Posts

13
Mar

Mini-IVF on the Rise: An Affordable Option with Great Potential

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The Wall Street Journal recently published an article highlighting the growing popularity of Mini-IVF.  At CNY Fertility Center, with locations in Syracuse, Albany, and Rochester, NY, we are proud to offer Mini-IVF as an affordable option to our clients, with great potential for success.  Mini-IVF and traditional IVF differ in medication protocol prior to egg retrieval.  Mini-IVF, or minimal stimulation IVF, uses fewer and more mild medications.  This results in fewer follicles produced, minimizing the risk for multiples, and saving clients significant money on medictions.
This unique protocol is something to consider if you are finding that the cost of medications for a traditional IVF cycle is limiting your options.  This is also a good option for those who would like to minimize the risk of multiples, or amount of medications used.  For more information on our Mini-IVF protocol, please see these two informative articles:  Are you thinking of doing a Mini-IVF? and Mini-IVF:  What is It and Why Should I Try It?
We welcome you to schedule a consultation or follow up talk to discuss all of your options, and create a unique protocol suited to your needs.  You are also welcome to contact our Financial Team at any time to discuss your costs and insurance coverage:  Costs@cnyfertility.com
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Request Consultation or Appointment
If you are a new patient and would like an initial fertility consultation, in-office or over the phone, please visit this link and fill out our New Appointment Form or call us toll free at 800-539-9870.

3
Dec

The Basics of Intracytoplasmic Sperm Injection (ICSI)

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What it is:
ICSI is a cutting-edge technique that’s used with in vitro fertilization (IVF) treatment to help increase your chances of a successful cycle. By injecting a sperm directly into an egg, instead of waiting for natural fertilization as with IVF, ICSI may offer a solution to your infertility issues.
Who it treats:
At the CNY Fertility Centers, all couples are encouraged to consider ICSI. Those who are most likely to benefit from ICSI with IVF treatment either suffer from unexplained infertility or have undergone an IVF cycle that resulted in low or no fertility. Also, if the male’s semen sample does not fall within “normal” parameters, ICSI could help conception. Medical conditions that affect the quality or quantity of a man’s sperm include poor sperm motility (athenzoospermia), abnormally shaped sperm (teratozoospermia), and low numbers of sperm in the ejaculate (oligospermia). ICSI can even allow a man who has had a vasectomy to fertilize a woman’s egg.
How it works:
Since ICSI is always accompanied by IVF, the treatment begins by planning for IVF. In preparation for IVF, the woman will take fertility drugs in order to stimulate healthy follicle production. After careful monitoring and assessment of the follicles, eggs will be retrieved from the woman’s ovaries.
Following egg collection, ICSI treatment will differ from IVF. Instead of placing the sperm and egg together in hopes of natural fertilization, an embryologist will inject the man’s sperm directly into the egg. The fertilized egg then develops in an incubator for several days before being transferred, now as an embryo, back into the woman’s uterus.
For fertilization, it is preferable to extract sperm from a semen sample since it’s less invasive. If this is not possible due to a medical condition or past procedure, an embryologist may use needle aspiration by inserting a very gentle, hollow needle into the testicles to immobilize and retrieve sperm. If neither of these options is possible, a testicular biopsy may be performed under anesthetic.
Call us today if you have any questions or would like to schedule an appointment. Click here for contact information.

