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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.

IVF for Older Women

Mini-IVF for Older Women Success

The biggest problem in IVF is the older woman. It is not her age that matters, but the age of her ovary and her eggs. She has fewer eggs and the eggs she has have a lower pregnancy rate per egg than younger eggs. This aging of eggs and decline in number of eggs begins earlier than many women realize. Fertility actually begins to decline in the 20’s and IVF success rates begin to decline in the mid 30’s. By 40’s and older, 80% of women are infertile, and IVF pregnancy rates are very poor. However, we do have good solutions for this problem.

A stimulation protocol we call “mini-IVF” originating in Japan and perfected by us in St. Louis, gives older women a smaller number of better quality eggs at lower cost. Older women will not get many eggs anyway, and so it is better to get good eggs at lower cost.

“Mini-IVF” takes advantage of your own natural FSH elevation with an ingeniously simple protocol that strives for a smaller number of better quality eggs. Instead of massive doses of expensive hormones to try to blast out a few poor quality eggs, it more naturally teases out of the ovaries their best quality eggs with a carefully devised protocol of minimal stimulation. There are no symptoms of huge hormonal swings of hyperstimulation. It is easier on the patient, more difficult on the doctor, and much cheaper than conventional IVF. For older women it is best to do several cheaper cycles to store up good quality embryos than go through the huge dose of an expensive conventional IVF cycle.

We are willing to take on the most difficult cases with lower prognosis, so long as we feel there is a chance for pregnancy. Women over 38 years of age often have very few eggs, respond poorly to conventional ovarian stimulation, and because of lower pregnancy rates, are often just cancelled by IVF clinics for fear that such cases will lower their reportable statistics. Also, such patients usually require huge doses of expensive drugs that can add another $6,000 or $7,000 to the already high cost of conventional IVF, bringing total costs to as much as $18,000 or more per cycle. That is not our approach.

Dr. Silber is world leader & pioneer of the most widely used in vitro fertilization techniques. His patients fly in long from 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.

What If There is Just No Good Eggs Remaining In The Older Woman So That Mini-IVF Fails?

We do suggest donor eggs to older women in whom even mini-IVF has failed, and we are strong advocates for donor eggs once a woman has run out of her own eggs. But with this mini-IVF approach of storing up vitrified embryos month by month in older women, we have a remarkable pregnancy rates even in women over 42 years of age but it takes a great deal of patience on the part of the patient to retrieve just a few eggs at a time for several months until enough embryos are banked to warrant thawing and transfer.

Dear Dr. Silber and Staff,


I wanted to write and thank you for making Mother’s Day 2010 one of the best days of my life. We celebrated with our amazing two-month-old twin baby girls and we wanted to extend our sincerest gratitude for helping us realize our dream to become parents.

We were both well over 40 and every doctortold us there was NO CHANCE. We soon found that local doctors were not willing to “work with us” because of my age 43 . We changed doctors 3 times and they all prescribed the same conventional treatments and tests. This went on for a whole year while I was just getting even older. We finally figured out these doctors were trying to waste enough time to force us into using donor eggs, rather than pursue a plan that would help us try to have our OWN children. We realized that using donor eggs is a viable option for some couples but had told each doctor from the beginning that was not what we wanted. I was devastated when I realized they had basically wasted 11 precious months of our time!

Then we saw Dr. Silber. I figured if Dr. Silber was that good at thinking outside of the box, he could help a healthy 44 year old become a mother. I “googled” and found out the office was only a four and a half hour drive away.

We believe that God works through people and we had a feeling we were in the right place when we noticed a “promise” displayed on the wall that said Dr. Silber would work to the best of the ability God had given him to help people. Dr. Silber explained to us the odds of conceiving because of my age, now 43, but he also had a plan to give us a chance. Things seemed to keep telling us we were on the right track.

July 6th we found out we were pregnant. July 21st we found out it was twins! WOW!! I was treated like any other “normal” high-risk pregnancy because of my “advanced maternal age” of43 and carrying twins. I had a very healthy pregnancy and made it to 39 weeks with what my OB described as a pregnancy better than most of her moms carrying “singletons”. We had beaten the odds.

