ACFS Blog

Arizona Center for Fertility Studies was founded in 1982 with a commitment to the successful evaluation and treatment of infertility, as well as to the emotional well being of couples and individuals. Some say that infertility cannot be overcome. At ACFS, we are committed to your vision of having children become a reality. The clinic embraces all patients, regardless of age, marital status and gender preference. What speaks far louder than the words of our commitment to you are the more than 8000 babies born to our patients. Today, the Center stands at the leading edge of fertility studies and scientific research.

ACFS continues to strive for new breakthroughs in the field of reproductive medicine by staying in the forefront of state-of-the-art techniques. This also supports us in offering you accurate information and the emotional support you need. Couples seeking to have children are often confused by the barrage of complex language and statistics that surround treatment. Yet, with the rapidly expanding options available, there is much to be gained from persistence in asking the right questions and demanding the answers that you can understand. In fact, we believe that with up to date technology and a clear understanding of your goal, pregnancy is now possible for more couples than ever before.

With best wishes and a successful outcome,

Jay S. Nemiro, M.D.

BECOME A FAN BY SEARCHING ARIZONA CENTER FOR FERTILITY STUDIES ON FACEBOOK

ACFS has had it’s first and only set of identical triplets in 25 years.  What a wonderful, inspirational and miraculous story.  What a privilege to work with such a remarkable woman.  The odds of such births are one-in-a-million, and some experts put them as high as one-in-200-million.

http://www.myfoxphoenix.com/dpp/news/only_on_fox/gayles-girls-5-25-2010

Published with permission of Gayle Jensen

New large meta-analysis suggest that women are not putting their lives at risk and that pregnancy may even have protective effect on overall survival. There is a wide perception in the medical community that women with a history of breast cancer should not get pregnant. This study strongly argues against that.  In all, 14 trails published between 1970 and 2009 were included in this meta-analysis.  Together these trials involved more than 19,000 women with a history of breast cancer, of whom 1,417 were pregnant and 18,059 were not pregnant at the time of the study.  Women who became pregnant after being treated for breast cancer had a 42% decreased risk of dying when compared with women who did not get pregnant.  These studies show that pregnancy is safe in women with a history of breast cancer, said Dr. Azim of the Institut jules Bordet in Brussels. Further analysis of the data are planned and more information is necessary but this is a great start.  ”For the time being, the take-home message is that women who want to get pregnant following breast cancer can do so-it’s safe,” Dr. Azim said.  Published in OB.GYN News, May 2010

SB 1306 (the egg bill)

The good news:  SB 1306 no longer bans compensation for egg donors (which would have effectively ended egg donation treatment in Arizona).

The bad news:  It still mandates unprecedented informed consent procedures for egg donation that apply only in Arizona.  Informed consent is already obtained by all physicians before any medical procedure, but the Arizona Government is now dictating to fertility doctors exactly how and when egg donor consent must be done.  The goal, it appears, is to discourage the long-standing and mainstream therapeutic treatment of egg donation for infertility, regardless of how much it might be needed by an infertile couple to have a family.

Although never intended for this use, a popular use of PGD (preimplantation genetic diagnosis) at ACFS is for gender selection, or to determine the sex of the embryo for “family balancing”, or motivated by social, psychological or cultural reasons. There is an ongoing controversy about using the PGD technology for determining the sex of the embryos. Not that there is necessarily an argument against family balancing or “wanting a boy rather than a girl”, it is more of what is done with the embryos of the undesired sex? If these “unwanted” embryos are donated anonymously to another couple, that is one thing; but many times they are discarded, raising all kinds of moral, ethical, religious, spiritual and psychological issues for the parents, the clinic and their staff and society as a whole. ACFS respects a couple’s right to choose and, although encourages anonymous donation of “extra embryos”, will honor the couple’s choice to do PGD for sex selection and their decision on disposition of the extra embryos.

Sex selection requires a couple to do IVF with ICSI in order to obtain multiple embryos to perform PGD for gender selection. This makes “having a boy or girl” an expensive procedure; and yet, a couple’s right to decide. ACFS has done numerous PGD procedures for sex selection with very good success rates. PGD is 99.99% accurate in determining the sex of each embryo; thus allowing the couple to accurately choose the gender they desire. To date, there are thousands of babies born, who as embryos underwent PGD for sex selection, with no reported statistical increase in birth defects or other identifiable problems.

Read the rest of this entry »

Egg or oocyte freezing has been around for years, but up to a few years ago was only available as an experimental technique of fertility preservation, and with limited success. While embryo cryopreservation (freezing) has been successful for the last two decades, freezing unfertilized eggs or oocytes is trickier. Eggs are more susceptible to damage from ice crystallization than embryos during the freezing process. Up to a few years ago, a young and/or single cancer patient who wanted to preserve her future fertility, only had the option of fertilizing her own eggs with donor sperm. Also, some couples were faced with the moral and/or religious beliefs in having to decide what to do with multiple unused embryos. A third concern, were from young women, either single or married, that wanted to delay childbearing but were concerned about “getting too old and/or having problems” with resulting increased difficulty with achieving pregnancy; or at being at increased risks of chromosome abnormalities and miscarriages if they delayed childbearing for too long.

