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Archive for the Category » In Vitro (IVF) «

December 05th, 2011 | Author:

California IVF Prepares for an Exciting Year Ahead and Celebrates with Family


The California IVF Family

In 2011, California IVF signed a collaboration agreement to take over fertility services for the UC Davis Department of OB/GYN, purchased a competitor’s facility in Sacramento and added three physicians to its roster. This coming year, California IVF will continue to expand and build the practice so we can help more patients in the Northern California region and from around the world.

Some of the most recent updates include: the installation of a new California IVF sign at our Sacramento facility, finalized renovation plans to bring a modernized IVF center to the Northern California region early next year, and new work with researchers at UC Davis to improve our ability to assess male fertility and embryo competency. ?Our California Conceptions Donated Embryo Program continues to grow and is providing an embryo adoption alternative for Canadian and Australian couples faced with restrictive oocyte donor laws.


Dr. Ernest Zeringue and Alisa Zeringue Enjoy the Picnic


Toddling Around the Party

Article source: http://feedproxy.google.com/~r/CaliforniaIvfDavisFertilityCenterInc/~3/2pcsvolzdAo/california-ivf-update-family-reunion.html

Category: Adoption, Egg Donor Program, In Vitro (IVF), Infertility, IUI - Insemination, Main  | Tags:  | Comments off
November 25th, 2010 | Author:


??????????????????California IVF: Davis Fertility Center, Inc. has released our November 2010 edition of our infertility newsletter titled “Babies in Davis”. In the first edition of our infertility newsletter, we discuss what it takes to make us more than just a fertility center. Our extended family and the referrals from the Sacramento area doctors help make us the successful clinic we want to be and our patients deserve. We are very aware that our patients would rather get pregnant on their own without having to go to the local infertility clinic.  When patients see our help, the California IVF family is happy to adopt new members into our family so we can work together to provide the best possible chances of having a baby.  Our family is what makes us great.Photos from the previous reunion fill the pages of our newsletter along with other interesting stories and announcements. California IVF has announced a donor embryo program know as California Conceptions, an egg freezing program, and recently launched our online egg donor application. It has been a busy year for the staff and infertility doctors at California IVF: Davis Fertility Center.  Continuing to expand our services is important in our efforts to provide our patients with the very best infertility treatments.
Rounding out the newsletter is a brief article on surgical services for our infertility patients.  Many of our patients seeking infertility treatment help with inseminations (IUI) or in vitro fertilization (IVF) are not aware that our doctors perform many infertility surgery procedures to help correct problems that affect fertility.  Among these surgeries are myomectomies, or surgeries to remove uterine tumors that can prevent pregnancies, hysteroscopies to correct uterine polyps and remove a uterine septum, and tubal ligation reversal surgery which allows a woman to have her tubes put back together after a tubal ligation surgery.

Stay tuned for more interesting developments including an option to sign up to receive our newsletter via email.  Once again, we would like to give thanks to our family that was able to make it to our third annual family reunion.  It was a rainy day but that didn’t stop our event!  It was a great day of “babies and bellies” in the park.  Photos from our events as well as an electronic copy of our newsletter can be found at http://www.babiesindavis.com/.
 
 © California IVF: Davis Fertility Center, Inc. Male and female infertility specialists near Sacramento.

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November 16th, 2010 | Author:

An embryologist is a scientist that works with sperm, eggs, and embryos. This field of work is known as embryology. Embryologists can work in human or animal embryology. Animal embryologist can help with breeding programs for a zoo, repopulation of endangered species, and breeding of livestock. Human embryologists work with infertility programs with the goal of helping couples have a baby.

The embryologist in an in vitro fertilisation program (IVF) plays a vital role in the journey to pregnancy for a couple struggling with infertility. During the course of infertility treatments, the embryologist will be involved from the start to finish of an in vitro fertilization – IVF cycle. During the testing phase before IVF treatments, the embryologists will prepare the embryology lab for infertility treatments by regulating and testing environmental conditions in the embryology laboratory including temperature, air quality, and humidity. Ordering supplies and the culture media, or liquids used to grow the embryos, is also a necessary step when preparing to start an IVF cycle.

Testing of sperm and freeing sperm samples from couples about to undergo treatment is another job of the embryologist during the testing phase Often, an embryologist will also work in the role of an andrologist, which is an individual that works with sperm.

In the IVF program at California IVF: Davis Fertility Center, Inc., our embryologist Deborah Johnson conducts an educational seminar before patients undergo the egg collection procedure, or oocyte retrieval. This “egg class” is designed to introduce infertility patients to embryology and terminology used in an embryology laboratory.

