This is East Coast Fertility’s current commercial airing throughout the Metro area.  Ten Months, its the best age…  Because you get to buy them their first pair of shoes.

Jon and Kate Divorce

Over the years, I have seen numerous high order multiple pregnancies, a side effect of transferring numerous embryos with an inefficient procedure. I have experienced through my patients, pregnancy complications, antenatal and postnatal demise and difficulties and complications suffered by the babies. Many of these marriages failed to survive the stresses, some of the patients suffered depression and there were many issues with the babies.

I still feel the pains I experienced with my patients during those early years of IVF. We infertility doctors were responsible for many high order multiple pregnancies that often did not end well. And I carry that in my heart. When I opened East Cost Fertility, I swore that I would not be responsible again for any conception greater than twins. The only triplets I have had since 2002 are from an embryo transfer of two where the embryos split and created a third baby. I don’t ever want to be responsible for anything like that again. Then IVF was inefficient, today, the implantation rates are far superior. There is no excuse for octomom or sextuplets like Kate has had. I don’t feel gonadotropins with IUI is as safe as IVF where you can limit the number of embryos. We need to enforce the guidelines provided by the American Society of Reproductive Medicine so that programs and patients are compelled to be responsible and limit risk. There is a competitive pressure felt by IVF programs to transfer more embryos as their statistics and success rates are inspected by prospective patients. Programs have not unifomly followed these guidelines. It is only through outside regulation that we can prevent the cause of these high order multiple pregnancies.

I started the Single Embryo Transfer program at East Coast Fertility to encourage patients to limit the number of embryos replaced into the uterus to one in good prognosis patients by eliminating the financial factor. These patients are offered free cryopreservation, embryo storage and frozen embryo transfers so there is no financial pressure for patients to put all their eggs in one basket. This represents a savings of up to over $12,000 and ensures a better chance of a healthy pregnancy and healthy baby. It is my sincere hope that situations that led to the sextuplets of Jon and Kate and octomom are eliminated through regulations and financial incentives such as the Single Embryo Transfer program.

• Injections of the natural hormones FSH and/or LH (gonadotropins) that are normally involved in ovulation every month are used for this purpose

• Additional medications are used to prevent premature ovulation

• An overly vigorous ovarian response can occur, or conversely an inadequate response

Medications may include the following (not a complete list):

- Gonadotropins, or injectable “fertility drugs” (Follistim®, Gonal-F®, Bravelle®, Menopur®): These natural hormones stimulate the ovary in hopes of inducing the simultaneous growth of several oocytes (eggs) over the span of 8 or more days. All injectable fertility drugs have FSH (follicle stimulating hormone), a hormone that will stimulate the growth of your ovarian follicles (which contain the eggs). Some of them also contain LH (luteinizing hormone) or LH like activity. LH is a hormone that may work with FSH to increase the production of estrogen and growth of the follicles. Luveris®, recombinant LH, can also be given as a separate injection in addition to FSH or alternatively, low-dose hCG can be used. These medications are given by subcutaneous or intramuscular injection. Proper dosage of these drugs and the timing of egg recovery require monitoring of the ovarian response, usually by way of blood tests and ultrasound examinations during the ovarian stimulation.

As with all injectable medications, bruising, redness, swelling, or discomfort can occur at the injection site. Rarely, there can be there an allergic reaction to these drugs. The intent of giving these medications is to mature multiple follicles, and many women experience some bloating and minor discomfort as the follicles grow and the ovaries become temporarily enlarged. Up to 2.0 % of women will develop Ovarian Hyperstimulation Syndrome (OHSS) [see full discussion of OHSS in the Risks to Women section which follows]. Other risks and side effects of gonadotropins include, but are not limited to, fatigue, headaches, weight gain, mood swings, nausea, and clots in blood vessels.

Even with pre-treatment attempts to assess response, and even more so with abnormal pre-treatment evaluations of ovarian reserve, the stimulation may result in very few follicles developing, the end result may be few or no eggs obtained at egg retrieval or even cancellation of the treatment cycle prior to egg retrieval. Some research suggested that the risk of ovarian tumors may increase in women who take any fertility drugs over a long period of time. These studies had significant flaws which limited the strength of the conclusions. More recent studies have not confirmed this risk. A major risk factor for ovarian cancer is infertility per se, suggesting that early reports may have falsely attributed the risk resulting from infertility to the use of medications to overcome it. In these studies, conception lowered the risk of ovarian tumors to that of fertile women.

