Embryo Cryopreservation

The In Vitro Fertilization treatment process at LifeStart Fertility Center, involves the use of hormones to stimulate the development of multiple eggs. These eggs are than retrieved and fertilized in the laboratory. In many cases, more embryos are created than can reasonably be transferred to the woman’s uterus. If the excess non-transferred embryos are of good quality, it is the patient’s choice that they may be cryopreserved (frozen) so that they may be transferred at a future date. Embryo cryopreservation provides the opportunity to have an additional embryo transfer without the inconvenience and expense of a full IVF cycle.

The IVF laboratory staff evaluates embryos under the microscope to assess quality. Various aspects of the embryo are evaluated based on standardized laboratory criteria. Cell shape, size and number are just a few of the features evaluated. The embryos selected for transfer are the highest in quality, or grade, to provide the optimal chance for pregnancy. Please note; the embryos are not being evaluated for genetic characteristics. Embryos may be frozen at any stage between day 1 (pronuclear stage) and day 6 (Blastocyst stage) after egg retrieval.

After placing the embryos in a cryoprotectant solution, they are frozen in a computer-controlled device designed specifically for embryo cryopreservation. Long-term embryo storage is in liquid nitrogen, at a temperature of -320°F (-196°C).

The cryopreserved embryos are thawed and replaced during a hormonally controlled cycle. It has been proven that 60 to 90% of the cryopreserved embryos successfully survive the freeze/thaw process. The stage and quality of the embryo at the time of freezing plays a major factor in the survival rate as well. The pregnancy rate after transfer of these embryos is similar to that of fresh embryos.

Prolonged periods of cryopreservation have been found to have no apparent affect on embryo viability. Embryos thawed after several years of cryostorage fare as well as those frozen for only one or two months. Since 1983, the cryopreservation procedure has resulted in the birth of thousands of babies worldwide. With this extensive experience, there have been no reports of any increase in birth defects as a result of cryopreservation.

For more information about the Embryo Cryopreservation service at LifeStart Fertility serving greater Los Angeles, California, please call 818-889-4532 (4LFC) or click here to contact us by our online form.

Assisted Hatching

At LifeStart Fertility Center, Assisted Hatching is one of the specialized IVF laboratory services offered. Assisted Hatching involves making a small hole in the outer shell surrounding the embryo, called the zona pellucida. The zona pellucida holds the cells of the embryo together and dissolves after the embryo arrives in the uterus, allowing the embryo to "hatch" and than implant. Implantation of the embryo into the wall of the uterus cannot occur until the embryo hatches.

Who can benefit from the Assisted Hatching procedure? Through years of study, it has been found that Assisted Hatching benefits women 38 years or older. It is also used in women who have failed multiple IVF cycles, in cases where embryo quality is poor, in some women suffering from endometriosis (link), and in women with an elevated FSH level on day 3 of their cycle.

Assisted Hatching may optimize the chance of pregnancy by helping embryos from these women implant in the uterus during an In Vitro fertilization (IVF) cycle. This procedure involves making a small "window" in the wall of the zona pellucida, using a dilute, or weak solution of acid that is placed onto the surface of the embryo using a fine needle. The embryos are then transferred into the uterine cavity.

For more information on Assisted Hatching and if this procedure may help you, please contact us by clicking the link or call LifeStart Fertility Center serving greater Los Angeles at 818-889-4532.

PGD (Pre-implantation Genetic Diagnosis)

Pre-implantation genetic diagnosis (PGD) is the ability to screen embryos for specific genetic diseases before they are replaced into the uterus. PGD is primarily used to evaluate known carriers of specific single-gene defects, such as Cystic Fibrosis, or for specific chromosomal abnormalities such as Down's Syndrome, Turner's Syndrome, and specific unbalanced translocations. Transferring "screened embryos" lacking the genetic defect makes it extremely unlikely that the disease could be passed to the child.

Who could benefit from PGD?

Patients at risk for having a child with specific genetic diseases such as those listed above, women older than 38, and women with repeated unexplained pregnancy losses. As stated above, PGD can determine the presence or absence of a certain number of chromosomal disorders, but cannot detect genetic disease nor predict congenital malformation.

Why should a patient consider PGD?

The purpose of PGD is to select for replacement only those embryos believed to be chromosomally normal with the intention of reducing the probability of losing the pregnancy or of carrying a chromosomally abnormal baby to term.

