Latest technology and advanced techniques. It seems most clinics out there make this very claim. We are not content to offer the latest technology and advanced techniques. We prefer to use our academic strengths to actually change the future of fertility treatments. Our collaborative arrangement with UC Davis Health System, and access to doctorates in reproductive science, allows California IVF to advance the routine offerings provided my most clinics. Through research and continuous process improvement, we are in a constant state of change with the goal if improving pregnancy outcomes.
Changing the way fertility treatments are being done through research and continuous process improvement.
California IVF Fertility Center doesn’t just offer the latest technology – we are defining it!
California IVF Research
Reactive oxygen species (ROS)are metabolic byproducts produced by cells caused by the breakdown of oxygen as part of normal cellular function. ROS are an important part of cell signaling and maintaining cell stability. During times of stress, ROS can increase to toxic levels and interfere with the genetic stability of the cells. As women age, the eggs begin to have increase ROS which interferes with the sorting of genetic information around the time of fertilization and in the critical days that follow. Even younger women found to have poor quality eggs have elevated levels of ROS in the eggs.
Nitric Oxide (NO) is one of the ROS produced by the mitochondria that can be measured in cells that are actively dividing or involved in inflammatory processes. Nitric Oxide has also been shown to play a role in egg development, aging of oocytes, and embryonic development. Dr. Pravin Goud and his wife Anuradha Goud PhD, have published extensively on ROS, NO, and oocyte ageing. Combining knowledge of ROS and ageing of oocytes, Dr. Goud has been instrumental in changes at California IVF that have resulted in improvements in egg quality and embryo survival.
Most labs can only observe egg quality and the poor development of embryos. Many labs are not even aware that this is occurring due to imbalances in ROS. At California IVF, we are changing way eggs are fertilized and cultured and bringing about big changes for patients that have previously failed IVF. Leveraging our collaboration with UC Davis Health System and the team of reproductive biologists, California IVF has committed a research lab and funding to expand work on oocyte aging and the potential for improvement in embryo development and pregnancy outcomes.
In addition to work on ROS, Dr. Goud has also worked on projects researching mitotic spindles inside oocytes. During the cell division process, the eggs align the chromosomes along mitotic spindles. There are many factors that affect the proper formation of mitotic spindles. Combining previous research with the use of a 3 dimensional microscope, California IVF is able to monitor the spindle formation throughout the early fertilization stages and progression on to a healthy embryo. Ongoing research hopes to combine changes that affect ROS with changes to culture media that are hypothesized to stabilize mitotic spindle formation and improve the number of quality embryos that form during the IVF process. This is another great example of how California IVF has migrated from simply observing the quality of eggs and embryos to improving the outcomes for our patients and increasing their changes of having a baby.
Globozoospermia is a condition where the sperm have rounded or “globe-like” sperm. This comes from a genetic defect that affects the shape and function of the sperm. This abnormality was detected very early and we were able to modify the fertilization technique before a fertilization failure occurred. Leveraging our experience and scientific knowledge, we have been able to bring about a pregnancy using altered fertilization techniques. Drs. Pravin Goud and Ted Tollner are reproductive scientists specializing in early egg and sperm interaction. Our patient was successful in building their family, not just once, but twice. The family and staff are proud of our scientists and the success they bring to our fertility clinic.
Male Infertility Research
Ted Tollner, PhD is an expert in sperm biology. His more recent work has focused on a sperm coat protein named DEFB126. This protein allows sperm to travel through the female reproductive system and acts as a protective barrier from the female immune system. The absence of DEFB126 has been associated with infertility. It is very possible that DEFB126 can be tested and have a more predictive role in male fertility evaluations than the standard semen analysis. Additional work will be required to refine the potential for testing and treatment of DEFB126 deficient males, but Dr. Tollner’s expertise in sperm activation (capacitation) and fertilization has already led to modifications in the embryology lab at California IVF. Changes in sperm selection, ICSI, and timing of fertilization has led to higher rates of fertilization with ICSI and improvements in outcomes for the embryos. Further refinement of the sperm processing techniques by Charlene Tollner has improved the isolation of top quality sperm. This refinement has allowed for more efficient selection of quality sperm use for ICSI and improvements in the preparation techniques for sperm used in artificial insemination (intrauterine insemination – IUI).
Through experience gained from research and the continual process improvement, California IVF strives to maximize the pregnancy rates for our patients. Dr. Tollner has been instrumental in changing the culture and handling techniques of embryos, including revisions to the assisted hatching process. These changes have resulted in better outcomes for our patients. Maintaining logs, performing rigorous quality assurance, and observing outcomes for many different aspects of embryology, our lab staff is constantly looking for ways to increase your chances of having a baby.