During the egg retrieval procedure, embryologists receive test tubes containing liquid removed from the ovaries. The embryologist will search this fluid under a microscope and identify the eggs. The eggs are collected together and placed into petri dishes for the remainder of the IVF process. The embryologist is also responsible for fertilizing the eggs with sperm by conventional insemination techniques or intracytoplasmic sperm injection (ICSI).

ICSI is a more complicated procedure that involves using microscopic instruments to remove the cumulus cells surrounding the egg, allowing the embryologist to assess egg maturity and egg quality. After the sperm preparation procedure, an individual sperm is injected into each egg. When ICSI is not needed, sperm are placed in the dish with the eggs after the sperm preparation or sperm washing procedure is completed.

The day after the sperm and eggs are combined, the embryologist checks for fertilization by examining each egg under the microscope. Eggs that did not undergo ICSI will need to have the outer cells removed so the embryologist can perform the fertilization check. The fertilized eggs, or zygotes, are placed into an incubator that has been regulated to control gas mixture, temperature, and several other conditions. Optimal conditions in the embryology laboratory will allow the zygote to progress to the cell division stage, at which point the zygote becomes an embryo. The embryologist will check on the embryos and change the culture media as needing during the 3 to 5 days before the embryo transfer procedure.

Embryologists also perform embryo biopsy procedures on embryos at day 3 or day 5. During the embryo biopsy procedure, an embryologist must rely on experience to remove a single cell from an embryo while minimizing the risk of damage to the embryo. The embryologist will work with the laboratory performing the genetic test and coordinate the handling of the cells and test results. The embryologists skill at performing micromanipulation procedures on embryos can play a vital role in the success of IVF.

Using micro-surgical techniques, embryologists may also perform assisted hatching on embryos. During this procedure, microscopic tools are used to thin the outer shell of embryos and make a hole in the zona pellucida to facilitate the hatching process. The embryologist will also assess the quality of the embryos and provide the infertility doctor with a report on embryo quality. This information is used to determine if there are any issues with poor embryo quality that could affect the chances of a pregnancy.

When the best quality embryos are identified, the embryologists will load the embryos into the transfer catheter and work with the doctor to perform the embryo transfer procedure. Any remaining embryos that are not transferred and appear to have the capability of making a pregnancy, are frozen for later use. The embryologist is responsible for the cryopreservation of extra embryos during the IVF process.

Embryologists usually obtain their training in biologic sciences. Many embryologist gain their initial experience in animal laboratories before transferring into human IVF. Over the last few years, embryology training programs for human IVF have been formed. It is likely that there will be more of these programs in the future. Regardless of the training background of an embryologist, hands on experience is one of the most critical factors in an IVF lab.

California IVF: Davis Fertility Center, Inc. has some of the most experienced embryologists with over 30 years combined experience. Their experience allows us to easily adapt to developments in embryology that will help our family maximize our patient’s chances of having a baby.

— © California IVF: Davis Fertility Center, Inc. Male and female infertility specialists near Sacramento.

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Category: Egg Donor Program, In Vitro (IVF), Infertility, Main  | Tags: , , ,  | Comments off
November 06th, 2010 | Author:

The “buzz” at the ASRM Annual Meeting in Denver, October 2010, was biopsy of Day 5 (blastocyst) embryos with subsequent genetic analysis. Current embryo biopsy techniques focus on Day 3 embryos for pre-implantation genetic testing (PGD) of embryos.

Day 3 embryos are usually composed of 6-8 cells, and one cell is removed, fixed to a slide, and analyzed in the lab. Having only one cell to work with, though, can be a negative in several ways. Firstly, there’s always the chance that the material from one cell will not be enough to provide a sample for analysis. Secondly, there is the somewhat complicated issue of mosaicism.
As cells grow and divide, genetic mistakes can happen. Since the embryo is made up of several different dividing cells, it’s possible that some of the cells divide normally, while some of them create genetic mistakes during their division.

The result can be a mosaic embryo—one that has some normal cells and some genetically abnormal ones. The concern with embryo biopsy on Day 3 is that with removing only one cell, how do you know that all the other cells have the same genetic makeup?

Studies show that embryos that make genetic mistakes have a high tendency to correct themselves by the time they reach the blastocyst (Day 5) stage. In other words, the normal cells continue to grow and divide, forming a healthy embryo, and the genetically abnormal cells disperse. This phenomenon is called self-correction. So a significant concern with Day 3 embryo biopsy is that a single cell can be analyzed and identified as abnormal, leading to discarding of that embryo, while in fact, it could undergo the process of self-correction, leading to the discard of a perfectly fine embryo.

