There is hope. Are you ready to make your miracle happen?

Guaranteed Results Come From Personal Care

Advanced Fertility Care Success Rates Among Nation’s Highest

By Dan Walker

When a couple has problems conceiving a baby, it can be devastating. Infertility is often the first life crisis a couple faces, and the stress it causes can result in depression, a loss in the joy of sex, a breakdown of marital bonds and even divorce.

What’s more, after all of the time, trouble and money placed in the hands of the average fertility expert, there is no guarantee of success. In fact, on average, the success rate of most fertility clinics is far less than a 50/50 chance.

Fortunately there is a fertility clinic serving the Greater Phoenix, Scottsdale and Southeast Valley communities that considers the average to be sub-par.

“Success rates in this part of the country have historically not been as high as some other areas,” says Nathaniel Zoneraich, MD, FACOG. Dr. Zoneraich is Board Certified and received both his undergraduate and medical degrees from the Cornell University. Before moving west to open Advanced Fertility Care, Dr. Zoneraich completed a four year OB/GYN residency, a three year fellowship in Reproductive Endocrinology & Infertility and spent several years in private practice on the East Coast. “My model is a little different,” says Dr. Zoneraich, whose practice, he feels combines the best talent, the best science and the latest technology with an extraordinary attention to detail. In the first few years after opening his doors, his success rates are proving the value in his model.

Advanced Fertility Care Success Rates: (October 2006-September 2007)

AgeAverage Number
Embryos / Transfer
Clinical Pregnancy /
Embryo Transfer
IVF Cycles Age <352.159.3%
IVF Cycles Age 35-372.383.3%
IVF Cycles Age 38-402.471.4%
Egg Donor / Recipient2.083.3%
Frozen Embryo Transfer2.266.7%

Dr. Zoneraich’s success has made him confident enough that, under certain conditions, he offers a full, 100% money-back guarantee. Unlike other centers that limit the guarantee to one cycle, Dr. Zoneraich gives patients 3 fresh IVF attempts to get pregnant. The benefit of the guarantee is that patients know they will either carry a baby home from the hospital, or have the funds returned to them to put towards their next step of either donor egg or adoption. Clinics that do not offer a guarantee often try to dismiss it as a gimmick. Dr. Zoneraich disagrees. “A 100% money back guarantee is an insurance policy for the patient. Individualized care means giving patients the right to choose. A guarantee is not right for every patient, so we also offer single cycle plans and package plans without a guarantee and allow patients to make a personal decision. A clinic must have high success rates in order to be able to offer patients a guarantee. If a clinic will not offer a guarantee to qualifying patients, a patient ought to ask why.”


Care In The Details

Personal care is more than just being friendly with your patient. It means empathy, compassion, and listening to your patients to ensure a positive outcome. Dr. Zoneraich is confident that his success rates are due in part to the attention given to every detail in his office. “I see every patient on every visit. I do all the procedures myself. I even do all their ultrasounds,” he adds. “Most of the other fertility centers have nurses doing the ultrasounds, but the patients actually get to see me every time, and that helps me to ensure consistency and catch the important, small details.”

Details In Diagnosis A big component of individualized care is performing appropriate diagnostic testing, allowing Dr. Zoneraich to zero in on the real reasons for infertility. It’s why his success rate is so high, even though the treatments are often less invasive. “I do a thorough diagnostic evaluation so we can learn exactly why they aren’t getting pregnant, and only then do I recommend the least aggressive and least expensive treatment that is medically appropriate to get them pregnant,” says Dr. Zoneraich.”There are too many places out there that are more like factories funneling people through the most profitable treatment, which is in vitro fertilization (IVF). It is critical that patients spend time with me understanding what is causing their infertility before jumping into IVF. Dr. Nathaniel Zoneraich has seen many patients who come to him after other fertility specialists have failed. Often, this failure could have been avoided. “If a patient has some kind of abnormality in their uterus, like polyps or fibroids, that can be addressed surgically. Way too often I see people coming in with medical records where this sort of testing is not even done. They’ve been put through treatments as extensive as three cycles of IVF and no one has bothered to look,” he says. “That’s not my way,” he stresses.Advanced Fertility Care’s approach always looks to the least expensive, least invasive way possible to help a family bring a baby home, but that doesn’t mean their services are limited to initial steps. Dr. Zoneraich offers the widest range of some of the most technologically advanced treatment options. From simple ovulation induction therapies to complex IVF with pre-implantation genetic screening, the facility is completely equipped to perform exactly the right procedures required with care and precision. Services include all forms of fertility diagnosis and treatments, recurrent miscarriage diagnosis and treatment, endocrine dysfunction, and advanced reproductive surgery. All procedures including hysterosalpingogram (HSGs), diagnostic and operative hysteroscopy and laparoscopy are performed in their attached, state licensed surgery center. “I wanted to have a surgical facility that’s all encompassing, that if someone needed surgery, I can do that right here, with exactly the right equipment, and where the patient and I both know the staff,” Dr. Zoneraich explains. “Most of the ambulatory surgery centers around here are very busy. Here, we can get and give personalized attention.”


