OVERVIEW
DR. VINCENT BRANDEIS, Board Certified in Reproductive
and Endocrinology fertility, has over 20 years experience
in IVF - natural cycle, minimal, and standard-dose
stimulation.
Dr. Brandeis was among the
first physicians in the United States to perform
IVF. He was a member
of the first IVF program in New Jersey in 1982
at the Robert Wood Johnson hospital of Rutgers University.
Dr. Brandeis established one of the first private
IVF programs in New York City in 1987.
Dr. Brandeis has helped thousands of couples to
become parents, through IUI and IVF.
Dr. Brandeis’s fertility
care has always been distinguished by his personal
attention to each couple. Nothing is ever taken
for granted.
That is why, both husband
and wife must first undergo a complete and individualized
fertility evaluation to establish a their diagnosis – the
exact reason(s) for their infertility. Further
diagnostic tests and procedures are done if necessary,
before proceeding to treatment.
For example, patients considering natural cycle
or modified cycle IVF are carefully evaluated to
be certain that there are no outstanding factors
that may lessen their chances for success.
If a fibroid is present, a sonohysterogram or MRI
is usually performed to evaluate the integrity of
the uterine wall and be certain that there is no
co-existing adenomyosis.
If a ovarian cyst is found
it is further evaluated by an MRI and in some cases
drained or surgically removed so it will not interfere
with the process of ovulation and follicle – egg
cell development.
All patients considering
evaluation cycle for natural
cycle IVF are first studied with evaluation cycle.
- Estradiol, FSH, LH during your period
- As ovulation approaches Estradiol, LH, Progesterone
starting several days before the day of ovulation
is expected and their daily until ovulation is
confirmed by the collapse of the follicle on sonogram.
- The endometrial lining and levels of Estradiol
and progesterone are done day 3, 6, and 9 after
ovulation to confirm the wellness of the 2nd half
of the cycle as well.
Based upon the findings
of this evaluation cycle, the couple and Dr. Brandeis
decide together whether modified natural cycle
IVF, minimal cycle IVF, conventional cycle IVF
are the best options.
We do not offer cycles in packages because, in our
experience, some patients are found to have an egg
factor on the first cycle and further cycles may
not be in their best interest.
In keeping with a strong
commitment to individualized to fertility, evaluation,
and treatment - Dr Brandeis always tries to be
sure that the particular choice of treatment and
actual treatment plan are tailored and adapted
to the diagnosis, needs, and circumstances of each
individual couple – whether the treatment
of modality is ovulation induction, insemination,
or some form of IVF, donor egg, or donor sperm program.
The consistent presence
of the treating physician is especially critical
in patients who which to conceive with natural
cycle IVF, minimal stimulation IVF, or modified
cycle IVF.
The couples history and
natural cycle patterns must be studied and known
to the physician both before proceeding to these
options as well as during the daily monitoring.
A sonographer can only report but so much to the
managing physician. A follicle that measures
15 by 13 is important but actually seeing the sonogram,
observing, the character and thinness/thickness of
the follicle as it evolves at a daily basis.
Asking the patient directly about changes in cervical
mucus changes in her basal body in temperature chart
and feelings of cramping are critical considerations
that are integrated when seeing the patient first
hand.
Additionally the daily personal interaction allows
the patient to express their concerns and sometimes
discuss matters that they will not feel comfortable
through on intermediary.
Our mission as a fertility center is to offer comprehensive
fertility evaluation and treatment.
MNC-IVF is an excellent first option for
patients who have no coverage for IVF, because
it drastically cuts down the cost of medication,
which usually represents a hefty part of out-of-pocket
expense in IVF.
For many patients under 35 with normal FSH, MNC-IVF
reduces the cost to the patient, allows her to have
multiple consecutive attempts, and cumulatively,
offers a clinical pregnancy rate similar to that
of stimulated IVF. without the risk of multiple gestation.
In patients over 35, the benefit
of MNC-IVF may be less, and perhaps low-dose or minimal-dose
stimulation may be considered as a first alternative.
Patients over 40 who undergo MNC-IVF may have eggs
that appear to be normal, but embryo development
will be less optimal than in younger patients. They
also have a higher miscarriage rat and a lower live
birth rate.
Patients over 40 with elevated FSH may consider
MNC-IVF but they should be aware that the pregnancy
will be affected both by age and the elevated FSH.
In particular, patients who have been poor responders
in stimulated cycles, with elevated FSH, may consider
NCIVF, but they must be aware of poorer prognosis
compared younger patients with normal or even slightly
elevated baseline FSH levels.
Many programs have a >20% live birth rate per
embryo transfer with MNC-IVF in women under age 39.
My personal, individualized
approach to fertility
care is particularly helpful for MNC-IVF or MS-IVF
cycles, because I do not rush patients into these
treatments without first stydying their history – especially
of past stimulated cycles with or without IVF – and
the present pattern of their natural cycles.
When they do undertake MNC-IVF, then I am much better
prepared to anticipate their special requirements in
terms of monitoring their cycle. In this sense, we
treat every patient as a special, individual case ,
and never take anything for granted.
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