Treatments and Services

IUI is a type of artificial insemination that allows doctors to inject sperm directly into a woman’s uterine cavity during an optimal time of ovulation. IUI is used to treat many causes of infertility, especially when there is a problem with the sperm, such as low sperm count or low motility (when sperm do not move well). IUI bypasses the cervix, so it is a useful treatment if there is incompatibility between sperm and the cervical mucus.

IUI is also an option when the man is unable to ejaculate inside the woman’s vagina (because of impotence, premature ejaculation, or other medical conditions). This procedure can be performed with either your partner’s sperm or with sperm from a donor.

The female partner is usually prescribed ovulation-stimulating medications a few weeks before an IUI procedure. Then, at a pre-scheduled follow-up visit, your doctor will use ultrasound to monitor your eggs in order to determine an optimal time to schedule the IUI procedure. IUI is a quick office procedure that only takes a few minutes and involves minimal discomfort.

On the day of the IUI procedure, a semen sample will be washed by the lab to separate the semen from the seminal fluid and your doctor will use a catheter to insert the sperm directly into the uterus. A follow-up pregnancy blood test will be scheduled for a few weeks after the procedure and your doctor will call you with the results.

Intracytoplasmic Sperm Injection (ICSI) is an infertility treatment that involves injecting one sperm directly into an egg. ICSI is performed as part of an In Vitro Fertilization (IVF) procedure. Doctors may recommend ICSI to treat many causes of infertility, especially when there is a problem with the sperm, such as low motility (movement) or a low sperm count. ICSI is especially useful in cases where the sperm cannot penetrate the female’s egg naturally or if the sperm are abnormally shaped.

The male partner will be asked to provide a semen sample. Two to three days before, you should abstain from sex order to maximize semen quality. We will then evaluate the sperm and select the healthiest sperm for the ICSI procedure. After the eggs and sperm are collected, the ICSI process takes place in the lab where an embryologist injects a single sperm into the cytoplasm (center) of each egg. After the eggs have been injected, we will observe the eggs for a day or so.

We understand that not every patient is ready or a god candidate for IVF, but it has been demonstrated to improve outcomes, reduce the risk of twins or triplets, and reduce overall time and money spent to achieve a pregnancy. Often our recommendation of IVF is based on a number of factors, including your age, sperm or egg quality or quantity, general medical history, recurrent miscarriage, and genetics.

IVF patients will do injections of fertility hormones to stimulate follicular (egg) development. Once the egg(s) reach the between 14mm-17mm in diameter, patients receive a final injection to spur final maturation of the eggs.

What is an Egg Retrieval? About 36 hours after the injection, the eggs are removed or retrieved from the ovaries by ultrasound guided aspiration during a 30-minute procedure. Most are able to return home an hour or so after the procedure. Following retrieval, you will begin injections or vaginal delivery of luteal phase progesterone to prepare the uterus for implantation.

What is Extended Embryo Culture? Eggs are fertilized in the IVF laboratory and if successful, result in growing embryos. Developing embryos are allowed to grow in the IVF laboratory for five to six days until they reach the blastocyst stage of embryonic development. Published data supports improved implantation rates and outcomes with extended embryo culture.

After the embryo has grown (the blastocyst stage of development) and the woman’s uterus is ready to receive the embryo, the embryo is transferred back to the uterus to implant and hopefully become a healthy pregnancy and delivery. While the embryo waits for the uterus to be ready – and while geneticists perform genetic testing on the embryo – the embryo is frozen awaiting transfer.

Frozen transfer cycles, versus fresh transfer cycles, show higher birth weight deliveries and lower risk of prematurity. FET also allows for optimal timing and a more natural transfer experience since the embryo can be cryopreserved or “frozen” until the patient’s hormone levels return to a more natural, receptive state, usually on their next cycle.

As an option for IVF patients, Pre-implantation Genetic Testing (PGT-A) allows a more evidence-based approach to selecting embryos to transfer during IVF. Using PGT-A, we can identify the healthiest embryos for transfer in advance of implantation. Embryos that are imbalanced, with too few or too many chromosomes, often result in a failed IVF cycle or miscarriage.

If a patient opts for PGT-A testing, a sample of genetic material must be biopsied from the embryo for analysis. Embryo biopsy is a highly technical process and requires a skilled embryologist to perform the biopsy. Published data supports that blastocyst stage biopsy (day 5) at the trophectoderm layer of the embryo is a safer method than cleavage stage embryonic biopsy (day 3).

Single Embryo Transfer (SET) is a procedure in which a single, high quality embryo is selected and transferred into the uterus, with the help of Pre-Implantation Genetic Testing for Aneuploidy (PGT-A).

The transfer of two or more embryos may result in high-risk and complicated pregnancies and deliveries. With a Single Embryo Transfer (SET), only a single genetically screened embryo is transferred, resulting in one healthy baby being born at a time.

We are pleased to announce that STL Fertility utilizes the Matcher electronic witnessing system to reduce the risk of innocent error and bring peace of mind to both patients and providers. STL Fertility is the only IVF center in Saint Louis to utilize the Matcher electronic witnessing system.

The Matcher electronic witnessing system is a barcode-based witnessing and chain of custody platform created for IVF centers to help prevent errors through mislabeling and provides more traceable way to track eggs, embryos, and sperm samples stored at our center. Dr. Molina Dayal, Medical Director at STL Fertility added, “our staff has the highest levels of respect for the materials they are working with every day. The standards of safety and quality control couldn’t be higher at STL Fertility.”

Visit www.imtinternational.com for more information about The Matcher electronic witnessing system. Have a question for your STL Fertility care team about Matcher? Connect with our patient experience manager, Andrea McClain at andrea.mcclain@stlfertility.com.

PGT-A or preimplantation genetic testing for aneuploidies, is a genetic test performed on embryos produced through IVF. PGT-A helps to determine if your embryos have too many or two few chromosomes. This imbalance of chromosomes will lead to a failed IVF cycle or miscarriage. Ask your STL Fertility provider if PGT-A is right for you based on your history.

PGT-M or preimplantation genetic testing for monogenic/single gene defects, can be performed prior to pregnancy to greatly reduce the risk of having an affected child. Patients who are at high risk for passing on genetic diseases such as Huntington’s Disease, Tay-Sachs, or BRACA I and BRCA II, are recommended to use PGT-M to accurately identify which embryos are affected and which are not. Compared to PGT-A, which tests for chromosomes, PGT-M tests for specific genetic defects.

PGT-SR or preimplantation genetic testing for chromosomal structural rearrangements, can improve the chances of establishing a healthy pregnancy and delivery. Patients with chromosome rearrangements have an increased risk of producing embryos with the incorrect amount of genetic material often leading to a failed IVF cycle or miscarriage.