Expert answers – what’s the difference between PGS and PGD?
Our Las Vegas IVF center offers two different types of genetic tests for embryos – preimplantation genetic screening, or PGS, and preimplantation genetic diagnosis, or PGD. Both types of genetic testing screen out abnormal embryos so only those that are “normal” can be transferred to your uterus. But, as our Las Vegas IVF experts explain, there is a big difference between PGS and PGD.
The difference between PGS and PGD is chromosomes vs. genes
When you elect to do PGS or PGD, cells are removed from each embryo created at our Las Vegas IVF center. These cells are then sent to a specialized genetics laboratory for analysis, and your embryos are frozen and stored at our laboratory while you wait for the results.
In PGS, the geneticists examine each cell’s chromosomes to determine if there are too many or too few – a condition called aneuploidy. When an embryo’s chromosomes are aneuploid, a pregnancy could end in miscarriage or cause the baby to have birth defects or intellectual disabilities, as with Down syndrome or Trisomy 13. If an embryo’s chromosomes are abnormal, that embryo can be set aside so that you can transfer an embryo that has a normal number of chromosomes.
So what’s the big difference between PGS and PGD? PGD goes deeper than PGS to analyze specific genes in the cell’s DNA, looking for the one that is linked to a known genetic disease. For example, if you know that cystic fibrosis runs in your family, the geneticists will search for the gene that is known to be linked to cystic fibrosis. If they find it, that embryo will be disqualified for transfer.
Geneticists can use PGD to search for more than 1,000 heritable diseases, including many common disorders that can cause lifelong disabilities or medical issues.
- Tay Sachs disease
- Spinal muscular atrophy
- Duchenne muscular dystrophy
- Huntington’s disease
- Sickle cell disease
Explore your genetic testing options
For most people with no family history of genetic diseases, PGS is enough to provide peace of mind before transferring embryos. However, if you or your partner has a family history of genetic disease, or if your genetic carrier screening indicates that one or both of you is a carrier of a genetic disorder, ask your Las Vegas IVF physician to determine if PGD could reduce your risk of passing a heritable disease to your children.
To learn more about the difference between PGS and PGD, contact us to schedule a consultation at our Las Vegas IVF center.
Egg freezing can protect your future fertility
Not so long ago, many women felt they had to sacrifice their careers, education and other priorities because they didn’t want to miss the chance to have a baby. Today, thanks to egg freezing, women have a tool to help delay motherhood until the time is right.
Because our fertility specialists are among the leading experts in fertility preservation, people come to us from all over the world for egg freezing in Las Vegas. The egg freezing process is similar to IVF, but instead of your eggs being immediately fertilized and growing into embryos, they undergo a special cryopreservation process that preserves them until you’re ready to use them, years or even decades from now.
Who should consider egg freezing?
Any adult woman who has not yet entered menopause and wishes to have a child in the future could be a candidate for egg freezing. Egg freezing keeps family-building options open for women in many different life situations.
- Women of any age who wish to delay motherhood to focus on education, career or other priorities
- Women who want a future family, but haven’t yet found the right partner
- Women who need cancer treatment and worry about losing their fertility
- Women facing deployment or extended time away from their partners
- Transgender individuals undergoing surgery to transition from female to male
Many factors affect the quantity and quality of eggs that can be retrieved and frozen for future use, but the most important one is time. If you’re considering egg freezing, don’t wait. Your egg quality and quantity will not improve with time, so there’s no better time than now to explore your options.
Get smart about your fertility
If you’re contemplating egg freezing, we urge you to make an appointment with one of our egg freezing specialists so that you can get tested to measure your remaining egg supply. You may learn that you have some time to wait to freeze your eggs, or that you need to act quickly to capture your eggs at optimum quality and quantity.
To learn more about egg freezing in Las Vegas, or to determine your ovarian reserve to make an informed choice, contact us to schedule a consultation.
Find out if ovarian reserve testing is right for you
If you’ve ever wondered how fast your biological clock is ticking, there’s a way to find out. Ovarian reserve testing provides information about how many eggs you have left so that you can decide when and how to conceive a child when the time is right.