Failed IVF Cycles - New Approaches
Learning from the past and present work of Dr. Goud and Dr. Tollner, California IVF has been able to modify several processes in the IVF laboratory with remarkable results.
Leading to changes in how eggs are fertilized. Preliminary work in patients with previous failed IVF cycles, poor quality eggs, and no embryos available for transfer has led to some remarkable outcomes. Patients previously thought to have little or no chance of pregnancy actually have been able to form day 5 blastocysts and have frozen embryos left over after treatment. While this work is preliminary, the results are impressive and could lead to changes that improve the outcomes for all patients.
UC Davis Connection
Catherine A. VandeVoort, PhD is a researcher at the California National Primate Research Center. She has a focus in primate reproductive physiology, including oocyte maturation, embryonic stem cells and ovarian toxicology. Cathy works on multiple projects that have direct overlap with human embryology and is able to conduct experiments that may not be possible in humans. As part of our collaborative research team with UC Davis Health System, Cathy has been very influential on various projects at California IVF and has worked on projects involving human granulosa cells <<float info>>. Cathy has previously identified markers in granulosa cells that are associated with the ability of an embryo to progress and ultimately form a baby. As this research evolves, we hope to identify markers that could refine the embryo selection process and improve rates of pregnancy. As work continues on changes to the early egg and embryo environment, these markers will likely become valuable for monitoring changes before embryos are selected for transfer.
Dr. VandeVoort’s research into bisphenol A has shown the tremendous impact of environmental toxins on the reproductive health of primates. This work along with other environmental factors have formed the foundation for several collaborative projects with California IVF and several National Institutes of Health (NIH) grant applications.
Dr. VandeVoort from UC Davis and the California National Primate Research Center, published a study in 2014, looking at the impact of dietary sugar on the oocytes of rhesus monkeys. It was shown that increased consumption of sugars modified gene expression and inhibited egg development. This research is in line with the insulin and diet modification work by Dr. Zeringue. Patients seeking help in our clinic are placed on a diet modification plan designed to reduce refined sugars and decrease insulin activity. The collaborative arrangement of California IVF and UC Davis Health System, allows us to leverage the research resources of one of the nation’s top academic institutions and bring significant changes to our patients. Many new patients comment that they have undergone treatment for years and no one ever addressed their diet. You can read more about insulin, PCOS, diet modification, and pregnancy.
Development of New Technology
Drs., Tollner, VandeVoort, Goud, and Zeringue have collectively worked on various projects designed to simplify and automate several processes in the embryology laboratory. By improving the efficiency and precision of many of the laboratory processes, California IVF seeks to gain improvements in success that would directly benefit our patients. Projects have ranged from modifications to fertilization techniques, including ICSI, culture systems and sealed incubators, modifications to the assisted hatching process, and the embryo selection process using developmental milestones and 3-dimensional imaging of embryo health. Our guiding principle is to not follow the status quo, but to define the way fertility procedures are done in the future.
Process Improvement and QA
Most every aspect of California IVF is subjected to some form of ongoing quality assurance. We perform constant internal evaluations on our own performance and adherence to standards. Not just accepting a technique and using it but instead adapting it to find the most optimal outcome. The embryology laboratory tracks an incredible amount of variables as part of an ongoing process improvement program. Measurements of outcomes such as embryo development and pregnancy rates are part of the ongoing process improvement as well as the ongoing research.
Improving Outcomes - Setting the Standard
Oocyte vitrificaiton (rapid freezing) devices and media are commercially available and have defined methods for how the products should be used. Most places are unable to verify their success due to the long interval between when eggs are frozen for fertility preservation and when they are used to make a pregnancy. Unless the clinics test and refine the “off the shelf” freezing methods, it is possible many programs may not be able to successfully thaw or fertilize the eggs in the future. Patients returning years later hoping to take advantage of the eggs they stored when they were younger may end up very disappointed when very few if any of the eggs survive and develop to the point they can be transferred. Our techniques were refined and tested before our oocyte cryopreservation services were offered to the public. This process improvement which resulted in live births from frozen eggs has also been applied to embryos. Our frozen embryo program has been so successful, it is changing the way IVF services are delivered.
When you are looking for a fertility clinic to help you have a baby, you want a center with the knowledge and experience that will help give you the best changes of having a baby. California IVF is proud of the many accomplishments that have been made and many more just around the corner.