IVF Special Considerations

Intra Cytoplasmatic Sperm Injection (ICSI): In cases where sperm count, mobility or function is compromised; injection of a single sperm into the egg may be the only way to achieve fertilization. Practiced at NEFI since 1993 this procedure requires sophisticated equipment as well as considerable skill. Using ICSI, fertilization can be achieved even with extremely low sperm concentration.

Assisted Zona Hatching (AZH): The Zona Pellucida is the protein shell that surrounds the egg and the embryo. Prior to implantation the embryo has to break through the shell and establish direct contact with the uterine lining. We suspect that in some cases, infertility is a result of the embryo’s inability to do so. AZH creates a weak spot through which would the embryo will emerge (hatch) from the Zona and implant. AZH at NEFI is performed with a state of the art laser instrument. The laser ensures accuracy and practically eliminates any risk to the embryo as a result of the procedure. AZH has been shown to increase the chances of IVF success.

Endometrial Activation: At the New England Fertility Institute we continually evaluate new research and keep abreast of medical breakthroughs in the field of reproductive endocrinology and infertility. Incorporating research into our practice allows us to contribute to the body of knowledge and advance the medical treatment of couples suffering from infertility. Over the past year we have evaluated a new procedure meant to improve the chances of implantation and successful pregnancy in IVF cycles. The procedure named “Endometrial Activation” was the result of research preformed in Israel by a team of scientists led by Dr. Nava Dekel of the world renowned Weitzman Institute in Rehovot, Israel.

Pre-Implantation Genetic Diagnosis (PGD): This procedure provides genetic information about the embryos prior to transfer. The information obtained through PGD is used to select the best embryos for transfer. A single cell is removed from an 8 cell embryo and used for diagnosis. The procedure requires considerable skill and does not effect the embryo’s viability. At NEFI a sophisticated laser is used to create an opening in the Zona Pellucida, which then allows the cell to be extracted.

PGD is used for

• Aneuploidy Evaluation: Any deviation from the normal number of chromosomes (extra or missing chromosomes) can lead to miscarriages or birth defects (down syndrome, etc.). Counting the chromosomes and ensuring a correct number can prevent some of these abnormal pregnancies by allowing us to pick the best embryos for transfer.
• Single gene defects: A variety of conditions are a result of a defect in a single gene (cystic fibrosis, muscular dystrophy, sickle cell anemia). These conditions can be diagnosed by PGD. The single cell is checked for the defective gene and the unaffected embryos are identified.

IVF for single women and gay couples: IVF using donor sperm or donor eggs is practiced regularly at NEFI. For gay men an egg donor is combined with the sperm of one or both partners. The embryos are then placed in the uterus of a surrogate. Gay women often use donor sperm for inseminations or IVF. We also provide support for single women who are contemplating pregnancy and interested in donor inseminations.