welcoming new babies live, but for many other getting pregnant can be a financial, physical

and emotional challenge. Today we are focusing on In Vitro Fertilization, or IVF. NBC’s

chief medical editor Dr. Nancy Snyderman is live from an operating room at St. Luke’s

Hospital in St. Louis. Nancy, good morning to you!

Nancy Snyderman: Good morning, Savannah. I’m here with Dr. Sherman Silber sitting right

here to the right of me and patient in front. What we’re looking at on the screen are

ovaries with follicles with eggs in them. Remember they’re being harvested this morning.

You know 40 years ago there wasn’t much of an option for an infertile couple in order

to go ahead and have a baby. But boy has technology changed. So this morning for the first time

on live television, you’re not only going to see eggs being retrieved from the ovary,

but we’re going to show you the fertilization process.

But first I’d like to introduce you to a couple who very graciously allowed us to be

a part of their experience.

[music] Dr. Sherman Silber is a renowned fertility expert and a pioneer in something commonly

known as IVF.

Sherman Silber: It’s short for In Vitro Fertilization, which simply means fertilization

takes place in a laboratory dish.

Female nurse: The pregnancy will implant there.

Nancy Snyderman: Thirty-three-year-old Jessica Menkhausen and her fiancé Derek Manion are

Silber’s patients, excited about the possibility of having a baby together.

Jessica Menkhausen: That’s where our baby is going to be.

Nancy Snyderman: Jessica had tried for nine years to have a baby and had almost given

up on her dream of motherhood.

Jessica: It took years to get over it. I was really glad when we met Dr. Silber. He did

give us so much hope.

Dr. Silber: Hi Jessica!

Nancy Snyderman: Jessica has been undergoing IVF pre-treatment for four weeks now, injecting

hormones and getting regular blood work.

Jessica Menkhausen: Hopefully these children know one day when we show them this how much

we wanted them.

Nancy Snyderman: And today, news that the medicine has worked. Jessica’s ovaries have

produced a large number of follicles, which house the eggs that will be fertilized with

Derek’s sperm.

Dr. Silber: If we count them, that count gives us an indication of how many eggs you’re

going to have. And it’s just a huge count.

Nancy Snyderman: The couple have put off wedding plans until next year, citing the cost of

IVF, which averages $12,000 to $17,000 per cycle. And it’s often not covered by insurance.

Jessica Menkhausen: We are borrowing to do this.

Nancy Snyderman: And they’re telling their personal story here, hoping to inspire others.

Jessica Menkhausen: It’s amazing to think what science can do now and how it can help

us out in conceiving.

Nancy Snyderman: It’s an all or nothing gamble for Jessica and Derek who are spending

their savings on what for them is a once in a lifetime chance at parenthood.

Jessica Menkhausen: We’re terrified of spending this amount of money and then it not working.

If it doesn’t we’ll be sharing bad heartbreak together. But it will be heartbreaking.

Nancy Snyderman: They say they can’t afford to do it again but remain hopeful about the

outcome.

Jessica Menkhausen: I want to be positive, and I think that we’re going to have twins.

I think that they’re going to have red hair and blue eyes. [laughs] That’s what we have

to keep thinking.

Nancy Snyderman: Right now Dr. Silber is inserting a micro-needle with a little suction into

the ovary and each of these black sacks you see really houses an egg. Those are being

sucked out and then will be examined behind us.

Can you feel that when you go in there and you’re looking at that egg, you know visually

exactly where you are?

Dr. Silber: I know visually exactly where I am, and I also can feel it in answer to

your questions. Like there is a follicle right there. We’re all right through.

Nancy Snyderman: That white line is the needle?

Dr. Silber: That white line is the needle. That opening, that little sack you see, has

an egg in it. They’re really nice and big size, so we know we’re going to have good,

mature eggs in there.

Nancy Snyderman: You’re already finding a lot of eggs. Is that because she’s been

on stimulating hormones?

Dr. Silber: Well she’s been on stimulating hormones, but some women on stimulating hormones

do not have that many eggs. It depends. She started out with a lot of eggs … let’s

go for this one here.

