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The Leading Edge IVF Research at The Fertility Center of Las Vegas At the Fertility Center of Las Vegas, our philosophy is to stimulate optimally, trigger safely, and transfer your best embryos into an ideally prepared uterus. While these principles may seem obvious, extensive research was needed to determine how to achieve these goals. We continue to improve the best practices of fertility medicine. We were among the first to standardize blastocyst transfer in the late 1990s. This practice allows us to select the most viable embryos for transfer. Growing embryos to the blastocyst stage before transfer prevents the transfer of embryos that lack the developmental potential to reach the blastocyst stage. This cannot always be recognized from an embryo’s appearance at earlier stages. With blastocyst transfer, we select the most viable embryos. This way we can sustain high pregnancy rates while transferring fewer embryos, and therefore reducing the risk of triplet pregnancy. Our recent publications on blastocyst transfer: Large blastocyst diameter, early blastulation, and low pre-ovulatory serum progesterone are dominant predictors of clinical pregnancy in fresh autologous cycles. Contrasting patterns in in vitro fertilization pregnancy rates among fresh autologous, fresh oocyte donor, and cryopreserved cycles with the use of day 5 or day 6 blastocysts may reflect differences in embryo-endometrium synchrony. Blastocyst diameter, day of blastulation, and pre-ovulatory serum progesterone simultaneously correlate with clinical pregnancy after blastocyst transfer. Comparing Day 5 and Day 6 Blastocyst Transfers in Fresh Autologous, Frozen Autologous, and Fresh Oocyte Donor Cycles Granulocyte-macrophage colony-stimulating factor enhances human embryo development to the blastocyst stage: a randomized study Vero cell coculture with sequential blastocyst media: a randomized controlled study comparing two different cleavage-stage media formulations Quantitative grading of a human blastocyst: optimal inner cell mass size and shape. A comparison of day 5 and day 6 blastocyst transfers. Predictive value of 72-hour blastomere cell number on blastocyst development and success of subsequent transfer based on the degree of blastocyst development.
Patient safety is paramount. One of the greatest risks for IVF patients, particularly those with high response to ovarian stimulation, is that they may acquire “ovarian hyperstimulation syndrome” (OHSS). The severe form of OHSS is serious, and should be avoided whenever possible. A hormone called hCG is implicated in the cascade of events leading to OHSS. Many clinics use only hCG to trigger ovulation in IVF patients. Often they are forced to cancel cycles in very high responding patients in order to avoid OHSS. Or they might “coast” (stop the stimulation early), a practice shown to reduce egg yield. Still, the incidence of OHSS remains too high. We were among the first to standardize the use of GnRH agonist for final oocyte maturation in very high responders. We use the GnRH agonist alone or with a very small dose of hCG. This practice safely gives high yields of high-quality eggs while virtually eliminating the risk of significant OHSS. There is no need to cancel or “coast” cycles in our patients with high response. Our recent publications on safe triggering to eliminate OHSS: Gonadotropin releasing hormone agonist combined with a reduced dose of human chorionic gonadotropin for final oocyte maturation in fresh autologous cycles of in vitro fertilization. Comparison of human chorionic gonadotropin and gonadotropin-releasing hormone agonist for final oocyte maturation in oocyte donor cycles. Cumulative pregnancy rates when using GnRH agonist instead of hCG for final oocyte maturation Eliminating Severe Ovarian Hyperstimulation Syndrome By Using GnRH Agonist Instead of HCG Effects of the ovulatory serum concentration of human chorionic gonadotropin on the incidence of ovarian hyperstimulation syndrome and success rates for in vitro fertilization. Low serum HCG concentrations following the ovulatory dose of HCG are not associated with reduced IVF success rates Comparison of human chorionic gonadotropin and gonadotropin-releasing hormone agonist for final oocyte maturation in oocyte donor cycles. Including a low dose of hCG along with GnRH agonist “trigger” reduces early pregnancy loss rates when compared to the agonist alone. We were among the first to employ blastocyst freezing and thawing. Our technique yields excellent embryo survival rates and high implantation and pregnancy rates, allowing us to give our patients more flexibility. For example, a high implantation rate with frozen embryos makes it more practical to transfer only one embryo at a time, for those seeking only singleton pregnancies. Our effectiveness with frozen embryos allows many patients to achieve pregnancy without needing to go through additional ovarian stimulation cycles if the fresh cycle should fail, or if they want to have additional children after a successful cycle. Our recent publications on the transfer of frozen blastocysts Improved Survival and Pregnancy Rates with Transfer of Cryopreserved Blastocysts Improved Survival and Implantation Rates for Thawed Embryos |
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