A World Class Fertility Lab Dr. Zoneraich is quick to admit that he is not the sole reason for his top success rates. “Our high success rates at the fertility center come from a close partnership between me and my embryology lab,” he says. The lab, which specializes in both embryology and andrology, is both CLIA (Commission on Laboratory Accreditation) and CAP (College of American Pathologists) certified. The lab has brand new equipment, meeting or exceeding the highest available standards for an embryology lab.Perhaps more important than the quality of the lab, though, is the quality of the people who work there. “My senior embryologist has been working with human embryos now for 14 years,” Dr. Zoneraich explains. “That’s a tremendous amount of experience today, because most embryologists started their career in veterinary science before moving up to human embryos. In addition to having one of the top embryologists in the country, I also have an outside laboratory director who is a world authority in all aspects of Assisted Reproductive Technologies (ART). “They are both phenomenal, and by working together so well, we can guarantee success for our patients,” says Dr. Zoneraich.


Lab Research: Day 3 vs Day 5 Transfers Another reason for Dr. Zoneraich’s success rates can be attributed to his obsession with reading and implementing the latest scientifically proven treatments in the field. “I try to attend at least two conferences per year with the top scientists and doctors in the reproductive arena.” Recently, many questions have arisen about when to transfer embryos.The benefit of culturing embryos past day 3 is to be able to select the embryo with the best chances for implantation. Current culture systems, at best, cannot yet perfectly mimic the conditions inside the womb. Even when culturing embryos in a computerized incubator, some small amount of damage is incurred daily in order to gain the much larger benefit of selecting the best embryo(s). However, extended culture is only advisable when we have significantly more embryos than what we are willing to transfer.Scientific research has shown that attempts to select good-looking morula-embryos on day 4 does not correlate with pregnancy success. Embryologists that attempt to select embryos on day 4 often mistakenly select lesser quality embryos for transfer. This is partly due to the fact that embryos on day 4 are in the transition stage between being fed by the maternal egg yolk and the newly acquired ability to feed themselves. Thus, the leading field research tells us to not even evaluate embryos on day 4; they are best left undisturbed in the incubators. Dr. Zoneraich says that, “we strive for day 5 blastocyst transfers as these correspond to the highest published implantation rates noted in scientific literature.” (Gardner & Lane, 2003).


The Future: Single Embryo Transfer Dr. Zoneraich strictly limits the risk for multiple pregnancies by rarely transferring more than two embryos at a time. Unfortunately, given the high quality of the lab, this still leaves the chance for a high twin pregnancy rate. Dr. Zoneraich comments that “twin pregnancies are not benign, but pose significant risks to the babies and the mother. Twin pregnancies can be prevented only by transferring single embryos. However, patients fear that a single embryo transfer may compromise their pregnancy chance or mandate more treatment cycles.”Due to the consistently high implantation rates achieved at Advanced Fertility Care, they are now offering certain patients the option of choosing a single embryo transfer. Dr. Zoneraich notes that, “I believe this to be the future of our field.”


A Personalized Donor Egg Program Care and attention to detail is even applied at the donor level. Many fertility centers depend on donor agencies to find young women willing to donate their eggs. This means that the keystones of what a baby will be (and become) are left to an agency, outside of the control of the people who care most. “Using donor agencies can be an expensive and emotional rollercoaster for someone looking to get pregnant,” says Dr. Zoneraich, who instead chose to build a sophisticated in-house donor program. “We do a potential donor’s initial testing up front, so before that donor makes it to our active list, they’ve actually been screened,” he explains. “They’ve had personal interviews with our donor coordinator. They’ve had a personal interview, physical examination, and consultation with me. I’ve done an ultrasound and we’ve done their initial hormonal evaluation so we know that they have enough eggs of good quality, and that their blood levels are appropriate. All this means there is a 99 percent certainty with the rest of the testing we do after a recipient picks them that they won’t get rejected, which is huge emotional and financial benefit to our recipient couples.”Advanced Fertility Care has a dedicated donor coordinator who acts as the liaison between the donor and the recipient couple. “There’s a bit of mental match-making going on in her head based on personality, based on looks,” Dr. Zoneraich adds. This is all achieved with the most advanced privacy protection protocols, so that donations remain completely anonymous.Many graduates of Advanced Fertility Care are now just beginning to come out of diapers, and there’s a steady march of new babies out there or on the way. One patient summarizes the effect of Dr. Zoneraich’s care and attention to detail: “Dr. Zoneraich provides extremely personal attention. Unlike other doctors, I didn’t feel like a number with him. He was so attentive to everything. He just amazed me because I knew he cared. His personal touch meant the world to us.” The patient also had one more thing to add: “I am due in September.”

There is hope. Are you ready to make your miracle happen?