When women come to us for Las Vegas fertility testing, ovarian reserve testing is one of the first tests we order. This simple blood test measures hormone levels in your blood at a specific point in your cycle, unlocking the mystery of what’s really going on with your egg supply.
Candidates for ovarian reserve testing
Because egg quality and quantity decline the closer you get to menopause, you might think that ovarian reserve testing is just for older women. But the truth is, diminished ovarian reserve can happen at any age, and it’s better to learn about it early if you want to have a baby someday.
For family planning, many women want to learn as much as they can about their current and future fertility. You may wish to get ovarian reserve testing if you:
- Have reached your 30’s and want to know if you have time to delay motherhood
- Have been unsuccessfully trying to get pregnant for six months or longer – especially if you’re in your 30’s
- Are considering preserving your fertility with egg freezing
Ovarian reserve testing is a standard part of our Las Vegas fertility testing for women, as it provides valuable information about the best treatment to overcome any fertility issues that may be discovered.
Women with low egg reserve may need assisted reproductive technology to become pregnant, such as intrauterine insemination (IUI) or in vitro fertilization (IVF). The results will also be used to calibrate your treatment plan and medications, maximizing your chances of success.
Get smart about your fertility
Ovarian reserve testing arms you and your fertility specialist with the information you need to plan your future family. The earlier you can identify issues with your egg supply, the more options you will have when you’re ready to have a baby.
To learn more about ovarian reserve testing and get answers about your fertility, contact us to schedule your Las Vegas fertility testing.
Nevada surrogacy laws make the state a great place for surrogacy
Helping another family realize their dream of having a child is the most rewarding part of becoming a gestational carrier. But thanks to friendly Nevada surrogacy laws, there are many other great reasons to learn more about Las Vegas surrogacy.
The laws of the state in which the baby is born are the laws that will apply to each case of gestational surrogacy. If you live in Nevada and are considering becoming a gestational carrier, or if you are an intended parent seeking the help of a gestational carrier, it’s important to understand how Nevada surrogacy laws provide strong protections for everyone involved.
Carrier-friendly Nevada surrogacy laws
Amended in 2012, Nevada surrogacy laws allow hopeful parents to make legal agreements with a gestational carrier, who will carry the baby for them but will not have any genetic relation to the child. Nevada law is specific about all aspects of surrogacy.
- A valid contract is required for all gestational carrier arrangements.
- A gestational carrier cannot be genetically related to the baby she is carrying.
- Gestational carriers can receive payment or compensation.
- Intended parents are responsible for all of the carrier’s medical and legal expenses, and any other related expenses that may arise.
- A pre-birth court order can establish parentage, so no post-birth adoption process is necessary.
Gestational carrier contracts, which are legally enforceable in Nevada, must explain in detail exactly what the carrier’s and intended parents’ rights are. This covers everything from embryo transfer to surrendering custody of the baby after it is born, as well as all other legal and financial aspects of the arrangement.
Under Nevada surrogacy laws, the intended parents are the legal parents of the future child as soon as the contract is signed. The carrier cannot be held responsible for any financial or other obligations, no matter what happens during the pregnancy or with the child.
Nevada surrogacy laws also open up parenthood for more people. Intended parents don’t have to be married or legally registered as domestic partners, and single people who want to become parents can also use a gestational carrier. Sexual orientation doesn’t matter, and intended parents don’t have to be from Nevada. In fact, many travel here from other countries to find a surrogate.
Learn more about becoming a gestational carrier
With Nevada surrogacy laws, both the intended parents and the gestational carrier are required to secure separate lawyers to guide them through the contract process. If the baby will be born in Nevada, be sure to use a Nevada family law attorney who has experience with assisted reproductive technology.
If you’d like to learn more about Nevada surrogacy laws and Las Vegas surrogacy, contact us to schedule a consultation.
Kim Trede coordinates international fertility treatment
When men and women from around the world travel to our Las Vegas fertility center for care, Kim Trede, director of communications, guides them through the first steps of the treatment process. Kim manages scheduling of international fertility treatment, bringing global patients together with our world-renowned physicians through technology.
