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Fertility 360

Making Sense of Reproductive Genomics



Reproductive Genomincs

Founded in 1989 with the goal of building the best fertility programme possible, ORM is globally recognised for its consistently high live birth success rates, individualised care, and innovation leadership. In 1999, ORM’s innovation led it to utilise the expertise of Intel clean room facility engineers, to develop its pioneering embryology laboratory clean room, one of the first in the world. More recently, this same drive to embrace the latest technologies to achieve the best outcomes has been behind ORM’s commitment to making industry-leading genetic screening and testing available to its patients.

The understanding of genetics and the variety of tests available are both expanding rapidly. We believe that our patients should feel empowered to make informed decisions based on the latest technology and with accurate, up-to-date, and easy to understand information. Separating it from most other clinics, ORM has an in-house state-of-the-art reproductive genomics programme. We have a team of highly-experienced, full-time, genetics counsellors who work with patients and are involved in the screening of every egg donor in ORM’s in-house programme.

ORM is also one of the only IVF clinics in the USA that has an on site genetics laboratory.

When it comes to genetic screening and testing it is important for patients to understand their options and the differences between pre-embryo creation and post-embryo creation screening and testing.

With pre-embryo creation it is possible to gather genetic history-focused data and conduct recessive carrier gene screening on each individual contributing eggs and sperm for the creation of embryos. By collecting and analysing family genetic history, ORM’s genetics counsellors help identify areas that may warrant further investigation and/or testing. Through a saliva or blood sample it is possible to screen whether individuals contributing eggs and sperm for the creation of embryos are carriers for a recessive genetic disease. The person being tested may not suffer from the disease being tested, but still be a carrier.

About 35% of people who we test at ORM are carriers for recessive genetic diseases. If both people contributing eggs and sperm are carriers for the same disease then there is an increased risk that a baby would develop that genetic disease. To minimise this risk for patients, we automatically test everyone who is contributing eggs and sperm for 100 recessive carrier genetic diseases. This is a significantly more comprehensive process than is standard among many clinics. The results of this pre-embryo creation genetic screening are available to patients before they commence their cycle and/or select a donor if that is part of their treatment and helps them make informed choices.

Reproductive Genomics

Pre-implantation genetic screening (PGS) and pre-implantation genetic diagnosis (PGD) are the two forms of post-embryo creation genetic screening which patients should understand.

PGS involves the testing of embryos to determine whether they carry the correct number of chromosomes to develop into a healthy pregnancy and baby. Embryos with the incorrect number of chromosomes will typically not develop, resulting in a failed IVF cycle or miscarriage, or a baby with one of several conditions – most of which are incompatible with life but which also include Down Syndrome. The most advanced form of PGS involves testing all of the chromosomes by a technique known as Comprehensive Chromosome Screening (CCS). At ORM we utilise the most newest, powerful version of this technique called Next-Generation Sequencing (NGS).

The formation of abnormal embryos (not possessing the correct number of chromosomes) is a natural phenomenon – around 25% of embryos from a young woman’s eggs will be naturally abnormal and this rate increases with the age of a woman’s eggs. These embryos will not make healthy babies and in most cases miscarry or do not implant at all. Because of this, CCS is a form of standardised genetic screening that is appropriate for every patient to consider as part of their IVF treatment and as a means to optimise the chances for success.

PGD involves the testing of embryos to determine whether a patient-specifi c genetic or chromosomal disorder is present. PDG testing is therefore customised and is only appropriate in certain circumstances with select patients.

In every IVF cycle embryos are first examined under the microscope in order to select the best-looking ones. In addition to this visual inspection of the embryos, it is possible to count the number of chromosomes in each embryo. Chromosomes are packages of genes, or DNA, which are present in every cell of a person. Normally, there are 46 chromosomes (23 pairs) in each cell. Embryos with the correct number of chromosomes have the best potential for implanting and resulting in a successful pregnancy. Abnormalities in chromosome number (extra or missing chromosomes) are the most common cause of failed implantation in IVF cycles and miscarriages, and are the only type of problem that becomes more common as women get older.

