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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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Preventing Ovary Aging: Dr. Silber’s New Pressure-Based Approach – ESHRE 2025

Reporting from the 2025 ESHRE Congress in Paris, Dr. Sherman J. Silber shares results that may rewrite the timeline of female fertility. Building on 40 years of ovary-transplant data, his St. Louis research group focused on the micro­environment that keeps a woman’s earliest egg cells—primordial follicles—in suspended animation until monthly recruitment begins. Using high-resolution pressure sensors originally developed for vascular surgery, they measured a surprisingly strong intra-ovarian mechanical tension. This “internal squeeze,” Silber explains, functions like a natural brake: when pressure remains high, follicles stay dormant and genetically intact; when it drops, more follicles exit dormancy, accelerating egg depletion and quality loss.

The team demonstrated the concept in paired ovary-transplant studies between identical twins. Transplanted tissue that maintained native pressure profiles aged at the donor’s original pace, while tissue relieved of tension showed a faster decline in follicle count and chromosomal integrity. The insight reframes ovarian aging as partly mechanical, not purely hormonal or genetic.

Silber’s lab is now testing non-invasive ways to sustain optimal pressure: injectable hydrogel micro-scaffolds and customized compression wear designed to support the ovarian cortex without impairing blood flow. Early animal data show a 25-30% extension in viable follicle life span. If translational studies in women aged 40-48 confirm similar retention, the approach could offer an adjunct—or even alternative—to egg freezing and high-dose IVF stimulation.

Because the strategy does not rely on pharmaceuticals or surgery, regulatory hurdles are lower and adoption could be rapid. Silber envisions simple office-based procedures that “reset mechanical youth” in the ovary, allowing extra years of natural conception or dramatically higher IVF success with fewer cycles. For millions of women facing dwindling egg supply, the discovery converts ovarian aging from an unavoidable countdown to a manageable variable—and brings the promise of extended fertility within sight.