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  1. Gender Selection: Choosing Your Girl or Boy

    There are two primary motivating factors that lead couples to choose the path of gender selection.

    • Family Balancing: Couples can use sex selection as an elective process to diversify gender in the household.
    • Medical Necessity: When specific gender related disorders are at high risk, screening for sex and identifying chromosomally normal embryos leads to the greatest chance for a healthy and successful pregnancy.

    Treatment Options

    The most successful method for gender selection includes IVF with Pre-implantation Genetic Screening (PGS). PGS is available to all patients using IVF to conceive, whether they are experiencing infertility or are undergoing treatment specifically for balancing their family. PGS is performed via embryo biopsy following in-vitro fertilization (IVF) and allows the patient to select the gender of the embryo before being placed in the uterus. After the biopsy, the embryos are analyzed for both karyotype chromosomal health and for gender.

    While PGS is not used to determine a specific disease diagnosis, it is used to screen for missing or extra copies of chromosomes (i.e.: Aneuploidy). This will help couples either select healthy embryos with a normal number of chromosomes or avoid conditions such as down syndrome.

    PGS is also helpful in preventing gender linked diseases from being passed on by allowing couples to use sex selection to increase the chances for a healthy baby. For example, couples may choose PGS for gender selection to decrease the chances of the child developing hemophilia or x-linked diseases. Both of these diseases are shown to be male dominant. In these cases, sex selection can be performed choosing to implant only female embryos.

    PGD is Pre-Implantation Genetic testing of embryos which are similar but a detailed analysis further down into a chromosome for mutations is performed.

    Accuracy and Success Rates

    PGS has proven to be safe and highly successful. Statistics show an accuracy rate of 99.9% in determining the baby’s sex.

    Furthermore, the transfer of a single healthy embryo helps to reduce the chance of a twin or triplet pregnancy, and increases the chance of a single healthy baby being born.

    Conclusion

    The popularity of gender selection with PGS is indicative of parents’ desire to have more control in the health of their child.

    To learn more about gender selection, please contact us at 904.260.0352 in Jacksonville or Tallahassee or 407.244.5515 in Orlando.

  2. Provider Spotlight – Emily Opdycke, ARNP

    Emily Opdycke, ARNP has been a part of Brown Fertility since 2012. She came to the clinic with over a decade of nurse practitioner experience in women’s health. She received her nursing degree from the University of North Florida in 2003, where she graduated in the top 10% of her class. Emily then earned a Master’s degree from the University of Cincinnati. She is currently a member of the American Society of Reproductive Medicine, the National Association of Nurse Practitioners in Women’s Health and Sigma Theta Tau (Lhambda Rho Chapter). Emily also holds certifications in the National Certification Corporation, ACLS, and basic life support.

    Some of Emily’s specialties include performing history and physicals for assessing, diagnosing and implementing a plan of care for couples experiencing infertility. She manages infertility treatments such as timed intercourse, insemination and IVF cycles.  Emily spearheads Brown Fertility’s successful IUI and timed intercourse program; this program is modeled after Brown Fertility’s IVF program and has a more conservative approach. The purpose of the intrauterine insemination is to increase the woman’s ability to become pregnant by washing the sperm to enhance its motility and by mechanically placing the sperm closer to the egg. It has a less invasive approach by using a small flexible catheter.  Emily works collaboratively with the physicians, the embryologist, andrologist, nurses and medical assistants to provide adequate care for patients.  Her expertise shows through her professionalism while remaining personable and respectable.

    Emily is a mother to three children and has been married to her husband for thirteen years. She enjoys spending time with her family, watching football, traveling and art. She also likes to spend time at the beach and plays volleyball in a recreational league.

