You may have read on our website or on our fertility discussion boards that SIRM takes issue with the current system for reporting IVF success rates. The problem is that the system can be manipulated to “enhance” reported birth rates by screening out those patients that are not as likely to be successful with In Vitro Fertilization. A prime example would be patients with poor or diminished ovarian reserve. Many doctors and clinics will NOT perform IVF on a couple with elevated FSH levels or too many previous IVF failures. By selecting only the “best” candidates, centers can effectively raise their IVF pregnancy rates as reported to SART / CDC.
Another method employed by some centers for screening out poor IVF treatment candidates is to routinely use Antagon and only “graduate” into an IVF cycle those who have at least 3-6 follicles and adequate estrogen levels. Those that don’t meet these criteria are diverted into an intrauterine insemination treatment and avoid the embryo transfer – thus keeping these low-success patients out of their SART IVF statistics.
At SIRM, we refuse to practice medicine in a way that discriminates against those who are more difficult cases, or who have failed IVF in the past. As a result, SIRM has become a hub for poor responders and women with high FSH who cannot get the help they deserve at other clinics. Our average patient is 36+ with 2 prior IVF cycles at other facilities. And we welcome these tough cases! To turn away a patient in order to manipulate our own success rates would be unethical. It contradicts our mission of “helping couples go from infertility to family.”
So, don’t believe everything you read about IVF statistics. As Mark Twain noted, “Figures often beguile me, particularly when I have the arranging of them myself; in which case the remark attributed to Disraeli would often apply with justice and force: ‘There are three kinds of lies: lies, damned lies, and statistics.‘”
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Currently, 33% of lesbians and 20% of gay households have children younger than 18 living in their homes. Most of these children were conceived from a previous heterosexual relationship. A recent survey found that 50% of lesbian women expressed a desire to parent. Many countries do not allow infertility treatments for same sex couples and … Read more
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Walid Saleh, MD
IUI is a fertility treatment that uses a small catheter to insert “washed” sperm directly into the uterus in a process similar to a pap smear. The goal of IUI is to increase the number of good sperm that reach the fallopian tubes and subsequently increase the chance of fertilization. IUI is usually selected as … Read more
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Walid Saleh, MD
While the reproductive risks of smoking are well documented, there is little public awareness about them. This small summary will review the reproductive hazards associated with cigarette smoking for both men and women: Female Risks Adverse impact of tar on egg quality and DNA results in delayed conception delay, infertility, increased risk of miscarriages and … Read more
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Walid Saleh, MD
Many of us know someone who would desperately like to have a girl. Or a boy. Perhaps a couple has several children of one gender already and would like to have another child — but would only consider doing so if the 50/50 odds could be shifted in favor of the other gender. Or, perhaps … Read more
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Walid Saleh, MD
Many doctors perform a laparoscopy for infertile women or “want to check that everything is ok prior to IVF”. Unfortunately, while it sounds effective, this is another useless procedure. I advise you to avoid it, no matter what your insurance covers. The reasons are simple: most of the time nothing is found, and even when … Read more
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Walid Saleh, MD
by Walid Saleh, MD The short answer: It depends when they are measured. 1) Early Pregnancy Because serum progesterone is a reflection of progesterone production by the corpus luteum, which is stimulated by a viable pregnancy, it is helpful as a screening tool to rule out an abnormal pregnancy like a miscarriage or tubal pregnancy. … Read more
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Walid Saleh, MD
Unfortunately, despite the lack of evidence to support it, many couples are prescribed gonadotropin injections and artificial insemination (COH/IUI) as a first line of treatment on the basis that “injections are better than tablets”. In reality, most studies agree that pregnancy rates are similar for both options. It makes perfect sense. If someone already ovulates … Read more
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Walid Saleh, MD
Anti Mullerian Hormone (AMH) is secreted directly by granulosa cells surrounding the oocyte (egg) and is measurable in serum. Because AMH reflects ovarian reserve, it decreases progressively over the reproductive years. Unlike FSH, inhibin-B and estradiol measurements, it is quite stable during the menstrual cycle and can be measured any day of the cycle. Because of … Read more
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Walid Saleh, MD
Ask Our Doctors
I am a 34 yeah old military veteran from 2 services and I have no biological kids and my wife has 2 and also have both tubes tied. we are trying to seek more information on the services you offer and see what’s our best option on the budget we have. we are looking to get pregnant soon. I signed up to come to the seminar in dallas on march 30
I look forward to seeing you at the Dallas Seminar Patrick. I am certain you will get all the information you seek there.
Please identify yourself to me then.
Thanks!
Geoff Sher
I will so we don’t have to wait for an invite if we already signed up or anything just come to the seminar if we already signed up
Copy!
Geoff Sher
I just turned 39 and my tubes have been tied/cut for 12 years. I was married for 10-years and my husband passed away in 2008 (we were considering having my tubal reversed before he passed). I have been blessed with another amazing man and we are hoping to have a child together. Would a mini-IVF be something we could consider? Do you do them at your Las Vegas facility? Thank you
I do do them in LV and success rate is high. Consider calling 800-780-7437 or 702-699-7437 to arrange a Skype consultation (free of charge to those who reside in the United States or Canada) with me so we can discuss your case in detail.
Geoff Sher
I am American and currently live in Italy. My husband and a have started 3 IVF treatments due to low AMH (<0.1). I am 35. The first cycle was cancelled on CD 8 due to appendicitis. The 2nd cycle with Menopur produced 6 poor quality eggs, and 2 poor quality embryos. My progesterone rose mid-treatment (CD 8), which probably led to poor egg quality. This time, I began with triptorelin for 2 days, then beginning gonal f 450. Due to strict protocols in Italy, I am not sure that I am receiving the best option. What are your thoughts on my current regimen? Do you work with patients living outside the US who only come to the USA for pickup and transfer?
Thanks!
The early rise in progesterone points to “premature Luteinization” and when this happens, 2 things are certain in my opinion: 1) A viable pregnancy will not occur in that cycle and 2) the protocol of stimulation needs to be re-examined and probably substantively modified (see below).
Please go to the home page of this blog, www.IVFauthority.com. When you get there, look for a “search bar” in the upper right hand corner. Type the following subjects into the bar, click on it and it will take you to all the relevant articles posted there.
1. “An Individualized Approach to Ovarian stimulation” (posted on November 22nd, 2010)
2. “Ovarian Stimulation in IVF: Why is it important to down-regulate LH?”
3. “Agonist/Antagonist Conversion Protocol”
4. “Premature Luteinization”
5. “Premature LH Surge”
6. “Traveling for IVF from Out of State/Country– The Process at SIRM-Las Vegas” (posted on March, 21st 2012)
7.“A personalized, stepwise approach to IVF at SIRM”; Parts 1 & 2 (posted March, 2012)
8. “IVF success: Factors that influence outcome”
9. “Staggered IVF”
10.“Embryo Banking”
11. “Egg Donation”
I think I can help….So you should seriously consider calling 702-699-7437 to arrange a Skype consultation with me so we can discuss your case in detail
Geoff Sher