UC San Diego Fertility » IVF

RP-UCSD provides IVF Services for the US Armed Forces

admin — Thu, 27 Aug 2009 19:20:24 +0000

Reproductive Partners-UCSD Regional Fertility Center has been exclusively providing IVF services to the US Armed Forces for over 10 years with extraordinary success. We are the only program within San Diego that has a long standing successful relationship working with the US Armed Forces.

Reproductive Partners was chosen for our outstanding IVF success rates that are well above the national averages in all categories and for our world class embryology lab. Additonally, our center is the only fertility center in San Diego receiving special recognition for achieving these high pregnancy rates with a low average number of embryos being transferred, which reduces the risk of triplets and the risks associated with higher order multiple pregnancies.

We are very proud that the military has continued to entrust us to provide IVF care for them. Qualified Military beneficiaries may use our Embryology services that have a proven successful track record in conjunction with the Navy Physicians. Patients may also elect to have all of their IVF services performed here at Reproductive Partners-UCSD Regional Fertility Center and take advantage of our discount for military patients. Please contact our financial services representative to find out more information.

22nd Annual In Vitro Fertilization and Embryo Transfer

admin — Mon, 06 Jul 2009 22:12:22 +0000

Dr. Garzo and Dr. Meldrum will be speaking in July at the following course organized by the UCLA Office of Continuing Medical Education.

Four Seasons Biltmore
Santa Barbara, California
July 12, 2009 to July 15, 2009

This program brings together a renowned faculty to present the latest developments in every phase of in vitro fertilization and embryo management. The course addresses the needs of practicing scientists, gynecologists, reproductive endocrinologists, residents, and fellows who wish to review the specialty and update their knowledge in this rapidly changing and expanding field.

Particular attention will be devoted this year to the use of new adjuncts to gonadotropins, GnRH antagonists, endometriosis and IVF, oocyte cryopreservation, extended embryo culture, cumulus co-culture, and practical aspects of ultrasound-guided transfer technique, in vitro maturation of immature oocytes, and new microarray techniques for PGS.

Program Agenda:

Sunday, July 12, 2009

Focus Session – GnRH Agonists and Antagonists

Adjuncts to Stimulation – Agonists, OC, Metformin, Growth Hormone, Androderm, Dex
David R. Meldrum, MD

OC Pretreatment of Antagonist Cycles and the Need for LH Activity
David R. Meldrum, MD

Monday, July 13, 2009

Transvaginal Follicle Aspiration – Making Difficult Retrievals Easier and Minimizing Risks
David R. Meldrum, MD

Gestational Surrogacy – Excellent Outcomes for the Most Difficult Patients
Gabriel Garzo, MD

Lifestyle, Stress Reduction, Counseling, Acupuncture, Smoking, Exercise and Nutrition – They All Make a Difference
David R. Meldrum, MD

Wednesday, July 15, 2009

Luteal Phase Support and Transfer Technique
Gabriel Garzo, MD

For more information, please visit: http://www.cme.ucla.edu/courses/event-description?event_id=660689

In Vitro Maturation of Immature Eggs (IVM)

Dr. David Meldrum — Fri, 22 May 2009 22:56:57 +0000

IVM is a variation of in vitro fertilization (IVF), wherein the eggs are aspirated from the ovaries with minimal hormonal stimulation. The eggs are then matured for 24 to 48 hours in the laboratory, fertilized with intracytoplasmic sperm injection (ICSI), and the resulting embryos are transferred to the uterus. This procedure prevents the need for stimulation of the eggs to full maturation in vivo, thus avoiding the discomfort of multiple injections, elevated hormone levels, and the risk of ovarian hyperstimulation syndrome (OHSS). The cost is somewhat less than regular IVF. Correspondingly the success rate is lower (about 30-35%) compared with regular IVF in comparable high-responding women (50-60%). The principal advantage is in avoiding OHSS, which can be very uncomfortable, require removal of fluid from the abdomen, sometimes require hospitalization, and rarely be complicated by serious complications or extremely rarely, by death. One disadvantage is the need to transfer more embryos to achieve this rate of success, exposing the patient to a risk of high order (more than twins) multiple pregnancy. With regular IVF now many of these highest prognosis patients can elect to have single embryo transfer (SET) with their risk of twins therefore being minimal. The most important risk is whether the increased exposure to in vitro conditions could increase abnormalities of the offspring compared with regular IVF. To date about 500 babies have been born with as yet no indication of an increased risk of fetal abnormalities, but until many thousands have been born (over a million IVF babies have been born world-wide), it will not be possible to determine whether IVM procedures are entirely safe. For this reason, IVM is still considered experimental.

The aspects of IVM that are being investigated to attempt to improve the outcomes are timing and preparation before egg retrieval, culture conditions, and improving implantation. For example, it has been found that when human chorionic gonadotropin (hCG) is given to the woman prior to egg retrieval, the rate and speed of in vitro maturation is accelerated. Various additives are being investigated in the culture medium, such as gonadotropins, fetal serum, and even newer substances that improve maturation of the egg nucleus and cytoplasm. Women with polycystic ovaries (PCO) are prime candidates for this procedure, but have a higher rate of miscarriage with IVM. One method that could reduce that risk would be metformin, which favorably affects a number of factors that influence implantation.

With improving culture conditions and embryo quality with regular IVF allowing more women to have SET, and with adjunctive treatments such as metformin, and cabergoline that reduce the risk of OHSS, it is difficult at present to say whether IVM is likely to be an advantage as an alternative to regular IVF in the future. Reproductive Partners UCSD Regional Fertility Center is constantly monitoring the progress of such techniques and will implement IVM at the point where it is clearly shown to be both safe and advantageous for our patients.