Infertility Center of Saint Louis: A Complete Patient Guide
The Infertility Center of Saint Louis occupies a singular position in the St. Louis fertility market — and, to a meaningful extent, in American reproductive medicine as a whole. Located at St. Luke's Hospital in Chesterfield, Missouri, the center has been performing IVF continuously since 1985, making its embryology lab one of the longest-operating in the United States. While the St. Louis region is home to several competent fertility practices, this clinic stands apart by the depth of its clinical history, the international reputation of its founding physician, and its willingness to treat complex cases that other programs might decline. Patients considering fertility care in Missouri should understand what distinguishes this practice before making a decision.
Physicians and Clinical Team
The clinical identity of the center is inseparable from its founder, Dr. Sherman J. Silber, M.D., who is widely regarded as one of the most accomplished reproductive microsurgeons in the world. Dr. Silber completed his medical degree at the University of Michigan and pursued post-graduate training at Stanford University, the University of Melbourne, and the University of Michigan. He holds adjunct professorships at the University of Amsterdam, the University of Michigan, and Sun Yat Sen University Medical School in China, and has collaborated with research teams at MIT Cambridge and the Kato Clinic in Tokyo.
His record of world-first procedures includes the first microsurgical vasectomy reversal in the 1970s, the first testicle transplant, the first ovary transplant of the modern era, and the development of TESE, MESA, and ICSI for male-factor infertility. He headed the clinical MIT team that mapped the Y chromosome and was among the first U.S. physicians to introduce vitrification for egg and embryo cryopreservation. Dr. Silber has authored six medical textbooks and five books for general audiences — including How to Get Pregnant (Little, Brown and Company) — along with more than 250 peer-reviewed scientific papers.
Dr. Michael DeRosa has been a clinical partner for over 28 years and is widely regarded as one of the most respected fertility physicians in Missouri and the broader Midwest. A New Jersey native and Air Force veteran, Dr. DeRosa brings decades of obstetric and reproductive surgical experience to the practice.
Dr. Yuting Fan completed training at Sun Yat Sen Medical School, conducted research at MIT, and pursued fellowship-level work at the University of Michigan before joining under Dr. Silber's mentorship. Her focus areas include IVF, reproductive endocrinology, and minimally invasive surgery.
Services and Treatments
The center offers one of the most comprehensive treatment menus of any fertility practice in Missouri:
IVF and Mini-IVF: Standard IVF is available for patients with adequate ovarian reserve (typically defined as 15 or more eggs retrieved). The center has also developed a robust Mini-IVF protocol — a minimal stimulation approach that uses lower medication doses, targets fewer but high-quality eggs, and significantly reduces the cost of a single cycle. Mini-IVF is particularly well-suited to patients with diminished ovarian reserve or those who respond poorly to aggressive stimulation.
Male Infertility: Dr. Silber's microsurgical expertise makes the center a regional destination for male-factor infertility. Services include microsurgical vasectomy reversal, tubal ligation reversal, TESE, MESA, and ICSI — all performed with the microsurgical precision that defined Dr. Silber's early career.
Genetic Testing: Preimplantation genetic diagnosis (PGD) and comprehensive embryo genetic testing are available for patients at elevated risk of heritable conditions or recurrent pregnancy loss. Learn more about how IVF integrates with genetic screening in our full treatment guide.
Fertility Preservation: Egg freezing, embryo freezing, sperm freezing, and — uniquely — ovarian tissue freezing and transplantation are all offered. The ovarian tissue transplantation program, pioneered by Dr. Silber, is one of the few in the world and has particular relevance for oncofertility patients facing gonadotoxic treatment.
Third-Party Reproduction: Donor egg programs and gestational surrogacy services are available for patients who require them.
Telemedicine: Initial and follow-up consultations can be conducted via telemedicine, which is particularly useful for patients traveling from outside the St. Louis metropolitan area.
Laboratory and Success Rates
The center's IVF laboratory, established in 1985, pre-dates most fertility clinic labs in the country. The facility features vitrification technology for egg and embryo cryopreservation, HD 3D ultrasound diagnostic equipment, and an integrated treatment-and-lab suite designed to minimize sample handling time between retrieval and culture. The embryology team is described as internationally recruited, reflecting the center's global clinical network.