- GnRH-agonists (Leuprolide acetate) (Lupron®): This medication is taken by injection. There are two forms of the medication: A short acting medication requiring daily injections and a long-acting preparation lasting for 1-3 months. The primary role of this medication is to prevent a premature LH surge, which could result in the release of eggs before they are ready to be retrieved. Since GnRH-agonists initially cause a release of FSH and LH from the pituitary, they can also be used to start the growth of the follicles or initiate the final stages of egg maturation. Though leuprolide acetate is an FDA (Federal Drug Administration) approved medication, it has not been approved for use in IVF, although it has routinely been used in this way for more than 20 years. Potential side effects usually experienced with long-term use include but are not limited to hot flashes, vaginal dryness, bone loss, nausea, vomiting, skin reactions at the injection site, fluid retention, muscle aches, headaches, and depression. No long term or serious side effects are known. Since GnRH-a are oftentimes administered after ovulation, it is possible that they will be taken early in pregnancy. The safest course of action is to use a barrier method of contraception (condoms) the month you will be starting the GnRH-a. GnRH-a have not been associated with any fetal malformations however you should discontinue use of the GnRH-a as soon as pregnancy is confirmed.

- GnRH-antagonists (Ganirelix Acetate or Cetrorelix Acetate) (Antagon®, Cetrotide®):

These are another class of medications used to prevent premature ovulation. They tend to be used for short periods of time in the late stages of ovarian stimulation. The potential side effects include, but are not limited to, abdominal pain, headaches, skin reaction at the injection site, and nausea.

- Human chorionic gonadotropin (hCG) (Profasi®, Novarel®, Pregnyl®, Ovidrel®): hCG is a natural hormone used in IVF to induce the eggs to become mature and fertilizable. The timing of this medication is critical to retrieve mature eggs. Potential side effects include, but are not limited to breast tenderness, bloating, and pelvic discomfort.

- Progesterone, and in some cases, estradiol: Progesterone and estradiol are hormones normally produced by the ovaries after ovulation. After egg retrieval in some women, the ovaries will not produce adequate amounts of these hormones for long enough to fully support a pregnancy. Accordingly, supplemental progesterone, and in some cases estradiol, are given to ensure adequate hormonal support of the uterine lining. Progesterone is usually given by injection or by the vaginal route (Endometrin®, Crinone®, Prochieve®, Prometrium®, or pharmacist-compounded suppositories) after egg retrieval. Progesterone is often continued for some weeks after a pregnancy has been confirmed. Progesterone has not been associated with an increase in fetal abnormalities.

Side effects of progesterone include depression, sleepiness, allergic reaction and if given by intra-muscular injection includes the additional risk of infection or pain at the application site. Estradiol, if given, can be by oral, trans-dermal, intramuscular, or vaginal administration. Side effects of estradiol include nausea, irritation at the injection site if given by the trans-dermal route and the risk of blood clots or stroke.

- Oral contraceptive pills: Many treatment protocols include oral contraceptive pills to be taken for 2 to 4 weeks before gonadotropin injections are started in order to suppresshormone production or to schedule a cycle. Side effects include unscheduled bleeding, headache, breast tenderness, nausea, swelling and the risk of blood clots or stroke.

- Other medications: Antibiotics may be given for a short time during the treatment cycle to reduce the risk of infection associated with egg retrieval or embryo transfer. Antibiotic use may be associated with causing a yeast infection, nausea, vomiting, diarrhea, rashes, sensitivity to the sun, and allergic reactions. Anti-anxiety medications or muscle relaxants may be recommended prior to the embryo transfer; the most common side effect is drowsiness. Other medications such as steroids, heparin, low molecular weight heparin or aspirin may also be included in the treatment protocol.

Cryopreserved Embryos

At East Coast Fertility, we are realizing the Jones’ dream of safer, more efficient and cost effective IVF. By utilizing the ability to cryopreserve embryos in 2007, 61.5% (118/192) of patients under 35 were successful in having a live birth as a result of only one egg stimulation and retrieval cycle! In addition, because of our outstanding Embryology Laboratory, we are usually able to transfer as few as 1 or 2 high quality embryos per cycle and avoid risky triplet pregnancies. In fact, since 2002, the only triplet pregnancies we have experienced have resulted from the successful implantation of two embryos, one of which goes on to split into identical twins (this is rare!). By cryopreserving embryos in certain high-risk circumstances, we are able to vastly reduce the risk of ovarian hyperstimulation syndrome requiring hospitalization. At East Coast Fertility, safety of our patients comes first. Fortunately, our success with frozen embryo transfers is equivalent to that of fresh embryo transfers, so that pregnancy rates are not compromised in the name of safety, nor are the babies.

