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  1. Fertility Preservation

    Cryopreservation of eggs (oocytes), embryos and sperm allow patients to protect their future fertility. The two main reasons patients choose fertility preservation are for medical necessity and social or lifestyle choices.

    Medical Necessity

    Patients who are set to undergo certain cancer treatments are also faced with making a decision about fertility. Cancer treatments such as chemotherapy, radiation and some surgeries can endanger reproductive health and cause irreversible damage in both female and male patients. The American Cancer Society suggests healthcare providers counsel their patients on the risk of infertility and the assisted reproductive strategies that are available to patients as soon as possible after initial cancer diagnosis.

    Lifestyle

    Many women are delaying motherhood for several reasons including personal, education, career or not having yet found a suitable partner. While women are empowered to put off having a child until a later age, the natural age-related decline in female fertility still persists. According to the Center for Disease Control “there were more than nine times as many first births to mothers 35 and older than there were in the 1970s.”

    Fertility begins to decline for women in their 30s and even more rapidly after age 35. Fertility preservation is a viable option for women who have decided ahead of time that they will wait until a later age to start their families.

    Treatment Options

    Sperm cryopreservation has been around for several decades and is known to be viable after being frozen for an indefinite number of years. Patients can either provide a sample to be frozen or sperm can be retrieved via a surgical sperm retrieval (i.e. PESA, TESE, MESA). Cryopreserved sperm can be later thawed and used in both Intrauterine Insemination and In Vitro Fertilization procedures without causing problems with the sperm of future offspring.

    Female patients have the option of either freezing their eggs through Oocyte Cryopreservation or freezing embryos (fertilized eggs). Eggs are retrieved from the ovary and either frozen, or fertilized and then frozen. As of 2012, the American Society for Reproductive Medicine has declared that egg freezing is no longer experimental and have announced that egg freezing is now an acceptable fertility treatment. Due to scientific advancements such as vitrification (extremely rapid freezing of oocytes and embryos), pregnancy rates as well as health of delivered babies have proven oocyte cryopreservation to be a safe and viable option.

    Through partnership with the non-profit organization Livestrong Cancer Program, we are able to offer reduced cost fertility preservation treatments.

    Conclusion

    Whether a patient defers parenthood by choice or due to their fertility being at risk, there are options available at Brown Fertility to meet the patient’s needs.

  2. Conceiving Miracles through Single Embryo Transfer

    At Brown Fertility, our goal is not only to conceive miracles, but also to do our best to ensure a healthy pregnancy. Single Embryo Transfer (SET), a procedure in which one embryo, selected from the couple’s total number of embryo’s retrieved, is placed in the uterus. Embryos selected for SET may come from the couple’s current fresh IVF cycle or from a previous batch of cryopreserved embryos. Couples often want to increase their chances of a successful pregnancy by transferring multiple embryos at a time. However, today’s newer methods allow our team to identify the strongest embryos for transfer resulting in success rates that are comparable to and safer than a multiple embryo transfer as performed by most fertility centers.

    What are the risks associated with multiple births?

    Multiple births increase the risk of pre-term delivery, which can lead to low birth weight, developmental disabilities and delays. For the mother, multiples often require delivery by caesarean section (C-section). This can be accompanied by other health complications and is a longer and harder recovery for a mother now responsible for the care of multiple infants. At times, not all multiples can be sustained in the uterus until birth, which could lead to a medical necessity for fetal reduction. This process can be physically and emotionally taxing on the mother. Candidates for SET will benefit by avoiding these risks.

    Who is a Candidate for SET?

    You might be a good candidate for SET if you are younger than 38 and produce good quality eggs and embryos. The American Society of Reproductive Medicine (ASRM) established guidelines suggesting a maximum of 1 to 2 embryos transferred for a female under the age of 35. This maximum is reduced to a single embryo transfer for that age group if the transfer is done on a day 5 blastocyst. At Brown Fertility, 95% of our embryos are transferred as a day 5 blastocyst. Thus, a majority of our fresh transfers are done using SET. These guidelines are for patients with a “favorable prognosis” and take into consideration not only the age of the female but other pertinent health factors.

    What are the success rates for SET?

    At Brown Fertility, we uphold the ASRM guidelines, placing one embryo in patients 35 or younger during a fresh cycle and one to two embryos during a frozen one. Our success rates for this age group are consistently higher than the National average at an average of 80%. Some months our fresh IVF cycles see rates of 100%!

    While we are very proud of these numbers and feel great joy in helping couples achieve their dreams of starting a family, our team will never prioritize success rates over the safety of our patients. Single Embryo Transfer is one of the many ways we are able to control the health and wellness of our couples and their future miracles.

