Infertile patients cannot afford to wait for treatment while their eggs get older.
Dr. Sherman Silber, Infertility Center of St. Louis, is offering free 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 via 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 free 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.
Extract from December 6th, 2019 The New York Times Article about Dr. Silber’s Pioneering Microsurgery
Dr. SilberA 36-year-old man born without testicles received one transplanted from his identical twin brother in a six-hour operation performed on Tuesday in Belgrade, Serbia, by an international team of surgeons.
“Sherman is the best infertility doc in the world, bar none.”
“Infertile couples from all over the world come to St. Louis, Missouri, to chase their dream, because Dr. Sherman Silber and his team are simply the best there is.” – Discovery Health Channel Documentary
Dr. Silber interviews cancer patients both before ovary freezing and years after they defeated cancer to then go on to have successful pregnancies.
Dr. Silber’s classic book, How to Get Pregnant, lays out in simple, clear terms the basic information that will help infertile couples learn how they can have a healthy, happy baby.
IVF and ICSI:
In vitro fertilization (IVF) means that fertilization takes place outside the body, in a small glass dish, and the fertilized eggs, i.e., embryos, are then placed directly into the uterus. IVF was originally used in cases where the fallopian tubes are damaged preventing natural pregnancy, but now it is successful for virtually all types of infertility. Intracytoplasmic sperm injection (ICSI) is recommended for fertilization to make sure the sperm (even poor quality sperm) fertilizes the egg properly. In ICSI, the eggs and the sperm are fertilized in the laboratory, by direct injection of a single sperm into each egg. The resulting embryos are then simply placed into the uterus with no surgery, just as with IVF. Dr. Silber and colleagues in Brussels were the original developers of intra-cytoplasmic sperm injection for the severest cases of male infertility, even azoospermia. His team is so experienced and competent with ICSI that they use it for all IVF to get the best fertilization results. Dr. Silber and Japanese collaborators have recently developed a new “mini-IVF” technique that saves money, eliminates complications of IVF, and is useful for older women and women with low ovarian reserve. He has pioneered “mini-IVF” in the United States, which lower cost dramatically and increases pregnancy rates.
IVF cost is a major concern of most infertile couples. Our “mini-IVF” protocol allows us to use less drugs (with virtually no hormonal side effects) to get fewer and better-quality eggs. This reduces cost in half and actually increases success rates.
There are now techniques to literally freeze your biological clock and preserve your fertility so that you can have children later, when you are older and ready to have children. Egg, ovarian tissue, embryo, and sperm can all be preserved indefinitely, and furthermore we have perfected our freeze/thaw procedures to achieve success rates which are just as high as with “fresh” eggs. We even have the ability now to determine precisely where you are on your biological clock , so that you will know exactly how long your fertility can be expected to last. Egg and ovary freezing are also remarkable for preserving fertility in young cancer patients who otherwise would become sterile as a result of their curative chemotherapy and radiation. Our clinic is the only one in the United States successfully freezing and transplanting back ovary tissue for cancer patients.
Microscopic vasectomy reversal allows men who have had a vasectomy to become fertile again. Tubal ligation reversal does the same for previously sterilized women. Vasectomy reversal is performed under a microscope with very high magnification, using delicate instruments and suture that Dr. Silber designed specifically for this surgery. This microscopic technique was first invented by Dr. Silber in 1975 and revolutionized vasectomy reversal. Dr. Silber re-operates on many men who have had unsuccessful vasectomy reversals elsewhere. Also, we can microsurgically and almost painlessly retrieve sperm and inject into your wife’s eggs (ICSI) as an alternative. Dr. Silber was, in addition, the first in the US to perform microsurgical tubal ligation reversal. He has a success rate of over 90% and has performed over 8,000 such procedures, dwarfing all other centers in the world.
First with identical twins, then with non-identical sisters, our center was the first in the world to perform successful ovary transplants. Using this technique to freeze the ovary before cancer treatment, we can stop your biological clock so you can have children at a later date after you are cured of the cancer. As with egg freezing, ovary freezing is remarkable for preserving fertility in young cancer patients who otherwise would become sterile as a result of their chemotherapy and radiation.
For men with heretofore considered hopeless infertility, with “no sperm,” microsurgical sperm retrieval is the technique for retrieving sperm directly from the testicles of men who have no sperm in the ejaculate.
Women with multiple fibroids and, even worse, “adenomyosis” are generally considered inoperable and are just advised to remove their uterus. That would eliminate their chance of ever getting pregnant. However, with our adenomyomectomy operation, we can now successfully save your uterus. This operation was originally taught to us by the famous Dr. Hiaso Osada, who now is retired. No one else in the world performs it, but our results with it are spectacular for the worst cases of adenomyosis of the uterus. You do not have to lose your uterus.
The Infertility Center of St. Louis also offers pre-implantation genetic diagnosis (PGD) of embryos, and we were one of the earliest centers to employ this, in the 1990’s. We are very experienced and knowledgeable with embryo genetic diagnosis. This reduces the risk for transmission of genetic disease you might be a carrier for and provides screening for birth defects such as cystic fibrosis, muscular dystrophy, Tay-Sachs, and Down’s syndrome, etc. However, general PGS or PGT-A for chromosome counting(without looking for a specific gene defect) is very inaccurate, can reduce pregnancy rate, and increase the cost dramatically. So you should be carefully advised about it. Many clinics erroneously and deceptively perform this on all patients just to generate more revenue needlessly.
In the News focuses on important developments in the science of infertility treatment, with articles of general interest and a selection of some of Dr. Silber’s scientific research papers. Also take a look at our selection of online video and audio (Media Library), optimized for downloading. Dr. Sherman Silber’s detailed book is summarized in the How to Get Pregnant section, as is a complete bibliography, for those who wish to study the field more deeply. About Dr. Silber gives you a closer look at the biography of this renowned pioneer in microsurgery and IVF.
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Dr Silber, head of the team that evaluated over 20,000 cycles of Mini IVF and natural IVF, and discovered that at any given age group, the live baby rate per egg is 4-5x higher with Mini IVF than with conventional massive stimulation. These results were reported at European Society of Human Reproduction and Embryology (ESHRE) in June 2019.