Today, as reported in the Daily Science: “The results are good news as an increasing number of children, estimated to be 25% of assisted reproductive technology (ART) babies worldwide, are now born after freezing or vitrification” (a process similar to freezing that prevents the formation of ice crystals).

The study, led by Dr Ulla-Britt Wennerholm, an obstetrician at the Institute for Clinical Sciences, Sahlgrenska Academy (Goteborg, Sweden), reviewed the evidence from 21 controlled studies that reported on prenatal or child outcomes after freezing or vitrification.

She found that embryos that had been frozen shortly after they started to divide (early stage cleavage embryos) had a better, or at least as good, obstetric outcome (measured as preterm birth and low birth weight) as children born from fresh cycles of IVF (in vitro fertilisation) or ICSI (intracytoplasmic sperm injection). There were comparable malformation rates between the fresh and frozen cycles. There were limited data available for freezing of blastocysts (embryos that have developed for about five days) and for vitrification of early cleavage stage embryos, blastocysts and eggs.

‘Slow freezing of embryos has been used for 25 years and data concerning infant outcome seem reassuring with even higher birthweights and lower rates of preterm and low birthweights than children born after fresh IVF/ICSI. For the newly introduced technique of vitrification of blastocysts and oocytes, very limited data have been reported on obstetric and neonatal outcomes. This emphasises the urgent need for properly controlled follow-up studies of neonatal outcomes and a careful assessment of evidence currently available before these techniques are added to daily routines. In addition, long-term follow-up studies are needed for all cryopreservation techniques,’ concluded Dr Wennerholm.

The use of frozen embryos has become a common standard of care in most IVF Programs. At East Coast Fertility we are able to keep multiple pregnancy rates down – by only transferring one or two embryos at a time – while allowing patients to hold on to the additional embryos that they may have created during the fresh cycle. It is like creating an insurance plan for patients. We developed a unique financial incentative program using the technology of cryo-preservation to encourage patients to transfer only one healthy embryo at a time. In order to ensure the best out come for mother and child – these special pricing plans take the burden off the patient to pay for the additional transfers and the cryo- preservation process. We have eliminated the cost of cryopreservation, storage and embryo transfer for patients in the single embryo transfer program. Thus, patients no longer have that financial pressure to put all their eggs in one basket! We truly believe we are practicing the most successful, safe and cost effective IVF utilizing cryopreservation.

PCOS

PCOS is the most common hormonal disorder of reproductive age women, occurring in over 7% of women at some point in their lifetime.  It usually develops during the teen years.  Treatment can assist women attempting to conceive, help control the symptoms and prevent long term health problems.

The most common cause of PCOS is glucose intolerance resulting in abnormally high insulin levels.  If a woman does not respond normally to insulin, her blood sugar levels rise triggering the body to produce more insulin.  The insulin stimulates your ovaries to produce male sex hormones called androgens.  Testosterone is a common androgen and is often elevated in women with PCOS.  These androgens block the development and maturation of a woman’s ovarian follicles preventing ovulation resulting in irregular menses and infertility.  Androgens may also trigger development of acne and extra facial and body hair.  It will increase lipids in the blood.  The elevated blood sugar from insulin resistance can develop into diabetes.

Symptoms may vary but the most common are acne, weight gain, extra hair on the face and body, thinning of hair on the scalp, irregular periods and infertility.

Ovaries develop numerous small follicles that look like cysts hence the name polycystic ovary syndrome.  These cysts themselves are not harmful but in response to fertility treatment can result in a condition known as Hyperstimulation syndrome.  Hyperstimulation syndrome involves ovarian swelling, fluid accumulating in the belly and occasionally around the lungs.  A woman with Hyperstimulation syndrome may become dehydrated increasing her risk of developing blood clots.  Becoming pregnant adds to the stimulation and exacerbates the condition leading many specialists to cancel cycles in which a woman is at high risk of developing Hyperstimulation.  They may also prescribe aspirin to prevent clot formation.

These cysts may lead to many eggs maturing in response to fertility treatment also placing patients at a high risk of developing a high order multiple pregnancy.  Due to this unique risk it may be advantageous to avoid aggressive stimulation of the ovaries unless the eggs are removed as part of an in vitro fertilization procedure.