CCS is the term for this type of testing. This process involves the precise laser removal from an embryo of about five cells that would otherwise develop into the placenta at the blastocyst (day Dr John Hesla Dr Brandon Bankowski
The ORM team five to six) stage. The biopsied cells are laboratory tested using advanced technology to determine the number of chromosomes present. The embryos are generally frozen for future transfer while the testing is being performed, but in select circumstances (based on the development of the embryos and availability of an in-house genetics testing laboratory as is the case at ORM) it is possible to complete the testing and transfer the selected embryo(s) prior to freezing. Transferring only embryos with the correct number of chromosomes can often improve the chances of a successful pregnancy and also decrease the chance of suffering through a miscarriage or having a baby born with a disorder linked to a chromosomal abnormality. CCS can be especially helpful for patients who are:

  • Women 35 years of age or older using their own eggs
  • Couples who have a history of repeated miscarriage
  • Couples who have had a pregnancy or baby with a chromosomal abnormality
  • Couples who have had multiple failed IVF cycles

However, embryos with an incorrect number of chromosomes are very common, can occur at any age, and are not related to one’s family history so CCS is an option for all patients undergoing IVF. New research shows that CCS can improve the implantation rates of embryos from egg donors who are in their twenties. Currently, at ORM over 80% of IVF patients now choose CCS as part of their cycle.

CCS using NGS technology is the most advanced form of this screening. Compared to conventional technology, NGS involves the attachment of several hundred thousand genetic probes to each biopsied cell. NGS technology delivers the greatest accuracy and speed for CCS procedures. ORM’s in-house genetics laboratory employs NGS technology.

Oregon Reproductive Medicine Team

Dr Bankowski & DR Helsa
ORM’s global practice is led by Dr John Hesla and Dr Brandon Bankowski, who have helped patients from over 40 countries create their families. Both completed their training at the Johns Hopkins Hospital – ranked as the number one in the USA for over 20 years in a row – and are recognised internationally for their professional excellence and commitment to improving their patients’ reproductive care.

Dr Hesla joined ORM in 1999 when he co-founded its IVF programme and was instrumental in building ORM’s pioneering embryology laboratory clean room, one of the first in the world. Dr Bankowski joined ORM in 2005 and he co-founded its industry-leading in-house genomics programme. Both strive to help patients achieve the best success while caring for the genetic health of their family.

ORM moved into its new state-of-the-art Fertility Center located in vibrant downtown Portland in autumn 2015. It is home to our 100-strong ORM family of doctors, nurses, embryologists, genetic counsellors, psychologists, patient co-ordinators, donor co-ordinators, and financial counsellors among others. This world-class facility comprises 25,000 square feet and four floors of patient care facilities. ORM’s Fertility Center houses its embryology and genetics laboratories, and increased space for ORM’s fertility services and treatments, including IVF, egg donation, surrogacy, advanced genetic screening, as well as comprehensive fertility counselling, acupuncture, community education and proactive fertility care.

ORM’s new Fertility Center builds on our commitment to achieve the highest success rates while providing a customised, compassionate patient experience. We look forward to welcoming you to ORM in Portland and to help you build your family!

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Fertility 360

NEWS: Get access to adult photos of the Cryos sperm donors



Adult Cryos Sperm Donors Photos

Viewing adult photos of Cryos sperm donors is now a reality. Visit today and get access to the new feature.

At Cryos it is now possible to access adult photos of sperm donors on our website, thus adding another dimension to your search for the perfect donor.

The unique chance to see both childhood and adult photos of your sperm donor, provides you with a more comprehensive idea of who your sperm donor is and moreover of the features of your future child. We hope that this extra dimension will upgrade your experience making your decision of a sperm donor easier.

The 5-6 adult photos are taken by a professional photographer and are a part of the donors extended profile where you also have access to childhood photos, an audio recording of the donor’s voice, a handwritten message, an emotional intelligence profile, and finally our staff impressions of the donor, amongst other exclusive features.

The adult photos require special access on our website. Visit our website and find out more and get access to this new feature now.

Please note that the person in the photos is a model and not a Cryos donor.
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Fertility 360

Fertility And Sex: Why Her Orgasm Matters



Why her orgasm matters

For many couples, trying to conceive can make sex feel less fun and more pressured. Instead of being an intimate and enjoyable experience, baby-making sex can start to seem like a finely choreographed routine. Often, the female orgasm is one of the first things to go, but the maleorgasm is not the only orgasm that matters when it comes to fertility.

Before I dive into discussing the potential benefits of the female orgasm for fertility, it’s important to note that reaching climax is not technically essential for conception. If you never, or rarely, achieve orgasm, don’t worry, you can still get pregnant! Around 1 in 10 women don’t experience orgasm, ever. What’s more, the exact nature of the female orgasm remains somewhat elusive. Some experience orgasm through clitoral stimulation, some through vaginal intercourse, some through both, and others through something else entirely, or not at all.

Even without reaching orgasm, sexual arousal is itself beneficial to fertility. Like an orgasm, arousal is, first and foremost, a good indication that sex is enjoyable. Sexual arousal and climax causes significant changes in your levels of neurotransmitters including noradrenaline, oxytocin, prolactin, dopamine, and serotonin. These ‘reward’ neurohormones help you bond to a sexual partner and make it more likely that you’ll have sex more often, thereby increasing your chances of conception.

