Cooper IVF: we build families and foster dreams.  Your success is our success...

Cooper Institute for Reproductive Hormonal Disorders, P.C.

Dr. Check  has over 30 years experience in the field of Reproductive Endocrinology.  He has published over 600 articles  in peer-review medical journals.

Congratulations to Dr. Jerome H. Check, M.D., PhD

Released: May, 2010

Once again, Dr. Check has been recognized by his peers as a “Top Doc” in the field of IVF/Reproductive Endocrinology.  Dr. Check has been a Top Doc in PA/NJ magazines every year for the past 10 years.  The staff of Cooper Institute is extremely proud that Dr. Check has once again been recognized for his tireless pursuit of the best treatment options—and outcomes—for his patients.

What makes Cooper Institute so special?

 

Personalized service because we really care about you

 

From the moment you have your first in depth initial consultation you will see the practice of good old fashion medicine.  After an in depth taking of your history you will be provided a great deal of medical information by the doctor conducting the initial interview that will enable you to actively participate in your type of treatment and type of diagnostic testing.  Expect the initial consult to be a minimum of one hour and frequently much longer.

 

We understand economics and try to make the treatment affordable

 

Achieving a pregnancy does not need to be expensive.  Though ultimately in vitro fertilization-embryo transfer (IVF-ET) is the quickest, most effective means of achieving a pregnancy, the majority of couples can achieve a pregnancy with other therapies that do not require more expensive IVF-ET procedures.  We are especially suited for finding non-IVF solutions since our head, Dr. Check, is a pioneer in the field of reproductive endocrinology and infertility and has published over 600 articles in peer reviewed journals over the last 35 years.  Many of these articles deal with unique original methods of diagnosis and treatment of infertility that has allowed us to quickly correct infertility problems despite failures in other infertility centers.  Some of these innovative ideas and methods will be discussed further in another section.

 

However if IVF-ET is needed we still try to reduce costs for our patients.  When you look at the cost section you will realize that we are one of the least expensive IVF centers -especially for a very successful, highly experienced one.  But the approximate price of $6000.00 for egg retrieval, embryo development and embryo transfer is not the only way you save money as seen in the next section.

 

Besides the initial low price for IVF-ET other ways to save you money

 

Our own pregnancy rates following frozen embryo transfer are about the same as when we transfer embryos fresh.  Many other IVF centers do poorly with frozen embryo transfer and make you go through the process of stimulating many eggs and oocyte retrieval if the first IVF-ET does not work.  The cost for frozen ET is about half of a fresh transfer not counting the savings on expensive drugs used for controlled ovarian hyperstimulation, blood work and ultrasound monitoring, and anesthesia.  Our success rates is related to our research since the reason why we are more successful than most other IVF centers with frozen embryo transfers is because we developed this particular freezing technique and it differs from the one used by most other IVF centers.¹

 

Minimal Stimulation IVF or “IVF Light”

 

Many IVF centers are just now beginning to utilize a minimal stimulation protocol for certain IVF cycles.  The benefits of this protocol include:

 

· The cost of medication is significantly less than that of a full IVF cycle

· Less side effects than that of powerful stimulation drugs

· Lower occurrence of multiple pregnancies

· Significantly less risk of hyperstimulation

· An overall gentler experience for the human body

 

When it comes to experience with Minimal Stimulation IVF, few centers can compare with Cooper Institute.  Dr. Check first discovered the benefits of “min-stim” IVF in the mid-1980’s.  In 1995, Dr. Check published a study praising the benefits of less stimulation hormones in a given IVF cycle, noting that these stimulation drugs actually produce a “toxic” environment in the body which could potentially interfere with IVF success.  A decade and a half later, Dr. Check has refined his min-stim protocol and is an expert in tailoring such protocols based on the specifics of the cases presented him. 

 

Mild ovarian stimulation not only saves money on the expensive FSH injections, but this type of cycle is half the cost of a traditional IVF-ET cycle.   We have shown that this technique not only can produce excellent live delivered pregnancy rates in women with elevated day 3 serum follicle stimulating hormone (FSH) and decreased egg reserve but this technique will provide higher pregnancy rates on the fresh transfer in women with normal oocyte reserve.^4,5  Using less drugs in women with normal egg reserve not only saves lots of money for medication and the cost of the IVF-ET but we can still create many embryos allowing some left over for future frozen embryo transfer.

