In Vitro Fertilization: Blastocyst Transfer

Over the past 10 years, a tremendous amount of debate has taken place concerning the ideal time to transfer embryos from incubator to the uterus. Traditionally, in IVF (in vitro fertilization), embryos were transferred on day 2 or 3 after fertilization because they could not survive in the lab beyond that time. The embryo remains under maternal control until day 3. After that point, the embryo must activate its own growth signals if it is to survive. Additionally, the embryo's nutritional and metabolic needs change after day three. In the past, culture medias were not available to meet the needs of the embryo beyond the third day of incubation. Therefore, physicians were forced to return embryos to the uterus on or before day three. With the development of improved culture medias, came the possibility to grow embryos an additional two days to the blastocyst stage prior to transfer.

Transferring blastocysts has a major advantage over transferring earlier stage embryos. By continuing to culture embryos past the point where they must take over their own control, we can more easily choose the embryos that will survive and form a pregnancy. Any embryos that cannot make this transition will not survive. After selecting the embryos for transfer, any remaining blastocyst can be frozen very successful with the innovation of rapid freeze protocols. Blastocyst transfer has lead to a pregnancy rate of 54% per transfer for our patients at The Fertility Center, LLC. We are pleased to see so many happy outcomes, but are constantly trying to improve our pregnancy rates with new advancements in fertility treatment.

Polycystic Ovarian Syndrome (PCOS)

Polycystic ovarian syndrome is a form of hormonal imbalance in which the ovaries produce too much testosterone. Symptoms can include any of the following: excess hair growth, irregular or absent menstrual cycles, infertility, excessive bleeding, weight gain or inability to lose weight, acne, fatigue, and lipid disorders. The ovaries have small follicles (cysts containing eggs) at the edge that never fully develop and never or rarely ovulate. If left untreated, this disorder can place the patient at a higher risk for diabetes, endometrial cancer, heart disease, hypertension and stroke later in life.

PCOS can result from an inappropriate elevation of the hormone, LH (luteinizing hormone), which stimulates the ovary to produce testosterone and prevents ovulation. Some patients with PCOS also have an elevated insulin level, a condition called insulin resistance. Treatment for this variation requires additional medication.

Because of the long term health risks that may result from polycystic ovarian syndrome, it is important that patients who suspect they may suffer from this condition be diagnosed and treated. Treatment may be as simple as regulating her menstrual cycles; but each person needs to have her hormonal condition investigated and the appropriate treatment individualized for her!

If you are interested in discussing this, or any other infertility services, please call our York office at 717-747-3099 or our Lancaster office at 717-544-3553. Our office strives to provide compassionate individualized care to all of our patients.