Day 5 embryo biopsy has definite advantages over Day 3 biopsy. Day 5 embryos generally have 100-150 cells, so usually 10-15 cells can be removed without harm. This allows a larger sample to test. The test is also run at the later, Day 5, stage, which allows for self-correction to happen. Also, by the time the embryo reaches the Day 5 stage, it has formed two separate structures: the inner cell mass, which can become a baby; and the trophectoderm, the outer cells which will form the placenta. The cells removed in the biopsy come from the trophectoderm, leaving the inner cell mass intact.

The major disadvantage of Day 5 biopsy is in the time it takes to run the genetic tests. The blastocyst stage is when the embryo would begin to burrow in and implant in a woman’s uterus. So by the team an embryo reaches blastocyst stage in the lab, it can only be transferred into a uterus or frozen for storage. Genetic testing may take several days, so an embryo that is biopsied on Day 5 must be frozen until the results are available. This would involve a scheduled future transfer of the normal embryo in another cycle, after preparing the uterus with hormones. Fortunately, improvement in embryo freezing techniques, primarily the use of vitrification, has made this option a successful alternative. It was revealed at the 2010 ASRM Annual Meeting that some centers are also working to shorten the time the diagnostic testing takes, so that the biopsy could be done early on Day 5 and allow transfer early in the morning the following day, with excellent pregnancy rates.

About Dr. Laurie Lovely:

Sacramento Infertility Specialist Dr. Laurie Lovely is board certified by the American Board of Obstetrics and Gynecology (ABOG) in both Obstetrics and Gynecology and Reproductive Endocrinology and Infertility. She has received a research grant from the American College of Obstetricians and Gynecologists for her work on the effects of hormones and the endometrial lining. She presented a prize-winning paper on the effects of stress and infertility at an annual meeting of the American Society for Reproductive Medicine. Additional professional interests include pubertal problems and reconstructive tubal surgery including tubal ligation reversals.

— © California IVF: Davis Fertility Center, Inc. Northern California Male and female infertility specialists near Sacramento and Roseville.

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November 04th, 2010 | Author:

Sacramento infertility specialists Dr. Laurie Lovely and Dr. Ernest Zeringue attended the annual meeting for the American Society for Reproductive Medicine, or ASRM in Denver Colorado.  This meeting is a gathering point for scientists and clinical practitioners from fertility practices worldwide.  Clinics and researchers share their techniques and scientific discoveries for the purpose of advancing the field of reproductive medicine.  This sharing of ideas usually serves as valuable means of evaluating developing techniques and technology, and often leads to the introduction of new treatment options for infertility patients.

 

There have been many exciting advancements in the infertility treatment arena.  The two most notable topics are oocyte preservation, or egg freezing for the purpose of saving a woman’s fertility for the future, and pre-implantation genetic diagnosis and screening (PGD/PGS).  Both egg freezing and  PGD/PGS advancements will offer immediate changes in the way infertility treatments are rendered.  California IVF: Davis Fertility Center, Inc. is at the forefront of these new technologic developments as we continue to bring our patents the latest and most advanced options for overcoming infertility.

 

Pre-implantation genetic screening PGS is used when embryos are tested for the presence of a genetic abnormality such as an abnormal number of chromosomes.  Pre-implantation genetic diagnosis, PGD, is used when there is a known risk of a specific genetic disease when there is a family history of a specific genetic disease.  PGD is often used to refer to both PGD and PGD services collectively, although this is technically inaccurate.  PGD/PGS has been used for several years, but the limitations of the technology and the types of genetic tests available for infertility treatments has been a limiting factor in the success of the testing.  High costs of the tests have also limited the use of the testing in addition to in vitro fertilization, IVF. 

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Recent advancements in PGD/PGS has allowed fertility clinics to move away from FISH and embrace SNP and aCHG for genetic screening of embryos.  These newer tests have the advantage over existing FISH technologies in that SNP and aCGH can look at all chromosome pairs.  There are 23 pairs of chromosomes with one pair used for sex determination.  A test will look for 24 chromosomes, 22 normal pairs of chromosomes plus the X and Y chromosomes which determine if the baby will be a boy or a girl.  Testing for X and Y chromosomes has also been useful for gender selection – determining a boy or girl with IVF before the embryo is used to make a pregnancy.

 

Refinements to the PGD/PGS process were presented at ASRM.  These latest changes will likely lead to an increase in the number of PGD/PGS cases performed in the United States.  By performing the embryo biopsy on day 5 using a laser and a precision microscope, the genetic test results have a higher prediction rate of a normal pregnancy than a biopsy performed on day 3.  Several researchers and infertility clinics reported pregnancy rates as high as 85 to 90% when PGD/PGS was used on a day 5 embryo.  While these are early studies and need additional verification, it seems very clear that the future of embryo biopsy and genetic testing is about to make a significant change to the field of in vitro fertilization.

