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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 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 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.

Chapter by Dr. Silber in Medical Textbook: Biology of the Oocyte

Transplantation of ovarian tissue or immature oocytes to preserve and restore fertility in humans

By SHERMAN SILBER

Biology and Pathology of the Oocyte: Role in Fertility, Medicine and Nuclear Reprograming,

Natalie Barbey and David Silber, June 24, 2013

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Introduction
It is now possible to preserve and restore fertility, using ovary and egg freezing and ovary transplantation, in young women with cancer who are undergoing otherwise sterilizing chemotherapy and radiation. This approach can also be used for any woman who wishes to prolong her reproductive lifespan. This chapter is limited to the clinically proven therapeutic applications of this technology. Our clinical results with these new therapeutic approaches are adding to our understanding of the basic science of reproduction, and may eventually obviate the growing worldwide epidemic of female age-related decline in fertility.

The developed world is in the midst of a widespread in fertility epidemic. Economies in Japan, the United States, southern Europe, and even China are threatened by a decreasing population of young people having to support an increasing population of elderly and retirees [1]. The most common reason to see a doctor in countries such as India and China, seemingly plagued with overpopulation, is for infertility. Infertility clinics are popping up throughout the world in huge numbers [2]. It is clear to all that the major reason for the world’s growing infertility epidemic is that as women put off childbearing, their oocytes die off and those that survive are of poor quality [3–6]. In her teen years a woman has a 0.2% chance of being infertile, and by her early twenties it is up to2%. By her early thirties, it is up to 20% [2, 7]. Many modern women today do not think of having a baby until their mid thirties, and by then over 25% are infertile, simply because of the aging and the decline in number of their oocytes. This is clearly demonstrated by the high pregnancy rate using donor oocytes from young women placed into the uterus of older women [2, 3, 7]. Yet fertility physicians struggle to make a pathological entity diagnosis to explain the infertility, which in truth in most cases is just a normal physiological response to oocyte aging [2, 3, 7].

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Gosden Chapter Figure 37.3

Histology pre (A) and post (B) vitrification of ovarian tissue

 

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