During an initial consultation, the patient discusses past fertility experiences and goals with Dr. Elassar to identify potential treatment options. Whether the goal is family building or fertility preservation (egg and embryo freezing), the Doctor will explain treatment options in depth, determine a timeline, and answer any questions. Consultation includes an ultrasound scan to determine the ovarian reserve and detect any uterine abnormalities. Blood is drawn onsite as a courtesy to evaluate hormone levels depending on your case.
Egg Freezing (Oocyte Cryopreservation)
Egg freezing is a method used to preserve women’s ability to get pregnant in the future. Following ovarian stimulation, eggs are harvested, then frozen and stored for later use. The egg freezing process takes approximately 2 weeks from beginning medications to retrieval. Egg freezing is a great option for those pursuing a career before starting a family, those wishing to preserve fertility for the future, those facing diseases and health issues, and those undergoing chemotherapy.
Unlike egg freezing, the embryo is frozen after the fertilization process of the egg and sperm. This is the most successful method for preservation of fertility.
This is the simplest and most successful approach to male fertility preservation. Sperm samples are collected, frozen, stored, and can be used later in IUI and IVF treatment.
Intrauterine Insemination (IUI)
An IUI procedure places sperm directly inside the uterus. This process includes
- Patient administered oral medication/ subcutaneous injection
- Hormone monitoring during follicular development
- Triggering ovulation via injection
- Sperm preparation
IUI can be used to treat patients with unknown infertility causes or mild male-factor infertility. While we suggest starting with this simpler procedure, it may not be right for everyone.
In Vitro Fertilization (IVF)
During an IVF cycle, the ovaries are stimulated with hormonal medications, eggs are retrieved and fertilized. The resulting embryos are grown in an outside media for an average of five to six days. At this stage the patient has the option to freeze the embryos or proceed with a fresh embryo transfer.
IVF can be an emotional and financial commitment. We may postpone this treatment plan until we have considered other treatment paths, though in some cases, IVF may be the only option for a patient experiencing severe male and/or female factor infertility.
In Intracytoplasmic Sperm Injection (ICSI), sperm is injected into the egg in the lab. This method is used when the quantity/quality of sperm is low such that the sperm is unable to fertilize the egg. Currently this is the most advanced technology in IVF treatment. This is recommended for severe male factor infertility or prior poor fertilization results.
Intracytoplasmic morphologically selected sperm injection, or IMSI is a specialized technique for ICSI where a high magnification digital imaging lens is used to select the best sperm for injection into the egg. This highly sophisticated technology is preferable in cases of abnormal sperm morphology (shape) or previously failed ICSI to improve fertilization outcomes.
FET (Frozen Embryo Transfer)
Implantation of a frozen embryo. This procedure is done when a patient opts for PGT testing before the transfer of embryos, or following a previous IVF cycle either after freezing of all embryos (no fresh transfer) or with a surplus of embryos after a failed fresh embryo transfer.
Genetic Testing (PGT)
Preimplantation genetic testing (PGT) can help choose the best suited embryos for IVF transfer, giving you the best chance of achieving a healthy pregnancy. PGT testing can be added to IVF/ICSI treatments to rule out genetic or chromosomal abnormalities by testing embryos prior to implantation.
There are two types of PGTtesting: (1) for single gene defects (PGT-M) and (2) testing for embryo chromosomes (number and structure of the chromosomes, PGT-A) using Next generation sequencing (NGS). Screening for genetic traits in parents can estimate the risk of transmission in pregnancy. We aim at increasing detection of the common recessive genetic diseases and if found, minimize the chance for their transmission to the baby. Those who might benefit from PGT:
- Those with known genetic abnormalities
- Those with few or no ejaculated sperm
- Those affected by inheritable diseases
- Those affected by recurrent pregnancy loss
- Those with repeated implantation failure
- Advanced maternal age
- Good prognosis patients undergoing single embryo transfer (SET)
- Those undergoing sex selection
Male Factor Infertility Treatment
Male factor infertility treatment begins with a sperm analysis to assess quality and quantity. Sperm is collected and tested in the lab.
Simple Male-Factor Treatments
Lifestyle Changes – Weight loss, avoiding smoking, reducing alcohol intake, and other simple changes can sometimes be enough. Dr. Elassar can collaborate with our nutritionist to offer the best advice for boosting male fertility.
Advanced Male-Factor Treatment
Surgery for Obstruction – Men with prior vasectomy or other obstructions may be able to undergo surgery to correct the obstruction. This is performed by our urologist.
Assisted Reproduction – Reproduction assistance is tailored to the patient’s sperm analysis to rule out the presence of obstruction, retrograde ejaculation, or decreased sperm production.
Sperm Retrieval – If too little sperm is ejaculated, sperm can be obtained by
- Combining and freezing multiple samples
- Using a vibratory device in those unable to maintain erection
- Post-ejaculation bladder wash in retrograde ejaculation
- Electro-ejaculation (EEJ) in those with spinal cord injury.
- Needle aspiration.
Donor Sperm – Donor sperm can be used when repeated sperm retrieval fails, in the case of some genetic disorders, and repeated fertilization failure.
Third Party Reproduction/LGBTQ+
Sperm collected from a known donor (often a friend or family member) or sperm bank (anonymous) is prepared to be injected into the uterus. Donor sperm from a bank has been tested for infectious disease and screened for quality.
Fresh or frozen sperm is prepared for home insemination.
Fresh or frozen sperm is prepared and injected at the office through IUI or IVF.
Eggs collected from a known donor (often a friend or family member) or eggs from a donation bank (anonymous) are retrieved and prepared for fertilization and implantation into the uterus.
The reciprocal IVF process allows both partners to participate in the pregnancy. One partner undergoes egg retrieval, the egg is fertilized with donor sperm, and transferred to the other partner.
A fertilized embryo (known or donated sperm/egg) is transplanted to the uterus of the gestational surrogate to carry the pregnancy.
IVM (In Vitro Maturation)
IVM involves collecting eggs from the ovary before maturation. In IVM, the eggs are matured in the lab as part of IVF treatment.
Donor Oocytes (Donor Eggs)
Donor Oocytes, or egg donation allows those with ovarian failure, poor egg quality, or previous failed IVF treatments to become pregnant. The eggs are harvested from a donor and then used as part of IVF treatment.
Fertility and Wellness
Nutrition and Exercise
Our novel KA rejuvenation method is a holistic and individually crafted wellness program to assist women through all stages of their fertility journey. After a personal evaluation of the physical and energetic body, patients are assigned a step-by-step nutritional, breathing and gentle exercise plan to boost functions of the reproductive system, organs and glands.
Trigger point massage is applied to the extremities, head and ears to bolster immunity and promote vitality throughout the hormonal treatment. Daily breath-work boosts circulation and gentle hip-openers stimulate the 2nd chakra for a relaxed and vibrant womb. Herbal tinctures and organic dietary supplements further assist detoxification and boost fertility. A special embryonic massage of gentle acupressure is administered right before the transfer to tone and stimulate blood flow into the uterus. During the post-transfer days of rest, five poses to aid implantation are practiced in bed. Each patient leaves with a customized plan of breathing and relaxation to open the body and calm the mind – paving her way into a healthy conception, pregnancy, birth and motherhood.