 

 

Many IVF centers refuse to treat patients with high FSH levels.  Not at Cooper Institute.  In fact, Dr. Check helped pioneer the treatment…

 

The pituitary gland manufactures the hormone FSH (follicle stimulating hormone).  FSH causes the ovary to produce oocytes.  In cases of diminished egg reserve (most commonly due to age or premature menopause) or damage to the ovaries, the pituitary continues to produce FSH.  This usually prevents the patient from producing the many eggs required in a full IVF cycle by lowering the sensitivity at the FSH receptor.  This is known as “down-regulation.” (see minimal stimulation IVF, above).

 

The area of infertility that we are most noted for is reversing menopause and making women ovulate and working with women with diminished egg supply as evidenced by a high day 3 FSH level or history of poor response to FSH drugs, or low antral follicle count, or low inhibin B or anti-mullerian hormone levels.

 

We established a technique to induce ovulation in women in apparent menopause over 25 years ago.⁷ By 1990 we published our experience with 100 cases of premature menopause and showed that we could make over 35% of these women ovulate (even though this was considered next to impossible at this time and showed that one could get about 20% of these women pregnant.)⁸ Over 20 years ago we showed live pregnancies were possible even in women in menopause whose FSH levels were over 100 and who were found on C-section to have almost no ovaries left.⁹   Many subsequent successes were reported including women in apparent menopause needing IVF because of tubal problems.¹⁰

 

Related to our work with diminished egg reserve and ovarian failure (i.e., premature menopause) we have studied the effects of aging in both women and men.  For women we show that age rather than quantity of eggs is the best determinant for egg quality.¹¹ However, are willing to try and have succeeded in achieving pregnancies in women 45 and above with their own eggs including one who was in menopause with a day 3 serum FSH of 63 mIU/mL and a husband with a very poor sperm count.  Interestingly they conceived with just an IUI not IVF after two cycles of restoring down-regulated luteal FSH receptors.¹²

 

We were one of the first centers to show that pregnancies were possible after age 50 using donor eggs.¹³  We are not reckless but we are open-minded to patients needs and requests.  Though we do nothing to try to entice women in their 50’s to try having children for fear that they may be at a greater physical risk we will sometimes even allow 59 year old women to have a baby.¹⁴

 

 

You can get IVF-ET free!  How?  Participate in our shared oocyte program… ^*

 

If you are willing to share half of the eggs retrieved with another woman who is either deficient in egg supply or has poor quality eggs, she pays the entire price for your stimulation medication, your ultrasound and blood monitoring, and your cost of IVF-ET.  You would only pay additional fees if there are extra embryos to freeze (there usually are extra embryos even despite sharing).  If you fail to get pregnant your option is to just do the affordable $2800.00 for a frozen embryo transfer or save these frozen embryos for the future and do another shared IVF-ET cycle.²

 

If you are the donor egg recipient, by choosing an infertile donor whose eggs give you the same pregnancy rate as paid donors you immediately save a lot of money because you do not have to pay the large fee customarily paid to donors.

 

However, even you choose a paid donor you can save a lot of money by sharing these eggs with another recipient.  Not only is the fee to the donor shared with another recipient, but so are the costs of medications, monitoring and anesthesia and the actual oocyte retrieval.³

 

But even without these cost saving methods you will find our overall charge to the donor egg recipient is often less than half of the fees charged by other major, experienced IVF centers.

 

 

What else makes us special?

 

First and foremost, we willingly accept the challenge of difficult cases.  We are world renown as problem solvers for cases that have baffled other experts.  Click here for two fascinating case studies from the Cooper Institute archives…

 

Our services offered also set us apart.  Here are a few of the routine procedures and services offered at Cooper Institute…

 

Sex selection and family balancing:

 

Sperm Washing and Gradient Separation

 

We have published several papers on our attempts to improve the odds of increasing the chance of either a male or female child without spending a lot of money.  We seem to achieve a 75% chance of a male offspring with our male selection technique.¹⁵   Though we found a method to increase the percentage of female sperm significantly, data has shown that this has not increased the percentage of live female births.^16,17

 

PGD (Preimplantation Genetic Diagnosis)

 

Though our male sex selection technique is very inexpensive it is far from perfect.  The most accurate method is to do IVF with PGD and only transfer back the male or female embryos.