Our very healthy and alert baby girls were born one week after my 44th birthday on March 8th! They continue to amaze us each day as we watch them grow and change. Brielle and Lillian bring such joy to our lives and we have not stopped smiling. We are so blessed.

We cannot thank you enough for your willingness to extend your expertise to successfully treat the infertility issues which older couples face.

Forever Grateful,
Dr. Dan & Lorelei Andedo
Rock Island, Illinois

Our Story:

Rich and I would like to extend a personal thank you to Dr. Silber, Dr. DeRosa and Mindy Stone for helping to make our dream of having a baby come true!


A friend of ours first told us about Dr. Silber in2012 as we began to explore IVF options. We were optimistic when we heard about his minimal stimulation IVF method designed to help older women get pregnant. At the time, I was 43 years old. We opted for very simple mini_IVF and were fortunate enough to generate 10 embryos. In November 2012, we had four of them implanted and as a result, we got our baby girl, Justine Rae Wooten on August 17, 2013! We couldn’t be more thrilled and feel truly blessed. It’s early to say with asix week old baby at home, but who knows — we might try for a little brother or sister for Justine with our six left over frozen embryos, which are hanging out over at St. Luke’s Hospital! Everyone else told us there was no chance with our own eggs, but we to you because we only wanted a baby with our own DNA. If you are thinking specifically about minimal stimulation IVF, Dr. Silber and Dr. DeRosa are so knowledgeable and on the cutting edge of this incredible science. And Mindy Stone was fantastic as our coordinator — so compassionate, organized, accessible and kind.

Julie Follman, Rich Wooten and Justine Rae Wooten
St. Louis, MO

A 45 year old woman and her husband had been through a tough terrible time. She had gone through years of unsuccessful and even damaging treatments, including surgery to remove her right ovary. She had IVF with conventional high dose stimulate in her home town and never got pregnant. She was told there was no chance of getting pregnant with her own eggs. So they came across the country to St. Louis to us for mini-IVF.

She had three very easy and relatively inexpensive cycles of mini-IVF in which I’ve wound up freezing a total of 14 embryos for less cost than her massive conventional IVF attempt at home. Of course with our freezing technology there is no embryo loss or damage.

Three months later we transferred three embryos (this was because she was 45 years old), and she gave birth to a healthy baby, plus she had eleven more frozen embryos (mind you with her eggs, not donor eggs) to add to her family when she is ready for more children. From those remaining frozen embryos, she got pregnant again, and had her second healthy baby at age 46.

A 47 year old woman and her husband were married for six years, and trying to get pregnant ever since with no success despite three cycles of conventional IVF elsewhere that cost them over 60, 000 dollars. Furthermore he had no sperm in the ejaculate and required TESE just to get sperm for ICS with her 47 year old eggs. Of course they were told to use donor eggs, but they only wanted a baby using her own eggs. So she came to us eventually to try mini-IVF. We got two embryos from only eggs in her first cycle and froze them. We got again two more embryos from only two eggs in her second cycle. Then she just ran out of eggs. But from those four embryos, at age 47 she obtained a healthy pregnancy (with her own eggs) at age 47.

Not everyone gets pregnant with their own eggs at such an advanced age, but many do, using mini-IVF.

We know that all women, older or not, want to get pregnant with their own DNA, and we work hard to achieve that. However that is not always successful. If a woman absolutely cannot get pregnant with her own eggs, then donor eggs are her only remaining option.

Actually, although not her first choice, is nonetheless, not a bad second option. We have been offering donor egg IVF for over 27 years and, therefore we have had a chance to follow these children and their parents for more than a quarter century. I have had a strong interest for over 40 years in child development, and have enjoyed watching these children I have helped bring into the world grow up. One of the things I have learned by my observation of these families is that personality, intelligence, character, and identity, are not in the DNA, but in the early interaction between parents and child during the first two or three years of life. We have never even had an unhappy story with donor eggs.

How Does It Work? How Do You Select An Egg Donor?

Many IVF programs just have a small local pool of egg donors, which we feel is not a favorable approach. We work with a variety of specialized donor agencies all around the U.S. encompassing every geographic region and every ethnic and racial group so as to give the couple with ovarian failure the largest possible choice.

If you have any questions, you may call us at (314) 576-1400.

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