 

The addition of day 5 embryo biopsy and genetic testing advances our capabilities and improves upon our 5 year experience with genetic testing and embryo biopsy.  Having egg freezing capabilities opens the doors for new avenues in donor egg banking, making the process of egg donation and infertility treatments with donor eggs less complicated.  Freezing eggs also offers a women the opportunity to save her fertility in the face of cancer treatments such as chemotherapy or radiation therapy.  Oocyte cryopreservation will soon offer women the opportunity to preserve their fertility for a later time in life when her own chances of conceiving may be reduced due to the effect of age on egg quality.

 

Thanks to the scientific community and professional sharing of knowledge and scientific study, ASRM members can remain up to date with the latest changes.  California IVF: Davis Fertility Center, Inc. continues to change our practice as new developments become available.  To this end, many fertility centers and patients and indebted to the efforts of ASRM.  According to the ASRM website, the Vision of the American Society for Reproductive Medicine (ASRM) is to be the nationally and internationally recognized leader for multidisciplinary information, education, advocacy and standards in the field of reproductive medicine. The ASRM is a non-profit organization whose members must demonstrate the high ethical principles of the medical profession, evidence an interest in infertility, reproductive medicine and biology, and adhere to the objectives of the Society. 

 

Dr. Laurie Lovely and Dr. Ernest Zeringue are proud members of ASRM and will continue to leverage the knowledge and research benefits of ASRM to realize the goals and dreams of our patients – having a baby.

September 02nd, 2010 | Author:

California IVF: Davis Fertility Center, Inc. strives to make in vitro fertilization (IVF) a cost effective approach to maximizing the chances of pregnancy. We understand the additional stress finances place on patients wishing to get pregnant and that for many, the cost of starting or continuing treatment is a barrier to pregnancy.

Cost, Overhead and the Modern Embryology Lab

The combination of physician, embryologist and staff experience along with our modern embryology laboratory, which creates an environment that mimics the human body, is why we can help women get pregnant with in vitro fertilization (IVF). However, in addition to high staffing costs, maintaining a high tech lab contributes significant overhead and affects the cost of treatment. Major lab systems include the:

Air System – Designed by a specialized engineer, this system creates a positive airflow that pushes air out of the lab, limits temperature fluctuations within 1-2 degrees and constantly removes contaminants with four Hepa filtration units. It is inspected annually for clean air compliance and maintains a 96% seal from the outside world.

Gas System – The oxygen concentration of normal air is toxic to embryos. Specialized incubators, microscopes and handling techniques protect the embryos and maintain a gas mixer that optimizes growth.

Microscope System – Given the tiny size of embryos, high powered microscopes fitted with mechanical manipulation devices are required to perform treatments such as intracytoplasmic sperm injection (ICSI) or embryo biopsy for pre-implantation genetic diagnosis (PGD).

Safety System – This system continuously monitors the lab for proper air and incubator temperatures and gas levels as well as the liquid nitrogen level of frozen embryos and semen samples. If there is a power outage, our diesel generator automatically starts and can run for several days without refueling.

California IVF: Davis Fertility Center, Inc. uses its modern embryology lab to increase the effectiveness of fertility treatment and patient pregnancy rates. If you have any questions regarding the embryology lab and its affect on the cost of treatment, please ask. We remain committed to helping patients realize the joy and miracle pregnancy can bring.

January 19th, 2009 | Author:

IVF is a procedure involving the stimulation of multiple ovarian follicles using gonadotropins. These follicles are then retrieved at the appropriate time. After fertilization in the lab, the subsequent embryos are transferred into the uterus where implantation can occur. This process bypasses the fallopian tubes and increases fertilization rates when there are problems with low sperm counts.

 

Candidates
In vitro provides many people with the opportunity to attempt pregnancy in the face of one or more factors that may otherwise decrease their chances. There are several reasons why you may be better off with IVF. Reasons for undergoing IVF include:

  • Significant adhesions (scar tissue)
  • A history of damage to the fallopian tubes
  • Endometriosis
  • Unsuccessful attempts with other types of infertility treatment
  • Low or abnormal semen assays Intra Cytoplasmic Sperm Injection
  • Reduced risk of pregnancies greater than twins 

Our facility does not select out patients or decline patients that may not be likely to conceive. There are no attempts to turn away couples in hopes of maintaining good statistics. With this said, however, realistic expectations need to be established. Your physician will need discuss your individual situation with you.

Prior to becoming eligible for treatment in an IVF cycle you will need to complete the tests recommended for you by your physician, have to have current infectious disease testing (good for 1 year), and your consent forms must be signed and returned before starting each cycle.

For more information visit: http://californiaivf.com/ivf.htm

Category: In Vitro (IVF)  | Comments off