Where Motherhood Can Be Possible

Dr. Louis R. Manara

Frequently Asked Questions: “Why did my treatment fail?”

Mar 29, 2014 — by manara99
Tags: Understanding Infertility Treatment

It is not unusual for infertility treatments to fail, and when this happens, patients often ask the simple question, “Why did our treatment fail?” In order to provide a logical and accurate explanation, the clinician must take the time to provide the couple with important basic information concerning reproductive function and efficiency in humans.  An important fact to review during this dialogue is that the monthly chance of pregnancy in fertile couples (monthly fecundity) is 20%.  While various infertility treatments clearly improve the prospects for pregnancy, most do not achieve a 20% or higher chance of pregnancy in a given single month, with the notable exception of in-vitro-fertilization. 

Fibroids and Infertility – New Information!

Mar 23, 2014 — by manara99
Tags: Fibroids And Infertility Ivf Success

It is generally agreed the while uterine fibroids are very common; they are usually not associated with infertility.  Size and location are the two main characteristics, which determine if fibroids may be implicated in infertility or increased risk of miscarriage.  These benign tumors have long been classified according to their location.  Fibroids located within the uterine cavity are referred as submucous fibroids.  If located within the uterine wall fibroids are classified as intramural, and when these tumors are positioned on the outer surface of the uterus, they are termed subserous.  

Should We Be Encouraging Preimplantation Genetic Screening (PGS)?

Mar 19, 2014 — by manara99
Tags: Ivf Success Improving Ivf Success Pgs

Selection of the best embryo for transfer is the goal of all IVF programs.  Preimplantation Genetic Screening, a technique that involves biopsy of an embryo and analysis of this cell(s) for specific disease or abnormality, holds the promise of identifying chromosomally normal embryos for transfer.  Although transferring only genetically normal embryos should theoretically lead to higher pregnancy rates, this has not been the case. In this article we will review PGS and provide some thoughts on the current clinical application of this technology.

DHEA – Improving Egg and Embryo Quality


An article in press at this time (“Role of dehydroepiandrosterone in improving oocyte and embryo quality in IVF cycles” by Zangmo, Singh, Kumar, Vanamail and Tiwari, in Reproductive BioMedicine Online) looked at the effects of dehydroepiandroterone (DHEA) in patients who had been shown to be poor responders in prior IVF treatment cycles.  This study looked at 50 patients before and after  four months of treatment with DHEA and noted an improvement in the number of oocytes retrieved, fertilization rates, and number of embryos in the DHEA treated group.

Frozen Embryo Transfer Success – Important New Information!

Many studies have shown that frozen embryo transfers result in a lower chance of pregnancy compared to fresh embryos.  However very few studies have looked at frozen embryo transfers in the context of the results of the preceding fresh embryo transfer (successful or not).  A recent study published in Reproductive BioMedicine Online  (Doherty, Martin, Kayisli, Sakkas, and Patrizio, Feb. 2014), looked at  outcomes of frozen embryo transfers in patients who had achieved pregnancy with the prior fresh embryo transfer and those who had not.

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