The IVF-Fertility Division of Women's Clinic, Ltd. was one of the first
private practice IVF programs in the United States. This began as a concept
in February 1984. We initiated our first patient stimulation in September
1986 and had our first pregnancy in April 1987. Baby #1 was delivered in
January 1988. We have continued to be extremely successful ever since. Our
pregnancy rates have always been good with top level rankings for the state
of Pennsylvania and National recognition. In 2008, our standard IVF clinical
pregnancy rate, proven by ultrasound, per embryo transfer has been 60.6% for
all comers to the program. Over 300 babies have been delivered from our
program. Vincent A. Pellegrini, M.D. is the Clinical Director of the IVF
Program, Shahab S. Minassian, M.D. serves as a Reproductive Endocrinologist
and Stephen H. Fehnel, M.D. is actively involved.
Our IVF program is
a very well controlled, personal and individualized program. There are only a few people involved in the day to day care of the IVF patients.This has allowed us to develop close relationships with our patients, while keeping their situation finely tuned.
This is part of the reason for our continued success. Attention to detail is another. Our IVF patients are very carefully screened to eliminate the presence of underlying conditions that might diminish their chances for pregnancy. Old records are extensively reviewed. Our patients are not placed into predetermined protocols, but are all studied and handled individually. A low drug dose stimulation is used for almost all patients, unless the clinical situation requires otherwise. It is our feeling that this produces better egg quality and enhances the potential of pregnancy.
From the beginning of our IVF program in 1986, we have had a very unique philosophy regarding embryos. All normally fertilized and developing embryos have always been transferred into each patient several days after the eggs were removed from her ovaries. In 2009 & 2010, the average number of embryos transferred was 2.4. In this scenario, the number of embryos transferred is limited by controlling the number of eggs inseminated. The number is determined by a mutual decision between the IVF team and the couple, taking into account the female's age and the clinical situation. Four eggs are most often inseminated, but the number varies between two and five. It is expected that 80% of the inseminated eggs will fertilize and become embryos. These embryos are all transferred. In this process, it is statistically unlikely for more than 50% of the transferred embryos to develop into fetuses. In the usual situation of inseminating four eggs, this would mean that three embryos will probably be available for transfer and one or two fetuses will result if pregnancy occurs. It would be rarely possible for all the inseminated eggs to fertilize and then all subsequently develop into multiple fetuses. Our multiple pregnancy rate has been 30% over all of our years, with most of these being twins. In this process, there are no “leftover” embryos to freeze, donate or discard. This thus avoids the moral questions raised by potentially discarding frozen embryos that are not needed in the future, as is reported to occur with up to 70% of all frozen embryos nationwide. The situation has been totally avoided by limiting the number of eggs that are inseminated to begin with.
The arrival of Dr. Minassian in September 2008 at
the IVF-Fertility Division of Women's Clinic
initiated an embryo freezing program. If embryos are hoped to be preserved by freezing, then most of the retrieved eggs will be inseminated. A few embryos of the highest quality will be transferred fresh. This would typically be two embryos. The rest of the embryos will be frozen for future use. For those couples who choose embryo freezing, the advantages include a decreased potential of multiple pregnancy, as fewer embryos are replaced, along with typically not having to subsequently repeat the entire IVF process since there will hopefully be frozen embryo embryos for their future use.
Dr. Minassian & Dr. Fehnel will perform the egg retrievals and embryo transfers in all patients planning embryo freezing. Dr. Pellegrini will not be involved.
Over the last ten years, we
have developed a successful intracytoplasmic sperm injection (ICSI) program as part of our vast array of available services. This
procedure is used to treat severe male factor infertility. It opens the door to a large number of men who would otherwise be considered
totally sterile. With this ICSI procedure, each egg is injected with a single sperm, one at a time. Therefore, only a few normal sperm are
needed. In some effectively sterile men, the sperm need to be obtained surgically. This procedure is carried out
under light anesthesia, with the help of several urologists. Aspirating the testicle itself or the surrounding tubules can obtain the
sperm. Excess sperm can be frozen for future use. Since ICSI will help a very significant number of infertile couples, it is
probably one of the most significant advances since the very beginning of IVF.
The IVF team is also made up of embryologist, Michele Haas, BS, and embryology assistant, Mindy Purcell, CMA. We have Barbara Zieckler, Cindy Cavalieri and Johanna Larese who do our sperm processing and blood testing. Additionally, Delphine Weitzel, Janice Cohen and Michele Nagle do our ultrasound studies. Debbie Kibler and Nicole Sekelic are involved in gynecologic nursing for the Program. The Program Coordinator is Debra Schott, C.R.N.P. who organizes all of the patients going through IVF, in addition to other infertility therapies. The IVF laboratory is overseen by its Laboratory Director, Dr. Sheldon Schlaff, a Medical Endocrinologist.
IVF egg retrievals are performed in our office under I.V. sedation administered by an M.D. anesthesiologist from the Reading Hospital. This type of procedure usually takes about 20 minutes and our patients are kept very comfortable by the anesthesia staff. Spouses are not permitted to be present in the egg retrieval room but are encouraged to be at the embryo transfer. We have a monitor arranged so that our couples can see exactly what we see on our ultrasound during the cycle monitoring. They will also see their embryos immediately before the embryo transfer procedure.
The embryo transfer process is usually carried out three days after retrieval with the aid of ultrasound visualization to assure the embryo transfer catheter is correctly located in the uterine cavity.
Our patients are accommodated in the office for about two hours after the transfer, and then go home to bed rest for an additional twenty-two hours.
IVF-Fertility Division of Women's Clinic
takes great pride in our in vitro fertilization program. We feel we have maintained a very superior program, and bring to it a very personalized atmosphere.
Below is an excellent video on the ICSI procedure.