ART Services

Assisted reproductive technologies (ART) involve retrieval of one or more eggs to increase the chance of successful conception. ART services include in vitro fertilization; GIFT, ZIFT and blastocyst transfer; assisted hatching; gestational surrogacy; and embryo and semen cryopreservation. A team of specialists including reproductive endocrinologists, nurses and embryologists work together with each patient to decide on which treatment is best, both medically and emotionally. Counseling services are available to help patients through the entire process.

In Vitro Fertilization (IVF)

Retrieved eggs are fertilized and monitored in the lab for about 1-3 days, or 4-5 days for blastocyst transfer. Typically one or two of the best embryos are selected for transfer, and are placed via an ultrasound-guided catheter into the uterus. Sensations during the procedure are similar to those of a Pap smear.

For more information on In Vitro Fertilization (IVF), click here.

Intracytoplasmic Sperm Injection (ICSI)

During ICSI, each of the retrieved eggs is placed in a dish and held still with gentle suction while a single sperm is carefully inserted into the cell using a needle. The next day it is possible to determine which eggs have been successfully fertilized. ICSI is useful for couples where the male patient has low sperm count or poor sperm morphology, since only one sperm is required to fertilize each egg. It may also be recommended for couples who have had low or no egg yield or poor fertilization success in the past, since there is greater control of fertilization.

For more information on Intracytoplasmic Sperm Injection (ICSI), click here.

Blastocyst Transfer

For some patients it is preferable to continue to monitor the developing embryo in the laboratory for about 4-5 days after fertilization before selecting the best embryos and thus increase the chance of achieving a successful pregnancy. By this time the embryo has divided into multiple cells and is known as a blastocyst. There are several advantages to blastocyst transfer, including the ability to choose high-quality embryos and a lower risk of multiple pregnancy. A drawback is that some embryos do not survive to the blastocyst stage even in the most optimal lab conditions. Embryo coculture techniques (the addition of fallopian tube or endometrial cells into the culture) can be used to nurture the blastocysts.

For more information on Blastocyst Transfer, click here.

Assisted Hatching (AH)

The blastocyst is held with gentle suction while a tiny needle delivers an acid solution that wears away an area of the outer shell (the zona pellucida). This helps the embryo "hatch" out of the shell and implant in the uterine wall. Shortly after the procedure, the embryo is transferred to the uterus. Assisted hatching is often recommended for couples who have had unsuccessful IVF cycles or where the female partner is over 37 or has high FSH levels, poor quality embryos or embryos with thick shells.

For more information on Assisted Hatching (AH), click here.

Preimplantation Genetic Diagnosis (PGD)

PGD allows us to test embryos for genetic disorders before performing the transfer. This is especially helpful for expectant parents whose child is at high risk of inheriting a genetic defect - i.e. if one or both of the parents has a genetic disorder, a family history of them, or a child with a birth defect or other condition. After the couple completes an IVF cycle, one cell from each of the fertilized embryos is tested for the DNA mutation responsible for the condition(s). It is currently possible to test for over 100 genetic disorders, including cystic fibrosis, sickle cell anemia, Tay-Sachs disease, Huntington disease, hemophilia, and some types of leukemia. Additionally, we test for the presence of the x and y chromosomes. This allows us to determine the sex of the embryo.

For more information on Preimplantation Genetic Diagnosis (PGD), click here.

Gamete Intra-fallopian Transfer (GIFT)

The ovaries are stimulated to produce several eggs. On the day of retrieval, the eggs are harvested and put in a petri dish with sperm collected from the male partner. In the same visit, the mixture is transferred to the woman's fallopian tubes. Fertilization then occurs inside the body (as opposed to ZIFT) and the embryo develops entirely within the natural surroundings of the womb. This can be a disadvantage as well: if no pregnancy results, it is impossible to know whether fertilization took place. GIFT also carries a risk of multiple and ectopic pregnancy (when the embryo implants in the fallopian tube rather than in the uterus).

For more information on Gamete Intra-fallopian Transfer (GIFT), click here.

Zygote Intra-fallopian Transfer (ZIFT)

ZIFT is similar to GIFT except that the sperm fertilize the egg outside the body. One day after egg retrieval, the zygote (single-cell fertilized egg) is then transferred to the fallopian tubes. One disadvantage of ZIFT is the need for two separate operations within a short time. As with GIFT there is an increased risk of multiple and ectopic pregnancy.

For more information on Zygote Intra-fallopian Transfer (ZIFT), click here.

Embryo Freezing/Cryopreservation

Cryopreservation involves the careful freezing and storage of untransferred embryos. After undergoing IVF and embryo transfer, couples may choose to preserve any remaining healthy embryos in case the pregnancy is not successful, they decide to have another child later, or they wish to donate one or more embryos to other hopeful parents. Only the healthiest embryos are frozen. The process can be very successful - thousands of babies have been born from frozen embryos since 1984.

For more information on Cryopreservation, click here.

Egg Donation

An egg donor donates to the expectant couple. This is the extent of her role in conception, and both parties may remain anonymous. The egg is then fertilized by the biological father and placed in the expectant mother's uterus.

For more information on Egg Donation, click here.

Donor Sperm Program

Artificial Insemmination with donor sperm is an excellent option for couples whose infertility is caused solely by male factor that cannot be treated. It is also an option for couples with severe male factor who do not want to pursue any of the Assisted Reproductive Technologies.

Donor Sperm from another male is placed in the woman's uterus at the time of her cycle when she is most fertile. Donor sperm can also be substituted for the male partner's sperm in any of the assisted reproduction procedures such as IVF, GIFT and ZIFT.

The Palm Beach Fertility Center offers both anonymous and known donor sperm options. If a couple chooses to use donor sperm, the infertility team can help them select an appropriate donor. We work with nationally recognized cryobanks including Fairfax Cryobank, California Cryobank, and Xytex, all of which have stringent protocols.

For more information on Artificial Insemination, click here.

Surrogacy

A surrogate is a woman who carries the fertilized egg to term in her uterus on behalf of the intended parents. There are two kinds of surrogacy: classic and gestational. A classic surrogate is inseminated with sperm from the child's father. Her own egg is fertilized, and she carries the baby to term on behalf of the intended parents. In gestational surrogacy, the baby is conceived entirely by the intended parents: the biological mother's egg is fertilized with the biological father's sperm. The embryo is then placed in the surrogate's uterus and carried to term.

For more information on Surrogacy, click here.