With these newer techniques of rapid egg freezing, or vitrification, it is now possible to cryopreserve the female egg (oocyte), as successfully as it has been to cryopreserve sperm. Egg freezing is still a new and mostly experimentally technology that has been shown to be highly effective in preliminary research. There are now a number of babies born with the use of egg vitrification technology; and ACFS now offers egg freezing for patients needing or choosing to preserve their future childbearing potential. We have had good results with vitrification of eggs. To date, there have been no increase in birth defects related to this process. Survival rates for eggs (oocytes) can reach as high as 85% and pregnancy rates as high as 65%, depending on the woman’s age. Pregnancy rates with egg vitrification, with subsequent thawing and fertilization, should be similar to success rates with that of frozen-thawed embryos. Once thawed, the egg can be fertilized using ICSI, an assisted reproductive technology, that injects one sperm directly into an egg.

At ACFS, we have found one additional option that has proven successful in patients attempting IVF- that is the addition of human growth hormone or hGH to the treatment protocol. It is a known fact that hGH is a cogonadotrophin and, like FSH and LH, is absolutely needed for the full and final maturation of an egg. Although, if measured, a patient will have a normal level of hGH in the blood, some patients do not have enough hGH for all the extra eggs that they make. These patients are impossible to identify “up front” but young patients that make a lot of eggs and have poor fertilization rates or do not get pregnant as expected; or women over the age of 38-39, in ACFS experience, and backed up by the scientific literature, seem to have better success rates when adding hGH to their treatment protocol. At ACFS, it is now our policy that all women 38 or older are offered the option of using hGH, as part of their starting protocol for IVF.

A new test was recently released that can accurately determine the sex of your baby at 10 weeks gestation. Studies have shown that in 85% of pregnancies, the baby’s sex was known prior to giving birth. Almost all were determined by ultrasound examinations prior to or around 20 weeks. These ultrasounds, although accurate, are not 100%. Studies indicated the following statistics that influenced the decisions to know the sex of the baby:

• 90% of woman wanted to know the sex of their baby
• 79% of partners wanted to know
• 64% wanted to be able to choose the baby’s name
• 46% wanted to plan the nursery
• 43% of older children and/or relatives wanted to know to baby’s sex
• 9% for genetic and/or health concerns like Fragile X and other X-linked disorders

The test is performed using the pregnant woman’s blood, drawn at about 10 weeks gestation to optimize accuracy. Earlier testing will be less accurate. Currently, Sequenom CMM (Center for Molecular Medicine) shows 100% accuracy at 10 weeks gestation. The test is based on detecting the presence of fetal DNA in the maternal plasma. Using PCR (polymerase chain reaction) technology, the test can detect and identify the SRY gene and multicopy DYS14 marker sequences consistent with Y- bearing or male chromosomes. In the absence of this detection, the fetus is assumed to be female. In order to decrease the risk of a false positive, an ultrasound should be done to rule out the possibility of a missed and/or vanishing twin pregnancy, which could introduce fetal DNA from a non -viable pregnancy. Pregnancy outcome and fetal sex, as determined by chromosome testing, ultrasonography, or after birth were ascertained. SYR and DYS14 PCR were positive in 105 of 105 plasma samples of women bearing a male fetus; and in all 81 plasma samples of women bearing a female fetus, PCR for SRY and DYS14 was negative. However, with any test result, there is always the risk of false positives and/or false negatives.

ACFS now offers this test to all couples who want to know the sex of their baby early in their pregnancy for personal reasons, to eliminate the potential inaccuracy of ultrasound, for genetic and/or health concerns and to avoid the risks associated with amniocentesis and/or CVS.

The cost is $395

Please call the office with any questions at 480-860-4792.

We wanted to write and try to put into words the most amazing experience of our lives, which you and your staff have afforded us.  As we started trying to put this into words, we found ourselves searching and searching to find words to describe our gratitude.  Sure we can say thank you over and over, but it does not even come close to describe our feelings.  We came to you with a dream, and you made that dream come true.  Through all the trials and tribulations we experienced you gave us hope.  In our times of doubt and frustration, you gave us answers.  And through your passion, education, and experience you gave us our son.  This has been the most amazing experience of our lives.  Getting to feel Asher move around in me and knowing that it is Stacy’s genes, and my body keeping him alive was truly AMAZING.  This has brought us both so much closer and we thank God for you guys everyday for being such miracle workers.  We cannot stop looking at Asher, he is truly a blessing and a true miracle.  And, because of you and your staff, he is in this world.  Thank you does not seem to capture the magnitude of gratefulness, but, from the bottom of, our now three, hearts, we thank-you.  You gave us our miracle and truly made us feel apart of your family not just patients.  We look forward to starting this journey all over again, and having three more miracles.  Yes, I said three more.   With all our love, Susan, Stacy and Asher