Treating Infertility

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Treating_Infertility_coverOur Program Philosophy

We work individually with each couple to determine what is the best choice of treatment for their personal situation. No fees are charged for such evaluation. We keep your own personal doctors well informed, and once you are pregnant, you can go back to them for your care.

We are happy to take the most difficult cases, which have lower prognosis, that other programs may refuse to treat or even cancel in mid-cycle (for fear it would lower their reportable pregnancy rate and thereby hurt their “marketing” efforts). We will give you an honest appraisal of your chance for pregnancy in any given treatment cycle and will not artificially “inflate” statistics by “patient selection.” We are happy to take patients over 35 with only small numbers of follicles [see video], couples with previous IVF failure, and men with severely low sperm counts or no sperm at all in the ejaculate (requiring microsurgical testicular sperm extraction). Nonetheless, by maintaining the highest possible quality of care and always being on the cutting edge of new technology, we will give even these difficult, lower prognosis patients their best possible chance. We have very high pregnancy rates despite taking on some of the most unfavorable cases. We have been ranked as one of the top 5 infertility centers in the country and the number one center in the entire midwest and south.

 

PREGNANCY RATES PER CYCLE
(Fresh and Frozen Transfers)

Procedure Performed Pregnancy Rates
ICSI w/ uterine embryo transfer (ICSI/IVF) 51% (361/711)
Frozen Embryo Transfer (FET) 49% (58/119)

PREGNANCY RATES PER CYCLE
(By wife’s age and ovarian reserve)

Normal Ovarian Reserve
Low Ovarian Reserve
Age Pregnancy Delivery Pregnancy Delivery
< 30 years old 64% (108/170) 56% (96/170) 48% (13/27) 41% (11/27)
30-39 years old 57% (183/323) 47% (151/323) 35% (62/175) 27% (47/175)
40-42 years old 37% (10/27) 15% (4/27) 20% (5/25) 16% (4/25)


There are many treatment additives that are often enthusiastically endorsed by some programs, that we feel have no validity. This includes varicocele surgery for the husband, and aspirin, heparin, or immunoglobulin infusions, etc., for the wife. We do not recommend such additives. However, we do employ the most effective stimulation protocols, the most advance culture systems, and very refined micro-techniques in the lab (such as ICSI, assisted hatching, fragment removal, and even blastomere biopsy to maximize your chance for having a baby) with no add-on fees or gimmick payment plans.

We do specialize in the most difficult infertility problems, where there has been failure to fertilize or to achieve pregnancy in previous efforts, and our results are quite good even with such cases. Patients with difficult infertility problems fly to St. Louis regularly from all over the world. But we will also treat simpler cases as well. We always prefer to avoid needless and expensive conventional testing and treatment approaches that give low success rates and just add to the couple’s mounting frustration. Our policy is to recommend the most effective treatment that is likely to get you pregnant the soonest.

Infertility treatment can be emotionally wrenching and can place a great deal of stress on the patient. We insist on providing personal care and attention as we guide you through this difficult period of your life. You should please feel comfortable to call my office at any time regarding any questions, problems or worries.


The Infertility Epidemic

We are in the midst of a worldwide epidemic of infertility. Ironically, even in countries with severe overpopulation, one of the most common reasons for a visit to the doctor is the inability to have children. Twenty-five percent of modern couples in their mid-thirties everywhere in the world are infertile. From our teen years (when the last thing we really want is a child) to our mid thirties (when we finally feel emotionally and financially secure enough to start a family), there is a twenty-five-fold decline in our ability to get pregnant. Let me explain.

Ironically, the incidence of infertility in teenagers is rare. For women in their early twenties, still only 1 to 2 percent are infertile. By their late twenties, however, 16 percent of women are infertile, and in their mid to late thirties, 25 percent are infertile. By age forty, more than half of women are infertile, and pregnancy beyond age forty-three is very uncommon. If you are in your thirties, have been working hard to establish yourself, and are now just casually thumbing through this booklet at your doctor’s office because you’re thinking maybe in a few years you might like to start a family, you should realize that there is a 25 percent chance you will not be able to do so without medical intervention. What accounts for this dramatic increase in infertility over the last forty years is just the woman’s biological clock, which correlates with her declining store of eggs. Even by the time you are just in your mid twenties, there is a 10 percent chance

follicle_pool


you will have become infertile, even though five years earlier you would have had no problem at all getting pregnant. The biology of fertility in humans has not changed in the last forty thousand years. What has changed in the last few centuries is our life span and the age at which we first try to conceive.

Men and women are now able to obtain fuller educations, develop themselves in their careers, and contribute dramatically to the intellectual and economic prosperity of the modern world. This would not occur so readily if we were saddled with children as teenagers or in our early twenties. But this change in society is also the reason for the epidemic rise in infertility.

Nonetheless, with dramatic new technology, virtually any couple now (with a few exceptions) can have a child. But you must understand the myriad complexities of your reproductive system in order to get the right help instead of the wrong help, and to deal with the emotional and financial costs the process might cause if you are not savvy. Most important, you need to understand your biological clock and how to manage it. Our intention is (1) to teach you how to manage your biological clock so that you won’t need technology to get pregnant, and (2) to explain how you can use technology safely to get pregnant if that is currently your only option.