Reasons to have IVF
IVF is usually not the first treatment option for infertile
couples. Your doctor may try other options including
fertility medications or IUI before resorting to IVF.
IVF may be advised if you or your partner have been
diagnosed with any of the following problems:
- Endometriosis
- Ovulation problems
- Damaged or blocked fallopian tubes
- Problems with the uterus
- Low sperm count or sperm motility problems
- Unexplained infertility
What should you do if you think you
need IVF?
Most couples will get pregnant on their own within
12 months of actively trying to get pregnant simply
by having regular unprotected intercourse. If you have
been trying to get pregnant on your own and are concerned
that you might have fertility problems, it is good to
start off by seeing a general gynecologist. You should
talk to your general gynecologist about your concerns,
discuss your medical history, and ask him at what point
he would refer you to a fertility specialist. If you
are under 35 and have been trying to get pregnant for
a year or more, your doctor may refer you to a fertility
specialist. If you are 35 or older, your doctor may
refer you for fertility treatment after just six months
of trying.
Tests that are done before IVF:
Before resorting to IVF, your doctor may want to do
some testing to determine what is causing your fertility
issues. Some tests that are commonly done before IVF
include:
- HIV & hepatitis test: (for
safety reasons you and your partner’s blood
will need to be tested prior to having IVF)
- Female fertility tests: Before
having IVF, you may be required to have blood testing
done to check your hormone levels, determine egg quality,
and verify whether or not you are ovulating. Your
doctor may also want to check the structure of your
uterine cavity and check for any blockage of your
fallopian tubes. You may be given a test called an
HSG, or hysterosalpingogram,
which is a special x-ray of the uterus and fallopian
tubes. It allows your doctor to see any abnormalities
in the uterus or if your tubes are blocked.
- Male fertility tests: Your partner
may be required to have a semen
analysis done before having IVF. A sample
of your partner’s semen may be sent off for
analysis to check his sperm count, sperm motility,
and sperm quality.
- Mock Transfer: Some clinics will
do a mock transfer before doing IVF. During a mock
transfer, your doctor will insert a catheter into
your uterus, much like he would during a real transfer.
This mock transfer allows him to measure the depth
of your uterus and to determine the best way to insert
the catheter during the real transfer.
IVF Treatment: What to expect
IVF involves fertilizing your eggs in a laboratory
dish and then transferring them back into your body.
In order for IVF to be successful, you will need to
ovulate and produce multiple eggs for fertilization.
To make this happen, your doctor will give you fertility
medication at the start of your cycle that will stimulate
your ovaries to produce several mature eggs for fertilization.
Your doctor will have you come in for blood work and
an ultrasound to check the development of your eggs.
Once your eggs are mature, your eggs can be retrieved
for fertilization.
You may be sedated or given local anesthesia for the
egg retrieval procedure. The eggs are removed from your
ovaries by inserting a thin needle through the back
of the vagina. Using an ultrasound to guide him, your
doctor will gentle suction the eggs and follicular fluid
into test tubes. You may feel some cramping on the day
of the procedure. Your doctor may prescribe pain medication
to relieve discomfort.
Your partner will provide a semen specimen the day
of the procedure. This semen will be used to fertilize
your retrieved eggs. If your partner has a low sperm
count, a procedure called intracytoplasmic sperm injection
may be performed in combination with IVF. This procedure
takes a single sperm and injects it directly into the
egg to fertilize it.
Your partner’s sperm and your eggs will then
be placed inside a laboratory dish and monitored for
up to five days. Each of your eggs will be watched until
they develop into a group of cells called an embryo.
Once your embryos are ready, they can be transferred
into your uterus. Your doctor will place up to four
embryos inside your uterus during the transfer. To transfer
the embryos, he will insert a thin catheter through
your cervix and into your uterus, releasing the embryos
at the top of your uterus. After the embryos are transferred,
you will need to rest. You may stay in bed for several
hours following the transfer before you are discharged.
If the transfer was successful, you should know within
a couple weeks.
IVF Success Rates
IVF success rates vary. Certain fertility problems
are more challenging to treat than others. Your age
is also a big factor in the success rate of IVF. Likewise,
some clinics have higher success rates than others.
The CDC keeps track of statistics for all assisted reproductive
technology procedures performed in fertility clinics
in the US. According
to the most recent report from 2005, the
percentage of cycles resulting in live births is approximately:
- 37% for women under age 35
- 30% for women age 35-37
- 20% for women age 38-40
- 11% for women age 41-42
Chances of having twins with IVF
If you have IVF, you will have a higher chance of having
twins or multiples. Having twins or multiples puts you
at a higher risk for having a miscarriage or other pregnancy
complications. During each IVF cycle you can transfer
up to four embryos. Transferring four embryos will improve
your chances of getting pregnant, but it will also increase
your chances of having a multiple pregnancy.
According
to the CDC, the percentage of IVF pregnancies
with twins is approximately:
- 33% for women under age 35
- 27% for women age 35-37
- 22% for women age 38-40
- 13% for women age 41-42
How much does IVF cost?
According to the American Society of Reproductive Medicine,
the average cost of one IVF cycle is about $12,400.
The price for IVF, however, will vary depending on where
you live and the amount of cycles you have done.
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