Other Services
Psychological Counseling
Psychological counseling is available to our patients who would like to talk through issues surrounding infertility at any point during the course of treatment. Psychological counseling can help you to clarify your goals and set reasonable expectations and limitations on your fertility treatment. Counseling can also help patients who are feeling stressed or depressed during the course of treatment. We also refer all our donor egg recipients for psychological counseling so that they can discuss and come to terms with the feelings and issues relating to non-biologic parenting.
Genetic Counseling
AFS's team of physicians will screen you for certain genetic conditions as part of their infertility work up. They can discuss genetic issues with you and refer you to genetic counselors and physicians specializing in genetics if necessary.
Pre-implantation Genetic Diagnosis
Preimplantation genetic diagnosis (PGD) allows genetic analysis to be performed on early embryos prior to implantation and pregnancy. PGD permits the diagnosis of certain genetic disorders at the embryonic stage, allowing couples to achieve pregnancies through IVF with the virtual elimination of the risk of certain genetic diseases in their offspring. Genetic conditions that can PGD can diagnose include Cystic fibrosis, Down Syndrome, Duchenne muscular dystrophy, Hemophilia A, Tay-Sachs disease, and Turner Syndrome. Furthermore, PGD helps to identify the presence of extra chromosomes, and therefore detect conditions such as trisomy 21. The chromosomes that usually get tested through PGD are 21, 13, 16, 18, x, and y. Therefore, PGD will reveal the gender of an embryo. You may wish to consult your doctor or genetic counselor for further information on whether PGD would be advisable in your situation.
Couples who elect to have PGD undergo IVF and often ICSI. Embryos are formed in the laboratory by the same process as standard IVF. The embryos are then biopsied with very fine glass needles and tools under microscopic observation and control to obtain one or two sample cells (blastomeres) for genetic analysis. Embryos whose biopsy results are normal are then available for immediate transfer into the uterus. Animal experiments and a very large experience with PGD in humans have documented the safety and efficacy of this technology in preventing genetic disorders and producing the births of normal children.
AFS currently uses an affiliate's laboratory for PGD.
Sex Selection
AFS offers sex selection services in accordance with the recommendations of the American Society of Reproductive Medicine (ASRM) Ethics Committee. For couples who are concerned about the possibility of transmitting genetic disorders that affect only one gender (such as certain types of muscular dystrophy) sex selection using pre-implantation genetic diagnosis (PGD) is recommended. PGD can be used to determine the sex of each embryo obtained with IVF prior to returning the embryo(s) to the uterus. By assuring that only embryos of the chosen gender are placed in the uterus, success in obtaining the desired outcome is virtually assured should pregnancy result.
For patients who are considering sex selection for other reasons, such as family balancing, using PGD for sex selection should be considered only when IVF is already recommended for the women to treat infertility or prevent the transmission of a genetically transmitted disease. Another less expensive, but also less reliable, method of sex selection is the MicroSort® sperm separation method. This method may be considered for patients considering sex selection for reasons such as family balancing. The MicroSort9® method may be used in conjunction with either IUI (intrauterine insemination) or IVF, since it entails separating sperm with X chromosomes from sperm with Y chromosomes rather than analyzing fertilized embryos.
At present the MicroSort® technology reports the following sex selection success rates: X sorting (female selection) has resulted in an average of 88% X-bearing (female) sperm in the enriched specimen and 91% of the babies have been female; Y sorting (male selection) has resulted in an average of 73% Y-bearing (male) sperm in the enriched specimen and 76% of the babies have been male.
AFS currently does the sperm preparation and refers patients to its affiliates for MicroSort® technology.
Fertility Preservation
Women who wish to preserve their fertility for medical reasons, such as undergoing treatment for cancer or for personal reasons, such as advancing age, can freeze (cryopreserve) their eggs (oocytes) at American Fertility Services' oocyte freezing program. The stimulation and retrieval of oocytes for cryopreservation would be the same process as an in vitro fertilization cycle, without creating embryos. If you are interested in fertility preservation, please speak to one of our physicians to learn more.
Cancer Treatment: Fertility Preservation Options For Women [PDF - 388K]
Gay and Lesbian Parenting
AFS is proud to assist in extending the joy of parenthood to committed couples and adults of all sexual orientations. With advancements in fertility treatments, more and more same sex couples and nontraditional parenting partners are finding it easier to have children of their own. AFS offers a full range of services for lesbians and gay men who are seeking to start their own families.
Lesbians tend to have a slightly higher rate of infertility than do women as a whole. This is because they tend to be older than the general population when trying to get pregnant and age is the most significant risk factor for reduced fertility in women. AFS provides affordable treatment and a supportive setting for lesbians who are trying to conceive, whether through intrauterine insemination, ovulation induction, standard IVF, or egg donation. For women who seek an anonymous sperm donor, we will refer you to a sperm bank such as California Cryobank where you can receive extensive background information regarding a prospective donor's medical, psychological, genetic, educational, and professional background, as well as a detailed family history so that you can be totally comfortable with the donor sperm selection process.
Assisted reproductive technologies have allowed gay men who wish to become parents an opportunity to do so through a full range of infertility treatments including, IVF, ICSI and egg donation. AFS is here to provide emotional support to all patients involved in this process. We collaborate with surrogate programs nationwide.
Acupuncture
Acupuncture could possibly increase blood flow to the uterus, and therefore improve fertility rates. Although there are no large confirmatory studies that prove this, at AFS we believe that acupuncture, when used as a complementary treatment for infertility, can have a positive effect on infertility treatment success. AFS is happy to accommodate patients who wish to use acupuncture in conjunction with their infertility treatment. We can refer you to skilled acupuncturists whose protocols involve two 45-60 minute sessions, one before and one after embryo transfer. Acupuncture may also be used at other times during infertility treatment to reduce stress levels and promote a general feeling of physical harmony and well-being.
Recurrent pregnancy loss prevention program and immunologlobulin G infusion (IVIg)
American Fertility Services collaborates with Dr. William Matzner, Director of Reproductive Immunology Associates of Los Angeles to evaluate patients for immune related miscarriages. Based on the diagnosis, immune enhancing vaccinations such as IVIg may be used for treatment. for more information on immune related pregnancy, please see Miscarriages Can Be Prevented [PDF - 51K]. Or call AFS at 212-750-3330.
Hysteroscopic Sterilization
Women who seek permanent sterilization now have an option at AFS for a new non-invasive technique, Essure. Our physicians are trained and certified in this new procedure and perform it in our operating room at our Manhattan office.
Essure is a hysterscopic procedure for female sterilization. Unlike, tubal ligation, with Essure there is no cutting into the body. Instead, an Essure trained doctor inserts spring-like coils, called micro-inserts, through the body’s natural pathways (vagina, cervix and uterus) and into the fallopian tubes. The procedure is performed without general anesthesia. If you are interested in this procedure, please speak with one of our physicians.