 

PGD began as a screening process for genetic and chromosomal abnormalities in embryos before they were transferred into the uterus.  A patient having IVF with PGD is simply requesting that the embryos be screened for X or Y chromosomes and the chosen embryos then be transferred.

 

Unfortunately this is the most expensive option in the world of sex-selection since PGD increases the cost of IVF from $2500-$5000.  Though we send out to a laboratory the cell of the embryo that we biopsied, and thus the genetic center not Cooper receives the PGD fee, to help couples we reduce our IVF prices for those having PGD for sex selection.  Several research studies have demonstrated that PGD is upwards of 95% effective in selecting the desired sex.

 

In certain cases of established genetic disorders, a patient’s health insurance may cover the cost of this procedure.  Please contact your insurer or Cooper Institute for more information.

 

Sperm Separation Techniques

 

We also work with Microsort® which uses “flow cytometry” to separate sperm by X or Y chromosome.  Research has demonstrated this technique as having a higher success rate for girls (X-bearing chromosome) than boys (Y-bearing chromosomes).  Also, upon completion of the process, the amount of sperm yielded can be low – which makes this process better suited for IVF than IUI in some cases.  Also, much like PGD, this process can be expensive.  Cooper Institute patients who choose this procedure will also have their IVF fees significantly reduced.

 

 

Cooper Institute is just the perfect size

 

Too little sun exposure and you become vitamin D deficient.  Too much sun and you get sunburn.  A single doctor infertility center has the theoretical advantage of getting to know your doctor better, and the doctor knowing you better, but it has the distinct disadvantage in that the doctor can not be in 2 or 3 places at one time and can not work every day.  An extremely large practice has the benefit of increased experience and usually convenience of appointments, but loses the personal touch.  You may feel like you are part of an assembly line.

 

There are some IVF centers that do 2000-3000 IVF cycles a year and yet only have about 50 employees.  At Cooper we have 105 employees and average about 800 retrievals a year.  We have 7 full-time and one part-time embryologist to take care of an average of 3 IVF-ET cycles per day.  Rounding out our IVF support team, we have eight IVF nurses and four full-time Andrologists (who handle all semen testing and preparation).

 

How do we provide experience and yet personal care?

 

First, we are a team of doctors not just a group of individual doctors using one IVF center.  We want you to have your own personal physician in our group.  All the doctors are available to do your initial consultation and that doctor remains your personal physician thereafter - unless you decide to change to another doctor in the group.  New patient appointments are made according to which doctor you want to see, rather than on a rotating basis.  That doctor however has the back-up of the other physicians in case one cannot be at two places at once.

 

The exception is when we are doing IVF.  There are just three doctors doing the retrievals: – Drs. Jung Choe, Deanna Brasile and Rachael Cohen.  They do it on a weekly rotational basis.  All have similar pregnancy rates.  This allows us to provide you with our best skilled physicians doing the mechanical procedures and frees up our head physician who has the most knowledge of reproductive and medical endocrinology and experience and has the most innovative and creative ideas for more consultations.  Dr. Check is thus always available to do more consults and to be available to help nurses with their phone calls, patient questions, and cycle instructions.

 

During the IVF week we generally have the doctor doing IVF to make the decisions on day to day management but the protocol would have been established by your primary doctor.  If the nurses question a decision or for that matter if you have concerns your primary doctor can be consulted on that decision or all your daily decisions during an IVF cycle.

 

The nurses doing call backs for non-IVF patients will generally consult your primary doctor for the decision or another physician if your primary doctor was not available.

 

Highly trained ultrasonographers do the scans.  Many office procedures, e.g., post-coital tests are performed by nurses allowing the doctors more time to spend with patients in consultation.  It should be noted that there is very little turnover at Cooper and many of our staff, e.g., Andrologists, nurses, embryologists, and ultrasonographers have been here for over 20 years.  Thus you will find our nurses extremely knowledgeable and frequently know as much as the physicians so do not be afraid to ask them questions or get their opinions.

