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Locations
Mandeville
800 N. Causeway Blvd.
Suite 2C
Mandeville, LA 70448
Metairie
4770 South I-10 Service Rd. W.
Suite 201
Metairie, LA 70001
Baton Rouge
8595 Picardy Ave.
Suite 240
Baton Rouge, LA 70809
Phone Numbers
Local calls: (985) 892-7621 Fax: (985) 892-9245
Toll free inside Louisiana:
(800) 375-0048
Toll free outside Louisiana:
(800) 433-9009
Advance Technologies
Assisted Reproductive Technologies (ART) started in 1978 with the birth of Louise Brown, born as a result of In Vitro Fertilization (IVF). IVF is the most common ART procedure. Other ART procedures include: Gamete Intrafallopian Transfer (GIFT), and Intracytoplasmic Sperm Injection ((ICSI)).
Success Rates
The Center for Disease Control (CDC) and Society of Assisted Reproductive Technology (SART) require that published IVF pregnancy rates be reported as pregnancy per stimulation cycle started, live births per stimulation cycle started and live births per egg retrieval and per embryo transfer.
FERTILITY INSTITUTE OF NEW ORLEANS IVF RESULTS:
Fresh embryos from non-donor cycles
| 2008 DELIVERED AND ONGOING PREGNANCIES | |||||
Age |
<35 | 35-37 | 38-40 | 41-42 | >43 |
| Number of Cycles |
166 | 89 | 72 | 19 | 16 |
Percentage of cycles resulting in pregnancies |
56.0% | 28.0% | 26.4% | 31.5% | 12.5% |
Percentage of cycles resulting in live births |
39.8% | 24.7% | 22.2% | 21.0% | 6.2% |
Percentage of retrievals resulting in live births |
44.6% | 31.4% | 26.7% | 25.0% | 8.3% |
Percentage of transfers resulting in live births |
47.1% | 34.9% | 29.1% | 30.8% | 9.1% |
NEW IVF LABORATORY
| JAN 1 - OCT 14, 2009 ONGOING PREGNANCIES | |||||
Age |
<35 | 35-37 | 38-39 | 40-41 | |
| Number of Cycles |
125 | 50 | 26 | 31 | |
Percentage of cycles resulting in pregnancies |
50% | 48% | 46% | 48% | |
Percentage of cycles resulting in ongoing pregnancies |
50% | 48% | 46% | 29% | |
Percentage of retrievals resulting in ongoing pregnancies |
54% | 53% | 48% | 32% | |
Percentage of transfers resulting in ongoing pregnancies |
55% | 54% | 52% | 43% | |
IN VITRO FERTILIZATION (IVF)
IVF was developed to treat infertility caused by blocked or damaged fallopian tubes. It is now used to treat a variety of infertility problems
IVF requires the stimulation of multiple follicles followed by aspiration of the eggs. These are placed with sperm in a laboratory dish to fertilize outside the body (in vitro). The fertilized eggs form embryos which are placed into the woman's uterus, or womb several days later, where implantation and embryo development can occur just as in any other normal pregnancy.
In vitro fertilization (IVF) is a four-step procedure:
Step 1: Ovarian Stimulation and Monitoring
Various medications are used to stimulate the ovaries to produce multiple mature follicles (controlled ovarian hyperstimulation or superovulation), rather than the single egg normally developed each month. Follicles are cysts in the ovaries in which eggs grow to maturity.
Follicle-stimulating hormone (FSH) is the hormone used to stimulate the development of multiple eggs containing follicles. FSH is given by daily injection. The number of days and the dose will vary depending on follicle development. The response to FSH is monitored by ultrasound and hormone levels. When the follicles are fully developed, usually after 8 to 10 days, human chorionic gonadotropin (hCG) is given to release the eggs and trigger the final maturation of the eggs
Ultrasound
Ultrasound uses sound waves to make sonar pictures of the body. Through ultrasound, the number and size of follicles can be observed.
Blood Tests
The response to FSH is monitored with frequent blood tests. Developing follicles secrete increasing amounts of the hormone estradiol. Along with ultrasound, estradiol levels are used to determine the optimal timing for the administration of hCG.
Step 2: Egg Retrieval
Eggs are retrieved by ultrasound-directed vaginal aspiration of ovarian follicles performed under narcoleptic analgesia, which is a combination of pain relievers and sedation. A needle is guided into each follicle in order to aspirate its contents. The egg along with the surrounding fluid is removed from the follicle. The fluid is immediately examined under a microscope. The process is repeated until all the mature follicles have been aspirated.
Step 3: Fertilization
A semen sample is obtained from the male partner and processed using laboratory techniques to obtain the strongest, most active sperm.
Prepared sperm are placed with one or more eggs in a laboratory dish. After 3 to 5 days, if the eggs have successfully fertilized and are growing normally, they are transferred to the uterus. Not all eggs will be fertilized and not all fertilized eggs will continue to grow. In some cases, the embryos may be transferred as early as 2 days or as late as 6 days after retrieval.
Step 4: Embryo Transfer
Embryo transfer is performed under ultrasound guidance without anesthesia. The embryos are placed in a catheter for transfer into the uterus.
