Clinic Services

In Vitro Fertilization

In Vitro Fertilization is a method of assisted reproduction, in which the male partner’s sperm and the female partner's egg (oocyte) are combined in a laboratory dish (petri dish), where fertilization occurs. The resulting embryo is then transferred to the uterus to develop naturally. Usually, two to four embryos are transferred.

Egg Freezing (Oocyte Cryopreservation)

Egg freezing (oocyte cryopreservation) is a new process which allows patients to store eggs for later use. Embryo and sperm freezing have been available for many years; however, egg freezing requires a new freezing technique called vitrification. This is a rapid freezing technique which greatly reduces the risk of injury to the egg.

In 2010, The Pacific In Vitro Fertilization Institute celebrated the birth of Hawaii's first baby using frozen eggs (see recent advances). This new technology allows women to store eggs for several medical indications.

The most common indications include:

1. Maintaining fertility in women who wish to defer pregnancy. Since increasing age decreases the pregnancy rate in women, storing eggs at a younger age is helpful in maintaining fertility.
2. Storing eggs prior to some types of radiation or chemotherapy which can injure the ovaries.
3. Couples with religious concerns about embryo freezing and what to do with extra stored embryos. With egg freezing available, fewer eggs can be fertilized for use now and extra eggs can be frozen and stored for future use.

IVF with Donor Eggs

Women who have poor quality or no eggs of their own for fertilization, and have a healthy uterus, are candidates for donor egg IVF. This procedure is the same as a regular IVF cycle, except eggs of a donor are fertilized with the male partner’s sperm and the resulting embryo(s) are transferred into the female partner’s uterus. This process of donor egg IVF has an extremely high success rate.

Gestational Surrogacy

In the gestational surrogacy procedure, the gestational surrogate acts as an “incubator” for the pregnancy. Gestational surrogacy is appropriate when normal embryos can be formed, but is necessary for these embryos to develop within the uterus of a host rather than the uterus of the egg source (female partner).

Gestational surrogacy may be thought of as a logical extension of the IVF process for a woman who has functioning ovaries, but does not have a uterus. Women who have experienced multiple miscarriages, or one who have been advised by their doctors not to become pregnant because of certain (or special) medical conditions may be candidates for gestational surrogacy.

Egg Retrieval

After the ovaries have been stimulated with fertility medications, the resultant eggs (oocytes) are obtained by a procedure called an egg retrieval. This is a non-surgical procedure done under intravenous conscious sedation, in which trans-vaginal ultrasound is used to guide the needle aspiration of eggs from the ovarian egg sacs called follicles. Although the procedure takes only a few minutes, sedation is administered for greater patient comfort.

Intracytoplasmic Sperm Injection (ICSI)

Intracytoplasmic sperm injection (ICSI) is a micromanipulation technique developed to help achieve fertilization for couples with severe male factor infertility or couples who have had embryos fail to fertilize during a previous in vitro fertilization attempt. This procedure overcomes many of the barriers to fertilization and allows couples to obtain embryos.

The procedure requires that the female partner undergo ovarian stimulation with fertility medications so that several mature eggs develop. These eggs are then aspirated and incubated under precise conditions in the embryology laboratory. The embryologist, using very precise maneuvers, then picks up a single live sperm in a glass needle (pipette) and injects it directly into the egg.

Assisted Hatching

The technique of assisted hatching was introduced to enhance the embryo’s ability to develop, and thus implant, after transfer. Assisted hatching involves the thinning of the zona pellucida (outer shell) of the fertilized egg prior to transferring into the uterus. It is believed that this outer shell becomes thicker and hardened with aging of the oocyte. As such, women of advanced age, or with an elevated FSH level may have a decreased chance for embryo implantation. Women with endometriosis and poor quality embryos may also have this problem.

Preimplantation Genetic Diagnosis (PGD)

Preimplantation genetic diagnosis (PGD) is a technique that helps couples minimize the risk of miscarriage and genetic defects. It can also assist couples who have repeatedly unsuccessful IVF cycles by screening embryos for genetic defects before the embryos are transferred into the uterus. Candidates for PGD include couples who are carriers of sex-linked genetic disorders or carriers of single gene defects. Only embryos that appear normal are transferred. This process increases the chance of pregnancy and likelihood of a healthy baby and decreases the possibility of miscarriage.

PGD is performed as part of an In Vitro Fertilization cycle where eggs are produced and retrieved from the ovaries of the female partner, and fertilized with the male partner’s sperm in the laboratory to create embryos. When the embryos reach the 8-cell stage (3 days after egg retrieval and fertilization), one cell is carefully removed microscopically from each embryo through a procedure called embryo biopsy. These cells are then analyzed to determine which embryos are free of genetic abnormalities.

Embryo Transfer

Embryos are usually transferred on the 3rd day after the egg retrieval. This procedure is much like a pap smear and does not require any anesthesia and is usually painless. The embryos are placed in a small amount of fluid inside a catheter, which is then passed through the cervix and placed inside the uterus.

Blastocyst Stage Embryo Transfer

An advance in infertility treatment which involves growing the embryos in the laboratory to a blastocyst stage before they are transferred into the uterus of the female patient following an in vitro fertilization cycle.

In this process, the embryo is cultured for an additional 2-3 days to an advanced stage of embryo development before it is transferred into the uterus. Advantages of a blastocyst transfer are that the transfer occurs closer to the natural time that an embryo enters the uterus when the uterine lining may provide a better environment for the embryo.

Since blastocyst embryos have a higher rate of implantation, a fewer number of embryos are required for transfer. This also allows for more embryos to be cryopreserved (frozen) for future use and prevents higher order multiple pregnancies (more than twins).

Cryopreservation of Embryos

Embryo freezing is a well-established form of assisted reproduction treatment where Pacific IVF will freeze spare embryos from a fresh IVF cycle. With the availability of frozen embryos, the patient will not have to undergo ovarian stimulation again in order to have to have an embryo transfer. Embryo cryopreservation provides the opportunity to have additional embryo transfers through an FET (frozen embryo transfer) cycle without the inconvenience and expense of a full IVF cycle.