Sperm preservation requires a visit to our facility with an ejaculate sample to freeze. These visits do require an appointment prior so that we can give you proper instructions and make sure you have been provided the appropriate forms and specimen cup. We cannot accept your sample unless it is produced in a sterile container (we prefer you use the ones that we provide you as we already know these are not toxic to sperm) and it must be dropped off by you with your government issued photo ID. We do not accept specimens for freeze if they are dropped off by anyone else unless you are an in-patient in a hospital, in which case we will make special arrangements ahead of time to accommodate you. All other patients must drop off their specimen themselves with their government issued photo ID on hand.
We store specimens on site in our NYS DOH licensed tissue bank. You may pay monthly or annually for this service, whichever is more convenient for you.
For patients who have just learned that they have cancer or another disease that will negatively impact their fertility, we can make same day appointments to accommodate you before you begin chemotherapy or radiation. Please call our office as soon as possible and explain your situation and our expert staff will take care of the rest.
The vast majority of patients who are trying to conceive do not need invasive treatment to make their dream a reality. Most patients only need regulation of their menstrual cycle in order to conceive naturally. Our experts will help you manage your cycle so that you and your partner can still conceive with timed intercourse.
When patients are not ovulating properly, our reproductive endocrinologists can use medication to help regulate the patient’s cycle and get the ovaries to respond and release an egg. When successfully treated with ovulation induction medication patients conceive at home with timed intercourse or in our office with intra-uterine insemination.
Intra-uterine Insemination (IUI)
Intra-uterine insemination is a very successful treatment option for many patients. A prepared semen sample (either provided that day or thawed from cryopreserved storage) is placed in a catheter which is fed through the cervix and into the uterus for placement of the sperm. This is a less trying journey for the sperm to swim into the fallopian tube directly from the uterus. This is the treatment method of choice for many diagnosis and for most patients using donor sperm.
For many years the scientific community worked tirelessly to find a cryopreservation protocol that would allow cryopreservation of human eggs (oocytes). Today, oocyte preservation with vitrification is a standard, routine treatment for patients looking to preserve their fertility options for the future.
Patients who have just learned that they have cancer or another disease which will negatively impact their fertility should call our office as soon as possible after diagnosis, before treatment with chemotherapy and radiation if possible. This will allow our team time to work with your other doctors to ensure your safety and to ensure successful treatment.
In Vitro Fertilization (IVF)
While most patients will never need IVF, for the select few who cannot conceive without it we provide all levels of micromanipulation and IVF in our brand new, state of the art facility in Commack, NY. We have built a high-level clean room and invested in state of the art equipment for incubation, specimen preparation, processing, and cryopreservation. Our team of expert embryologists are well skilled in all aspects of IVF including ICSI and embryo biopsy. Our embryologists are also available every day to answer your questions and address any concerns you may have regarding your sperm, eggs, and embryos. You can reach them at any time through your patient portal or by calling our offices and leaving a voicemail. They will return your call either that day or the following day.
Intra-cytoplasmic Sperm Injection (ICSI)
Intra-cytoplasmic Sperm Injection is a micromanipulation procedure during which a highly trained embryologist places one sperm at a time directly inside of each mature egg. This procedure works best to help patients with either severe male factor or patients with egg abnormalities in the zona pellucida (egg shell).
All embryos must hatch free of the zona pellucida (egg shell) in order to implant in the uterine lining. When we suspect that embryos may have an inability to do this on their own we recommend assisted hatching, where the embryologist will make a breach in the zona pellucida with a focused diode laser to allow the embryo to hatch free and encourage implantation.
Embryo Biopsy for Preimplantation Genetic Testing
Embryo biopsy is a procedure where an embryologist takes a small biopsy (about 3-4 cells) from an embryo to send out for genetic testing. This testing can either confirm the genetic code of the cells, looking for gene sequences that match a disease pattern that the patients know they may carry, or can be looking at the structure and number of chromosomes in the cells. Chromosomal testing (preimplantation genetic screening or PGS) is primarily for patients with elevated maternal or paternal age, recurrent pregnancy loss (especially if they have ever had abnormal products of conception testing in the past), or patients who have tried several rounds of treatment with no success. Genetic testing for specific sequences (preimplantation genetic diagnosis or PGD) is primarily for patients who already know that they or their partner may carry a gene sequence that has been identified as the cause of a disease or disorder. Many of these patients have an affected relative in their family already, but occasionally they are not aware they are carrying defective genes until they perform prenatal genetic testing which we do routinely on all infertility patients prior to treatment.
Cooper Genomics is our preferred partner for PGT, but we can work with any genetics laboratory that you or your insurance company require.
Many patients need the services of a sperm donor, patients who do not make any sperm at all on their own or same sex female couples. Our team can work with any NYS DOH licensed sperm bank. You choose the bank, choose your donor, we file paperwork with the bank requesting the course of treatment, and the bank ships the sperm directly to our office. We will also work with an individual that you know and wish to be your sperm donor.
Sperm banks often sell different types of sperm vials which have different names depending on the bank. The basic configuration is as follows:
These samples are going to have the highest total motile sperm, but can be costly. They work well for IVF cycles though and will be the only way to try for a standard (non-ICSI) insemination in an IVF cycle.
These samples work well for IUI, especially if you are in a hurry that day as they can usually be thawed and inseminated with minimal processing (as long as you are not allergic to the cryoprotectant).
These samples work well for patients going through IVF and who are prepared to have ICSI done. They are usually cheaper than the other types of vessels, but they also usually contain less total motile sperm, which is fine because the embryologist does not need much for ICSI.
For patients who are no longer capable of providing their own healthy eggs for IVF, egg donors are available to provide enough eggs for your treatment cycle. We work with donors who can cycle at the same time as you, providing fresh eggs, as well as with donors who have already provided eggs which have been frozen and are available for your use. We will also work with an individual that you know and wish to be your egg donor as well as with an egg donor that you have already chosen through an egg donation agency.
When patients undergo IVF they often have excess embryos cryopreserved. Occasionally these patients decide later on that their family is complete and donate them back to other infertile couples who wish to use them to establish a pregnancy.
Patients with severe uterine factor infertility and same sex male couples will need to use the services of a gestational carrier to carry the pregnancy for them. Our team works with you and your carrier to ensure that you are prepared for the complexities of this type of treatment both mentally and physically. We provide all of the support that you need to make your gestational carrier cycle successful.