A diagnosis of PCOS may be made by history and physical examination including an ultrasound of the ovaries.  A glucose tolerance test is most useful to determine the presence of glucose intolerance and diabetes.  Hormone assays will also be helpful in making a differential diagnosis.

Treatment starts with regular exercise and a diet including healthy foods with a controlled carbohydrate intake.  This can help lower blood pressure and cholesterol and reduce the risk of diabetes.  It can also help you lose weight if you need to.

Quitting smoking will help reduce androgen levels and reduce the risk for heart disease.  Birth control pills help regulate periods and reduce excess facial hair and acne.  Laser hair removal has also been used successfully to reduce excess hair.

A diabetes medicine called metformin can help control insulin and blood sugar levels.  This can help lower androgen levels, regulate menstrual cycles and improve fertility.  Fertility medications, in particular clomiphene are often needed in addition to metformin to get a woman to ovulate and will assist many women to conceive.  The use of gonadotropin hormone injections without egg removal as performed as part of an IVF procedure may result in Hyperstimulation syndrome and/or multiple pregnancies and therefore one must be extremely cautious in its use.  In vitro fertilization has been very successful and offers a means for a woman with PCOS to conceive without a significant risk for developing a multiple pregnancy especially when associated with a single embryo transfer.   Since IVF is much more successful than insemination or intercourse with gonadotropin stimulation, IVF will reduce the number of potential exposures a patient must have to Hyperstimulation syndrome before conceiving.

It can be hard to deal with having PCOS.  If you are feeling sad or depressed, it may help to talk to a counselor or to others who have the condition.  Ask your doctor about support groups and for treatment that can help you with your symptoms.  Remember, PCOS can be annoying, aggravating even depressing but it is fortunately a very treatable disorder.

Before the tips, here’s a hopeful quip:

“Slow down and everything you are chasing will come around and catch you,” said John De Paola.

I don’t know if pregnancy will “catch” you if you slow down…but heck, it’s worth a try! To learn more about sperm, ovulation, and getting pregnant, click Fertility and Infertility for Dummies by Gillian Lockwood and others. And, read on for dozens of tips on reducing the stress of infertility….At East Coast Fertility, join our Mind Body Program where reducing stress and improving your odds is the name of the game.

Social Ways to Reduce Infertility Stress

- Tell your friends what you need. If don’t want people to keep asking if you’re pregnant (I hate that!), then tell them that you’ll give them the good news when you’re ready!

- Accept your way of dealing with infertility. You and your partner’s method of coping with infertility could be much different than mine, or your sister’s – and the sooner that you accept it, the better.

- Talk to your friends about your frustrations and joys.

- Have a relaxing glass of wine or a margarita with friends, but don’t overdo it (though some say you shouldn’t drink alcohol at all when you’re trying to get pregnant…that’s a personal choice).

- Prioritize invitations to reduce stress. Give yourself time to unwind and do what you want to do. Say no to parties or get-togethers, or just make a brief appearance.

- Don’t fall into the trap of comparing your life, situation, relationship, or family to other people’s.

Physical Ways to Reduce Infertility Stress

- Get a full-body massage – and tell your massage therapist that you’re trying to get pregnant.

- Spend time out in nature: walking, skating skiing in the winter, hiking in the summer.

- Take a warm bubble bath (but if you’re a female or male coping with infertility, make sure you check with your doctor first).

- Stop eating before you’re full – don’t gorge on chocolates, chips, or fast food.

- Get enough sleep.

- Reduce your caffeine intake (I’m sure you’ve heard that before!).

- Take your vitamins, supplements, minerals (you’ve heard that before, too, I bet).

- Drinks lots of water.

- Get a manicure or pedicure.

- Make love for the sake of making love.

Mental Ways to Reduce Infertility Stress

- Volunteer at a food bank, hospital, or animal shelter.

- Take downtime to snooze, read, relax.

- Play your favorite card and board games – laughing will reduce the stress of getting pregnant.

- Take a regular crossword puzzle or Suduku break.

- Pick your battles, choose your priorities.

- Let go of the little stuff.

- Watch your favorite TV shows or movies.

- Share your baking or meals with homebound people or lonely neighbors.

Emotional Ways to Reduce Infertility Stress

- Practice gratitude.

- Have realistic expectations.

- Laugh!

- Stay in touch with your authentic emotions.

- Cry, scream, or punch the pillow when you need to.

- Stop to take a deep breath every hour or so throughout the day.

