Welcoming Information
The information provided in this portion of the website is derived directly from our Patient Information Handbook. You will find, herein, information concerning the In Vitro process: the required preliminary testing, a description of the procedure, the risks and responsibilities of participants, and the andrology/embryology protocol.

Our program began in 1988 at our Melrose Park, PA office. In September 1990, we opened a new state of the art IVF laboratory in Marlton, New Jersey and in November of 1991, we merged our two In Vitro Fertilization programs to form the Cooper Institute for IVF in Marlton, New Jersey. In 1994, we re-established the Program as the Cooper Center for In Vitro Fertilization, P.C. We have been a member of The Society for Assisted Reproductive Technology, (SART), since 1989. This society is an affiliate of the American Society for Reproductive Medicine. SART's function is to set guidelines and monitor the pregnancy rate of its members in this new and growing field of In Vitro Fertilization. We perform approximately 550 egg retrievals per year and are considered one of the largest IVF programs in the United States.

We are affiliated with the University of Medicine and Dentistry of New Jersey, and the Robert Wood Johnson Medical School at Camden. We have a well trained and experienced staff of physicians, nurses, embryologists, and andrologists.

General Patient Information
We are very pleased to provide you with information concerning our In Vitro Fertilization (IVF) Program. A brief overview of the IVF Program is described herein. Additional information will be provided at the time of consultation.

In addition to explaining the IVF/ET (Embryo Transfer) technique, this introductory information describes the major significant and foreseeable risks of the procedures, possible alternatives to IVF/ET, if any, the responsibilities of couples who participate in our IVF program, and more.

Introduction
In order for pregnancy to occur, an egg has to be released from the ovary and unite with a sperm. Normally this union, called fertilization, occurs within the fallopian tube. When this process cannot take place in the body, it can be accomplished in the laboratory by using the in vitro fertilization (IVF) technique. The technique, as currently practiced, involves uniting an egg(s) collected from a woman's ovary with sperm collected from her partner under laboratory conditions. The resulting normal embryo(s) may be transferred to the uterus (womb) for continued growth. The benefit of IVF and ET is that it gives a couple who may be unable to achieve a pregnancy an opportunity to attempt to overcome their infertility.

Who will benefit from IVF?

1. IVF is of demonstrated value for patients with absence or blockage of the fallopian tubes.
2. IVF is also recommended to those where corrective surgery has either failed and/or is
   deemed inadvisable.
3. Couples with infertility related to severe male factor, e.g., lowered sperm counts or motility, antisperm antibodies, or sub-normal hypo-osmotic swelling test.
4. Those who have other causes of infertility such as: endometriosis, hostile cervical mucus, un-ruptured follicle syndrome, unexplained infertility, or couples that have experienced repetitive intrauterine insemination (IUI) therapy failure.

What are your chances of success?
The probability of conceiving a child and delivering a healthy baby is very individual to each couple. Success has many variables such as: age, cause of infertility, the woman's response to fertility medications, the rate of the sperm's ability to fertilize the egg, the couple's willingness to undergo multiple embryo transfers, and the expertise of the chosen IVF program. Click here to view our latest pregnancy rates.

Factors & Risks Associated with the IVF Procedure
1. Due to the nature of this procedure, which uses a metal needle to remove the egg(s), there is potential risk of injury to other organs: bladder, bowel, uterus, fallopian tube(s) or blood vessel(s). A minor problem or a serious complication may develop (such as internal bleeding and/or infection) which may require hospitalization and/or further surgical intervention to correct the problem(s) or to save life. This potential risk is less than 0.1%.

2. Pelvic scarring and/or technical problems may prevent recovery of one or more eggs from the ovaries.

3. There may be failure to recover an egg because ovulation has occurred before the time of retrieval.

4. One or more eggs may not be recovered on attempted aspiration of the follicle.

5. Laboratory conditions may arise which make it impossible or impractical to proceed with in vitro fertilization at the time that egg retrieval would otherwise be indicated.

6. The eggs obtained may not be normal.

7. The semen specimen produced may be of very poor quality i.e., low count and motility, or it may not be able to be produced.

8. Appropriate laboratory processing of the sperm specimen may be difficult or impossible.

9. Fertilization of the eggs to form embryos may not occur.

10. Cell division (growth) of the embryos may not occur.

11. The embryos may not develop normally. If, in the physicians best judgement, this occurs, efforts to continue growth of the embryo(s) may be halted. When reasonably possible, this will take place only after previous consultation with the patient and her partner. Eggs or embryos which have failed to develop and are therefore not viable will not be transferred.

12. Embryo transfer into the uterus may be technically difficult or impossible, due to unforeseen circumstances, or abnormal anatomy.

13. If transfer is performed, implantation(s) may not result, (which is the most common cause of a failed cycle).

14. If implantation occurs, the embryo(s) may not grow or develop normally.

15. Equipment failure, infection, and/or human error or other unforeseen factors may result in loss or damage to eggs, sperm sample, and/or embryos.

