a highly personal, sensitive, and cost effective manner.

    Arizona Reproductive Medicine Specialist offers IVF options for women up to the age of 49 with financing offering payments as low as $200 per month.

    In addition, Arizona Reproductive Medicine Specialists is the only practice in Phoenix to have enough confidence in our success rates to be able to offer five “Refund Plan” options to indemnify our patients against fear of failure, including our new plans for women between 37 and 39 and an innovative new plan for recipients of donor eggs.

    For more information about our program, please join us for a free “Lunch and Learn” seminar at our central office.

    Arizona Reproductive Medicine Specialists is the only comprehensive infertility clinic in the Phoenix area that provides fertility diagnosis for both partners at one location. This ensures close communication, efficiency and privacy for our patients.

    Location Info:
    1300 North 12th Street, #520
    Phoenix, AZ 85006
    Phone: 602.343.2767
    Email: info at arizonarms.com