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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.

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The Infertility Center of St. Louis
The Infertility Center of St. Louis
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Frozen vs Fresh Eggs Success: Jana’s Story at the Infertility Center of St. Louis (Part 7)

Episode 7 of Jana’s eight-part series shifts from banked potential to practical game plan: how the Infertility Center of St. Louis turns vitrified eggs into babies—five, ten or even fifteen years after freezing. Seated beside Dr. Sherman J. Silber, Jana asks what happens “when future-me comes back.” Silber begins with reassuring data: because vitrification prevents ice-crystal damage, thaw-survival and embryo-development rates are nearly identical to those of fresh eggs. The only measurable difference is a ∼10% decline in per-egg efficiency, so the clinic’s strategy is to freeze a larger cohort up front.

Using a tablet, he shows a probability curve: 15 eggs ≈ 70% chance of one live birth; 25 eggs ≈ 90%; 32 eggs ≈ 97%, plus surplus embryos for siblings. Jana’s own stash currently stands at 18 eggs, and she plans a second low-stimulation cycle to reach that 32-egg “sweet spot.” Silber emphasizes that numbers are individualized: ovarian reserve, partner-sperm quality and willingness to pursue genetic testing all feed into a personalized forecast.

The protocol for return patients begins with standard pre-pregnancy labs and uterine assessment. On thaw day, embryologists warm 5–6 eggs at a time, rinse out cryoprotectant and immediately perform intracytoplasmic sperm injection (ICSI) to maximize fertilization. Embryos grow to day 5/6 blastocysts; optional pre-implantation genetic testing (PGT-A) can identify euploid candidates, further raising success odds and lowering miscarriage risk. A single euploid embryo is transferred in a hormone-prepared cycle; extras are refrozen with a minimal survival penalty.

Silber notes that live-birth outcomes and neonatal-health metrics mirror those from fresh eggs, dispelling myths about “older womb, older eggs.” The episode ends with Jana reflecting on the relief of a numbers-based roadmap: technology makes egg freezing possible, but statistical planning makes it powerful. Viewers learn that proactive cohort goals and tailored thaw-to-transfer protocols convert stored youth into tomorrow’s family.