She takes the complexity out of international fertility treatment
Working with patients primarily through email, Kim collects as much information about each individual or couple as possible so that they and their physician can make the most of their remote consultations. She also works with the master calendars for our office and each of our physicians, scheduling appointments to take place using Skype video conferencing.
This advanced approach to international fertility treatment minimizes travel time and expense for patients, while providing access to the same level of personal, compassionate care that has made our Las Vegas fertility center a worldwide destination for fertility treatment.
Because her job involves juggling schedules across meridians and oceans, she has mastered the art of scheduling across time zones and keeping with international preferences.
“For example, when the patient is in France or Spain, they prefer late appointments, and noon here is 9 p.m. their time, so it works out perfectly,” she notes. “They can schedule their doctor appointments for when they are at home, and they don’t have to worry about fitting it into their workday.”
With carefully coordinated Skype appointments and electronic sharing of patient information, even complex international fertility treatment involving egg donation or surrogacy can be primarily conducted remotely. Each patient is assigned an international case manager who can speak their native language – English, Spanish, French or Chinese. All case managers have extensive experience with the fertility treatment process, and they are present to assist the patient during the initial consultation and on all follow-up Skype conversations.
A longtime member of the FCLV family
Kim also assists with payroll and employee benefits for the fertility center’s staff.
“What I love most about my job is that each day is different,” Kim says. “There’s a lot of variety in my day, and I really enjoy the people I work with. I really enjoy making a difference in people’s lives.”
Kim initially joined The Fertility Center of Las Vegas in 2000, working in medical records. Her husband’s job in another state took her away from Las Vegas for a few years, but when the family moved back in 2011, we eagerly welcomed her back in her current role.
Originally from Colorado, Kim and her husband of more than two decades have three children. Together, they enjoy cooking and travel – and not surprisingly, given her aptitude for scheduling, Kim’s the one who loves to plan their family vacations and outings.
To learn more about international fertility treatment, contact us to schedule a consultation. Kim, together with our entire team of experienced professionals, looks forward to assisting you.
Dr. Shapiro to share single embryo transfer research at ASRM 2017
People travel from all over the world to our Las Vegas fertility center for a good reason – our reproductive endocrinologists are among the best in the field, and they are innovators who are changing fertility care for the better on a global scale. Two of Dr. Shapiro’s research studies showing that frozen/thawed embryos implant more readily than fresh embryos were called “two of the most important trials performed in IVF in the past 10 years” by Jacques Cohen, the Editor in Chief of the medical journal, Reproductive Biomedicine Online.
At the upcoming ASRM Scientific Congress and Expo, Dr. Bruce Shapiro will lecture the Reproductive Endocrinology and Infertility interest group on the proper conduct of research, and Dr. Carrie Bedient, will study leading-edge research while sharing their own insights with their peers on groundbreaking topics, including single embryo transfer.
The ASRM Scientific Congress gives reproductive endocrinologists and other reproductive medicine professionals a valuable opportunity to explore the newest innovations and research in the field. At the event, which takes place October 28 – November 1, Dr. Shapiro will be giving a presentation on “Implementing Research in Your Everyday Practice,” and will share three research abstracts.
The latest research on single embryo transfer and IVF
Two of the abstracts co-authored by Dr. Shapiro explain recent research that supports elective single embryo transfer and “freeze-all” IVF, in which embryo transfer is delayed until after an IVF cycle and preimplantation genetic screening (PGS) is employed to reduce the risk of transferring a chromosomally abnormal embryo.
A third abstract examines the effectiveness of a specific anti-Müllerian hormone (AMH) test.
- Routine transfer of multiple embryos is no longer necessary to achieve high rates of healthy singleton births in women up to 42 years old.
- Blastocyst vitrification and PGS have facilitated “freeze-all” cycles, benefiting both the patients and laboratory.
- The report of AMH for predicting premature ovarian failure using the Access 2 Immunoassay is consistent with published data using earlier ELISA-based AMH assays, and supports that AMH may be a useful biomarker for assessing ovarian reserve as part of evaluation for women considering IVF.