Additional Procedures in IVF offered by the Fertility Institute of New Orleans
ICSI
Intracytoplasmic sperm injection (ICSI) is performed when sperm quality is poor due to a very low sperm count. The head of the sperm is injected into the egg using an extremely small glass needle to pick up the sperm and place it in the egg.
The sperm used for ICSI can be obtained by masturbation or directly from the testes by surgical procedure. Sperm can be extracted directly from the epididymis via aspiration or microsurgical techniques, such as microsurgical epididymal sperm aspiration (MESA) or by sperm aspiration or from the tested as testicular sperm aspiration (TESA). Congenital absence of the vas deferens or seminal vesicles or failed sterilization (vasectomy) reversal, inability to ejaculate are reasons why MESA or TESA might be necessary.
Assisted Hatching
Assisted Hatching involves creating an opening in the outer covering, or Zona pellucida, of the embryo is created using micromanipulation techniques. This technique is used for embryos with thickened zona pellucida.
Cryopreservation
Not every growing embryo will be transferred. It is recommended that only one or two embryos be transferred to most patients. Untransferred embryos can be frozen (cryopreserved) and stored for future transfers. Louisiana State law requires that all embryos which are not immediately transferred and continue to grow must be cryopreserved. Once embryos are stored, they can remain frozen for long periods of time. Half to two thirds of embryos will survive the freezing and thawing process. Cryopreservation allows for further attempts at pregnancy without further surgery.
Egg donors
Conditions requiring the use of donated eggs include premature ovarian failure, genetic abnormalities, prior ovarian surgery, radiation, or chemotherapy, repeated failure of in vitro fertilization, unexplained and repeated miscarriages and advanced age. Egg donation programs may use two types of donors: known or Anonymous. Known donors can be friends or relatives who undergo ovarian stimulation in order to help the recipient. Anonymous donors may be patients who have produce a large number of eggs and are willing to donate their excess eggs or women who are paid to donate their eggs. The Fertility Institute of New Orleans performs egg donation only for known donors and women willing to share eggs from their own IVF cycle (Egg Sharing Program).
Host Uterus
In the absence of a functional uterus, a patient may choose to have another woman carry the genetic baby conceived from her eggs and her partner's sperm. Eggs are retrieved and fertilized in the same manner as for IVF, except that the resulting embryos are transferred into the host uterus to develop. This procedure is performed only after careful psychological evaluation is performed on both couples involved and a legal agreement is in place between the couples.
PGS
PGS (Pre-Implantation Genetic Screening) technology is an optional diagnostic test that can be performed as part of an in-vitro fertilization (IVF) cycle. PGS permits analysis of the genetics of embryos prior to transfer. Common genetic abnormalities, such as Trisomy 13, Trisomy 18, Trisomy 21 (Down's syndrome) and Trisomy 22, which can end in term pregnancy, and genetic abnormalities such as Trisomy 8, Trisomy 9, Trisomy 15 and Trisomy 16, which result in miscarriage, can be detected. Genetic testing may also be used to determine the sex of embryos. Multiple oocytes are produced, retrieved and fertilized. Once the fertilization occurs and embryos develop over the next 2-3 days to 6-8 cell stage, one or two cells from each embryo are removed for analysis.
Genetic testing of pre-implantation embryos is indicated for patients with recurrent pregnancy loss or repeated unsuccessful IVF, whose infertility may be related to chromosomal abnormalities and for patients at risk of Down Syndrome and Trisomies that may go to term.
PGD
PGD (Pre-implantation Genetic Diagnosis) is performed in the same manner as PGS but is indicated for patients who are at risk for inherited genetic disorders. Genetic disorders for which PGD is used include Cystic Fibrosis, Tay Sachs, Thalassemia, and sex linked genetic disorders, such as muscular dystrophy. New programs under development will allow PGD to be used to screen for increased risk of cancer, cardiovascular disease and diabetes.
GIFT and ZIFT
Other ART procedures that are sometimes used include gamete intrafallopian transfer (GIFT) and zygote intrafallopian transfer (ZIFT), provided that the fallopian tubes are open.
In GIFT, conception (uniting of the sperm with the egg) occurs inside the woman instead of in the laboratory. Therefore, it is acceptable to couples that would otherwise not have the benefit of IVF and advanced technologies for religion reasons. ZIFT involves transfer of developed embryos into the fallopian tubes by laparoscopy. ZIFT is performed when it is not possible to transfer embryos into the uterus by the vaginal route, as is done in regular IVF.
Egg Sharing
Egg sharing allows couples who require IVF, and expect to have more eggs then they need, to share their excess eggs with another couple who need eggs due to age or other reasons. In return for sharing their eggs, part of the expenses of the IVF cycle is paid for by the couple who receive eggs. Both couples benefit: the couple who share eggs because part of their IVF cycle is paid for and they have the satisfaction of helping another infertility couple; the recipient couple because otherwise eggs would have to be obtained from a paid egg donor. The woman planning to share her eggs should be younger than 35 years, with no chronic health problems and should expect to develop 8 or more mature or nearly mature eggs during ovarian stimulation.