    About Brown Fertility: With more than 30 years of combined experience and the management of more than 5,000 IVF cycles, Dr. Samuel E. Brown and Dr. Rafael A. Cabrera are dedicated to Conceiving Miracles™. Brown Fertility offers a fully comprehensive array of fertility treatments, including in vitro fertilization, egg donation and artificial insemination and is home to Florida’s most state-of-the-art IVF center, which produces some of the highest pregnancy rates in the country. Brown Fertility has earned a reputation for not only producing excellent outcomes and offering affordable treatment options, but also for providing patients with the one-on-one attention and the compassionate care they deserve (see our testimonials). Visit www.BrownFertility.com for more information.

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    Media Contact:
    Nicole Haggerty, Director of Marketing
    nahaggerty@brownfertility.com
    904.260.0352
     
     

  3. Understanding Male Factor Infertility

    Infertility is defined as “the failure of a couple to conceive after one year of unprotected intercourse.” Roughly 15% of married couples attempting their first pregnancy experience some degrees of difficulty to conceive. The male factor plays a significant role in about 50% of infertile couples.

    Causes of Male Factor Infertility

    • Age: Generally, a man’s fertility starts declining at around the age of 35 as the quality of a man’s sperm diminishes. In addition, sperm motility can also decline with age.
    • Immune disorders: Problems with the immune system can cause a man’s body to treat sperm as if it were a foreign matter. As a result, the immune system may produce antibodies to fight and destroy the sperm.
    • Cancer treatments: Depending on the location of the treatment and the drug and dosage used, chemotherapy and radiation may contribute to male infertility.
    • Sexually transmitted diseases (STDs):  STDs may damage the parts of the body that transport sperm through the reproductive tract.
    • Testosterone, Androgel, and other male hormone substitutes:  Used in lieu of antidepressants or as performance-enhancing additives, they increase testosterone levels, but may also be responsible for halting sperm production.
    • Other factors: Lifestyle and environmental factors may lead to issues with a man’s sperm.

    Pre-Testicular

    • Hypothalamic disease
    • Isolated gonadotropin deficiency (Kallmann’s syndrome)
    • Isolated LH deficiency (“Fertile eunuch”)
    • Congenital hypogonadrotropic syndromes
    • Pituitary disease
    • Pituitary insufficiency (tumors, infiltrative processes, operation, radiation)
    • Hyperprolactinemia
    • Hemochromatosis (iron overload)
    • Exogenous hormones (estrogen-androgen excess, glucocorticoid excess, hyper and hypothyroidism)

    Testicular

    • Chromosomal abnormalities (Klinefelter’s syndrome, XX disorder, XYY syndrome)
    • Noonan’s syndrome (male Turner’s syndrome, X0)
    • Myotonic dystrophy
    • Sertoli-cell-only syndrome (germinal cell aplasia)
    •  Gonadotoxins (drugs, some trace metals, thermal exposure, radiation)
    •  Orchitis or systemic disease (renal failure, hepatic disease, sickle cell disease)
    •  Cryptorchidism
    • Varicocele
    • Mutation of LH and FSH receptors

    Post-Testicular

    • Disorders of Sperm Transport
      • Congenital disorders such as Young’s syndrome or cystic fibrosis; acquired disorders such as infections, vasectomies or surgeries leading to damaged ducts; functional disorders such as diabetic neuropathy and spinal cord injury
    • Disorders of Sperm Motility or Function
      • Congenital defects of the sperm tail; maturation defects; immunologic disorders or infections
    • Sexual dysfunction 1

    A deficiency in any of these factors may cause infertility in men. Although sperm count is important, sperm motility and forward progression appear to be even more crucial in determining the likelihood of the sperm fertilizing the egg. Despite a low sperm count, many men with high-quality sperm may still be fertile.

    As a result of these many male infertility factors, it is important to perform semen analysis early on in the attempt to determine the reasons for infertility. Two to three analyses should be performed over a period of two to six months since sperm quality can change over time. These tests will help give doctors a broader overview of any infertility issues related to the man’s sperm.

    Contact Brown Fertility today to learn more about male factor infertility and its possible impact on you.

    Major parts of this handout were directly taken from the following sources:

    1. Perloe, Mark, M.D.: http://www.ivf.com with special thanks.

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