Additional Services

Depending on your particular circumstances, one or more of the following procedures offered at fertility clinic locations in the San Francisco Bay Area or Sacramento may be right for you. These procedures are not included in your single-cycle IVF fee and have an additional cost.

Assisted Hatching

Assisted hatching uses micromanipulative techniques (under a microscope using special laboratory equipment) to create a small slit or opening in the protective coating surrounding an embryo. This is intended to make it easier for the embryo to "hatch" out of the protective coating before being implanted into the woman's uterus during in vitro fertilization (IVF). Assisted hatching may increase the chance of implantation, especially in older women.

Cryopreservation of Embryos

Cryopreservation of embryos involves storing extra embryos retrieved and fertilized during a cycle for use in a later frozen embryo cycle. If the uterine lining is not suitable for implantation in a stimulated cycle, cryopreservation allows transfer during a different menstrual cycle. Also, women facing medical procedures that affect fertility can bank embryos for the future. As part of the single-cycle plan cost, you can store embryos for up to six months. After six months, embryos may be stored for an additional fee.

Intracytoplasmic Sperm Injection (ICSI)

ICSI uses micromanipulative techniques to inject a single sperm directly into an egg. Only mature eggs ready for fertilization are selected for this process. Most often, ICSI is used in cases of known or suspected male factor infertility, or in cases of previously demonstrated poor fertilization rates.

Preimplantation Genetic Diagnosis (PGD)

PGD uses a technique where a single cell is removed from the embryo to identify certain genetic disorders in an embryo created during the IVF process before the embryo is transferred to the uterus. PGD is recommended to prevent the passing of a genetic disease to the offspring and provides particular benefit to patients at risk of passing on inherited genetic diseases such as cystic fibrosis and muscular dystrophy. PGD is also used for embryos that may be affected by a certain genetic condition, which could result in an unsuccessful pregnancy.

Microsurgical Epididymal Sperm Aspiration (MESA)

Microsurgical epididymal sperm aspiration refers to retrieval of sperm-containing fluid from optimal areas of the epididymis that are selected and sampled using high-power optical magnification provided by an operating microscope. Retrieved sperm are subsequently used for intracytoplasmic sperm injection (ICSI) to induce fertilization and pregnancy.

Testicular Sperm Extraction (TESE)

Microscopic testicular sperm extraction is the microsurgical retrieval of sperm directly from the testicles. Performed in conjunction with IVF, TESE is a revolutionary treatment for severe male factor infertility caused by the absence of sperm (azoospermia) in the semen due to anatomical obstructions or low/no sperm production.

Percutaneous Epididymal Sperm Aspiration (PESA)

Percutaneous epididymal sperm aspiration is a sperm aspiration procedure in which a needle is inserted into the epididymis (gland that carries sperm from testicle to vas deferens) in order to retrieve sperm for use in an IVF procedure.

Preimplantation Genetic Screening (PGS)

This testing is called Preimplantation Genetic Screening and its purpose is to examine the embryo's number of chromosomes in order to improve the likelihood of IVF being successful and you actually getting pregnant.

Vasectomy Reversal

Vasectomy reversal is a type of surgery to restore your fertility by reconnecting the tubes that carry sperm into your semen. After the surgery, when your semen contains sperm again, you may get a woman pregnant.

About 6 percent of men who have a vasectomy later change their minds and want to father biological children.

While most vasectomies can be reversed, your chance of conceiving a child depends on the:

  • Type of vasectomy you had
  • Length of time since your vasectomy

Vasectomy reversal is performed as an outpatient procedure in a hospital or surgery center.

After surgery, you may be sore for several days and must avoid sexual activity for 3 to 6 weeks, depending on your doctor's instructions.

Microsurgical Varicocelectomy

Varicoceles are abnormally dilated testicular veins (pampiniform plexus) in the scrotum. Varicocele is found in approximately 15% of the general population, 35% of men with primary infertility and in 75–80% of men with secondary infertility. It is more common on the left side. In adolescents, the incidence of varicocele is approximately 15%; the abnormality is extremely rare in pre-pubertal boys. Varicocele repair is by far the most commonly performed operation for the treatment of male infertility.

Although most men with varicoceles are able to father children, there is abundant evidence that varicoceles are detrimental to male fertility. A study by the World Health Organization (WHO) on over 9,000 men showed that varicoceles are commonly accompanied by decreased testicular volume, impaired sperm quality, and a decline in Leydig cell (the cells that manufacture the male hormone testosterone) function. Another report by Johnson and colleagues showed that 70% of healthy, asymptomatic military recruits with palpable varicoceles had abnormal semen analyses.

Furthermore, studies in animals and human suggest that varicoceles cause progressive testicular damage over time. It appears that surgical repair of varicoceles not only halts this decline in testicular function but often reverses it. Whether the improvements in semen parameters, seen in 70–80% of men after varicocelectomy, translate into improved pregnancy and delivery rates had previously been a matter of controversy. Recent controlled studies clearly indicate that varicocelectomy improves pregnancy rates. The potentially important role of urologists in preventing future infertility and/or androgen (testosterone) deficiency underscores the importance of utilizing a varicocelectomy technique that minimizes the risk of complications and recurrence.

For more information, speak to your personal infertility doctor.