 

Our large staff allows us to work all seven days (only IVF and IUI on Sunday’s).  IVF is open all year except for one week closure during Christmas.  You would think that such services would have to be very expensive.  However, we have a heart and we ask you to compare prices – we are one of the least expensive infertility centers in the country despite our extensive experience.

 

We hope this overview of our center and its many services has been enlightening.  We are caring professionals, dedicated to helping you pursue your dream of family building.

 

 

Come see for yourself what makes Cooper so special for our patients.  Our success is our patient’s success.  We hope it can be for you, too….

 

 

For more information or to schedule

 a consult,  please contact us at:                         

Cooper Institute

 (856) 751-5575

 

 

References

 

1. (Check JH, Choe JK, Nazari A, Fox F, Swenson K: Fresh embryo transfer is more effective than frozen ET for donor oocyte recipients but not for donors.  Hum Reprod, 16:1403-1408, 2001)

2.  (Check JH, Fox F, Choe JK, Krotec JW, Nazari A:  Sharing of oocytes from infertile versus paid donors results in similar pregnancy and implantation rates.  Fertil Steril 2004;81:703-704)

3. (Check JH, Fox F, Deperro D, Davies E, Krotec JW:  Efficacy of sharing oocytes from compensated donors between two recipients.  Clin Exp Obst Gyn 2003;30:199-200)

4. (Check JH, Summers-Chase D, Yuan W, Horwath D, Wilson C:  Effect of embryo quality on pregnancy outcome following single embryo transfer in women with a diminished egg reserve.  Fertil Steril 2007 Apr;87(4): 749-56;)

5. Check JH:  Mild ovarian stimulation.  J Assist Reprod Genet 2007;24:621-627)

6. (Check JH, Chase J: Ovulation induction in hypergonadotropic amenorrhea with estrogen and human menopausal gonadotropin therapy. Fertil Steril 42: 919‑922, 1984)

7. (Check JH, Nowroozi K, Chase JS, Nazari A, Shapse D, Vaze M: Ovulation induction and pregnancies in 100 consecutive women with hypergonadotropic amenorrhea. Fertil Steril 53(5):811‑816, 1990)

8. (Check JH, Chase JS, Wu CH, Adelson HG: Case Report: Ovulation‑induction and pregnancy using an estrogen‑gonadotropin stimulation technique in a menopausal woman with marked hypoplastic ovaries. Am J Ob‑Gyn 160:405‑406, 1989)

9. (Check ML, Check JH, Choe JK, Berger GS: Successful pregnancy in a 42-year-old woman with imminent ovarian failure following ovulation induction with ethinyl estradiol without gonadotropins and in vitro fertilization.  Clin Exp Obst Gyn 2002;29:11-14)

10. (Check JH, Peymer M, Lurie D: Effect of age on pregnancy outcome without assisted reproductive technology in women with elevated early follicular phase serum follicle-stimulating hormone levels.  Gynecol Obstet Invest 45:217-220, 1998)

11. (Check JH, Check ML, Katsoff D: Three pregnancies despite elevated serum FSH and advanced age: Case report.  Hum Reprod 15(8):1709-1712, 2000)

12. (Check JH, Nowroozi K, Barnea ER, Shaw KJ, Sauer MV: Successful delivery after age fifty: a report of two cases as a result of oocyte donation. Obstet Gynecol, 81:835‑836, 1993)

13. (Check JH:  A 59-year-old woman gives birth to twins – when should a fertility specialist refuse treatment?  Clin Exp Obstet Gynecol 2008;35(2):93-97)

14. (Check JH, Katsoff D: A prospective study to evaluate the efficacy of modified swim‑up preparation for male sex selection. Hum Reprod, 8(2):211‑214, 1993)

15. (Check ML, Bollendorf A, Check JH, Hourani W, Long R, McMonagle K: Separation of sperm through a 12-layer Percoll column decreases the percentage of sperm staining with quinacrine.  Arch Androl 44:47-50, 2000)

(Bollendorf A, Duroseau M, Hourani W, Mcmonagle K, Check JH:  The efficacy of sperm separation by a 12 layer Isoprep column on X bearing sperm enrichment and subsequent percentage of female births.  In:  International Proceedings of the 8^th International Congress of Andrology, Medimond Editore, Pgs. 71-73, 2005)