Released on = April 1, 2007, 10:17 am

Press Release Author = Vermesh.Com

Industry = Healthcare

Press Release Summary = Infertility practice specializing in IVF, donor eggs,male
factor infertility, and other advanced fertility treatments.

Press Release Body = Eliran Mor, MD

Michael Vermesh, MD

The Center for Fertility and Gynecology

Tarzana, CA

The roller coaster ride of fertility treatment is emotionally and physically
exhausting. Couples typically begin treatment with simple and relatively inexpensive
interventions such as ovulation induction and intrauterine insemination (IUI), and
when treatment has failed, progress to injectable medications and finally in vitro
fertilization (IVF). Each treatment protocol may last up to one month and several
cycles of the same method are often repeated to maximize chances for success.

The IVF process, while expensive and physically demanding, has been associated with
the highest success rates of all treatment modalities. However, many couples remain
childless after one or more attempts. Couples who have failed IVF multiple times are
often depressed, angry, disappointed, discouraged, and in general emotionally,
physically, and financially drained. If IVF, the procedure with the highest success
rate for achieving pregnancy, has failed, what other hope is there?

When standard IVF has failed multiple times, some infertility specialists offer
couples a procedure in which gametes (eggs and sperm) or zygotes (day-one embryos)
are transferred into the fallopian tubes: gamete intra-fallopian transfer (GIFT), or
zygote intra-fallopian transfer (ZIFT). In GIFT and ZIFT, all steps from
downregulation to ovarian stimulation to egg retrieval, are identical to standard
IVF. However, several important differences exist. In a GIFT procedure, retrieved
eggs and sperm are mixed together and transferred into one or both fallopian tubes
(where natural fertilization normally occurs). In a ZIFT procedure, on the other
hand, fertilization is allowed to take place in the laboratory just like in standard
IVF, however when day-one embryos are formed, they are transferred into the
fallopian tube(s).

Success rates, although reported to be higher than standard IVF when prior IVF
cycles have failed, are only modestly higher and are individualized to different IVF
clinics. In our program, for example, we found that with prior failed IVF cycles, a
GIFT or ZIFT procedure achieved similar pregnancy success rates to standard IVF.

So what is next? Recently, yet another technique had been described offering the
infertile couple who had exhausted all other standard treatment modalities (IVF,
GIFT, ZIFT) true hope: combination GIFT/IVF or ZIFT/IVF. In these procedures, all
known technologies are combined to maximize success rates. After transfer of gametes
or day-one embryos into the fallopian tube(s) via laparoscopic surgery (a GIFT or
ZIFT procedure), remaining embryos that had been left to develop in the laboratory
are transferred into the uterus through the cervix two or three days later, when the
embryo is three days old.

In a recent review of over 100 of our own cycles of combined GIFT/IVF and ZIFT/IVF
procedures, couples that had failed on the average at least 2 prior IVF cycles had a
clinical pregnancy rate of 60% across all age groups, the oldest patient conceiving
at age 44 (data soon to be published). Twin and triplet pregnancy rates were found
to be identical to standard IVF, reassuring that transfer of more gametes or embryos
in the combined procedure did not result in any significant increase in the multiple
gestation rates, compared to IVF.

Inability to conceive can be a devastating phenomenon to a couple. Often times, the
road of fertility treatment may be torturous and full of disappointment. Thanks to
medical advances in the field of Reproductive Endocrinology and Infertility, couples
that had met previous failure can now be offered new procedures that may
significantly enhance success rates and offer renewed hope.

FREQUENTLY ASKED QUESTIONS?

Am I a candidate for GIFT/IVF or ZIFT/IVF despite being a poor responder?

The usual number of eggs/embryos used for transfer to the fallopian tubes is 3,
while the number of embryos transferred trans-cervically is typically 2. Therefore,
a GIFT/IVF or ZIFT/IVF cycle would require that at least 5 eggs/embryos are
available for transfer. If you had previously responded poorly to a stimulation
protocol (< 5 eggs), it is possible to freeze embryos in 1 or 2 consecutive cycles
until enough embryos are accumulated in order to complete a GIFT/IVF or ZIFT/IVF
cycle.

How does a history of poor quality embryos affect success with GIFT/IVF or ZIFT/IVF?

Embryo quality may be determined by many factors such as the stimulation protocol,
egg quality, and sperm quality. Some embryos may further be over-sensitive to
laboratory conditions, which can contribute to poor development. Placement of such
embryos in their natural environment, the fallopian tube (as is done with GIFT/IVF
and ZIFT/IVF) at the critical early stages of development may enhance their ability
to survive and ultimately implant in the uterus. In fact, a history of poor embryo
quality may be an indication for GIFT/IVF or ZIFT/IVF.

Will I have enough time to recover from surgery prior to undergoing trans-cervical
embryo transfer?

A standard GIFT or ZIFT procedure at our Center lasts an average of 15 minutes. This
means the recovery time from surgery and anesthesia is very rapid and will not
affect your trans-cervical embryo transfer 2 or 3 days later. Most patients resume
normal daily activities within 12-24 hours of laparoscopy.

What are the basic requirements prior to GIFT/IVF or ZIFT/IVF?

Several limitations exist with either a GIFT or ZIFT procedure. First, tubal embryo
transfer is not suitable for patients with tubal factor infertility, as at least one
normal tube has to be present. An x-ray test called a hysterosalpingogram (HSG)
would be required before surgery to confirm tubal patency. Second, not all fertility
programs can offer this procedure since it requires surgical intervention at the
time of, or one day following, the egg retrieval procedure. This requires that a
laboratory equipped to handle gametes and embryos be in close proximity to an
operating room.

Eliran Mor, MD and Michael Vermesh, MD can be reached at 818-881-9800 or
www.vermesh.com


Web Site = http://www.vermesh.com

Contact Details = The Center for Fertility and Gynecology
18370 Burbank Blvd Suite 301
Tarzana, CA 91356
Phone: (818) 881-9800
Fax: (818) 881-1857

Contact Name - Rajesh Gavali
Email - rlg_in1@yahoo.com