4
Mar

April's Journey to Fertility: Week Thirty Nine

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April is a CNY Fertility Center patient and has been on her journey to fertility for approximately two and a half years. April will share candid stories and a unique perspective on the fertility challenges many women and couples face. CNY Fertility Center has locations in Syracuse, Albany and Rochester, NY.
Week 39: Trusting Fate
As my husband and I enter the third year in our journey to fertility, I realize there is one important thought that I must keep in mind. One, I still need to believe that I am going to be pregnant; I need to remain faithful that this is a process and a journey that will end at the time that is right for me. Whether it be the universe, God or karma, I am right where I need to be in this moment.
I have learned many lessons along the way and have even embarked on some different adventures, like writing to you weekly. Although the thought of approaching year three is daunting and scary, it is also exciting! I have read so much about what can be done during the IVF process to increase pregnancy chances (assisted hatching, ICSI, etc.) that I am in awe. I have looked over CNY’s financial packages and am grateful. My journey is not over and there are many, many reasons for me to be hopeful and trust fate.
Just the other day, I was watching the February 25th episode of The View (I highly recommend watching this), which completely focused on fertility challenges and treatments. One of the broadcasters of the show went through IVF to achieve pregnancy, one had switched to a gluten free diet and Barbara Walters adopted her daughter. However, Barbara Walters adopted because there were few options for women that many years ago. I try to consistently remember how fortunate we sub-fertile couples are (I refuse to believe we are infertile!) simply because we have choices. There was no IVF years ago, no egg donor option, no ICSI or even recognition of infertility as a disease! I know my husband and I are about to begin our next whirlwind of emotionally and physically demanding appointments as we “turn it up a notch” and begin the IVF process. But I know my chances of becoming pregnant are much better, and we know this is what we want to do. Enough is enough, and it is time for us to move on!
A year ago, I was not sure I would ever be ready for IVF even though I never thought the IUIs would work. I wanted my pregnancy to just happen – who doesn’t? But part of my journey has been about letting go of the way I think life should be and embracing the possibilities that still lie ahead of me. I am letting it all go so that I can peacefully, and even excitedly, move forward and know that we are doing everything we can to create our family!
Fertile Blessings,
April all Year Read more

21
Jan

Embryo Transfer – Day 3 versus Day 5

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CNY Fertility Center has locations in Syracuse, NY Albany, NY and Rochester, NY. CNY Fertility offers affordable fertility treatments including low cost IVF (In Vitro Fertilization). Patients often have questions about the day that their embryos will be transferred back to their uterus following their IVF procedure. This article is a quick summary of the history and advantages of both Day 3 and Day 5 embryo transfers.
Until about 10 years ago, all embryos were routinely placed in the uterus on day 3 of the cycle. Embryos are then at the 6-8 cell stage.

(8 celled embryo – Day 3)
Culture methods then emerged which allowed healthy embryos to continue developing to day 5, the blastocyst stage which has several attractive features.  Most importantly it allows some of the embryos which are doomed to failure due to internal defects to fall by the wayside as they arrest and do not continue to develop. Thus the more hardy embryos are self selecting and the rate of implantation of each embryo is higher.  Culturing embryos out to the blastocyst stage reduced the number of embryos that were transferred back as well, reducing the incidence of multiple gestations.

(Blastocyst stage embryo – Day 5)
Initially it seemed as this was applied in IVF practice, that the ability to choose the more robust embryos by self selection in this manner would raise pregnancy rates. In a common scenario, the choice if a patient had 5 embryos available for transfer, all about equal in quality on inspection under the microscope, the option would be to replace 3 embryos on day 3 or two on day 5. It was hoped that the day 5 embryo transfer would yield higher results for the IVF patient. This has not turned out to be the case. It is however true that the number of triplets is reduced by use of the day 5 strategy, which is an important option to consider when the risk of multiples is paramount.

21
Jan

IUI with Clomiphene, a First Line Treatment for Infertility

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This information is provided for couples who may just be starting out in fertility treatments and are trying to conceive using IUI with clomiphene. CNY Fertility Centers provide infertility services including low cost IVF (In Vitro Fertilization) for couples who are starting or continuing their families in Albany, New York, Rochester New York and Syracuse, NY. In addition to our local services we work with patients from across the country and world offering affordable IVF and fertility treatments.

Unexplained infertility is when a couple can’t conceive although the woman is ovulating, and her fallopian tubes, uterus and partner’s semen results come back normal after testing. Some of the women have had endometriosis diagnosed and treated, thus are not truly unexplained, but do fit into this category in terms of an approach for treatment.

Clomiphene is inexpensive, and acts in women who already ovulate to stimulate production of several eggs during a treatment cycle. Clomiphene causes the brain to misinterpret blood estrogen levels. This induces the pituitary gland to produce a surge of the follicle stimulating hormone or FSH. The result is the production of more than usual numbers of follicles, each with one egg.  Intrauterine insemination (IUI) places more sperm into the uterus and then the fallopian tubes than could ever reach through intercourse. Thus more bullets are shooting at more targets.

The combined use of clomiphene and IUI has been shown to nearly double the results compared to using clomiphene alone to improve pregnancy likelihood (Guzick, 1998). The master student of IUI, Dr Richard Dickey and colleagues in 2002 compiled a large series in New Orleans and reported almost 10% success per cycle.

