Fertility Science Has Changed In A Big Way, But The Basic Principles Remain

by Dr. Louis Weckstein

Fertility through the yearsWith the birth of the first “test tube” baby born in the San Francisco East Bay in 1985 and the second baby in the nation born from a frozen embryo one year later, a new era in fertility science was ushered through the doors at Reproductive Science Center.

Having been an infertility specialist for more than 25 years, I’ve seen some significant changes to the practice of fertility science. As RSC has remained on the leading edge of scientific advancement for the past thirty years, so too we remain steadfast in our mission to provide the best opportunities  for making all people families.

When I joined RSC in 1990 the practice of fertility science was in its infancy and the work we were doing was approached with pronounced caution. College-aged women simply didn’t talk about donating their eggs, and couples were equally guarded in disclosing their IVF treatments to family and friends. At that time, the public still viewed fertility treatment as taboo. It is for this reason it took until 1999, 18 years after the first IVF birth in America, for the number of IVF births in the U.S. to reach 45,000.

For clinics across the nation, the public perception of fertility was only legitimized through a process of normalization: our science was gradually accepted in society as more families experienced successful fertility treatment.

One of the most prominent shifts in fertility science has been the realization that men are a primary source of infertility: low sperm counts in men result in infertility about 40 percent of the time. During analysis of sperm, we focus on sperm density (number of sperm per milliliter), sperm motility (percentage of moving sperm) and sperm morphology (sperm appearance). With the introduction years ago of the technique ICSI (Intra Cytoplasmic Sperm Injection) we see high success rates for couples with male factor infertility.

For women who are experiencing infertility, blastocyst culture and transfer has proven to greatly improve IVF pregnancy rates and lower multiple pregnancies.

For this procedure, we now grow embryos to the blastocyst day-five stage after fertilization in the laboratory, and choose the most developed embryos to implant back into the uterus. RSC is pioneering the use of time-lapse photography to see which embryos are growing and dividing quickest, which – preliminary studies show – may have the best chance for pregnancy.

This process not only allows us to implant fewer embryos, but also through a process known as pre-implantation genetic diagnosis (PGD) we can screen for devastating genetic disorders such as Cystic Fibrosis, Huntington’s disease, Sickle Cell disease and Tay-Sachs disease.

With advanced technology we no longer need to transfer high numbers of embryos to ensure a greater chance for pregnancy. With refinements in embryo selection techniques we encourage single embryo transfers to reduce multiple pregnancies in many women. At RSC in 2012, 31 percent of women using their own embryos – 38 years of age and younger – elected to transfer one egg and the clinical pregnancy rate was 61 percent. 

Last October, American Society of Reproductive Medicine (ASRM) removed the “experimental” label from the technique of vitrification (a method of cryopreservation or freezing of eggs), thereby granting clinics greater freedom in focusing efforts to use frozen embryos in the future. Vitrification allows women undergoing chemotherapy and young women who would like to delay childbearing the potential to preserve their fertility.

For women needing an egg donor, vitrification freezing of donated eggs can be used whenever a recipient needs them, without having to worry about donor synchronization. As infertility specialists we have gained greater control of the egg donation process, as the vitrified eggs are proving successful.

So what does all this new science mean for our patients?

When RSC opened its doors, the founders made a commitment to ensure that all prospective patients had the opportunity to create families. 30 years later that vision is thriving. In addition to pioneering technology, RSC is fully dedicated to its mission of helping single women, LGBT couples and women over 40 achieve their dreams of starting families.

I have been practicing at Reproductive Science Center for 23 years because our whole team has remained dedicated to providing support and quality care to every patient. Best care is provided not by a single doctor, but when the whole team is invested in working together to help every patient get though the challenging process of infertility.

We’ve covered a lot of ground over the past thirty years and RSC, to me, exemplifies the unfaltering, persistent vision of fertility for all in need. I believe this is why the practice will remain an integral part of building families in the East Bay community.

The Reproductive Science Center of the Bay Area is a leading pioneer in infertility treatments including IVF with egg donation and LGBTQ family building. We’ll work with you to help you achieve your dreams of having a baby.

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