ART
(Assisted
Reproductive Technology)
ART is the general term
applied to all procedures where the oocyte (egg) is removed for a period
of time from the woman's body.
IVF
(In
Vitro Fertilization)
IVF involves the union of oocyte
and sperm in the laboratory with the embryo returned, two to six days
later, to the uterus. This is the original ART procedure and was
first done for tubal disease or severe endometriosis. It is now
often done for male infertility, including previous vas ligations, and for
couples with unexplained infertility.
ZIFT (day
after retrieval) and TET (2 or 3 days after retrieval) involve return of
the embryo to the fallopian tube rather than the uterus. TET and ZIFT are done
only in very select situations in our
facility because of the increased expense involved and the need for a
laproscopy to do the transfer. The success of ZIFT and TET is no better
than IVF. No ZIFTS or TETS have been done since 2001.
ICSI
(Inter
Cytoplasmic Sperm Injection)
ICSI is
done either for very low sperm counts or when sperm morphology is
poor. The ICSI technique injects
a single sperm into an oocyte to achieve fertilization and an
embryo. This is done as part of an IVF procedure (see photos on
home page)
GIFT
(Gamete IntraFallopian Transfer)
GIFT is the simplest of
the ART procedures. It involves placing oocyte and sperm in the fallopian
tube. It can be done during a diagnostic laparoscopy or during a
laparoscopy to assess or treat mild to moderate endometriosis. GIFT was a
common procedure from 1985 - 1998. Improvements in IVF outcome and the
avoidance of surgery with IVF have made GIFT less desirable. GIFT
procedures have not been performed at Grand Rapids Fertility since 2002.
BLASTOCYTE CULTURE
This procedure involves
culturing the embryo for 5-6 days in the lab before transfer to the
uterus. On average it
does not improve the overall success rates for IVF. Good prognosis
patients do well with or without blastocyst culture. In selected couples, blastocyst culture may decrease the risk of multiple
pregnancy.
Patients with a poor
prognosis will have a poor outcome with or without blastocyst
culture. It is important to realize that blastocyst culture
does not make embryos better. It does allow us to identify the embryos that
are more likely to result in pregnancy and decrease the risk of multiple
pregnancy. For some patients this is a
benefit that warrants the expense of three additional days of embryo
culture.
Cryo Embryo Preservation
Grand Rapids Fertility is a Right to
Life program. All embryos not transferred are Cryo preserved. Cryo preservation
and Embryo thaw neither improve or worsen the prognosis for any embryo. Not all
"embryos" are normal and many abnormal embryos do not survive the Cryo and
Thaw process. Those embryos that do survive have as good or better
prognosis than fresh embryos as they may be "selected" for their normality
by the Cryo/Thaw procedure.
Cryo Sperm
The IVF lab offers Cryo Sperm
Storage for cancer patients and soldiers serving in combat regions. We do
not run a commercial sperm bank. Patients doing donor sperm cycles
purchase sperm from commercial banks and may store up to 2 specimens in
our facility for future use.
Cryo Oocytes
The IVF lab is evaluating protocols for oocyte cryo preservation. Until recently the cryo preservation of
oocytes has had only sporadic success. Several protocols have recently
been trialed in limited studies which indicate that this procedure may
have enough success for oocyte cryo preservation to be offered to
patients. We have IRB approval for oocyte cryo preservation and will offer
this technique after we move to our new facility at the Women's Health
Center.
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