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Our newly designed state of the art IVF laboratory is certified with distinction by the College of American Pathologists (CAP) and directed by Michael B.
The Reproductive Medicine Institute (RMI) is a leading medical practice in Orlando Florida devoted to the diagnosis and treatment of infertility. Therefore, our team of reproductive medicine specialists is eager to assist you with your fertility care needs. It is very important that you as the patient are able to be engaged and understand the very detailed information that you will receive from Dr. IVF Florida Reproductive Associates offers the most convenient locations throughout Southeast Florida from Miami to Jupiter. Did you know that patients with a history of ovarian hyperstimulation syndrome (OHSS) can greatly reduce or eliminate the risk of hyperstimulation through the use of Natural IVF? IVF FLORIDA is proud to announce the opening of our newest fertility clinic in Miami, located at 11410 N. With the resurgence of Natural IVF treatment options, a lower priced option for In Vitro Fertilization emerges as an option for some women. As Florida's premier provider of fertility treatment, IVF FLORIDA has been providing the highest quality fertility treatments for people in South Florida since 1986. The Society for Assisted Reproductive Technologies has released the most recent data regarding IVF outcomes for clinics from across the U.S. The American Society for Reproductive Medicine has launched a website dedicated to providing the most current and unbiased information on reproductive medicine. KristenRain, vmgoodell, tcromer456, ciarared75, shnmcdonald and 15 others earned the First Anniversary badge. KristenRain, ciarared75, prego843, debikae and maries1974 earned the Second Anniversary badge. KristenRain, venicewk, RedwoodTree, jes0, Lozzocks and 9 others earned the Photogenic badge. IVF is simply a process of fertilizing an egg with a sperm in the laboratory (in vitro) to form an embryo. You may have already completed some of the required testing during your fertility evaluation. High complexity semen analysis to assess sperm concentration, motility and morphology, and a semen culture to check for the presence of bacteria. Sonohysterogram (Saline Infusion Sonography or SIS) to evaluate the uterine cavity to make sure there are no abnormalities, such as, uterine polyps or fibroids, which may interfere with embryo implantation. Antral Follicle Count or AFC is an ultrasound evaluation to count the number of eggs present in your ovaries. In this test, saline is injected in to the uterus while performing vaginal ultrasound to make sure that there are no uterine abnormalities (fibroids, polyps, scar tissue or uterine malformations) which may interfere with embryo implantation. A typical IVF treatment consists of suppression and stimulation phases and takes about 6 weeks to complete. Microdose agonist protocol – In patients with high FSH levels, or previous poor response to stimulation with fertility hormone injections, the suppression phase of the treatment is omitted. Antagonist protocol – Here, Ganirelix or Cetrotide injections are given daily starting on day 6 of gonadotropin hormone injections or when the largest follicle is 14mm in size.
Day 2-3 of cycle - You will have an estradiol level and a vaginal ultrasound, before you are cleared to start treatment, to make sure your ovaries contain no cysts which can interfere with proper egg development. Gonadotropin injections; you will be given daily hormone injections for about 8-10 days to stimulate your ovaries to produce multiple eggs. Day 4 of hormone injections - An estrogen blood level is measured and the medication dose is adjusted accordingly. Day 6 of hormone injections – begin a series of Estrogen level measurements and ultrasound evaluations of the number and size of your follicles (Fig.
The ultrasound examination also evaluates the thickness (solid white line) and pattern of the lining of the uterus (Fig.3). The HCG injection is given when the follicles (containing the eggs), reach 18-20 millimeter in size and the uterine lining is at least 8mm thick. The eggs are removed from the ovaries by a minor transvaginal ultrasound surgical technique, performed in our in-office operating room suite. After the retrieval you will be receiving daily progesterone treatment (injections or suppositories) until your pregnancy test 2 weeks after the retrieval. Now that your eggs have been removed from your ovaries, the next step is for the embryologist to prepare your eggs and your husband’s sperm for fertilization. Utilizing ICSI or Intracytoplasmic Sperm Injection, a single sperm for each egg is all that is needed.
