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Infertile patients cannot afford to wait for treatment while their eggs get older.

Dr. Sherman Silber, Infertility Center of St. Louis, is offering video consultations for patients who need to plan now for their treatment while stay-at-home orders are in place. He is talking to and evaluating patients in their home to comply with social distancing measures.

Dr. Silber is discovering that patients actually prefer this method of telemedicine consultation over the conventional office visit. Patients have conveyed that “it is so much more convenient and less stressful” to have a telemedicine personal consultation than to take a day off from work to travel to the doctor’s office and sit with other nervous patients in the waiting room.

The COVID-19 pandemic is thus changing much of the way we will do things in the future, and for the better. “Our patients are surprisingly much happier with this approach. Of course, at some point we need to perform hands on treatment. But with this new manner of seeing patients, we can come to the right diagnosis and treatment plan for most patients more efficiently, quickly, and painlessly, with no loss of personal one-on-one communication.” This is a very welcome new era of telemedicine that has been forced on us by the current difficult times.

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Ask Dr. Silber: Mini-IVF (In Vitro Fertilization)

Ask The Doctor

By Sherman Silber, MD, St. Luke’s Infertility Specialist
Health & Harmony
Spring/Summer, 2007

health-harmony-coverMini-IVF (In Vitro Fertilization)

Q. Explain the new, low cost innovative fertility treatment known as mini-IVF.

A. Mini-IVF is a new approach to IVF, which was developed in Japan as part of the Kato Clinic-St. Luke’s Collaborative Program. “Mini-IVF” avoids many of the common complaints that patients have about conventional IVF. It costs much less, and avoids the complications of hyperstimulation and excess hormones.

 

Unlike conventional IVF, mini-IVF is designed to retrieve only a few, high quality eggs instead of large numbers of mediocre ones. As a result, the procedure completely eliminates the risk of hyperstimulation

Sherman Silber, MD, Director of the Infertility Center of St. Louis at St. Luke’s Hospital
Sherman Silber, MD, Director of the
Infertility Center of St. Louis
at St. Luke’s Hospital

syndrome, in which a fluid imbalance causes dehydration due to body fluids that collect in the abdomen. In addition, the cost of the drugs is reduced from $7,000 to about $700. There are very few injections and it does not require painful progesterone injections.

With mini-IVF, the patient starts on a low dose of Clomid, a drug used to stimulate ovulation, on day three of her menstrual cycle and continues taking the Clomid until ultrasound monitoring shows she is ready to ovulate. Continuing on Clomid reduces the chance of premature ovulation while allowing for the development of high quality eggs for IVF.

Although Clomid results in very high quality eggs, it can inhibit development of the uterine lining, making the embryos less likely to implant. This can be solved, however, by employing a remarkable, new method of embryo freezing called vitrification (also developed by the Kato Clinic-St. Luke’s Collaboration). This method is safe because the frozen embryos suffer no damage from this type of freezing, and they have the same success as fresh, unfrozen embryos. The frozen embryos are then transferred into the uterus during a subsequent natural cycle without the need for taking any hormones at all.

Also, whether using minimal stimulation, or conventional stimulation of the ovaries, vitrification [see technical video] of the embryos is so effective that it allows the transfer of only one embryo at a time. This eliminates the risk of dangerous multiple pregnancies such as triplets or quadruplets which carry a greater risk to both mother and child.

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