     

    About Brown Fertility: With more than 30 years of combined experience and the management of more than 7,000 IVF cycles, Dr. Samuel E. Brown, Dr. Rafael A. Cabrera and Dr. Bruce Rose 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. 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. In Vitro Maturation: IVM

    You need IVF. But, you hate the idea of taking lots of drugs that push your hormone levels into the stratosphere. You are concerned that really high estrogen levels may be unhealthy and doctors just don’t know it yet. You really don’t want to be prodded for multiple laboratory tests.  You have things to do; places to go.  You would really like something easier than IVF.

    You may be a candidate for IVM, or in vitro maturation, a new approach at Brown Fertility for getting pregnant. The eggs that a woman is born with are kept in an immature state, meaning a sperm cannot fertilize them, until ovulation.  Most medications used in IVF are intended to enable the patient to develop multiple eggs that are mature.  It is now possible to take eggs from a woman’s ovaries and mature them in the laboratory.  This means it is not necessary to treat women with high doses of stimulating hormones for two weeks before retrieving eggs.  Technically, eggs can be retrieved at any time. These eggs can be matured in the laboratory (IVM).   They are then capable of being fertilized and embryos can be created using the normal IVF tools.

    This was always the dream of the creators of IVF, but it proved to be more difficult than IVF. It was not until 1991, that the first birth occurred using IVM, by Dr. Cha in Korea.  He obtained a donor egg from a woman during her Caesarian Section and used it to help a couple have a baby.  Once in vitro maturation was shown to be possible, physicians and scientists in IVF programs throughout the world began working on the details of how best to use this technology.  Several thousand babies have now been born using IVM, but there is no uniform agreement on how to best use IVM techniques in humans.

    Although in vitro maturation is practiced in centers throughout Europe and Asia, it has limited availability in the United States. IVM is easier for the patient than IVF, but is harder on the physician and laboratory.  Dr. Bruce Rose has one of the larger experiences with IVM in the United States, having performed more than 200 IVM cycles and published a half dozen papers on related topics.  He recently joined Brown Fertility to bring this new technique to the Jacksonville area.

    IVM is not a replacement for IVF (In Vitro Fertilization), but it is a more gentle approach to high tech reproduction than IVF, which in selected patients has almost as high a pregnancy rate as IVF. Traditionally, physicians treat medical problems by using the least invasive, lowest side effect treatment first and then moving on to more aggressive treatments if they are needed.  This is the way we should view the relationship between IVM and IVF.  Patients at high risk for significant side effects with IVF, could use the more simple, safer IVM approach; and if that fails them, then turn to IVF.

    The best candidates for in vitro maturation are those patients with a large number of small cysts or antral follicles (2-10 mm) in their ovaries. These patients are at highest risk for the most severe common complication of IVF- ovarian hyperstimulation syndrome OHSS.  Even without development of OHSS, patients with a large number of resting follicles in their ovaries will experience significant bloating and abdominal discomfort for several weeks after IVF as the ovaries and the pelvis return to normal.  Patients with polycystic ovaries are the candidates most likely to benefit from IVM, but most young women will also have a large number of small follicles in their ovaries.  A subset of older women not meeting the clinical criteria of PCOS (polysystic ovary syndrome) will also be good candidates.  The only way to determine who is a good candidate is to perform a transvaginal ultrasound and evaluate the ovaries.

    IVM should still be viewed as an experimental procedure.  Our present objective is to find the best way to apply the procedure so that our patients achieve a success rate similar to our IVF success rate without the risk of IVF like side effects.  The cost of this procedure is lower than IVF in that limited medications are used and IVF medication costs usually constitute about 40% of the cost to undertake IVF.  Laboratory and physician costs are similar.  Except for egg harvesting (the same setting as IVF), IVM is minimally disruptive to our patients.  It even works for patients who either struggle to ovulate or fail to ovulate with clomid, femara, or gonadotropins.  We have performed IVM in patients a week before they are getting married or while breast feeding.  Brown Fertility now offers an effective, more natural alternative to conventional IVF.

    About Brown Fertility: With more than 30 years of combined experience and the management of more than 7,000 IVF cycles, Dr. Samuel E. Brown, Dr. Rafael A. Cabrera and Dr. Bruce Rose 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. Visit www.BrownFertility.com for more information.

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    Media Contact:

    Nicole Haggerty, Director of Marketing

    nahaggerty@brownfertility.com

    904.260.0352

See what our Patients are Saying About Us View All

“Throughout our journey to conceive, Dr. Brown became so much more than our reproductive endocrinologist. He became our therapist, problem-solver, cheerleader, and—most importantly—our friend.”Greg & Dana