The eggs and sperm are placed in a dish containing culture media rich in nutrients essential for embryonic development. The fertilized egg, as it appears 16-18 hours as after fertilization, showing the male and female genetic material (pronuclei) is called a zygote. PGD is a diagnostic test for the detection of chromosomal abnormalities or single gene defects in the embryo.


Assisted hatching is a procedure, performed by the embryologist, to create a small hole in the envelope of the embryo utilizing high powered microscopy and a sophisticated laser beam.
We generally do not transfer embryos on day 3 because not all day 3 embryos will develop into blastocysts. If less than 3 embryos are available on day 3, there is a small risk that no embryos will develop into blastocysts resulting in no embryo transfer.
You will be asked to sign consent forms for embryo transfer and for freezing any remaining embryos.
Your pregnancy test (beta HCG) will be performed two weeks after your retrieval and you will be notified of the result within 1-2 hours.
You will be referred to your obstetrician who will be taking care of you for the remainder of your pregnancy. RMI's advantageous geographical location makes our practice very attractive for patients coming from all over the states of Florida and Georgia, the Caribbean, Central and South America and Europe.
You may have been treated with fertility drugs, undergone artificial insemination, or you may have had laparoscopy to treat scar tissue, fibroids or endometriosis. Your nurse will go over your file and will let you know what else may need to be done in preparation for IVF. This, together with other ovarian reserve markers (FSH and AMH) can help the doctor determine the dosage of hormone injections required to stimulate egg development. The uterine cavity has an irregular outline consistent with endometrial polyps (outlined in red and marked by white arrows). Your doctor will determine which stimulation protocol is best for you, taking into consideration your age, weight, and ovarian reserve assessment indicators, such as, day 3 FSH (Follicle Stimulating Hormone) level, Antral Follicle Count (AFC) and AMH (Anti Mullerian Hormone) level. The purpose of Lupron is to prevent ovarian cysts from occurring, and to block spontaneous ovulation during the stimulation cycle. The woman is treated instead with injectable hormones to stimulate ovulation beginning on day 2 or day 3 of the menstrual cycle in combination with low dose (microdose) Lupron. Pretreatment with oral contraceptives may be used with this protocol at the discretion of the physician.
During this time uterine evaluation and trial transfer can be performed before you begin the stimulation phase of the treatment. You will have several ultrasounds and blood tests to monitor the development of the eggs and the thickness of the uterine lining (endometrium). The lining of the uterine cavity should be at least 8mm thick with a trilaminar (three lines) appearance. You may also be given Tetracycline (antibiotic) and Medrol (steroidal anti inflammatory) for 4 days to help the embryos implant.
In conventional fertilization, the sperm and egg are placed in culture media in a round dish. You will receive daily briefing from the IVF nurse coordinator, informing you of the embryos development.
Using microscopic techniques (micromanipulation) a single sperm is drawn into a very thin-tipped glass pipette. Sometimes more than one sperm can penetrate the egg resulting in an abnormal zygote which will not be transferred into the uterus. The embryo is beginning to hatch out of its soft shell (white arrow) and is ready to implant.
PGD is utilized most often in patients with genetic abnormalities, such as hemophilia or Cystic Fibrosis (CF), as a way to prevent transmitting the abnormal gene to their children.
This is typically done on the fourth day (4-8 cell stage) or sixth day (blastocyst stage) of embryo development. Assisted hatching is performed on day 3 of embryo development in preparation for biopsy 2 days later (blastocyst stage).
The cervix will be cleansed with culture media and the embryos will be gently transferred into a predetermined site within your womb using a very soft catheter. We recommend that you continue to take it easy at home for the next 24 hours, but it is not necessary to confine yourself to bed rest.
A positive result means that an embryo implanted and you will be instructed to continue with progesterone treatment (injections or vaginal suppositories) until the 12th week of pregnancy. A less than ideal rise in HCG level can sometimes indicate a possible miscarriage or tubal pregnancy.
