The Dilemma of Mosaic Embryos

Since physicians have been performing preimplantation genetic testing for aneuploidy (PGT-A) biopsing several cells from a blastocyst and using more advanced genetic tests, Reproductive Endocrinologists been at a loss for how to deal with embryos with cells with more than one chromosomal arrangement, one normal and others with a variety of abnormal configurations. Mosaic embryos weren’t easily detectable until about …

Fresh or Frozen Embryo Transfer? That is the Question.

For some time now our experience has shown us that when we do all-freeze cycles and only tranfer embyos in frozen embryo cycles we get better results. This phenomenon occurs whether PGS is performed to help us select chromosomally normal embryos or in non-PGS cycles when we select embryos by morphology.

However in contrast to our experience, results from two …

No Wait After Miscarriage

It was traditional to tell patients to wait three months after a miscarriage before trying to conceive. There was no scientific evidence that the wait was beneficial and for a long time I have been telling patients that they can try to conceive after their first period following the miscarriage. After the emotional disappointment from a miscarriage it’s very difficult …

A Defense of PGS

An article recently published in The Cut column of New York Magazine has captured the attention of the fertility and genetic testing community. Titled “A New Last Chance”, the article questioned the utility of preimplantation genetic screening (PGS) – a technique which data from the CDC and SART, along with the results of several randomized controlled trials (RCTs), have all …

Genetic Testing of Embryos May Cause Ethical Dilemma

There is an emerging ethical morass in the field of reproductive medicine: what to do when patients seeking to get pregnant select embryos with DNA that could lead to a disease or disability. Should clinicians’ desire to help their patients have children override concerns about possibly doing harm to those children? And what about cases in which patients end up …

Fertility Business Booming. Why?

According to an article in the Washington Post, the multibillion-dollar fertility industry is booming, and experimenting with business models that are changing the American family in new and unpredictable ways. Would-be parents seeking donor eggs and sperm can pick and choose from long checklists of physical and intellectual characteristics. Clinics now offer volume discounts, package deals and 100 percent guarantees …

New Fathers’ Age is Rising

Maybe this is why we are seeing more cases of male infertility and many cases of IVF are requiring ICSI.

Researchers at Stanford University reviewed data on 168,867,480 live births from 1972 to 2015, making statistical adjustments for missing paternal records. The average age of the father of a newborn in the United States, the investigators found, has risen to …

The Role of Preimplantation Genetic Screening in IVF

Over the past 2 decades, preimplantation genetic screening (PGS) has fallen in and out of favor among fertility specialists.  The benefits of performing PGS with in vitro fertilization have been hugely debated.  While the techniques and technology for PGS have advanced during this time, it’s still unclear whether PGS provides a benefit and that should be determined for each individual …