DVIF&G Blog

2020

Although fresh embryo transfer (ET) is the norm during assisted reproductive therapies (ART), in the past few years avoiding a fresh embryo transfer and instead freezing all the good quality embryos has emerged as an alternative strategy during in vitro fertilization (IVF) cycles (Roque, 2015). The success of IVF depends not only on embryo quality, but also on the interaction between the embryo and the endometrium, the implantation. During IVF cycles, there are several concerns about the possible adverse effect of the controlled ovarian stimulation (COS) and the high estradiol (E2) levels on the endometrium, which in turn might have an effect on the pregnancy rates (Shapiro et al., 2011; Roque et al., 2013). It is postulated that during the freeze-all strategy, the cryopreserved embryos are transferred later when the E2 is at physiologic levels and the endometrium present a physiologic environment. (Roque, 2015). By performing delayed frozen-thawed ET (FET), any adverse effects of COS over the endometrium is thus avoided, and this should lead to better outcomes (Shapiro et al., 2011, Roque et al., 2013; Roque, 2015). Current perspective of the available literature regarding this subject is that the freeze-all strategy is not designed for all IVF patients. At least two studies show that only patents with polycystic ovary syndrome (PCOS) might be benefited (Chen et al., 2016; Shi et al., 2014). Today, it is reasonable to perform elective cryopreservation of all embryos in cases with a high risk of OHSS development, and in patient with supra-physiologic hormonal levels during the follicular phase of COS. It is not clear if all the patients that had a normal response and poor responders to COS may benefit from this strategy (Roque et al., 2017). We questioned this premise at DVIF&G by analyzing our own data from the last three years and we compare the implantation rates between the fresh and the frozen embryo transfers. The implantation rates were favorable and increased during frozen embryo transfers when compared to fresh embryo transfers. The combined data from 2017 and 2018 showed that the frozen implantation rates almost double by comparison to those in a fresh embryo transfer and in 2019 the frozen embryo implantation rates more than double those of fresh, achieving a high 60% rate. It follows that an increase in implantation rates will lead to a decrease in the average number of embryos transferred. Indeed the average number of embryos transferred in frozen cycles has decreased from 1.5 in years 2017+2018 to an average number of 1.1 embryos in 2019. Whereas, the average numbers of embryos transferred in fresh cycles were higher approximating 2 embryos per transfer than in FET. In the light of these results, our patients are advised to proceed with a freeze all cycles in the hope that their goal will be achieved faster and at the same time minimizing the disappointment from a failed embryo transfer

January

2020

Fresh versus Frozen Embryo Transfer

Although fresh embryo transfer (ET) is the norm during assisted reproductive therapies (ART), in the past few years, avoiding a fresh embryo transfer and instead of freezing all the good quality embryos has emerged as an alternative strategy during in vitro fertilization (IVF) cycles (Roque, 2015). The success of IVF depends not only on embryo […]

DVIFG

December

2019

Ketogenic Diet and Fertility

The last few decades different approaches have been advanced to address medical epidemics such as obesity, diabetes, and for women in reproductive age, polycystic ovaries syndrome (PCOS) and its cause of infertility. One of the most common measure is a diet. In the recent past almost every year a new diet is introduced, frequently sponsored […]

DVIFG

August

2019

Details Matter… It’s Worth Waiting To Get It Right

Infertility affects 1 out of 10 patients of reproductive age! More than 1 out of 20 babies in the USA are born to couples that have received evaluation for infertility or have received infertility treatment! Over the last decade there are major breakthroughs and considerable success in the reproductive medicine armamentarium for both of these […]

DVIFG

February

2019

A Nod is As Good As a Wink to a Blind Horse

In Vitro fertilization (IVF) is offered to couples that undergo infertility treatment when all the other measures to achieve pregnancy fail. The success of IVF, as a treatment modality, has gradually improved over the last 4 decades, due to scientific and technological advances. Nonetheless the resulting pregnancy rate has been modest and seems to have […]

DVIFG

November

2018

2018 Best of Vineland Award

Delaware Valley Institute-Fertility Receives 2018 Best of Vineland Award Vineland Award Program Honors the Achievement VINELAND October 30, 2018 — Delaware Valley Institute-Fertility has been selected for the 2018 Best of Vineland Award in the Health category by the Vineland Award Program. Each year, the Vineland Award Program identifies companies that we believe have achieved […]

DVIFG

September

2018

Ovarian Reserve

“Ovarian Reserve” is a term that has been in use to describe a woman’s reproductive potentials since the early 1980s. Over the years, several tests have been introduced to assess the “Ovarian Reserve” (OR). These include the clomiphene challenge test (CCCT) and Gonadotropin releasing-hormone agonist (GnRHa) in 1989 and, Inhibin b in 1997, among others. […]

DVIFG

May

2017

On This Mother’s Day…

To those who gave birth this year WE CELEBRATE WITH YOU To those who lost a child this year WE GRIEVE WITH YOU To those who are in the trenches with the little ones WE APPRECIATE YOU To those who experienced a miscarriage, failed adoption, or runaway child WE MOURN WITH YOU To those who […]

DVIFG

March

2017

In-House Donor vs Agency Donor? How do I chose?

Most fertility centers will have their own in-house pool of egg donors. However, there is also the option of using an outside agency donor to find the best match. Which is best for you? What are the advantages and disadvantages of both options? The benefits of using an in-house donor Using an in-house donor offered […]

DVIFG

February

2017

What comes first…the Fertility Clinic or the Surrogacy Agency?

For many first-time LGBT patients, beginning the process of family building can be overwhelming and confusing. There are so many factors for same sex couples to consider, including costs, legal concerns and finding the right egg donor and carrier. Since male couples do not have the benefit of a referral from a GYN or OB, […]

DVIFG

February

2017

Reseveratrol and PCO

Resveratrol, a natural chemical present in grapes, nuts and berries, is known to have antioxidant, anti-inflammatory and cardio protective properties. It was also found to have a beneficial effect in PCO by reducing the production of androgens approximately by 25%. Both ovarian and adrenal productions of male hormones were decreased to the same degree and […]

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