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GIVF eNews

January 2012 eNews

Ten Things to Do Now If You Want to Have a Baby in 2012

  1. Find out exactly what your health insurance covers. Will your insurance cover all or part of the medical costs of a fertility assessment (for both partners), fertility treatment (if you need it), pregnancy, delivery and infant health care? Talk to the benefit expert at work, call your insurance carrier and/or read your policy. If your coverage is not adequate, try to get additional coverage before you need it.
  2. Explore your options for taking time off for medical appointments before the baby arrives and for parental leave after delivery. If you are married or have a partner, check out leave options for both of you. Some couples take serial leave -- first one and then the other -- to provide care for an infant. Look at everything available to you: medical leave, parental leave, vacation time, unpaid leave, etc., to make a plan. You might find that skipping a few days of vacation before you conceive will allow you to spend more time with your new baby later.
  3. Get a physical. If you have been trying to get pregnant but haven't succeeded yet, both potential parents should consider getting a fertility assessment by a reproductive endocrinologist. Men and women are equally likely to suffer infertility. According to the National Survey of Family Growth approximately 6.1 million women and their partners in the U.S. are affected by infertility, i.e., 10% of the total reproductive-age population.
  4. Make improvements to your overall health. Consider your Body Mass Index (BMI). Being in good shape and good health will improve your likelihood of having a healthy pregnancy and a healthy baby. Obese women may have difficulty conceiving and they are at risk for weight-related complications during pregnancy, including high blood pressure and diabetes. Underweight women may have irregular cycles or stop ovulating all together. Perfect need not be the goal, sometimes just a 5% or 10% weight reduction (or increase if you are underweight) makes a significant difference when trying to conceive. If you smoke, quit before you become pregnant. Smoking during pregnancy is linked to miscarriage and to low birth weight for babies.
  5. Consider your space. Do you have space in your current home for a nursery? Will a crib, changing table and all of the other equipment babies need crowd your current abode? Should you consider rearranging your space to make room for baby? Or should you move?
  6. Stop taking birth control pills at least two months before you want to become pregnant. Since birth control pills affect your hormones, quit taking the pills to allow your body time to readjust. You can switch to another form of birth control until you are ready to try for a pregnancy.
  7. Take folic acid pills. Folic acid helps to prevent neural defects in developing babies, even in the very early stages of pregnancy. Start taking the pills as soon as you decide it is time to become pregnant -- don't wait for a positive pregnancy test. (Prenatal vitamins contain folic acid.)
  8. When you are ready to get pregnant, make sure you are having sex at the "right time of the month." The greatest chance for pregnancy is when intercourse occurs one to two days prior to ovulation and the day of ovulation. Additionally, optimal semen quality is obtained after 2-3 days of no ejaculation. Therefore, a general recommendation would be to have intercourse every 2-3 days after the menstrual period has stopped. Other more precise methods include tracking the changes in cervical mucous (increased production of slippery clear mucous is associated with ovulation) and use of over-the-counter urinary LH-detection kits which can more precisely predict the actual day of ovulation.
  9. Talk to your doctor about any medications, vitamins or herbal supplements you take. Many medications (including some used to treat depression, high blood pressure and other common conditions) and over-the-counter supplements can be harmful to a developing fetus. Find out now if you need to change your medication or supplement regimen.
  10. Get expert diagnosis and treatment if you have difficulty conceiving. If you are a woman under 35 and have been trying to get pregnant for over a year or you are over 35 and have been trying to get pregnant for six months, consult a fertility specialist who can diagnose and treat you. 85% to 90% of infertility cases can be successfully treated. Reproductive endocrinologists are OB/Gyns with specialized training in diagnosing and treating infertility. After reviewing your medical history and test results, a reproductive endocrinologist like the experts at Genetics & IVF Institute can recommend a course of treatment to help you have the baby you want in 2012.


What's New at GIVF

GIVF's Affordable IVF Programs in 2012

GIVF's multiple cycle IVF programs are the best value in the Washington Metropolitan area. We understand that building a family requires a significant emotional and financial investment and we are committed to helping you cope with both. Our affordable Multicycle financial programs allow you to pay a discounted price for multiple IVF or donor egg IVF cycles. Our Delivery Promise℠ program offers you an opportunity to pay a discounted price for multiple cycles with a 100% refund feature.

We also offer affordable shared donor egg cycle packages, lower-cost frozen donor egg cycles from the region's largest donor egg bank and attractive financing plans.

