Contenu connexe Similaire à Seminar Presentation Geoffrey Sher MD 9-13 (20) Seminar Presentation Geoffrey Sher MD 9-131. SUCCESSFUL IVF!
GEOFFREY SHER M.D.GEOFFREY SHER M.D.
Sher Institute for ReproductiveSher Institute for Reproductive
Medicine (SIRM)-St. LouisMedicine (SIRM)-St. Louis
2. Find Us Online!
(See Sheet in Your Packet)
Website:
www.haveababy.com
Discussion Boards:
forums.haveababy.com
IVF Authority Blog:
www.IVFauthority.com
3. Positive 1st Betas by Cycle Date
66%
62%
48%
62%
52%
60%
52%
52%
47%
61%
68% 69%
67%
78%
69%
88%
79%
81%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Jan-
12
Feb-
12
Mar-
12
Apr-
12
May-
12
Jun-
12
Jul-12 Aug-
12
Sep-
12
Oct-
12
Nov-
12
Dec-
12
Jan-
13
Feb-
13
Mar-
13
Apr-
13
May-
13
Jun-
13
Jul-13 Aug-
13
Cycle Date
4. Jan-Dec 2012 Feb-Aug 2013
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
% Positive
Beta hCG
Average Positive 1st Beta hCG
Prior to and After Feb 2013
n=410
n=190
57%
77%
5. "Maximum" Birth Rate
Per Single Embryo Transferred
Blastocyst vs. Cleaved Day-3 Embryo
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
<35 35-39 40-42 43-44
Age
BirthRate
1-CGH Normal Blast
1-Untested Blastocyst
1-Untested Cleaved Embryo
6. "Maximum" Birth Rate
Per Transfer of Two (2) Embryos
[Blastocyst vs. Cleaved Day-3 Embryo]
0%
10%
20%
30%
40%
50%
60%
70%
<35 35-39 40-42 43-44
Age
BirthRate
2-Blastocysts
2-Cleaved Embryos
8. Establishing an ideal “Soil”/”Seed” relationship!
SOIL / SEEDSOIL / SEED ENDOMETRIUM / EMBRYOENDOMETRIUM / EMBRYO
75%75%25%25%
10. It is primarily the
chromosomal integrity of
the egg, rather than the
sperm that determines
embryo Chromosomal
integrity or “competence”!
30. Causes of a Thin Uterine Lining
Uterine scarring
• Inflamation
• Surgery
Reduced blood flow
• Age
• Diffuse adenomyosis
• Multiple fibroid tumors
• Over-use of clomiphene
31. Viagra Improves Blood Flow
Dilates vascular smooth muscleDilates vascular smooth muscle
Can improve uterine blood flowCan improve uterine blood flow
Increased EIncreased E22 deliverydelivery
38. Day 3 vs. Day 5?
How Many embryos to transfer?
Full bladder
Ultrasound guidance
Cntd.