At Braverman IVF & Reproductive Immunology we have initiated a COMPLETE
program to minimize damage to oocyte (egg) mitochondria and to maximize
oocyte mitochondrial function. It is important to understand that many
areas of treatment are available and ALL should be employed to make every
effort to improve mitochondrial function and thus improve embryo quality
and behavior.
During our years of providing IVF treatment to patients from all over the
world, we have found that many of the failures in patients suffering from
Endometriosis and Polycystic Ovary Syndrome (PCOS) are caused when mitochondria, which are responsible for creating the
energy embryos need to correctly divide the nucleus symmetrically and
keep the embryo in the “euploid” (normal genetic) state and
support life, fail to function as they should. When they do, abnormal
division of the nucleus ensues and the embryo converts to an aneuploid (abnormal genetic) state leading to failed implantation or miscarriage (or
chemical pregnancy).
ENDOMETRIOSIS
For our patients in whom we diagnose
Endometriosis, below is our
treatment plan to
optimize embryo quality and behavior, even in those where FSH is already elevated or AMH is low.
Many patients are incorrectly told when these levels become abnormal that
they are entering menopause, when in fact, they have a correctible issue
that will not return them to a normal egg count but most importantly (and
mostly misunderstood by many IVF centers) it will repair the environment
the eggs that are left develop in, and these eggs can return to being
developed normally leading to improved embryo behavior. This is why many
patients who come to our center who are told they need egg donation are
able to have biologic children with our program. While we cannot promise
success for all, the treatments do work and should be attempted prior
to seeking egg donation. (See our case reports)
OUR OOCYTE MITOCHONDRIAL RESTORATION PROGRAM:
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Surgery: Patients with endometriosis undergo complete excision surgery by Dr.
Vidali, our world renowned endometriosis surgeon. These surgeries are
done robotically for patients all around the world that travel to our
center. He specializes in endometriosis surgery for those with infertility
and understands the care that must be taken to optimize results while
taking caution to protect ovarian function.
-
G-CSF treatment: Our own research here at BRI shows that granulocyte-colony stimulating
factor (G-CSF) treatment increases follicular fluid levels that are associated
with improved egg quality, with improved mitochondrial function a most
likely reason. For this reason we now offer GCSF therapy during your IVF
stimulation to continue the process of improving egg development in these cases.
-
Supplements: Reproductive Immunology Supplements has created a line of supplements
that may help improve mitochondrial function by lowering levels of inflammatory
cytokines that have been associated with mitochondrial damage in patients
with endometriosis. The first product is Endo Optimize and soon a probiotic
with similar activities will be released as well. Research has proven
that the ingredients in these supplements have a positive impact on mitochondrial
function and can even inhibit the growth of endometriosis lesions.
-
EmbryoGen culture medium: We use this specialized culture medium once your eggs are retrieved.
It has been proven to improve embryo quality and behavior and lower failed
implantation and miscarriage rates.
PCOS/INSULIN RESISTANCE
Many patients come to our center with history of many eggs and embryos
but poor quality or simply failed implantation, even with PGS tested normal
embryos. Many are found to have high AMH, an excessive number of eggs
during their stimulation, or signs of insulin resistance (such as Gestational
Diabetes). Many come here not aware they have PCOS or insulin resistance
as the cause of their mitochondrial dysfunction simply because they don’t
present with the “typical’ symptoms of PCOS, which are not
necessary to make the diagnosis and initiate correct treatment.
MITOCHONDRIAL RESTORATION PROGRAM FOR PCOS PATIENTS
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Surgery using ovarian drilling in our resistant cases has shown significant improvement
in egg and embryo quality.
-
Metformin treatment prior to the start of an IVF stimulation or at least 4 weeks
prior to trying IUI or natural relations.
-
Probiotics (Reproductive Immunology Supplements will soon release a new line of probiotics
to help improve egg and embryo quality in both endometriosis and PCOS
patients).
-
Inositol for those that do not use Metformin has also shown marked benefit in improving
egg and embryo quality (soon to be released by Reproductive Immunology
Supplements)
-
EmbryoGen culture medium (see above)
-
IVF stimulation that minimizes the impact of high estrogen levels in PCOS patients –
levels that have been shown to affect mitochondrial function.
No other clinic uses the comprehensive, innovative approach we do here
at Braverman IVF & Reproductive Immunology. We have a thorough, research-based
understanding of mitochondrial dysfunction and its effect on fertility,
as well as the various ways to treat this condition. No matter where you
live in the world, we encourage you to get in touch with our doctors and
to seek treatment at our New York facility. Please visit our website to
learn more about
insurance & financing options as well as information on
how to prepare for your treatment.