Second, orgasm and arousal have a range of physiological effects that might aid conception, which I’ll discuss in a moment. And, third, sexual arousal and orgasms for everyone can help sperm-producing partners avoid feeling like they’re being used just for their sperm. In fact, some studies show that male partners who engage in cunnilingus prior to vaginal intercourse have greater sexual arousal and produce more semen!


The female orgasm can help relieve stress, and promote healthy circulation and balance in the body. Stress is a key cause of diminished libido and may also reduce the chances of conception by raising levels of the stress hormone cortisol. Conversely, good sex can help raise levels of oxytocin and the other neurohormones mentioned above. These help you to relax and bond to your partner.

Published in 1967, the author even went as far as suggesting that the increase in these hormones after orgasm help support conception by temporarily incapacitating you. Put simply, this ‘poleax’ effect means you’ll feel so relaxed that you’ll stay lying down, which may increase your chance of conceiving. Whether staying supine does make conception more likely is still under debate, but I’m all for promoting relaxation, so if this theory provides added motivation, go for it!


There is some suggestion that orgasm affects the shape and function of the cervix. These effects, which may include cervical ‘tenting could enhance the likelihood of conception by promoting the movement of sperm into the uterus and beyond. If you are curious as to what your cervix looks like during different stages of your cycle, check out these photos.


One of the main ways in which female orgasm has been linked to fertility is something called the ‘upsuck’ theory (or, sometimes, the ‘insuck’ theory). This theory proposes that the female orgasm causes uterine and vaginal contractions that actively draw semen up into the uterus and towards the fallopian tubes, thereby increasing the chances of an egg being fertilized.

Scientific evidence to support this theory is rather inconsistent, but there’s certainly no harm in trying! One proposed underlying mechanism of this theory is oxytocin-mediated uterine peristalsis, i.e. the same mechanism that causes uterine contractions during labour could be partially responsible for increasing the likelihood of conception. Indeed, some research has found higher pregnancy rates in women shown to experience this ‘insuck’ phenomenon.


More recently, one small study found that orgasm may increase sperm retention. This study involved women using a syringe to insert a sperm simulant (lube) prior to external stimulation to orgasm. As such, the study’s findings may be especially applicable to anyone undergoing artificial insemination (IUI).

The take-away: Chances are that if you orgasm 1 minute before or up to 45 minutes after insemination (whether artificial or otherwise), you will probably retain more sperm, which may increase your chance of conceiving.


To sum up, the female orgasm might enhance fertility in a variety of ways, but it isn’t essential to conception.

The take home message is that orgasm and sexual arousal itself have many benefits to fertility, partner relationships and stress relief. Don’t worry though, if you have a low libido, conception can still happen even in the absence of arousal and orgasm!

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Fertility 360

What Is Polycystic Ovary Syndrome (PCOS)?



Polycystic Ovary Syndrome

Polycystic Ovary Syndrome or PCOS is a hormonal imbalance that affects 5 to 10 percent of women of reproductive age across the world, and results in irregular or absent periods, acne, excess body hair and weight gain. It is also a major cause of infertility and yet is frequently misdiagnosed and often missed completely.

PCOS gets its name because under an ultrasound scan, the ovaries can look like a bunch of grapes, each one covered in what look like multiple cysts. In fact, these aren’t cysts at all, but are small, undeveloped follicles.


Not every woman with PCOS will get the same symptoms, but common signs to look out for include:

  • Few or no periods
  • Excess hair on the face or breasts or inside of the legs or around the nipples
  • Acne
  • Oily skin
  • Scalp hair thinning or loss (male pattern baldness)
  • Skin tags (known as acrochordons)
  • Skin discolouration (known as acanthosis nigricans) where the skin looks ‘dirty’ on the arms, around the neck and under the breasts
  • Mood swings
  • Depression
  • Lack of sex drive
  • Weight gain especially around the middle of the body
  • Difficulty in losing weight
  • Cravings and binges
  • Irregular or no ovulation
  • Difficulty in becoming pregnant
  • Recurrent miscarriages

PCOS creates a vicious cycle of hormone imbalances, which has huge knock-on effects throughout the rest of your body. With PCOS, the problem often starts with the ovaries, which are unable to produce the hormones they should, and in the correct proportions. But linked to this is the very common problem of insulin resistance. Women with PCOS very often have difficulties with blood sugar levels which can cause weight gain and the excess insulin can stimulate your ovaries to produce yet more testosterone. Half of all women with PCOS do not have any problems with their weight, yet they can still have higher insulin levels than normal.

How is Polycystic Ovary Syndrome diagnosed?