The distinguished Boston IVF group in a study led by Dr. Alan Penzias recently confirmed a cycle success rate of 11.5% (Dovey, 2008) from over 4000 cycles of treatment. The patients were ovulatory and some of the men had low sperm counts.  The success of treatments cumulatively over up to four cycles, was successful in 24% of patients under age 35. Age specific pregnancy rates per cycle ranges from 12% under age 35 to 4% over age 40. Corresponding decreases in overall success were seen according to age. Only one patient was successful (1.8%) of the 55 women treated over 43 years of age.

The study verified findings by others who found that 90% of success is found in three or four cycles. Those who are not pregnant by then should move to gonadotropin and IUI or IVF therapy.

At RBA in Atlanta, Dr Massey and colleagues found that the addition of a chemical called PAF to the sperm wash dramatically improved success rates (Roudebush 2004) to nearly double those without it. This is a reasonably simple method which more clinicians might use.

Those who are concerned with cost effective treatment for infertility continue to believe that clomiphene and IUI are a good treatment for younger patients who are trying to conceive, and fit the criteria outlined.

Selected References
Dovey S et al Fertil Steril 2008:90:2281-86
Guzick, DS et al Fertil Steril 1998;70:207-13
Dickey RP et al Fertil Steril 2002;78:1088-95
Roudebush WE et al Fertil Steril 2004;82:52-56

21
Jan

Low Cost IVF in the United States

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CNY Fertility Center, founded and directed by Dr. Robert J. Kiltz, with offices across New York State, offers low cost fertility/infertility treatment that include IVF, ICSI, PGD, Cryopreservation, Donor Eggs, and much more. Although fertility treatments are offered worldwide, wide variations are noted in different countries in regard to quality and availability. Medical tourism is becoming a popular means for consumers to find state-of-the-art medical care around the globe. We have integrated both Eastern and Western medicine to provide our clients with a holistic approach to their reproductive care. It is our goal at CNY Fertility Center to become the center of choice both across the United States and to our friends abroad.

Our mission is to provide comprehensive reproductive services in a compassionate, honest and friendly environment at a low cost to our clients. In 2010, Dr. Kiltz has created financial plans to minimize the stress on our clients on their journey to build their family. We offer multiple cycle discounts as well as IVF refund programs. Couples interested in donor eggs will also find that we offer exceptional rates in comparison to many other programs and we as well offer both multiple cycle discounts and refund programs for couples/recipients who are interested in pursuing donor eggs.

As our centers grow to offer services across the United States and around the world, we will strive to meet your needs. We understand the inconvenience of leaving your home for medical care and we will assist you in any way we can to make your stay in New York as comfortable and as convenient as possible. We will provide you with continuous support throughout your journey. Our staff is here for you and it would be our pleasure and our honor to help you build your family.

If you are interested in exceptional, quality care, in a warm environment, at a low cost, please visit our website at www.cnyfertility.com. If you have questions regarding any aspect of the services offered at CNY Fertility Center, please do not hesitate to contact us at (518) 690-0700. Our staff is available 24 hours per day, 7 days a week, to answer any of your questions. We look forward to working with you.

Justine Taylor, RN, BSN
Nurse Manager and IVF Coordinator
jtaylor@cnyfertility.com

24
Sep

PICSI/HBA Multi-Site Clinical Trial

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CNY Fertility Center Syracuse is recruiting patients to participate in a multi-site clinical trial of the PICSI dish’s effectiveness. A PICSI dish is used to select mature sperm which bind to hyaluronan, and the sperm is then injected into an egg during an ICSI.

Intracytoplasmic Sperm Injection (ICSI) is used for about 99% of patients at CNY Fertility Center who are doing an In Vitro Fertilization (IVF) cycle. It is the process in which an embryologist directly injects one sperm into a mature egg, in an attempt to fertilize the egg, creating an embryo.
The embryologist selects the sperm using a microtool called an ICSI needle, under a large, high-tech microscope. The sperm are evaluated for their progression (swimming), as well as their morphology (shape), however neither of these attributes can definitively tell the embryologist that the sperm is mature.
A PICSI dish contains

hyaluronan microdots, to which only mature sperm can bind. Once the sperm are added to the dish the embryologist is able to select only the bound (mature) sperm, using them for injection into the egg. The concept is that mature sperm are more likely to be chromosomally normal, potentially increasing the fertilization rate and subsequent pregnancy rates.


