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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.

Ovarian Transplant Recipient Gives Birth Twice

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First Child Was Born After Fertility Treatment, but Second Child Was Conceived Naturally

by Kathleen Doheny

WebMD Health News, February 24, 2010

A former cancer patient in Denmark who had an ovarian transplant and gave birth to a daughter after IVF has had another child who was conceived naturally.

The news did not surprise a U.S. fertility expert, who tells WebMD most of his transplant patients have conceived naturally. “They just get pregnant naturally with intercourse,” says Sherman Silber, MD, director of the Infertility Center of St. Louis, at St. Luke’s Hospital.

Still, Andersen says that “we are surprised [at] how robust the procedure turns out and how long the transplants actually remain functional. We have other women who have had functional tissue for more than five years, having been transplanted with somewhat more tissue.” Silber says, “We have 10 children [from his center] already,” he says.

Although the numbers of transplants, pregnancies, and births resulting from ovarian transplants are in constant flux, Silber estimates about 50 ovarian transplant attempts have been made worldwide, with 13 at his center.

In an email interview, Bergholdt recalled the transplant experience. “Of course it is not pain free, but when you have cancer and are facing chemotherapy and much bigger and more invasive surgery this [transplant] was not a big deal,” she writes. “At least not for me! The benefits and hope of having a child of my own did compensate for that pain and discomfort.”

While both pregnancies were initially ”hard to believe,” Bergholdt says eventually “as I grew bigger and bigger I became less skeptical and began to enjoy the pregnancies and all the great expectations about the babies, and me becoming a mother!”

How Ovarian Transplants Work

The freezing or cryopreservation of ovarian tissue is a relatively new medical method, developed initially to help cancer patients with the hope of reproducing once their treatment is finished.

Although the transplant has been viewed as experimental, it is slowly becoming accepted now as the fertility-preserving method of choice.

Ovarian transplants might also help women whose fertility is impaired by treatments for other diseases such as autoimmune diseases. More controversial than a transplant after treatment for a disease is freezing ovarian tissue for transplantation in women who have delayed childbearing or who have entered menopause but then want to conceive.

Silber says that the transplant “sounds like a lot of surgery, but actually it is just a simple outpatient procedure, and not very invasive, compared to months of hormonal stimulation and multiple cycles of treatment required for IVF or egg freezing.”

In response to the Human Reproduction paper, William Gibbons, MD, president of the American Society for Reproductive Medicine, said in a prepared statement: “There is no question that the science behind ovarian tissue preservation and transplantation continues to advance. It is an exciting and rapidly advancing field of research.”

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