The clinic publishes its own internal outcome data — an important practice, though patients should note these figures reflect pregnancy rates rather than SART-reported live birth rates. For standard IVF with good ovarian reserve (15+ eggs), the center reports a 62% pregnancy rate for patients under 30 and 30–39 years of age, dropping to 31% for patients 40 and older. Mini-IVF frozen embryo transfer shows a 47% pregnancy rate for patients under 30, 43% for those aged 30–39, and 23% for patients 40 and older. A newer Denmark Mini-IVF protocol shows a cumulative pregnancy rate of 59% across all age groups in early internal data.
Critically, the center explicitly states that it does not cancel cycles because of a low follicle or egg count — a policy that lowers the apparent success rate compared to programs that discard poor-responding cycles before retrieval. Patients with complex diagnoses or low ovarian reserve may find that context especially meaningful when comparing numbers across clinics.
Patient Experience
The center maintains a 4.6-star average rating on Google across more than 155 reviews, with patients consistently noting Dr. Silber's depth of knowledge and willingness to take on difficult cases. The clinic offers free initial consultations, which lowers the barrier for new patients evaluating their options.
Patient feedback also reflects the realities of a high-demand boutique practice. Because Dr. Silber travels internationally for research and teaching, some patients have noted longer waits during peak appointment periods or when scheduling overlaps with his academic commitments. Patients who value continuity with a specific physician should discuss scheduling expectations during their initial consultation. Dr. DeRosa and Dr. Fan provide clinical coverage and direct patient care during those periods.
The Chesterfield location adjacent to St. Luke's Hospital — consistently ranked among the best hospitals in Missouri — provides access to hospital-grade surgical facilities and emergency support that standalone fertility clinic buildings cannot match.
Considering At-Home Insemination?
Not every fertility journey begins in a clinic. At-home intracervical insemination (ICI) is a lower-cost, private option that suits patients with no known fertility diagnosis — including single parents by choice, same-sex couples, and people who want to try a few cycles before committing to clinical treatment.
At-home insemination kits like those from MakeAMom come with step-by-step instructions designed for donor or partner sperm. Kits are a one-time purchase that can be reused until conception succeeds, require no clinic visit, and arrive in plain, discreet packaging. Many patients use them as a first step while working toward a fertility consultation — or alongside ovulation tracking while they wait for an appointment slot.
If you have a known fertility diagnosis, have been trying for 12 months without success (six months if you're over 35), or your physician has already recommended IUI or IVF, a board-certified reproductive endocrinologist is the right next step.
Insurance and Financing
Missouri does not mandate that private insurers cover IVF or other assisted reproductive technologies, which means most patients at this clinic will pay for treatment out-of-pocket or with limited insurance assistance. Diagnostic testing and some medications may be reimbursable depending on individual plan terms, but full IVF cycles are rarely covered under standard Missouri-issued health plans.
The Mini-IVF protocol was specifically developed, in part, to reduce cycle costs. Because it uses fewer medications and targets fewer eggs per retrieval, medication costs are substantially lower than in a conventional stimulation cycle. For patients who are not good candidates for standard IVF — or who are pursuing fertility preservation on a budget — this can meaningfully change the financial calculus.
The center does not prominently advertise third-party financing partnerships, so patients interested in loan-based financing options should inquire directly. For a broader look at fertility treatment options across the state, see our guide to fertility clinics in Missouri.
Frequently Asked Questions
What makes the Infertility Center of Saint Louis different from other St. Louis fertility clinics? The center's 40-year continuous operating history, Dr. Silber's record of world-first procedures, and its willingness to accept complex cases that other programs decline set it apart. It is particularly well-suited for patients with male-factor infertility, diminished ovarian reserve, or prior failed cycles elsewhere.
Is Mini-IVF the right choice for everyone? No. Mini-IVF is best suited for patients with low ovarian reserve, those who respond poorly to aggressive stimulation, or those seeking to reduce medication costs and side effects. Patients with good ovarian reserve may retrieve more usable embryos through a standard protocol. Dr. Silber's team can help determine which approach fits your individual situation.
Does Dr. Silber personally perform all procedures? Dr. Silber is the center's primary physician, but Drs. DeRosa and Fan share clinical responsibilities. Patients are encouraged to ask explicitly about which physician will oversee their specific cycle at the time of consultation. Dr. Silber's full biography and credentials are available on the clinic's website.
Does Missouri require insurance coverage for IVF? No. Missouri has no state mandate requiring insurers to cover IVF. Patients should review their own insurance plan documents carefully and contact their HR benefits department to understand any available fertility benefits before beginning treatment.