Included in GIVF's Multicycle Packages:

Multicycle Program

  • Up to three fresh IVF cycles or two donor egg IVF cycles
  • All in-house monitoring services including hormone assays, sonography and medical review related to IVF
  • Oocyte retrieval, identification, embryo culture, and embryo transfer with ultrasound guidance if needed
  • Cryopreservation (freezing) of extra embryos from each cycle
  • Frozen embryo transfer cycles
  • Mock Cycles
  • Includes all pregnancy tests and one gestational sonogram
  • Live birth, if a loss occurs the remaining cycles can be used
  • Embryo storage is included for the life of the contract or until the birth of the child

Multicycle with Conversion Option Program

  • Allows for more than one birth within the 5 year timeframe
  • Three fresh IVF cycles
  • Allows the option to convert into donor egg after 1 or 2 IVF cycles with a credit applied towards the donor contract
  • All in-house monitoring services including hormone assays, sonography and medical review related to IVF
  • Oocyte retrieval, identification, embryo culture, and embryo transfer with ultrasound guidance if needed
  • Cryopreservation (freezing) of extra embryos from each cycle
  • Frozen embryo transfer cycles
  • Includes all pregnancy tests and one gestational sonogram
  • Live birth, if a loss occurs the remaining cycles can be used
  • Embryo storage is included for the life of the contract or until the birth of the child

Our Delivery Promise℠ program includes:

  • Up to six fresh IVF cycles and associated frozen embryo transfer cycles
  • All in-house monitoring services including hormone assays, sonography and medical review related to IVF
  • Oocyte retrieval, identification, embryo culture, and embryo transfer with ultrasound guidance if needed
  • Cryopreservation (freezing) of extra embryos from each cycle
  • Frozen embryo transfer cycles
  • Embryo storage fees until the terms of the agreement are fulfilled
  • All in-house pregnancy tests for each treatment cycle if indicated
  • One gestational Sonogram, once pregnancy has been determined
  • Live take home birth
  • Two options for donor egg IVF treatment

For more information about how we can help you afford IVF treatment in 2012, contact financial counselor Barbara Pastorious at 703.289.4218


PGD Using Day 5 Biopsy and 24 Chromosome Microarray:
Promising Results from the 2011 American Society for Reproductive Medicine Meeting

by Harvey J. Stern, MD, PhD, FACMG, FAAP

Several months ago in this newsletter, we discussed the decision to change our technology for Preimplantation Genetics Diagnosis (PGD) for chromosome disorders from fluorescent in-situ hybridization (FISH) to 24 chromosome microarray, along with changing the time of embryo biopsy from day 3 to day 5. This decision was made based on preliminary studies from several centers that suggested that this approach would be more successful. PGD and the use of chromosomal microarray was one of the most discussed topics at this year's ASRM meeting which took place in Orlando in October. Several research papers were presented that continued to support this approach.

In a very interesting study, Scott and colleagues enrolled patients for a trial where IVF was done and a patient's 2 best embryos were selected on either day 3 or day 5. One of the two sister embryos underwent embryo biopsy on either day 3 or day 5 and then both embryos (un-biopsied and biopsied) were returned to the uterus. In cases where a pregnancy resulted, testing was done to see which of the two sister embryos implanted. Embryos that had a day 3 biopsy had a 34% reduction in implantation rate compared to day 5 biopsy, where implantation and pregnancy in biopsied versus non-biopsied embryos was not significantly different. This was felt to be strong evidence for a negative effect of day 3 embryo biopsy. Harton and colleagues reported that embryos that had day 5 blastocyst biopsy had higher implantation rates compared to day 3 biopsy in women of all ages. This group also reported that the implantation rate for normal blastocysts were not significantly different between young and older patients; a finding that confirms the ability of 24 chromosome microarray testing to identify embryos with the best chance of producing successful pregnancies. This and other reports suggested that day 5 biopsy gives accurate results without compromising implantation as is seen in embryos undergoing day 3 biopsy.

Grifo and colleagues reported on a study of PGD with chromosomal microarray testing in couples with a history of recurrent pregnancy loss. A significant reduction in miscarriage was seen in patients undergoing PGD with microarray testing from an expected loss rate of 35% to 6%. Of interest to patients who carry chromosome rearrangements (translocations, inversions), a report by Colls and colleagues showed that these chromosome changes can be successfully evaluated in embryos by using microarrays which in addition, can provide information on chromosomes not involved in the rearrangement. Previous testing using FISH could provide information only on a limited number of chromosomes beyond those involved in the rearrangement. In a recent paper, this group had shown that in couples who had PGD testing for a chromosome rearrangement approximately 1/2 of the embryos found to be normal for the rearrangement had abnormalities in other chromosomes. Microarray analysis is now clearly the method of choice for couples with translocations and other rearrangements and is the method we now use at GIVF.

Rabinovitz and colleagues reported on concurrent PGD testing for genetic diseases (such as cystic fibrosis) along with 24 chromosome microarray for women of advanced reproductive age or a history of recurrent pregnancy loss. Since the initial step in the microarray process involves making multiple copies of the fetal DNA, this material can also be effectively used for genetic disease determination. At GIVF we have also been developing this technique and can now offer concurrent genetic disease and 24 chromosome microarray testing for appropriate patients.

To find out more information regarding PGD or to schedule a consultation, please call 800.552.4363 or 703.698.7355.

Dr. Stern is the Director of Reproductive Genetics at GIVF.


The Genetics & IVF Institute (GIVF) regularly publishes an informative newsletter featuring the latest infertility news and developments. The newsletter is sent electronically via email. To subscribe, click here.