CNY Fertility Center Syracuse is participating in a multi-site clinical trial of the PICSI dish’s effectiveness. We are currently recruiting patients to be in the clinical trial. If you are interested in participating and potentially having a PICSI dish used for the selection of sperm for your ICSI please speak to your nurse, doctor or contact Deb Woodhouse at dwoodhouse@cnyfertility.com.

24
Aug

Preimplantation Genetic Diagnosis (PGD)

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The latest in IVF technology is now available at CNY Fertility Center!
Preimplantation Genetic Diagnosis (PGD) is a procedure for screening for genetic diseases in an embryo prior to transfer to the uterus. PGD can be used to detect embryos with single gene defects. This allows us to screen for diseases like Tay-Sachs, Cystic Fibrosis, Huntington Disease and Sickle Cell Anemia. PGD can also be used to detect embryos that have chromosomal disorders such as Down’s Syndrome.
PGD must be done in conjunction with IVF. After the eggs are retrieved, they are inseminated with the partner’s sperm via ICSI (Intracytoplasmic Sperm Injection) where they take a single sperm and directly inject it into an egg. If the egg becomes fertilized, it should develop into a 6-10 celled embryo by the third day after fertilization. At this point 1-2 of the embryo’s cells (or blastomeres) are biopsied and then the genetic information is analyzed. The laboratory can then tell which embryos are unaffected for the disease
being screened. Only those unaffected embryos are transferred back to the uterus in hopes of a pregnancy.
For more information on PGD, contact CNY Fertility Center, or visit these websites:
http://www.emedicine.com/med/topic3520.htm
http://www.dnapolicy.org/

21
Aug

What is a Semen Analysis?

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A semen analysis is an important diagnostic tool that can indicate male factor infertility. The male partner collects a semen sample in a sterile cup, either at home or at the medical center. A small volume of the specimen is placed on a Mackler counting chamber, which has a grid with 100 squares. The sperm concentration is determined by counting the number of sperm in ten squares, then multiplying by 1 million. The motility of the specimen is determined by calculating the percentage of the sperm that are moving in the same 10 squares. The progression of the sperm (forward motion) is graded on a scale of 0 (no motility) to 3+ (moving quickly across the grid in a forward direction). The pH, agglutination (attraction between sperm), viscosity (gelatinous texture of the sample), and number of red and white blood cells are recorded. Read more

25
May

Male Factor Infertility

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One of the contributing factors to a couple’s fertility difficulties can be problems with sperm number or function. Approximately 15-20% of infertility can be ascribed to male factor infertility. When sperm are evaluated, they are assessed for quantity, motility, and how normal they look. Results can appear normal, borderline, or severely abnormal. Severely abnormal semen analyses will often require in vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI) to achieve pregnancy. Normal or borderline sperm may be able to generate a pregnancy, but at a reduced chance of success.
An important item to remember is that a semen analysis does not measure male fertility; it measures sperm production. From those numbers, we try to draw connections between analyses and chances of pregnancy, but the correlation is not always exact. If problems with sperm production are identified, urological evaluation may be suggested. A urologist can perform a focused history, physical exam, and laboratory assessment, that might identify a reason behind the male’s difficulties. Many times, a hormonal or anatomic reason can be identified, which might be treated with medication or surgery.
Treatment for male factor generally involves increasing the number of normal, motile sperm having access to the eggs. This can be done with timed intercourse around the time of ovulation, intrauterine insemination, or IVF-ICSI. With intrauterine insemination, the seminal fluid is exchanged with neutral, hypoallergenic media, and the best-swimming sperm are collected after treatment in a centrifuge. Misshapen, immotile sperm are discarded, and the fraction of strong-swimming sperm is placed with a thin catheter into the woman’s uterus. Conception will still rely on the sperm’s ability to reach the egg, bind to its shell, and fertilize. If an insemination does not work, there is no way to tell where the process failed.IVF with ICSI minimizes failure by leaving the least to chance. Individual normal, motile sperm are carefully placed into oocytes, giving the highest chance for fertilization. The fertilized eggs are placed directly into the uterine cavity, minimizing the chance for ectopic pregnancy.
Other recommendations for maximizing male fertility include eating a regular diet, and avoiding tobacco, alcohol, and illegal drugs. One multivitamin per day may also help. The elements most likely to impair sperm number or quality include chemotherapy, radiation therapy, and anabolic (muscle-building) steroids. Many times, male infertility can not be “fixed”, but its effects can be minimized with intrauterine insemination or in vitro fertilization.