The ultrasound will show how many embryos implanted, and display the baby’s heart rate pattern.
We work hard to ensure our centers are not unnecessarily encumbered and are easily accessible, especially for those patients who are undergoing stimulation monitoring before their workday begins. Even with a scheduled appointment wait time is at least 45 minutes and sometimes over 90 minutes. The financial side is very unorganized so I recommend you keep close tabs on your insurance and make sure everything is submitted. If uterine polyps or scar tissue are detected, minor surgery (hysteroscopy) can correct the uterine abnormality.


The tip of the pipette is inserted into the egg through the egg shell (zona pellucida) and the sperm is injected into the egg.
Here, only half of the eggs are injected (ICSI), and the remaining eggs are allowed to fertilize conventionally (no ICSI). A computer controlled system precisely regulates temperature, oxygen and CO2 levels within the incubators conducive for embryonic growth.
If more than 3 such embryos are available, your doctor may choose to allow them to grow two more days in the laboratory to a blastocyst stage. Since implantation rate for blastocysts is significantly higher than day 3 embryos, only 2 blastocysts need to be transferred minimizing the risk of multiple pregnancies. New technological advances allow for rapid detection of chromosomal or single gene defects in the embryos by doing the embryo biopsy at the blastocyst stage.
Embryo biopsy is often performed to make sure that the embryo is chromosomally normal before it is transferred back into the uterus or frozen for future use.
Therefore, your doctor may order the test every 2-3 days to make sure that the level rises appropriately.
The pictures below demonstrate a single intrauterine pregnancy at 9 weeks on the left and the baby’s heart rate on the right.
Matilsky is board-certified by the American Board of Bioanalysis as a High Complexity Laboratory Director (HCLD) in both Embryology and Andrology with more than 19 years of clinical IVF experience. Our office is on the left (east side of State Road 7) across from Northwest Medical Center. The office staff was great, dr was ok but regardless, they got the work done, and I was able to get pregnant within the first six months of seeing him. Staff are not helpful, you hardly ever get a live person when calling any one of their facilities and questions are answered rudely. The problem may be traced to tubal function, pelvic adhesions or scar tissue preventing release of the egg from the ovary. Our operating room is certified by the American Association for the Accreditation of Ambulatory Surgical Facilities (AAAASF). When there are sperm abnormalities and the sperm cannot penetrate the egg, the embryologist can inject one sperm directly into each egg. If there is normal fertilization in the non ICSI group of eggs, then ICSI may not be necessary. At BocaFertility transfer of two blastocysts on day 5 results in an overall delivery rate exceeding 50%. The biopsy utilizes sophisticated microscopic laser technology to remove peripheral cells, called trophectoderm, which are destined to become the placenta. Therefore, we would rather follow the embryos to day 5 and see if they can make the transition to blastocyst.
Our office is a quarter of a mile down on the left side (east side of STATE ROAD 7) across from Northwest Medical Center.
Our office is approximately one mile north on the right side (east side of STATE ROAD 7) across from Northwest Medical Center. Many times my chart was put in the wrong que and after waiting over an hour I found out I was in the wrong line for the wrong test. It is also possible that the sperm can not get into the egg because of low sperm count or structure or thickened egg shell. The eggs are returned to the incubator and are checked 24 hours later to see how many fertilized.
This significantly lowers the cost of treatment if you were to require another round of IVF. Kendall Drive for about 4.6 miles and turn left onto SW 117th Avenue Road into Kendall Summit, 11410 N. Keep in mind that Mother Nature may do a better job than the embryologist in selecting sperm to fertilize your eggs. Dr Keegan always seemed rushed when I did see her, never up to date on my chart, arrogant, short and rude in her answers if you dared ask any questions.
You never knew what the next step was and left feeling like a number and was never treated like a human being. Currently, this procedure has not yet been proven to be of benefit for patients with repeated IVF failures, older patients or patients with recurrent miscarriages.
Once this technology becomes more cost effective, all embryos may be routinely biopsied to avoid transfer of abnormal embryos.



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