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Infertility Solutions, P.C.
A traditional approach to the problem of infertility is to perform a standardized work-up to exclude major causes of infertility and then wait for pregnancy to occur. Such an approach does not take advantage of recent scientific advances in our understanding of reproductive physiology.
At Infertility Solutions, P.C., our objective is to perform a targeted rapid evaluation of the couple before moving to providing help to make pregnancy occur as quickly as possible using the technologies that are available. Testing is done to help determine choices of therapy that are going to be most effective. Any therapy is undertaken for a limited number of tries before re-evaluation. Most studies show that if a particular therapy is going to work, it will work in three to six attempts. The couple then either undergoes further testing or moves to a more advanced therapy. We believe that this targeted therapy is both more cost efficient and time effective than other approaches to infertility care.
There are always underlying reasons that couples have difficulty getting pregnant even when that reason is not obviously apparent. One issue that is often missed in non-specialty and some specialty practices is the problem of decreased ovarian reserve. In this setting, a women appears to be ovulating normally, but has fewer eggs in her ovaries than one would expect based on her age alone. Such women produce an increased number of abnormal eggs, have an increased risk of miscarriage, and will have menopause at an earlier than average age. We often can make this diagnosis during a couple first visit. Some women in their mid-twenties will unexpectedly have this problem. Recognizing it early will enable them to have a chance at pregnancy which could be lost with a few years of delay caused by entry level therapies.
Our practice has a focus on women over age 40. Women over 40 need an IVF procedure to have a reasonable change of getting pregnant. Mini-stim IVF is a cost efficient effective approach for such patients.
Infertility care can be the most stressful event that a couple has ever experienced. Our patients are seen in a comfortable, private setting. Our professional staff understands the problems that the couple is experiencing and are able to provide a caring environment in which therapy can take place. Professional psychologists are also available as needed.
Our IVF program, unlike other programs, does not exclude patients with a poor prognosis based on their history, examination or laboratory testing (such as elevated day 3 FSH levels or decreased AMH levels). Our approach is to very directly explain their poor prognosis to them and if they still wish to proceed with therapy, we will help them to try to achieve pregnancy using the technologies that are available. When we use IVF, this hurts our IVF statistics compared to programs that don't do this, but it helps patients who have no other place to turn. Some patients with a poor prognosis do get pregnant. Poor prognosis usually does not mean that pregnancy is impossible. Some patients need to try everything possible before moving on to adoption or donor eggs/sperm.
The cost of therapy is a major stress for many of our patients. We can not eliminate costs or make insurance cover costs it has not agreed to cover. However, we strive to limit the testing we do what effects our decision making and make costs as clear as possible to patients. We package our large procedure to make them more affordable and understandable.
Infertility Solutions, P.C. was established by Bruce I. Rose, Ph.D., M.D. to provide specialized care for women with gynecological problems and to couple's experiencing infertility. Dr. Rose is board certified in gynecology, in reproductive endocrinology, and in infertility. We strive to meet both the clinical and emotional needs of our patients. Our small size and personal experiences with infertility make us more capable of helping patients in this way. We are not a "clinic" and our patients are not "numbers". We believe that we are a different type of infertility center and asked some of our patients to share their experiences about us.
The practice is supported by a state-of-the-art advanced reproductive laboratory. We believe that laboratory quality is a major factor in distinguishing infertility practices from one another. Our laboratory is nationally certified. Our small size enables us to have a closer connection between clinical medicine and a subspecialty laboratory than many larger practices have.
This practice has long had both a clinical and research focus on male infertility. We are supported by our male infertility assessment laboratory and our sperm/embryo cryobank. Almost any sperm problem can be overcome with current technologies. Even some men who produce no sperm in their ejaculate can also achieve pregnancy with TESE. We perform testicular biopsies in our office on men with obstruction (for example from a vasectomy) to obtain sperm for use in their wives.
Infertility care is tailored to the needs of each patient. We believe in an active, as opposed to observational, approach to achieving pregnancy as quickly as possible. There is potentially an endless amount of testing that can be done on infertility problems. We try to make our evaluations targeted and cost efficient.
We are very aware of the burden that limited insurance coverage places on patients and have tried to utilize approaches that maximize the impact of their resources. We offer several approaches to funding IVF which we believe are among the best in the country. We also offer several procedures that provide most of the benefits of IVF at 1/3 to 1/2 of the cost.
Infertility can be attributed to multiple factors, many of which are treatable. Because the factors which produce infertility are shared almost equally by male and female, treatment requires that both partners be evaluated.
A thorough evaluation usually begins with the simplest tests and progresses to the more complicated or more invasive tests. The results can help determine the best course of treatment for increasing the couple's probability of achieving pregnancy. We usually are able to formulate a plan to treat a couple's infertility in the first two visits with them. Some infertility treatments enable pregnancies to occur that otherwise would have no chance of occurring. However, most infertility treatments make possible pregnancies more likely to occur in a shorter period of time. This is important because we cannot see into the future. Although a patient might achieve a spontaneous pregnancy five years from now, it is also possible that five years from now, she would have lost her ability to ever become pregnant. Advancing age in female patients is problem we can least effectively treat. Advanced age requires a more aggressive urgent focus on solving the problem of getting pregnant.
Breakthroughs in medications, microsurgery, and advanced reproductive technologies offer more hope than ever before for infertile couples. Therapies and an enhanced understanding of the scientific basis of reproduction continue to progress at a very rapid pace in this area of medicine.
Unfortunately, insurance coverage plays a major role in determining what patient's can do to treat their infertility. We do our best to control the costs of infertility care that are born by a couple both by the testing we undertake and the treatments we recommend. For example, we periodically review the schedule of endocrine tests we obtain during a treatment cycle to see if any tests can be eliminated due to new information.
As a specially trained microsurgeon, Dr.. Rose offers the highest level of expertise in reproductive pelvic surgery including tubal ligation reversal. A long term focus of his practice is providing extensive reconstructive surgery through very small laparoscopic incisions. This is both cosmetically more desirable than the traditional approach and greatly decreases recovery time.
Dr. Rose also possesses expertise in some of the newer reproductive techniques including removal of fibroids through the hysteroscope, ovarian drilling and transcervical tubal canalization of blocked tubes.
Infertility Solutions, P.C. offers leading edge advanced reproductive technologies including in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), fertilization technology utilizing testicular sperm (TESE), PGD, embryo cryopreservation/vitrofication and assisted hatching. IVF, ICSI and TESE enable us to treat almost any male infertility problem including cases in which no sperm is in the ejaculate. Assisted hatching maximizes our effectiveness in achieving pregnancies in women over age 35. Embryo cryopreservation decreases the cost of achieving pregnancy with IVF in younger women. PGD is a new technology which involves removing a single cell from an embryo and sending it for genetic diagnosis. It can be used to select normal embryos from patients with genetic translocations, recurrrent IVF failures, recurrent miscarriages, and X-linked diseases. It can also be used for sex selection.
Infertility Solutions, PC. now offers both IVM (in vitro maturation) and Mini-stim IVF (minimal stimulation IVF), which are new approaches to advanced reproduction technologies. The procedures can help more than half of infertility couples who need IVF to achieve pregnancy at one-third to one-half the cost of traditional IVF. We are currently unaware of any programs that offer both of these procedures (and very few programs that offer either of them).
All IVF procedures are performed in our Allentown office adjacent to the IVF laboratory. This includes sperm harvesting (TESE). Monitoring of the ovulation induction is done in both offices. Patients are seen seven days a week as required by their menstrual cycles.