“Freeze all” cycles followed by single embryo transfer have become the standard of IVF care at our Las Vegas fertility center, resulting in high pregnancy and live birth rates with greater safety and improved infant health over the obsolete approach of transferring multiple embryos in order to compensate for inferior implantation rates with fresh transfers. Because achieving success with just one embryo reduces the risk of a high-risk multiples pregnancy, our clinical goal can now be summed up with just five words – “one embryo, one healthy baby.”
The abstracts submitted by Dr. Shapiro add to the wealth of fresh research to be presented at ASRM 2017. Dr. Shapiro and Dr. Bedient look forward to attending the event’s lectures, poster sessions and other educational and networking activities to explore the most current research available in the field of reproductive medicine.
To learn more about single embryo transfer or freeze-all IVF, contact us to schedule a consultation at our Las Vegas fertility center.
Romain Taillandier provides French fertility coordination for third-party IVF and reproduction
When Romain Taillandier learned that our Las Vegas fertility center was seeking a French-speaking professional to coordinate international third-party reproduction, he was excited to apply. Bringing the perfect personality, skills and experience for the job, Romain was welcomed into our team this month as an IVF case manager, providing French fertility coordination services for egg donation and surrogacy in Las Vegas.
Romain and his husband, the French television host, author, producer and actor Alex Goude, moved to Las Vegas four years ago to have and raise a child together. Surrogacy, known in France as “gestation pour autrui” (GPA), is not permitted in their home country, and as a gay couple who wanted a biological connection to their baby, the United States was the best place to get the fertility treatment they needed. Their son, Elliot, is now two years old and the light of their lives.
“I want to help French people do the same process and have a family, and I know everything about that,” he says. “So when I saw that The Fertility Center of Las Vegas was looking for someone to take care of French IVF patients, I said, ‘It’s the perfect job for me!’”
A perfect fit for French fertility coordination in Las Vegas
Having gone through the process of finding an egg donor, choosing a surrogate and experiencing third-party IVF first-hand, Romain is a strong advocate for gay fertility treatment and parenting, as well as for all French couples and individuals who need third-party reproductive services to grow their families. His personal experience and compassion make him an ideal liaison for patients needing French fertility coordination in the United States.
Because Romain and his husband are well-known in France, he has become somewhat of an ambassador for French patients who need third-party reproduction to build their families.
Romain maintains a strong social media presence on Twitter, Instagram and Facebook, sharing his family’s story through words and photographs. When French couples reach out to him to learn more about gay family building, he is always eager to help them find their way to egg donation, or “don d’ovules,” and surrogacy through our “centre de fertilité” in Las Vegas, where LGBTQ people are warmly welcomed.
Romain’s typical day starts with using Skype to meet with French couples and coordinate their treatment plan, working around different time zones. Sometimes, that means working on weekends, when French couples are often more available.
“I manage each person’s care with all of the people here who are taking care of the patient, from the doctors to the nurses to the laboratories and third-party agencies,” Romain explains. “I can also translate during appointments when patients don’t understand English.”
Before joining our fertility center to manage third-party IVF, Romain used his master’s degree in marketing and communications to start his own digital communications company and manage websites for clients. After Elliot was born, he took about a year off to just be a dad.
Family life in Las Vegas
“I love Las Vegas,” he says. “It’s so easy to have a family here. It’s calm, it’s quiet, and we have a house and backyard. My husband works in Paris right now and travels home quite a bit. We have a dog, and I love to go to the cinema. I’m a Netflix addict and like to play poker, although I play less often now that we have a baby.”
Apart from his job providing French fertility coordination and managing egg donor and surrogate IVF treatment, spending time with his husband and little boy is Romain’s greatest joy.
“For us, the IVF process was just wonderful,” he says. “We met with just one surrogate mother, or mére porteuse, and the first embryo transfer took. Elliot was born right on his due date, and everything was just perfect. Our boy is perfect, too. We’re thinking of having another child, and might start the process again next year.”
To learn more about third party reproduction, including donor egg, donor sperm and surrogacy in Las Vegas, contact us to schedule a consultation. Romain, together with our entire team of experienced professionals, looks forward to assisting you.