The most widely accepted criteria for the diagnosis of PCOS says that you should have two out of these three problems:

  • Infrequent or no ovulation
  • Signs (either physical appearance – hirsutism or acne – or blood tests) of high levels of male hormones
  • Polycystic ovaries as seen on an ultrasound scan

The Seven Nutritional Steps to beat Polycystic Ovary Syndrome

Good nutrition is the foundation of your health and you should never underestimate how powerful it can be. It is the fuel that provides you with the energy to live your life and it gives your body the nutrients it needs to produce your hormones in the correct balance. The better the supply of those nutrients, the more healthily your body will function.

The fundamental aim of my nutritional approach to PCOS is to target a number of areas simultaneously so that you get the maximum effect in the minimum amount of time.

Here’s how:

  1. Switch to unrefined carbohydrates (eaten with protein) and never go more than 3 hours without food to keep your blood sugar levels balanced
  2. Eat oily fish and foods rich in Omega 3s to help your body to become more sensitive to insulin so it can overcome insulin resistance
  3. Cut out all dairy products for 3 months to bring levels of male hormones under control
  4. Eat more vegetables and pulses to which helps control male hormones
  5. Cut right back on or cut out alcohol for 12 weeks to allow your liver function to improve
  6. Cut down on caffeine to give your adrenal glands a rest
  7. Cut down on saturated fats and eliminate trans fats to help control the potentially damaging inflammatory processes PCOS causes in the body

PCOS Symptons

Best Supplements for PCOS

The use of certain vitamins and minerals can be extremely useful in helping to correct Polycystic Ovary Syndrome, along with a good diet.


Chromium helps to encourage the formation of glucose tolerance factor (GTF), which is required to make insulin more efficient. A deficiency of chromium can lead to insulin resistance.  It also helps to control cravings and reduces hunger. Can help to reduce insulin resistance associated with PCOS

B vitamins

The B vitamins are very important in helping to control the symptoms of PCOS. Vitamin B2 helps to burn fat, sugar and protein into energy. B3 is a component of GTF which is released every time blood sugar rises, and vitamin B3 helps to keep the levels in balance. Vitamin B5 has been shown to help with weight loss and B6 is also important for maintaining hormone balance and, together with B2 and B3, is necessary for normal thyroid function.


Zinc helps with PCOS as it plays a crucial role in the production of your reproductive hormones and also regulates your blood sugar.


Magnesium is an important mineral for dealing with PCOS because there is a strong link between magnesium levels and insulin resistance – the higher your magnesium levels the more sensitive you are likely to be to insulin.

Co-Enzyme Q10

Co-Q10 is a substance that your body produces in nearly every cell.  It helps to balance your blood sugar and lowering both glucose and insulin.

Alpha lipoic acid

This powerful antioxidant helps to regulate your blood sugar levels because it releases energy by burning glucose and it also helps to make you more insulin sensitive. It also has an effect on weight loss because if the glucose is being used for energy, your body releases less insulin and you then store less fat.

Omega 3 fatty acids

Omega 3 fatty acids taken in supplement form have been found to reduce testosterone levels in women with Polycystic Ovary Syndrome.

Amino Acids

Certain amino acids can be very helpful for PCOS as they can improve your insulin sensitivity and also can have an effect on weight loss.

N-Acetyl cysteine

In women with PCOS this amino acid helps reduce insulin levels and makes your body more sensitive to insulin. Study using NAC in women who were clomiphene resistant and had ovarian drilling.  After ovarian drilling, the women given NAC compared to a placebo showed a significantly higher increase in both ovulation and pregnancy rates and lower incidence of miscarriage.


Arginine can be helpful in reversing insulin resistance. In one study, a combination of both arginine and N-acetyl cysteine were given to women with Polycystic Ovary Syndrome.  The two amino acids help to improve blood sugar and insulin control and also increased the number of menstrual cycles and ovulation with one women becoming pregnant on the second month.


Carnitine helps your body break down fat to release energy and can help improve insulin sensitivity.


Tyrosine is helpful for women with PCOS who are overweight as it helps to suppress the appetite and burn off fat.


This amino acid is useful for helping with sugar cravings as it can be converted to sugar for energy and so takes away the need to eat something sweet.  It also helps to build and maintain muscle which is important for fat burning.

Branched Chain Amino Acids (BCAAs)

BCAAs include three amino acids leucine, isoleucine and valine. They are important in PCOS because they help to balance blood sugar and having good levels of these BCAAs can have a beneficial effect on your body weight


A study used inositol (2,000mg) in combination with NAC (600mg), a significant increase in ovulation rates.

Having a good diet, regular exercise, controlling stress and taking key nutrients will help in getting your hormones back in balance and reducing the negative symptoms associated with PCOS.

More information can be found on

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