How is PGD performed?

First the patient must undergo a cycle of In Vitro Fertilization. Than the pre-embryos obtained have one or two cells, called blastomeres, removed. These cells are than tested for chromosomal abnormalities or for the presence or absence of specific genes, related to the disease of concern. The results are usually available in one to two days. The embryos whose biopsied cells tested to be normal are replaced back into the patients uterus or cryopreserved for later transfer.

Why might PGD benefit women over 38 years old?

As a woman advances in age, her eggs are exposed to an aging process that can lead to chromosomal abnormalities. If the egg has an abnormality with an extra or missing chromosome, the embryo created by that egg would have an extra or missing chromosome. This situation is called aneuploidy. Often the affected embryos will fail to attach to the womb and a pregnancy does not develop or the embryo does attach but miscarriage occurs. Sometimes, the embryo implants and results in the birth of a child with a chromosomal disorder. Some chromosomal disorders that may result include Down’s Syndrome, Turner's Syndrome and Klinefelter's Syndrome. Overall, the risk of aneuploidy is known to increase with maternal age, from 1/385 at 30 to 1/179 at 35, 1/63 at 40 and at the age of 45 the chance of delivering an affected child is 1/19.

For women 35 and over, as much as 35% of pregnancies are miscarried sooner or later. In up to 50% of these cases, a chromosomal abnormality was the reason for the loss. These figures are approximately the same whether the pregnancy is after an IVF procedure or in the general population

For more information on PGD and to schedule an appointment with LifeStart Fertility Center serving greater Los Angeles, please click here to contact us or call us at 818-889-4532.

Intrauterine insemination (IUI)

Intrauterine insemination (IUI) is a common treatment for infertility. It can be used in cases where the male has a low sperm count or when abnormalities of ejaculation (retrograde ejaculation, impotence) exist. IUI is also utilized when the cause of infertility is unknown, when cervical disorders are present or with use of donor sperm. Ovulation inducing drugs are usually used as well.

In this technique, semen is collected into a sterile cup by masturbation and than processed for IUI. The processing of the semen sample involves washing the sample with "specialized media" to remove prostaglandins and other substances from the semen that can cause cramping. The processed sperm is than inserted directly into the uterus with a tiny catheter, bypassing the cervix. Since IUI relies on the natural ability of sperm to fertilize an egg within the reproductive tract, the sperm function of the male must be reasonable and the fallopian tube(s) must be healthy and functional. An IUI takes approximately 10-15 minutes to complete.

Appropriate timing of the intrauterine insemination procedure is important in optimizing outcomes. Usually the procedure is performed the day after an LH surge detected by an ovulation prediction kit or 36 hours after an injection of hCG. Ultrasounds also may be utilized to track the development of the follicle and impending release of the egg. Ultrasounds to time IUI’s are usually used when the patients are taking oral or injectable fertility medications.

For more information about the Intrauterine insemination (IUI) treatment in Los Angeles, please call LifeStart Fertility at 818-889-4532 (4LFC) or click here to fill out our online contact form.

Intracytoplasmic Sperm Injection (ICSI)

At LifeStart Fertility Center, another specialized IVF laboratory service offered is Intracytoplasmic Sperm Injection (ICSI). ICSI enables men with poor sperm quality to father children. It is also used in some cases of unexplained infertility. In the ICSI procedure, a single sperm is injected directly into the egg using a microscope, micromanipulation equipment and a microinjection pipette (glass needle).

ICSI has been utilized successfully to treat even the most severe cases of male factor infertility. In men with no or very little sperm present in the ejaculate, sperm for ICSI can be obtained directly from the epididymys or testes. The procedure utilized for direct aspiration of sperm from the epididymys is known as PESA (percutaneous epididymal sperm aspiration). The procedure for aspiration of sperm from the testis is called TESE (testicular sperm extraction). Sometimes a more detailed procedure known as MESA (microsurgical epididymal sperm aspiration) might be utilized to obtain sperm from the epididymys. TESE, PESA and MESA procedures combined with ICSI allow many men, previously considered sterile, to have children.

The ICSI procedure is performed for patients of LifeStart Fertility Center. For more information on the ICSI procedure, please click here to contact us or call us at 818-889-4532 for an appointment.