Nancy Snyderman: So this bodes well for her to have such big follicles and have so many?

Dr. Silber: Yeah. We’re excited. She has very few small follicles, and those are the

follicles that cause patients to get sick from IVF. The way we stimulated her, we have

only big follicles. These big follicles are going to be mature. They’ll have …

Nancy Snyderman: And this is a safe procedure with these medications for Jessica, right?

Dr. Silber: It really is safe if done right. If not done right it could be dangerous. [laughs]

Nancy Snyderman: I have to underscore it. That’s exactly why you go to a center where

IVF is not only established but doctors have been doing it for years and years and years.

So that one, you harvest healthy eggs. Two, it results in healthy babies. And three, the

health repercussions long term for mom, miniscule. [crosstalk]

That’s it. Savannah we’ll be back to you shortly. Hey Matt.

Matt Lauer: Can we just ask you real quickly, she is sedated but will there be discomfort

from this procedure, you know, in the coming hours or days?

Nancy Snyderman: She is sedated and there will not be discomfort. There is a vaginal

probe in her, which allows us to see the ovary, but it’s no more different than a pelvic

procedure. So no, she’s going to have minimal discomfort, and they’ll watch for a little

bleeding afterwards but they expect no complications. This has been going absolutely perfectly this

morning.

Savannah Guthrie: We hope that continues. Dr. Nancy Snyderman, thank you so much. We

know that in our next half hour she’s going to be there. We’ll watch the procedure live

on television. This is the first time when Jessica’s eggs are fertilized. We hope … we

are rooting for them.

Matt Lauer: Yeah, I was going to say after you hear their story how can you not root

for them? [crosstalk all] It’s been successful in so many other couples around the country

as well. [break]

Savannah Guthrie: But first in our series Born Today. In the last half hour, Dr. Sherman

Silber conducted the first part of an IVF procedure retrieving Jessica’s eggs in the

operating room. Now hold onto your French fries men. We’re going to turn to Dr. Nancy

Snyderman. She’s actually moved into the lab where we’re hoping to capture a conception

process live.

Jessica and Derek are in the recovery room. They’re ready to watch. Dr. Nancy good morning.

Fill us in on what’s going on.

Nancy Snyderman: Hey you guys. Let me orient you because this is one of the coolest things

you’re ever going to see. This is just a pipette that’s holding an egg in place.

This is an egg that was taken from Jessica just a few moments ago.

This little thing on top is called a polar body. I’m only telling you that because

the egg has to be oriented in space. What you’re going to see Kathy do right now with

a needle on this side, which has a sperm in it, is puncture the outer layer of this egg.

You’re going to see how tough it is. That little sperm is right there – pop into it

– the sperm will be released, and as soon as she knows the end of the needle is there,

boom, there went the sperm. The sperm is right there. This is now a fertilized egg. Conception

has taken place.

And this now will be put into a special medium for the next 48 hours as a fertilized egg

and observed. You have now for the first time ever on television seen a sperm go into an

egg, and that’s modern IVF. That is cool stuff.

Carson Daly: That’s amazing … [claps] [crosstalk]

Nancy Snyderman: We’re going to keep doing more. I know Matt you’re going to really

love this part as Kathy goes ahead. These are sperm that are swimming around in this

special solution. [crosstalk]

Matt Lauer: Not sure where you’re going with this Nancy.

Al Roker: Matt really loves to see that.

Nancy Snyderman: She whacks the tail off the sperm.

Matt Lauer: Yeah, no, it’s amazing. Now you have a fertilized egg. And then they will

implant those fertilized eggs in Jessica. How long will we know, or will it take, to

know if this is a viable pregnancy?

Nancy Snyderman: So, we got a lot of eggs out of her today. Again, there’s the sperm

and the needle. Pop in, the sperm goes back up. Boom, it’s in. Another fertilized egg.

Forty-eight hours these will be watched. They’ll now start to grow under the microscope, and

then Dr. Silber because he’s a very ethical doctor only implants two. You’ve heard of

the controversies before where there are too many fertilized eggs put into women. The uterus

is not a condominium. You put in two hoping for one or two healthy babies in pregnancies,

right?