Two kids after failed vasectomy reversal: The Carro family’s story
Jessica Lovell, a former Las Vegas news anchor and reporter, was 35 when she married 43-year-old Tony, who runs a legal services company and was already the father of two pre-teens. When they decided to have kids together, Tony underwent surgery to reverse a prior vasectomy, and for a year, they tried to conceive naturally. But by the time Jessica turned 37, she still wasn’t pregnant.
Overcoming a failed vasectomy reversal
Jessica’s obgyn told her that her best chance to become a biological mom was a visit to our Las Vegas fertility center and Bruce Shapiro, M.D., who he described as “a fertility genius.” Jessica first attended a free seminar at our fertility center, then made an appointment to get to the bottom of the couple’s inability to conceive.
Fertility tests ordered by Dr. Shapiro quickly revealed sperm quantity and quality issues related to the failed vasectomy reversal, as well as the fact that Jessica had a blocked fallopian tube and age-related egg quality issues. Dr. Shapiro’s solution: IVF with frozen embryo transfer.
“We were surprised to learn we had one bum tube, egg quality issues and not enough sperm,” Jessica says. “We had just figured we were going to be able to have kids when we were ready. We never thought it would be an issue. Infertility wasn’t something I ever thought I’d come across. We weren’t thinking we would ever have to go into the IVF world. It just wasn’t on our radar.”
That spring, Jessica began taking fertility medications for the first of three nearly back-to-back egg retrievals, with a goal of producing as many eggs as possible. After each IVF cycle, in March, April and June, her eggs were fertilized by Tony’s sperm, and the resulting 15 embryos were frozen, giving Jessica’s body time to recover before embryo transfer.
“Frozen transfer made a lot of sense when Dr. Shapiro explained it,” she says. “You go through all this medication to do the retrieval, then you’re asking your body to get back in the mode of accepting transfer right away. It’s better to wait a month or two and then start over, making sure that your body is ready to take the embryos in. It worked for me.”
Ultimately, two embryos survived the thaw and growth stages, and both were transferred. One became Jessica and Tony’s first child together, daughter Sunnye Lucille.
Repeat IVF after failed vasectomy reversal
Soon, the Carros decided to try again. This time, the day before egg retrieval, Tony got cold feet. The idea of a fourth child suddenly became overwhelming. When Jessica came into the office upset and uncertain about what to do, Dr. Shapiro offered to retrieve Jessica’s eggs and freeze them until the couple was ready, and even offered to let them pay for the retrieval when they were ready to move ahead.
“It was such a tough, emotionally charged time for us, and Dr. Shapiro knew it,” she says. “What he did for us just shows what kind of person he is.”
Four months later, Tony was back on board, and the couple decided to move forward with fertilizing Jessica’s frozen eggs. This time, they got three embryos, yet sadly, genetic testing showed that they would not be able to survive.
When Jessica was 40, the couple decided to try one more time to make their dream of another child come true. This time, only one egg was retrieved.
“We thought there was no way that one egg would make it all the way through the process of fertilization, genetic testing, freezing, thawing, transfer and implantation, but it sure did,” Jessica says. “I had really accepted that there was no way we were going to have another baby. When they called the day of transfer to say the embryo was ready to go, I couldn’t believe it.”
That embryo is now the Carros’ son, Dominic David, born when Jessica was 41.
“I always tell people who are experiencing infertility not to get discouraged, because it really only takes one good egg,” she says. “Embrace the process and science behind this journey. It may not be what you planned, but enjoy and have faith in this path, regardless of the outcome.”
An emotional journey
During her experience at our Las Vegas fertility center, Jessica came to count on the IVF staff to answer questions, provide moral support, explain how to give injections, and even answer her middle-of-the-night texts when she feared she was having a miscarriage.
“I felt so needy, but the girls at the office always reassured me that everything was fine and it would be OK,” she says. “They were busy, but they always knew exactly where I was in my process without having to pull my chart. They knew me. I felt so good about that.”
Though infertility and IVF weren’t easy for the Carros, they came out the other side stronger than they were before.
“It puts a lot of strain on your finances and your marriage,” she says. “You see the pictures of me and my family, and you think that we had this perfect, ideal situation. To get there, it was not pretty. It was not fairy tale stuff. I want people to know that sometimes it’s rough, but keep fighting on. I did two transfers and got two healthy babies. It’s never lost on me how lucky we have been.”
