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Low Dose Gonadotropin - In Vitro Maturation (LoGo-IVM™)

There’s no getting around it – infertility treatment is expensive!  The recession has made us very cautious in how we spend our money.  Rich and poor alike are far more conscious of their spending.  At Batzofin Fertility Services, we are acutely aware of these difficult economic times and have introduced some exciting programs into our infertility therapy options to help make fertility treatments more available and more affordable.  Perhaps the most important of these approaches is our LoGo-IVF™ or LoGo-IVM™ approach.  LoGo stands for Low Gonadotropins.  These agents (Gonadotropins) are used to stimulate multiple follicle development and at an appropriate time (immature follicles in the case of IVM, and mature follicles in the case of IVF) the eggs are removed via a transvaginal ultrasound guided procedure.  The eggs are then treated in the laboratory and resulting embryos are transferred back in an effort to achieve a pregnancy. 

During conventional IVF procedures, patients are given medication to grow multiple follicles.  The follicles “house” the eggs.  When the follicles are mature, (usually after 8 – 10 days of stimulation with gonadotropin therapy), a medicine called HCG (human chorionic gonadotropin) is administered to signal the egg to prepare for ovulation.  32 to 36 hours later the egg retrieval is performed and the harvested eggs are fertilized in the laboratory.  In-vitro Fertilization has been around for more than 25 years (the first IVF baby was born in 1978) and is quite successful and used in a variety of clinical situations. 

For some patients, the risks of taking gonadotropins are quite significant.  For example, patients with Polycystic Ovarian Syndrome (PCOS) are at relatively high risk for Ovarian Hyperstimulation Syndrome (OHSS) when they are exposed to high levels of gonadotropins.  In addition, for all patients taking gonadotropins, the monitoring to ensure their safety, is quite extensive—involving at times, daily ultrasounds and blood test determinations.  Recent scientific advances, primarily in the laboratory, have enabled scientists to successfully mature eggs in the laboratory. “In Vitro” means in the laboratory, as distinct from “In Vivo”, which means in the body.  IVM therefore means maturation of the eggs in the laboratory. 

The advantages of the IVM approach are that the patient will not need to take as much (and in some cases any) gonadotropins to mature the eggs in the body.  This decreases the need for extensive monitoring and substantially reduces, or even eliminates the risks of OHSS.  In addition, the monitoring needed to ensure patient safety is substantially reduced.  This means the patient will have fewer visits to the doctor’s office and accordingly, significantly reduces the cost of treatment. When one considers that the drugs themselves are quite expensive, there can be significant per cycle savings for the patients with the lower amount of medication.  LoGo-IVM™ costs around $5,800 including medication as compared to traditional IVF which can cost anywhere between $12,000-$15,000.  Furthermore, there are still some unknown long-term effects of gonadotropin therapy and here again; IVM affords theoretical advantages for the patients. 

Immature eggs are not able to be fertilized and therefore, if one removes immature eggs from the patient, it is essential to perform IVM using sophisticated hormone preparations.  In essence, it is as if the eggs, rather than the patient, receive the medication required to achieve egg maturation.  As discussed above, this reduces the costs of treatment and therefore, can make ART (Assisted Reproductive Treatments) more affordable and available to a larger group of those in need. It has been estimated from demographic data, that in the United States, approximately 90% of those who need ART or IVF treatment, do not get it and the single biggest reason is lack of affordability. 

It is still relatively early to understand how the success rates of LoGo-IVM™ will compare to conventional IVF.  We anticipate that the success will be about 10 % lower than conventional IVF but we are not certain.  It could be that they are equivalent.  We are presently undertaking studies in this regard.  We were delighted when the very first patient we treated with IVM at Batzofin Fertility Services conceived:  See links: http://www.nydailynews.com/news/2009/04/13/2009-04-13_have_a_baby_at_new_low_low_price.html  and
http://www.myfoxny.com/dpp/health/test_and_procedures/090507_new_fertility_treatment. 

This result was televised nationally.  We will monitor results closely to determine how efficacious this treatment will prove to be.  LoGo-IVM™ will need to be compared to conventional IVF treatment and we predict it will ultimately prove to be the therapy of choice for a select subgroup of patients, primarily those with PCOS and those at risk for exposure to gonadotropins.  It will definitely open a more affordable treatment option for many patients dealing with infertility.

This is a brief summary of the procedure using LoGo-IVM™ or LoGo-IVF™.  If additional information is needed, please contact our office at 212-679-2289.  Batzofin Fertility Services truly believes everybody should be afforded the chance to have a baby.