The latest advancements and treatments in reproductive medicine give new hope to those struggling with infertility.

Having a baby is one of life’s greatest joys for parents, but not all are able to conceive without help. In fact, infertility issues are quite common—one in eight couples has trouble getting pregnant, according to the Centers for Disease Control and Prevention.

Fortunately, the Orlando area has some of the top reproductive medicine doctors and facilities to assist couples in their journey to become pregnant—giving them hope, setting aside fears and using some of the latest technological advancements available.

Dr. George Patounakis, medical director of Reproductive Medicine Associates of Florida, says there have been major advancements when it comes to in vitro fertilization (IVF).

“IVF is when we give the patient medications to stimulate ovaries in order produce as many eggs as they can, but before they ovulate, we perform a minor surgical procedure and take out the eggs that have grown,” he says. “Those eggs are put into the embryos and joined with sperm, which can be done a few ways.

“One advanced way is to take a single sperm and put it directly into an egg,” Patounakis continues. “If a partner only produces 200,000 sperm through ejaculation instead of 20 million, with this, we just need as many sperm moving that we have eggs. It’s really revolutionized the area of male factoring fertility because we just need a few sperm. It also allows us to use sperm that’s directly from the testicle so the male can have a surgical procedure to extract sperm, just like as extra eggs, in case there is a problem with ejaculation or the sperm doesn’t develop. It can be extracted directly from the testicle and can be used with the procedure to inseminate the eggs.”

Minimal Stimulation IVF
This takes the same approach as traditional IVF, but without the high quantity of fertility medications, according to Dr. Rafael Cabrera of Brown Fertility.

“Traditional IVF combines the harvesting of eggs with high doses of fertility drugs, increasing both the length of time between cycles and the cost of treatments,” he explains. “A minimum stimulation cycle takes a different approach, minimizing or eliminating the use of injectable fertility drugs to both increase cycle frequency and reduce the financial burden on patients. In some cases, women receive no fertility drugs at all, while in others, they may receive oral doses of clomiphene citrate and a simple hCG trigger shot.

“For women seeking an easier and less invasive alternative, minimal stimulation IVF may hold the key to successful conception.”

Genetic Testing
This latest advancement helps advance pregnancy rates and can help couples avoid serious diseases.

“Once embryos reach the blastocyst stage on day five through seven of embryo development, an embryologist will take a few cells from the embryo for genetic testing,” Cabrera says. “The number of chromosomes will then be analyzed in each embryo. Since the test results usually take about two weeks to come back, all embryos will be cryopreserved until the results of the analysis are available. This is an effort to advance pregnancy rates, a source of improvement.”

“By taking a few cells outside of the embryo, we genetically analyze them for the right number of chromosomes of any genetic disorders the couple may carry and can avoid serious disease like cystic fibrosis,” Patounakis adds. “This all can be done with 10 cells outside of the embryo. The whole time the embryo is frozen and this allows to store extra embryos for the patient if they want to have other children later on.”

Donor Eggs
According to Corey Burke, tissue bank director for Cryos International—the world’s largest sperm and egg bank—the biggest advancements he has seen is in donor eggs, specifically frozen eggs.

“It’s come to the point now where district 5 donor eggs (frozen eggs) are equal to fresh donor eggs—it’s the gold standard,” he says. “Frozen eggs are as successful as fresh donor eggs. It’s a great achievement not just in our bank, but other banks as well. So much has developed in the egg side of the market.

“In the past, frozen eggs have been around a 35-37% rate and pregnancies to term with fresh eggs were around a 55% or higher rate. Over the past few years, we’ve seen them come around being much more in line with the fresh eggs,” Burke explains. “Right now the frozen eggs are a 50% rate and the fresh eggs are around a 55-60% rate—a phenomenal increase in success. It’s made the egg market open up to those who couldn’t afford it previously. Using frozen eggs is more economical to start with. That’s made some people able to use donor eggs who couldn’t afford them in the past.”

Patounakis says his patients are open to all the different treatments available.

“One way or another, they are going to be able to grow their family, and as with anything in medicine, and everyone has to be comfortable with whatever decision they choose,” he says. “Some people are not open to using donor or sperm eggs, or IVF. We’ll always work with them to figure out what they are comfortable with if it is feasible. Once we know what the issue is, we can go through what different treatment options there are and give them our recommendations.

“Even though the diagnosis of fertility may be similar, it’s not always the same thing and it’s exciting to help each patient that walks through our door.”

That may be one of the biggest advancements of all—giving every person the chance to experience parenthood, not just the traditional man and woman.

“We have always been open for same-sex couples, single women, etc., and always believed that everyone should have the right to become a parent,” Burke states.

This article originally appeared in Orlando Family Magazine’s April 2020 issue.