Intrauterine Insemination (IUI)
Intrauterine Insemination (also known as artificial insemination) is the process of preparing and delivering sperm so that a highly concentrated amount of active motile sperm is placed directly through the cervix into the uterus.
In Vitro Fertilization/Embryo Transfer (IVF- ET)
This procedure was first successfully used in humans in 1977 in England by Drs. Edwards and Steptoe. The scientific importance of this discovery was recently recognized with the awarding of the Nobel Prize in Medicine to Dr. Edwards. To date, millions of babies have been delivered worldwide as a result of this treatment. The procedures to achieve IVF pregnancy have become increasingly simpler, safer, and markedly more successful. To achieve pregnancy as a result of IVF, several steps are necessary:
- Hormonal suppression with birth control pills or other drugs for a few weeks prior to the start of the cycle
- Stimulation of the ovaries to produce several eggs
- Retrieval of the eggs from the ovaries
- Fertilization of the eggs and cultivation of the embryos in the laboratory
- Placement of the embryos into the uterus for implantation anywhere from 2 to 6 days later (At day 5 or 6, blastocysts are transferred)
- Cryo-preservation of any remaining high quality embryos for later us
Watch to Learn More About IVF at ORH
Intracytoplasmic Sperm Injection (ICSI)
This procedure was first successfully used in the early 1990s, and was developed for couples with severe male factor infertility or couples who have had failure to fertilize in a previous in vitro attempt. ICSI overcomes many of the barriers to fertilization and allows couples with little hope of achieving pregnancy to develop fertilized embryos. The procedure to retrieve eggs is the same as for conventional IVF. However, when it comes time for insemination a single sperm is selected and injected directly into the egg.
Watch to Learn More About ICSI at ORH
Pre-implantation Genetic Diagnosis (PGD)
The different techniques that we can employ in the fertility world are increasing all the time. Pre-implantation genetic diagnosis (PGD) is one of the tools that we now can utilize in order to check the chromosomal status of the embryos, test for specific genetic conditions or determine their gender. We have been carrying out embryo biopsies since 2003, allowing parents more choices than they were previously available in their reproductive health. PGD is carried out by removing either one or both polar bodies, a single day 3 embryonic cell, or a collection of cells from a trophectoderm (future placenta) of a day 5 or 6 embryo. Those cells are then either fixed to a microscope slide or frozen in transfer media and shipped to a reference laboratory for analysis. This will then give us a picture of the chromosomal content of the embryo, and in conjunction with the embryo development score, allow us to better select which embryos should be transferred during the cycle.
More information about Pre-implantation Genetic Diagnosis (PGD).
Transfer of Cryo-preserved Embryos
A procedure where embryos frozen during a previous treatment cycle are thawed and transferred into the uterus for implantation.
Donor Egg Program
Eggs removed from the ovaries of a fertile donor for use in a couple.
Further information about our Donor Egg Program.
Donor Embryo Program
Transfer of an embryo/embryos developed from one couple for use by another couple.
Embryology Lab/Clean Room
A standard of quality control not exceeded in the Pacific Northwest.
Setting the standard is something we do naturally; we established our clean room in 2000.
From the time the eggs are retrieved until the embryos are safely replaced all procedures take place in a Certified Class 10,000 clean room. This is an environment classified for aseptic production according to ISO Standards. The room is equipped with not only HEPA filters to remove particles from the air but also charcoal and potassium permanganate (KP4) filters to literally scrub the air of damaging Volatile Organic compounds (VOC’s ) and formaldehyde.
Following the National Institute of Occupational Safety and Health (NIOSH) method 500, we routinely test for some 60 VOC’s, as well as airflow into and out of the laboratory space, dust loading and dust characterization in the space. The laboratory is built as well as sealed in such a fashion that outside contaminants cannot enter the lab. The room itself is in a positive pressure in relation to the outside environment, leading to an air outflow, not inflow. The air exchange value of 1025 CFM is close to 40 air exchanges per hour, as compared to others with only 6-12 per hour. It is this combination of high air exchange per unit time, positive pressure, low O2 incubators, and heated stainless steel benches in a specifically designed anti-contamination working suite which creates an environment where maximum sterility and quality is assured.
Why is this important? Previous studies have shown that decreases in pregnancy rates coincide with the emission of VOC’s. VOC’s hinder cell division in mouse embryos. Finally, studies have shown increased fertility rates and improved embryo cell stage development in a clean room environment. After all, our patients deserve the best chances that science can give them.