- Let yourself grieve. Reducing stress involves expressing your emotions.

- Keep your old traditions and healthy habits alive, but be open to new ones.

Creative Ways to Reduce Infertility Stress

- Paint, draw or carve your thoughts and feelings.

- Visit a museum or art gallery to reduce holiday stress.

- Go to a movie in the middle of the day by yourself.

- Listen to music that relaxes and/or energizes you.

- Go for a drive in the country; stop for hot chocolate and muffins.

- Write in your journal to reduce stress.

Spiritual Ways to Reduce Infertility Stress

- Pray, and remember the big picture.

- Read the Bible, Torah, or other meaningful book.

- Seek the deep meaning behind church or mass services to reduce holiday stress.

- Remember that your God, Creator or Higher Power is working behind the scenes.

- Adjust your perspective to include peace, compassion, and forgiveness.

Family Ways to Reduce Infertility Stress

- Change your regular responses to aggravating family members, especially if your normal responses haven’t worked in the past!

- Shrug off challenges and criticisms.

- Let go of past betrayals, mistakes, failures – both yours and others’.

- Don’t expect people to change (unless you change first).

- Maintain healthy boundaries to reduce infertility stress.

Readers, how do you let go of the stress of trying to get pregnant? I find that walking in the woods out behind our house is hugely relaxing – it reminds me that life can be beautiful even without kids. There’s something about deep breaths of fresh air that energize me, no matter how bad I’m feeling…

Young, healthy patients and patients with many follicles such as those with polycystic ovarian syndrome have the best response to the minimal stimulation with a result that typically includes multiple high quality embryos often even allowing for cryopreservation of embryos for a potential additional transfer in the future. When combined with East Coast Fertility’s Single Embryo Transfer Program, the cryopreservation, embryo storage and future frozen embryo transfers are free.

As an alternative to intrauterine insemination, patients can triple their success and lower their risk at pretty much similar costs. Of course patients with pelvic adhesions/scarring, blocked fallopian tubes, endometriosis and severe male factor have an even lower or no chance of success with intrauterine insemination but yet their probability of success with MicroIVF is as good as that of any other patient.

The fee at East Coast Fertility for MicroIVF is currently $3900 but an additional $1000 fee is added if patients require ICSI to facilitate fertilization and/or $550 if anesthesia is requested. An IUI with hormone injections ranges from $3500 to $4500 including medication. The medication cost for MicroIVF is not much more than $100. Furthermore, one need not worry with MicroIVF that all the eggs ovulated may fertilize and implant as could happen with intrauterine insemination. The risk of high order multiple pregnancies that one faces with intrauterine insemination is eliminated with MicroIVF. You control how many embryos with which you can potentially get pregnant.

There is a risk of hyperstimulation syndrome associated with hormone injections that is essentially eliminated with MicroIVF. This condition can result in enlarged ovaries, abdominal swelling and bloating, fluid that can push up on the lungs causing difficulty with breathing. Patients can develop dehydration that can place them at risk of developing a blood clot. This is not a concern with MicroIVF as it is with intrauterine insemination.

In summary, MicroIVF, especially as an alternative to intrauterine insemination, offers a low cost, safer and more efficient means to build a family.

Dr. Panayiotis Zavos

Source: www.ivf.net

Fertility doctor denounced for claims of human cloning

First Octomom and now this. I get the impression there are fertility specialists out to ruin the reputation of IVF for the rest of us. In the case of octomom, there is some question as to how the patient was counselled. We focus on high success with least risk as possible. It is unfortunate that a few others aspire to something other than their patient’s best interests. It is very difficulty for a fertility specialist to deal with patients who insist on using up all their embryos in one attempt. We share with the patient a desire not to discard embryos but retain responsibility for not allowing for potentially dangerous outcomes.

Cloning is an ethical dilemma yet to be solved by society. Until then we do not participate in cloning since we are unsure whether to do so is ethically sound. Benefits of modified forms of cloning have been proposed. Multiplying high quality embryos in patients would theoretically increase their success rates. Women who had poor quality eggs (cytoplasm) could have their nuclei transplanted into the egg of a healthy young woman. Again, theoretically, this can improve success rates. Another proposed clinical use is to produce tissue for transplantation say in a child with cancer who requires chemotherapy.

The form of cloning that usually comes to mind however, is the creation of an identical being whether it be to replace a loved lost child or in our common vernacular a “minime”. It is this possible use of the technology that causes almost universal disdain in our society. We have yet to figure out whether there is a place for any of the aforementioned forms of cloning that is potentially more palatable.