To learn more about options for having children after a failed vasectomy reversal, contact our Las Vegas fertility center.
New study reveals dramatic sperm count decline
It’s natural for men to be curious about their fertility, especially when they are ready to become dads. That’s why so many men visit us for fertility testing in Las Vegas. They want to know what’s going on with their sperm count.
New research offers some surprising news that men today may not be as fertile as their fathers and grandfathers, which highlights the importance of male fertility testing.
A new study, published in July 2017 in Human Reproduction Update, reveals that in the four decades leading up to 2011, sperm count declined by 59% among men in North America, New Zealand, Europe and Australia. Sperm concentration also went down by 52%.
What do these sperm count findings mean?
The long-range study of nearly 43,000 men was based on semen samples collected between 1973 and 2011, in 50 different industrialized Western countries. Overall, sperm concentration declined by 1.4% each year, and sperm count went down by 1.6% annually.
- Sperm concentration: The number of sperm in each milliliter of fluid
- Sperm count: Sperm concentration multiplied by total ejaculate volume
The research didn’t delve into the reasons behind the declining sperm count numbers, but the leader of this study suggested that exposure to a growing number of chemicals may be one of several causes. Exposure to certain endocrine-disrupting chemicals can have harmful effects before a man is even born, as these chemicals can cause issues with a baby’s growing reproductive system.
Certain chemicals – including some frequently used for pest control – can also affect hormone production in adults. Other research has associated low sperm count and declining fertility with obesity, smoking, stress and exposing the testicles to extreme heat.
Our advice for men who are trying to become dads and are concerned about sperm count:
- Try to avoid exposure to chemicals, heat and stress
- Eat a healthy diet
- Stop smoking
If you’re like most men and really want to understand what your sperm count and concentration mean, see us for male fertility testing.
Male fertility testing can provide detailed information about a man’s fertility potential, including overall sperm count and the sperm’s ability to swim and penetrate an egg. A simple test called semen analysis is the first step, and it’s often covered by insurance as part of a complete fertility diagnostic workup.
To learn the facts about your or your partner’s sperm count, contact us to schedule male fertility testing in Las Vegas.
Single embryo transfer for a single healthy baby
If you’ve been trying to conceive for a while, getting pregnant with twins might seem like a dream come true. So, if you’re undergoing IVF, you might be surprised when your fertility specialist plans to transfer only one embryo. There is a good reason that we typically recommend single embryo transfer, though: It’s simply safer for you and your baby.
Our goal is for you to have a healthy baby. Our Las Vegas IVF experts have perfected the IVF process, often producing several high-quality embryos. This means we can choose the single best embryo for transfer, with high confidence of success. For most women or anyone pursuing surrogacy, just one good embryo is all that is needed, and any remaining embryos are frozen in case the first transfer fails or a future sibling is desired.
The risks of multiple vs. single embryo transfer
Still, many people ask, why not save time and just go for twins, instead of doing a single embryo transfer? While many twin pregnancies end in the safe delivery of two healthy babies, the risks are simply much higher with two or more fetuses.
- 57% chance of low birth weight with twins, compared to 9% with a singleton
- 9% chance of a very low birth weight with twins, compared to 2% chance with a singleton
- 65% chance of premature birth of twins, compared to 14% chance with a singleton
Low birth weight and prematurity can be very dangerous for a newborn, in some cases resulting in lengthy hospitalization and long-term disabilities. In addition to jaundice and an inability to regulate body temperature, these newborns are at greater risk for respiratory, digestive and heart problems; hearing or vision loss; intellectual disabilities; cerebral palsy; bleeding in the brain; and even death.
Twin pregnancies are hard on the mom’s body, too, and require costly “high-risk pregnancy” care. You’re more likely to have pregnancy complications or need a cesarean section with twins, too.
Trust your doctor
If you’re undergoing IVF and want to learn more about the risks of multiple vs. single embryo transfer, talk to your fertility specialist. Together, you can weigh the risks and benefits, so that you and your physician can choose the approach that’s right for you.
To find out more about multiple vs. single embryo transfer, contact us to schedule a consultation with one of our Las Vegas IVF experts.