Transcribed video of Dr. DiMattina

Hi, I’m Dr. Michael DiMattina, the Medical Director of Dominion Fertility.  I’m happy today to share with you some of the secrets or not so secrets of IVF.  I’m going to tell you today how Dominion Fertility approaches patients for IVF and other treatments in reproductive medicine. I’ve been doing IVF personally for 35 years and with Dominion Fertility for 31 years.  The United States began performing IVF in 1982 and Dominion Fertility was founded by me in 1987.  We have a lot of experience in doing IVF and have developed what I call the”Dominion Way” of approaching patients for IVF.  There are many different ways of approaching anything in this world. But there’s clearly some approaches that are superior to others, and we believe that we have a very superior approach and pregnancy rates.  I went to medical school to be the best doctor that I could be, and to take care of patients. I really love what I do and people know it and it’s all about the patient. The Doctors at Dominion Fertility spend a lot of time educating our patients, in order for them to feel comfortable with their treatment plan.  This makes the patients more comfortable and confident knowing all parts of their procedure.  We feel knowledge is power, therefore, we like to design and educate our patients about their individualized plan.  Iʼm going to share with you several real patient examples, where our customized care made a difference.

Most of our patients are successful with stimulated IVF from a single egg collection. They are pregnant within their first or second single embryo transfer.  Why is that?  What are the secrets that we have that really are not so secret?  We practice the “Dominion Way.”  So what is the “Dominion Way” and what are our secrets? Regarding stimulated IVF, first, off we don’t transfer embryos fresh all of our embryos that we transfer are frozen embryos.  The reason we don’t transfer them fresh is the result of data that has been around for several years now and many studies have shown that frozen-thawed embryos transferred outside of the stimulated cycle have superior pregnancy rates, thats just a matter of fact. The stimulation drugs can have an adverse effect on the lining of the uterus and the endometrium, making it difficult for implantation.  If a patient has only one or two prized embryos then we don’t want to transfer those embryos in her fresh cycle because she has less of a chance of getting pregnant. Then if we took the embryo frozen and transferred it a month or two later in a frozen thaw cycle where there are no stimulation drugs present.  We don’t do fresh embryo transfers that is key.  The second thing is we have been involved in preimplantation genetic screening or testing for many years, often referred to as PGS/PGT. We utilize that on virtually all our patients where we perform IVF.  This test allows us to find the chromosomal normal embryos, which decreases the chance of miscarriage. It also decreases the risk of having twins, since it is no longer a guessing game on which embryo is the good one.  Therefore, we almost always transfer only one embryo.

Here’s an example of a patient who we saw just recently, she was 37 years of age and never been pregnant. She had strong ovarian reserve, which means she has many eggs.  The problem was her husbandʼs sperm count was only 1.9 million. The normal counts are 15 to 200 million per man, only 19 percent of his sperm were moving, the rest were dead. The normal for sperm mobility is over 40 percent.  She had been with another fertility center who treated her with artificial insemination.  It is rare to get pregnant with that sperm profile. It didn’t work so this couple ended up at Dominion Fertility.  I said weʼll do stimulated IVF, which resulted in 24 eggs. We tested the embryos and four of them were genetically normal. I put one embryo in her and she’s now pregnant! Plus, she has three more genetically normal embryos sitting in the freezer.  From a single egg collection, our goal with somebody like this patient would be to collect as many eggs as we could and then produce as many genetically normal embryos as possible. Then transfer one at a time to get an entire family from a single collection.

Preimplantation Genetic screening allows us to have higher pregnancy rates, single embryo transfer, reduce the cost to patients because they are not going through multiple cycles and reduce miscarriage rates. Many patients who’ve had repetitive pregnancy loss by miscarriage don’t want to experience more.  This is a great treatment because we can find out about the chromosomes before transferring the embryo. It’s 99 percent accurate and at Dominion Fertility the cost is very reasonable. It’s only 150 dollars at Dominion Fertility per embryo that we test.  The cost is low due to our strong relationship with the laboratory who runs the test as well as our experienced lab who has been performing  PGS/PGT for a long time.

Here is another interesting patient case with male factor infertility, this lady was 32 years old and trying for 2 years. Everything was about her husband’s very low sperm count, 3.5 million.  Again most of the sperm  was genetically abnormal.  Her doctor referred them to a urologist and the urologist told this guy to have a varicocelectomy. Years ago they believed that these dilated veins often resulted into infertility and cutting these veins was the solution.  Unfortunately, this man had this unnecessary procedure, which did not help with infertility.  It actually lowered his sperm count by another million. Their doctor told them to wait another year and luckily this couple said “No” and came to Dominion Fertility.

I told her you know you have good ovarian reserve and your young, let’s do stimulated IVF.  Guess what, she is pregnant too!

Another thing we see is that providers put patients on birth control pills before stimulated IVF.  This treatment is ok for the normal to high ovarian reserve patients.  However, birth control suppresses the ovaries, so if you put someone on it that has low ovarian reserve, it is just going to compromise her very few eggs as well as suppress them even more.  What about patients who have poor ovarian reserve and have failed stimulated IVF.  Otherwise, they either did not respond to stimulation drugs or they only produced a couple of eggs and they do not get pregnant.  Most IVF centers will tell these patients to use a donor egg. At Dominion Fertility our approach for that patient is if you’re having regular menstrual cycles, consider natural cycle IVF.  We make lots and lots of babies in patients using natural cycle IVF without infertility drugs as long as they can produce 1 egg on their own.

The crown jewel of these examples, is a lady who was 48 years old,who delivered a normal healthy baby with her own egg in her very first transfer of natural cycle IVF.  Her history was from ages 41 to 43, she with another IVF center and they did 4 stimulated IVF cycle. She did very poorly in fact in her fourth cycle of stimulation she produced no eggs.  They told her at 44 she must do egg donor IVF.  She didn’t want to do it and walked into my office at 47 and a half.  I said egg donor is probably the best treatment for you, but she still had regular menstrual cycles and she wanted to try natural cycle IVF. Now her age, this is like hitting the medical lottery getting pregnant with your own egg.  Much to our surprise she got pregnant the first time with her own egg! I’m trying to say, if you have poor ovarian reserve and you don’t respond to fertility drugs or stimulated IVF, try natural cycle IVF.

Come experience the “Dominion Way”  with more treatment options specifically designed for each patient.   High pregnancy rates because our secrets, are not so secret.