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.
If you have any questions, you may call us at (314) 576-1400.
“Dr. Silber is world leader & pioneer of the most widely used fertility techniques. His patients fly in from long distances all over the world for treatment at his fertility center and, he is happy to take care of the most difficult cases with warm personal attention and great technical skill.“
History – Dr. Silber invented microsurgical sperm retrieval and ICSI, and was the first to introduce ICSI to the United States.
Low sperm counts and azoospermia used to be considered the one infertility problem which IVF could not treat successfully. Then in 1992, Dr. Silber and his colleagues invented MESA, TESE, and ICSI. This revolutionized IVF and the treatment of the severest male infertility. [watch video here]
If there is a question of the sperm’s ability to fertilize the egg, due to either a low sperm count or poor quality of the sperm, that poses no problem whatsoever. Intra-Cytoplasmic Sperm Injection (ICSI) would be performed instead of regular IVF. We actually were part of the original Belgian team that developed ICSI, and first introduced it to the U.S. We can take a single, almost non-moving “dead” appearing sperm and inject it into a woman’s egg, getting a normal embryo and a completely normal baby. So far, over a million babies have been born with this new technique, from men who were otherwise considered hopelessly sterile. The babies are physically, mentally, and genetically normal, no matter how poor or miserable the sperm of the father.
We can take a man who would otherwise have to resort to donor sperm, and if we can find just a few weak sperm in his otherwise sterile appearing ejaculate, it is more than enough to microsurgically inject these few sperm into his wife’s eggs, fertilize them normally, and get her pregnant.
If there is absolutely no sperm in the ejaculate, we can perform a microsurgically precise testicle biopsy, remove the few non-moving sperm that we find through a highly refined ultra micropipette, inject it into the wife’s egg and still get her pregnant. Even in testicles where allegedly there is no sperm production, we can usually (but not always) find a few sperm, which is enough for successful ICSI. Even in cases where we find no sperm, we can safely freeze the wife’s eggs and save them for a future date when further breakthroughs will allow us to find sperm.
How ICSI Works
With ICSI, the eggs are retrieved the same as if you were doing conventional IVF. However, the eggs and the sperm are then fertilized in the laboratory, by direct injection of a single sperm into each egg. Two to five days later the resulting embryos are simply placed into your uterus with no surgery, just as with IVF. Extra embryos are frozen for later allowing for much less expensive attempts at pregnancy, using the Japanese vitrification freezing technique which does no harm at all to the embryos.
Figure 1: Immobilizing the sperm’s tail before picking it up.
Figure 2: Injection of sperm into the egg.
Figure 3: Fertilized egg demonstrating the two nuclei – one from the father, one from the mother.