IVF, is a clinically useful form of technology that is allowing for greater than 40,000 more babies to be born each year who may otherwise never have been given life. But, as with all technology there are risks and potential downsides that need to be considered. Today, cloning as well as high ordered multiple embryo transfers moves the IVF technology beyond our comfort zone with our assessment of the potential risks and downsides. Let us not distort the relative benefit vs. risk of IVF technology by wrongfully applying it to cloning or high order multiple embryo transfer.

I. Dr. Rudy Quintero, M.D., F.A.C.O.G. (on the CON side of the debate) Founder and Medical Director of C.A.R.E. Fertility in Los Angeles, CA.

“IVF over the past twenty years has evolved and been optimized from a point where pregnancy rates were at best quoted to be 10% back then to about 50% today. We have become better with stimulation protocols and techniques over this time period. Nevertheless, this success has unintended consequences including the possibility of embryo overproduction and multiple births.

Minimal Stimulation IVF is currently being touted as a solution for this, and we all hope that it soon will be. However, we lack sufficient data from clinical trials to support its use. In one of the better trials to date from Pelinck et al (Netherlands), an 8% pregnancy rate was noted, with a 20.8% pregnancy rate after three attempts with Minimal Stimulation IVF. Some authors have published success rates of up to 40% using Minimal Stimulation IVF, but percentages may be influenced by bias and other study errors due to their retrospective design.

More data needs to become available to truly assess the success of this protocol for different types of patients.”

II. Dr. David Kreiner, MD, F.A.C.O.G. (PRO Micro IVF), Medical Director of East Coast Fertility in NYC.

“Micro IVF is a great way to assist patients with achieving their goal of having a single baby while minimizing their risk of complications such as multiple pregnancy, hyper-stimulation syndrome or producing financial hardship. Its lower cost and risk should outweigh diminished pregnancy rate which for young high responders and older poor responders will be minimal. The reason these groups would see a minimal decrease in success is that the younger high responders have a higher implantation rate per embryo and do not need as many embryos to produce the healthy one that will result in a baby. The older poor responders do not make extra embryos with aggressive stimulation and have nothing to gain by adding gonadotropins in a conventional IVF cycle.”

III. Dr. Eva Littman, M.D., F.A.C.O.G. (CON)

Founder & Medical Director of Red Rock Fertility in Las Vegas.

“My biggest fear is that this procedure will be misused by couples and patients who require conventional IVF, but because of the economy they opt for the lower price and subsequently, the lower chance of success. It worries me that in order to try to save money, patients may fall for a ‘gimmick’ and use up funds that could have gone towards a real chance at success.”

As a new procedure, time will tell what its ultimate role will be as one of the fertility treatments offered by fertility specialists. My opinion is that for patients without insurance coverage for intrauterine insemination, for a few extra dollars it offers a better success rate with lower risk of multiple pregnancy and hyperstimulation syndrome.

Lets break it down for you.  We have the NYState DOH grant that for patients who qualify for this income based grant will pay between $2,000 and $12,000.  The amount of money provided by the state is limited so it is not available for patients who require high doses of medication.  It does include frozen embryo storage for 1 year and 1 frozen embryo transfer, ICSI and medications.

1- NY State DOH grant based on combined income includes 1 year of storage and 1 FET, meds and anesthesia is covered. Does not include Procedure room fee + assisted hatching = $1500.

2- ECF grant- $6950-$9950 based on combined income from <$100k- 200k, $6950 for $100k and lower, 1/2 price for all additional procedures, meds, anesthesia and procedure room fee not covered but PR fee 1/2 price ,$500.

3- Embryo freezing study- $3000 stipend, most meds covered, coculture and embryo glue included. Procedure room fee not included. If combined with ECF grant basic IVF cost is $6950. If pt selected for freeze all then cryo and storage for 1 yr and up to 3 FET free.

4- Egg freezing study- most meds covered, coculture and embryo glue and ICSI, procedure room fee and anesthesia included. Cryo and FET of frozen eggs included. Cost $8850.

5- Mini (Micro) IVF- minimal stimulation IVF $4900. Through the month of June $3900. This includes monitoring, retrieval, transfer and basic IVF lab and procedure room fee. Does not include meds, anesthesia ($550)- optional, ICSI or any other additonal IVF procedures other than basic.

If you have a question regarding these programs, please don’t hesitate to contact me at dkreiner@eastcoastfertility.com.