16. Follicles containing mature eggs may not develop in the monitored cycle. This may prevent obtaining eggs, or may result in obtaining immature eggs which will not fertilize.

Alternatives to IVF
There are other surgical techniques available for patients with open and functional fallopian tubes: GIFT, ZIFT, and TET. GIFT (gamete intrafallopian tube transfer) is a surgical technique where the egg(s) is(are) extracted by a similar method to a transvaginal IVF procedure. The egg(s) and sperm are then placed in the fallopian tube laparoscopically. ZIFT (zygote intrafallopian tube transfer) involves having a transvaginal IVF procedure along with a laparoscopy the following day. Fertilized eggs are placed in the fallopian tube. In GIFT, fertilization is not verified. Fertilization has already occurred with ZIFT. TET refers to tubal embryo transfer. The procedure is essentially the same as ZIFT except that the fertilized egg(s) are at a more advanced cell stage and are placed in the fallopian tube via laparoscopy two days following IVF.

Damaged fallopian tubes may be amenable to further surgical repair. The success rate for surgical repair of severely damaged fallopian tubes or for reported surgical attempts at repair usually does not exceed 30%. Of those pregnancies that are thereafter conceived, there is a subsequent high rate of ectopic (tubal) pregnancies, which require further surgery to prevent or stop bleeding into the abdomen. The risks of surgical treatment for tubal factor infertility include injury to the bowel, bladder, blood vessels and uterus; also infection, bleeding and anesthetic complications (including death) may occur. Some of these risks may be increased if the scarring that is often associated with damaged fallopian tubes and/or repeated surgical repair is present.

Low sperm counts or sperm motility may at times respond to drug treatments or surgical treatment for varicose veins in the testes (varicocele). Drug therapies for low sperm counts or sperm motility which have been utilized clinically include clomiphene, low dose testosterone, Bromocriptine®, Pergonal®, or hCG.

Various types of infertility due to hostile cervical mucus, immunological factors, or low sperm counts have been overcome with use of inseminations of washed sperm. Placing the sperm directly into the uterus via a small plastic catheter bypasses the poor or hostile cervical mucus. A small risk of infection, uterine cramping or even blood pressure collapse may occur with inseminations, but such occurrences have been rarely reported.

In all groups, and especially in patients with infertility of unknown cause, spontaneous conception is a possibility. The severity of the cause of the infertility combined with its duration may influence the spontaneous conception rate. The IVF technique is a treatment option which, in our opinion, offers a reasonable therapeutic alternative to other medical or surgical treatments.

Expectations of Success
Despite the encouraging statistics, it must be emphasized that successful conception and childbirth for any specific couple cannot be guaranteed by any IVF program, even if the couple undergoes multiple attempts. The probability of success depends on many factors, including, but not limited to, the patients age, the cause of infertility, and the talent, skills and experience of the IVF team. (While almost all children resulting from human IVF have been normal, the possibility cannot be excluded that IVF could involve some unknown or increased risk to children who are conceived by this method.) Most infants who have been born following human in vitro fertilization have appeared healthy at birth. Animal offspring have usually been healthy following in vitro fertilization and/or embryo transfer. Yet, congenital abnormalities, birth defects, genetic abnormalities, mental retardation, and/or other possible deviations from normal may occur in children born following in vitro fertilization (as they may occur in children resulting from natural fertilization). At present there does not appear to be any increased risk of birth defects, though multiple births may be complicated by prematurity.

A pregnancy following IVF usually has a successful outcome but like any other pregnancy, may end in miscarriage or still birth. There is no evidence that the frequency of these events are increased by IVF. Even a tubal pregnancy is possible following IVF, but less likely than with natural conception. There is also a greater chance of heterotropic pregnancy ie: one in the uterus and one in the fallopian tube. In this situation saving the intrauterine pregnancy is probable.

How can you make this IVF cycle the most successful it can be?

• Stop Smoking: Many studies have suggested that smoking cigarettes decreases the pregnancy rate. If you are unable to stop smoking entirely, a decrease in the number of cigarettes you smoke in a day will have a positive effect especially during the time period after the embryos are transferred.
• Limit Medications: Tylenol (Acetominophen) is the only medication that may be taken without prior discussion with the IVF staff. Many other medications are acceptable to take but some medications are dangerous. Aspirin, Motrin, Advil, Naproxen, Aleve, to name a few, should NEVER be taken during an egg retrieval cycle.
• Avoid Alcoholic Beverages: Males and females should not drink more than two alcoholic drinks per day prior to the egg retrieval. After the embryo transfer, the female partner should refrain from all alcoholic beverages.
• Avoid Hot Tubs/Steam Rooms: It has been shown that excessive heat is detrimental for the motility of the sperm and a fetus in utero. Males should avoid excessive heat at least 90 days prior to the egg retrieval and females should abstain after the embryo transfer.

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