Planning Your Family
Using technology and technique, George S. Taliadouros, M.D., of Delaware Valley Institute of Fertility & Genetics, helps families grow in sensible, informed manners
by Staff

Founded in 1994, the Delaware Valley Institute of Fertility & Genetics (DVIF&G) is one of the leading fertility practices in the greater Philadelphia area. With three New Jersey offices conveniently located in Marlton, Vineland and now Princeton, the center provides personalized fertility treatment tailored to the needs of each individual couple. From molecular medicine and robotic surgery to emotional and nutritional counseling, DVIF&G offers a full spectrum of care.

The newest DVIF&G office is located in the Forrestal Professional Center on the Forrestal campus of historic Princeton University. George S. Taliadouros, M.D., founder and director of DVIF&G, says he and his team are extremely pleased for the opportunity to grow their area of service to include this developing Mercer County region. 

“Our fertility center has been serving the community in New Jersey for over 20 years, and this new office is recognition of this New Jersey’s fast-growing community,” Dr. Taliadouros says. “We are proud to be one of the top fertility centers in the New Jersey area that offers excellent fertility treatment at very competitive pricing.”

Patient Education
As important as factors such as geographic and financial accessibility are to the DVIF&G philosophy, so is patient education. As each couple is different, the possible reasons for infertility and types of treatment vary greatly. For some couples, in vitro fertilization (IVF) is a good option. It has been around for almost a half of a century and has resulted in the births of several million babies worldwide. IVF has had “a dramatic effect on the field of reproductive medicine,” Dr. Taliadouros says, “and an unparalleled wealth of scientific discoveries resulted from its application that improved our understanding of reproductive physiology.” 

Couples who seek fertility treatment are vulnerable because of their desire to fulfill their life’s dream of having a family. Although infertile couples, in general, are considered as one of the most informed groups of patients in terms of having knowledge of their medical condition, navigating through the plethora of information concerning different diagnoses and treatments can be difficult. 

The infertile couple’s appropriate goal should be the identification of the cause for their plight, and then they can make certain that this is corrected so that they can become pregnant naturally.  There are causes of infertility such as bilateral tubal occlusion, severe male factor infertility with hardly any sperm or no sperm present and premature ovarian failure, as well as others that can be documented adequately and if appropriately and clearly explained. Knowing the cause of infertility will help the interested couple select the treatment, such as a surgical procedure, in vitro fertilization or an intracytoplasmic sperm injection (ICSI) procedure. The couple might even choose to proceed with alternative treatment such as participating in an oocyte (egg) or embryo donor program. 

Unfortunately, clear-cut causes of infertility are infrequent. By contrast, the vast majority are inundated with marginal explanations, such as somewhat decreased sperm count, decreased sperm motility and somewhat odd appearance of the sperm, weakness or infrequent ovulation and others that could make the occurrence of pregnancy less frequent. There are also cases in which no apparent explanation can be found. 

In these cases, the infertile couple finds itself at the road’s bifurcation. They can take the left path that provides several kinds of interventions, all of them trying to compensate for the existing imperfections in the reproductive system by assuming inseminations, ovulation correction or induction with injectable gonadotropins or pills, such as antiestrogens or aromatase inhibitors (clomiphene citrate or letrazole). 

This might not be a correction of a cause but merely an override of a process that forces the system to perform under duress. What an infertile couple can experience is successive failures of interventions that lead to a slippery slope of more complicated, more intensive, more invasive and more expensive measures. For instance, a method to detect known chromosomal abnormalities—preimplantation genetic diagnosis (PGD)—was expanded to a screen test for the selection of chromosomally normal embryos. The result is a 10 to 15 percent higher success rate with 40 to 50 percent additional costs to the treatment, and yet 50 percent of the miscarriages during the first three months of the pregnancy and more than 90 percent of the late miscarriages have normal chromosomes.

So they have tried, without effect, interventions such as pills, injections, inseminations, IVF, ICSI, assisted hatching and PGS, with still more options just around the corner. In essence, this all amounts to a declaration of failure and to provide a diagnosis and correction to a problem. The sad reality is that infertile couples are trotted through lesser interventions to the more advanced ones in the hope that their goals will be met. A right turn at the road’s bifurcation might require an inquisitive mind and a little more patience. 

Designed Not to Fail
The reproductive system has evolved over many centuries, and it has been designed not to fail. Questions as to why a particular couple is unable to become pregnant within a reasonable time are appropriate. If a cause is identified, additional questions should be directed as to what can be done so that this upset is corrected and the function of the reproductive system is restored.  If there is inability to provide clear answers or the provided answers do not make sense, additional investigation is needed. Young, healthy couples should seek answers prior to treatment and shy away from the “hammers” that are offered to them.

This holds even greater importance in those cases when there is adequate sperm, the anatomy of the reproductive system is intact and a woman is ovulating properly. Even if there is a problem such as an aberration in ovulation, patients need to know why this is occurring and what can be done about it. 

“We are successful in treating the underlying cause and allowing the vast majority of patients to become pregnant on their own,” says Dr. Taliadouros. “At the same time, we do not shy away from new achievements in technology.” For instance, DVIF&G has achieved excellent results concerning insemination, with success rates similar to what other programs are reporting for their IVF treatment. 

“We are one of the leading programs in IVF-ET without having to subject the embryos to biopsy,” he adds. “Although we have mastered this technology and provided it to our patients when necessary, our embryo biopsy rate is 1 percent. The single embryo transfer, admittedly, with patients that desire to have a single embryo transfer, has a respectable 60 percent pregnancy rate—again, without obtaining embryo biopsies. We have developed a method to mature oocytes in the lab (IVM) and are the only program in the country with continuous success using this method.” 

DVIF&G’s oocyte donor program was listed fifth in the country in terms of success. The center provided the SEEDS (Semen, Embryo, Egg Depository and Storage) program for cancer patients who would like to preserve their fertility potential. So far, 10 babies have been born to parents who were cancer survivors. 

Dr. Taliadouros is confident that debate in the scientific forum will lead to patients’ abilities to make informed decisions with which they can be at peace.

“Technology is important for fertility treatment yet has inadvertently been exploited,” he says.  “While regulations are in place to control such misuse, they are not perfect. Therefore, at DVIF&G we embrace such technologies and use them wisely.”

Delaware Valley Institute of Fertility & Genetics
George S. Taliadouros, M.D., FACOG
6000 Sagemore Drive, Suite 6102
Marlton, NJ 08053

Photograph by Alison Dunlap