refers to a procedure designed to overcome infertility and produce a pregnancy as a direct result of the intervention. In general, the ovaries are stimulated by a combination of fertility medications and then one or more oocyte(s) are aspirated from ovarian follicles. These are fertilized in the laboratory (“in vitro”), after which, one or more embryo(s) are transferred into the uterine cavity. These steps occur over about a two-week interval of time, which is called an IVF cycle.

refers to the procedure of thawing embryos from a previous cycle or cycles to transfer into the uterus.   For optimal success, the endometrium (uterine lining) needs to be precisely synchronized with the developmental stage of the thawed embryos. 

There are two types of preimplantation genetic testing:

Preimplantation genetic diagnosis (PGD) is performed on cell(s) removed from a preimplantation embryo or a polar body from an oocyte. The goal is to establish a pregnancy that is unaffected by specific genetic characteristics, such as a known heritable genetic mutation or chromosomal abnormality (eg, translocations) carried by one or both biological parents. It is also used to select embryos for transfer that have specific characteristics, such as a particular gender 

is performed on cell(s) removed from a preimplantation embryo or a polar body from an oocyte. The goal is to identify de-novo aneuploidy in embryo(s) of couples presumed to be chromosomally normal. Theoretically, avoiding transfer of aneuploid embryos will reduce the risk of pregnancy failure and improve the probability of conceiving a viable pregnancy

When preimplantation genetic testing is planned, assisted reproductive technology (ART) must be used for conception even if infertility is not an issue for the couple.


An embryo’s karyotype can be identified as male or female using either FISH to examine chromosomal karyotype or polymerase chain reaction (PCR) to identify a specific allele. For the purpose of sex selection, FISH is the predominant technique employed. Regardless of the technique used (FISH or PCR), the analysis is usually performed within 48 hours to allow for transfer of embryos at or before the blastocyst stage.

Theoretically, the loss of one cell at a totipotent state from a cleavage stage embryo should not have long term effects on implantation, the developing fetus, or the resulting human. Human studies have shown no adverse effects from biopsy to the viability, metabolism, or development of the blastocyst . However, there are studies that have shown unequal distribution of regulatory proteins in early stage cleavage embryos. It is still unclear how PGD may impact embryonic development following removal of a blastomere and what the resulting long-term effects will be.

a simple DNA test before pregnancy can screen for birth defects associated with over 100 genetic diseases.

During the initial stages of development, your embryo is contained in a “shell” or layer of proteins, known as the zona pellucida. The zona pellucida is designed to protect the embryo until it reaches the blastocyst stage of development. In order to successfully implant into the uterine lining, the embryo needs to “hatch out” of this zona pellucida and attach to the walls of the uterus.

In certain situations, the zona pellucida (the outer shell or wall surrounding the embryo) is abnormally thick and/or hardened. If this is the case, than it may make it difficult or impossible, for an otherwise normal embryo, to break out, or hatch, from the zona pellucida at the time of implantation. This condition, would then compromise the ability of the embryo to implant in the uterine wall.

AZH  is a procedure of assisted reproductive technology in which a small hole is made in the zona pellucida, using a micromanipulation, thereby facilitating for zona hatching to occur.Zona hatching is where the blastocyst gets rid of the surrounding zona pellucida to be able to implant in the uterus. 

comes from the Latin word vitrum, meaning glass. In the context of freezing embryos, vitrification is the process whereby the solution containing the embryos is cooled so quickly that the structure of the water molecules doesn’t have time to form ice crystals and instantaneously solidifies into a glass-like structure.

All embryo grading systems are subjective. While we can make educated guesses about an embryo’s potential based on the experience of our embryologists having had graded millions of embryos, there are many cases of embryos with poor grades that make pregnancies and perfect embryos that do not. Also, no matter the grading system, the embryo grades do not tell us what is going on inside the embryo genetically.

The use of grading systems helps us determine which embryos to transfer and/or freeze. At the Advanced IVF Institute, embryo transfers typically occur either 3 days or 5 days after the retrieval. Because embryos are developmentally different on these days, we have different grading systems for day 3 embryos and day 5 embryos.  You will speak with an Embryologist anywhere from 1-2 times after your retrieval and prior to your embryo transfer to discuss your embryos development specifically.

SART is the primary organization of professionals dedicated to the practice of assisted reproductive technologies (ART) in the United States. ART includes the practice of In Vitro Fertilization (IVF). Thir mission of their organization is to set up and help maintain the standards for ART in an effort to better serve their members and their patients.

One of the most important functions of their site is to help patients locate and contact infertility clinics and view national and individual clinic IVF success rates.