Dr. Silber: And we can freeze the extras safely.

Nancy Snyderman: She can hold onto them for a long, long, long time. And in some cases

even be given to other women.

Dr. Silber: Absolutely. And they will never be hurt by our freezing process.

Nancy Snyderman: So this is safe for mom, cool for dad, great for science.

Savannah Guthrie: Well Nancy you really have a way with words. The uterus is not a condominium.

I will remember that forever. [laughing]

Nancy Snyderman: This is pretty neat. So we’re just going to stand here and again watch this

go on and on and on and keep fertilizing these. A lot of sperm. Very healthy. And with these

eggs being able to be held here by suction, they have 26, 27, 28 eggs were harvested.

And they’ll all be fertilized and then stored.

Then the best ones will be implanted in Jessica, and we will follow up with Derek and Jessica

over the next couple days and months. I have no reason to not expect that this is going

to result in a healthy pregnancy.

Dr. Silber: I’m sure this is going to work.

Nancy Snyderman: I have to tell you doctor talk earlier, we were also saying she has

a really good-looking uterus. So I think this is going to be a go. [all laughing] [crosstalk]

All is good at St. Luke’s in St. Louis.

Matt Lauer: [crosstalk] Well thanks for the folks out there for letting us do that.

Savannah Guthrie: Guys is that the first IVF procedure you’ve watched with French fries?

Carson Daly: Yes. [crosstalk]

Savannah Guthrie: Let’s just acknowledge the weirdness of that. [all laughing]

Al Roker: It’s called dinner and a show. [crosstalk]

Savannah Guthrie: Bizarre. We’ll keep track of Derek and Jessica to find out what happened.

[break]

Savannah Guthrie: Last month during our Born Today series you may remember we introduced

you to Jessica Menkhausen and her fiancée Derek Manion. They let us go on their journey

with them as they underwent IVF live on our air.

Well, NBC’s chief medical editor Dr. Nancy Snyderman is here to give us an update on

how they’re doing. Nancy, good morning.

Nancy Snyderman: Good morning, Savannah. Our cameras were there when Jessica underwent

In Vitro Fertilization; in this case something called ICSI. Since then we have been following

this pair, and this morning we have chosen to take it one step further and they’re

going to share the results with us.

Jessica Menkhausen: I want to be positive, and I think we’re going to have twins. And

I think they’re going to have red hair and blue eyes. [laughing]

Nancy Snyderman: After struggling with fertility issues for nearly a decade, 33-year-old Jessica

Menkhausen and her fiancée Derek Manion are excited about the possibility of starting

a family.

Jessica Menkhausen: Hopefully these children know one day how much we wanted them.

Dr. Silber: That’s really the moment of conception.

Nancy Snyderman: That moment, a first on live television, fertilization, via IVF. [from

previous broadcast] This is now a fertilized egg.

Dr. Sherman Silber, a fertility expert, performed the procedure.

Dr. Silber: I want to have enough frozen embryos that we can be guaranteed that she’s going

to get pregnant.

Nancy Snyderman: Back at the hospital three days later, the anxious couple learned how

many of Jessica’s fertilized eggs had grown into viable embryos.

Dr. Silber: So this one is not so equal sized.

That is gorgeous! That is an eight-cell embryo. That is a baby right there.

Nancy Snyderman: Dr. Silber chooses two good embryos for transfer into Jessica’s uterus,

and then shares the news.

Dr. Silber: Okay, so we did really, really well. This is for your baby album. These are

the two embryos.

Nancy Snyderman: Jessica remains awake and watches with Derek as Dr. Silber gently places

the embryos.

Dr. Silber: And, uhh, those are your babies.

Nancy Snyderman: It will take 10 days to find out if Jessica is pregnant.

Jessica Menkhausen: I think I’m just going to keep our positive thoughts.

Dr. Silber: This is the big, unknown period of what is happening inside her uterus. I

recommend that they try to relax.

Jessica Menkhausen: Worrying is not going to change what’s going to happen.