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Houston Fertility Journal

    8 Frequently Asked Questions about IVF

    October 29, 2018 / by Center of Reproductive Medicine   

    Center of Reproductive Medicine


    Few things are as startling or gut-wrenching for a couple as infertility. It can feel like the end of the world, as if your hopes of starting a family are completely dashed. But that isn’t always the case. Thanks to the miracle of modern medicine, fertility specialists are able to help many who wish to be parents finally bring their little bundles of joy into the world.

    One of the most useful tools for overcoming infertility has been in vitro fertilization, commonly known nowadays as IVF. Yet, despite how this process has proven to be an effective way to treat infertility, the details involved in what IVF is and how it works remain a mystery to many who would actually benefit from it. We know you may have questions about IVF. So let’s take a few minutes to demystify it and go over the top 8 most frequently asked questions about IVF.

    What Is IVF, and How Does It Work?

    To start with, let’s establish what IVF is on a fundamental level. The process begins by extracting eggs and sperm samples and combining them in a laboratory setting. Then, once the eggs have been fertilized, the resulting embryo (or embryos, as the case often is to maximize success levels) is implanted into a woman’s uterus. In the ideal circumstances, IVF results in a fertilized egg (again, or eggs) that successfully implants, leading to pregnancy. However, the conditions must be just right for this to work (more on that later).

    That’s the broad description, but as you can imagine, IVF is far more complicated than this. Before anything else happens, your specialist will boost egg production by administering prescribed fertility medication. By stimulating the creation of more eggs, this gives the optimum chance that one or more can be fertilized to create a viable embryo. A number of tests follow, including a transvaginal ultrasound and blood work. Once the time has come, the eggs are retrieved during a relatively painless surgical procedure that uses ultrasound imaging to guide a hollow needle into the woman’s pelvis.

    Once the eggs have been retrieved, the sperm sample is manually combined with the eggs to (hopefully) achieve fertilization in a process known as insemination. In some cases, the sperm will need to be injected directly into an egg. This process — called intracytoplasmic sperm injection (ICSI) is used specifically for cases wherein fertilization appears less likely. A few days after fertilization, the embryo(s) are transferred into the woman’s uterus using a catheter for implantation. From there, you’ll know within two weeks whether you are indeed pregnant.

    Is IVF My Only Option?


    Now that you understand how IVF works, perhaps you don’t think it’s the right decision for you at this time. That’s totally understandable, as undergoing IVF treatment is a huge step. Thankfully, you have other means at your disposal to boost your fertility levels. The most popular alternative to IVF is intrauterine insemination (IUI). In this procedure, fertilization occurs by depositing sperm directly into a woman’s uterus. In some cases, this may actually be preferable to IVF. For instance, if the male has a low sperm count or the female has a disorder that might be preventing a successful pregnancy. In addition, IUI might be the best choice in situations wherein donor sperm is being used or if you’ve exhausted other, less invasive options.

    Of course, you shouldn’t necessarily opt directly for IVF or IUI to boost fertility. There are a number of other measures you can first. In many cases, simple lifestyle changes — such as losing weight, quitting smoking and reducing alcohol consumption — may improve your fertility dramatically. Also, be aware of any medications you may be taking, as they may be conflicting with your fertility, and consider taking hormone medication to encourage ovulation or support early pregnancy. Even by keeping a close eye on your menstrual cycle, you may be able to identify a larger issue standing in the way of you and your successful pregnancy. If all these fail, you could consult with your specialist to see if you need to undergo fertility surgery or other procedure to address any lingering issues.

    How Do I Know if I’m a Good Candidate for IVF?

    We’ve established that IVF isn’t the right path for everyone experiencing fertility issues, but there are a few signs that you should seriously consider IVF. For the most part, IVF works best for women who are experiencing infertility due to an obstacle such as a blocked or damaged fallopian tube or a severe case of endometriosis. These ailments are problematic in achieving fertilization by traditional means but are surmountable with the aid of a process like IVF. In addition, other unexplained fertility issues may be solved by IVF as can irregular ovulation cycles, since the treatment is already intended to induce ovulation. If, however, infertility is due to an issue on the male’s side, IUI might be preferable to IVF.

    On the other hand, there are some situations for which IVF is not a wise choice, and seeing as the process can be time-consuming, costly and emotional in and of itself, it’s best not to dive in unless you meet the above criteria or, at least, don’t have any significant issues standing in your way. If, for example, a woman cannot produce healthy eggs, a donor may be necessary for IVF to make sense. In fact, studies show that women over 40 have the best chances of success with IVF when they use donor eggs to achieve fertilization. So you’ll have to decide to use a donor’s eggs before you consider IVF. Also, women over the age of 37 may similarly experience limited ability to create viable eggs and any woman dealing with conditions such as ovarian dysfunction, fibroid tumors, abnormal hormone levels and uterine abnormalities might not be able to get the full benefit of IVF.

    What Do I Need to Do to Prepare for IVF?

    With any kind of detailed medical procedures, there are certain steps you need to take before you begin. So, if you and your fertility specialist do decide that you are a prime candidate for IVF, you should begin preparing yourself and your partner for the road ahead. Naturally, the emotional toll that IVF can take on you and your partner dictates that these preparations start with ensuring that you’re putting the necessary love and care into how you feel about what you’re about to embark on. For many couples, infertility can leave them feeling defeated, and you need to step up your support for each other to get through IVF. You may even wish to consider counseling or join an IVF support group, as connecting with those in a similar situation can make a huge difference.

    The other important thing you need to do to prepare for IVF is to educate yourself. Granted, reading this article will give you a baseline about what to expect from the process, but you should stay in close contact with your specialist before, during and after your procedure to answer any questions you have. Make sure that you completely understand the entire process before you begin, including the risks involved (more on that in a bit). In addition, you’ll need to undergo thorough testing to evaluate you and your partner’s health. These will help your specialist get a more accurate picture of your body’s fitness for the procedure.

    How Do I Find the Right IVF Clinic for Me?

    So you think you’re ready to move forward with IVF and understand what lies ahead. Yet, you still may wonder how you can find the right IVF clinic. We’ve got you covered there too. Determining which IVF clinic is the right fit for your specific situation is largely a matter of personal preference. Still, a few more universal criteria remain very much in play as you narrow it down to focus on the clinic that you feel would provide the best experience for your IVF treatment.

    Chief among these is that any clinic you consider adheres to the proper steps of a standard IVF procedure. Much of this basic practice has already been detailed above but remains the most fundamental qualification for any clinic you may be considering to provide your treatment. After your specialist analyzes the male’s semen, he or she will conduct a trial embryo transfer to establish more familiarity with the female’s body. Next comes the medication to stimulate egg production and the rest of the IVF process.

    You’ll also want to be vigilant about your clinic’s success rates. These statistics are among the most telling aspects of a clinic’s history and performance, revealing the odds that your treatment will be up to snuff and lead to a happy ending for you and your family. In particular, pay attention to variables that can be manipulated to extrapolate one’s success rate. Find out as much as possible about past patients, their treatments and how this data is being reported. Don’t worry. All clinics are required to provide their success rates. So you shouldn’t receive serious resistance.

    What Side Effects Can I Expect?


    As with most serious medical treatments, IVF is not without its side effects, unfortunately. As you undergo treatment, you may experience a wide variety of reactions to the drugs. Some of these are fairly expected, such as mood changes — we are dealing with hormone levels, after all — anxiety and headaches. But because of how closely IVF interacts with your body’s chemical balance, you may also experience hot flashes, weight gain or even bloating. Because your ovaries are working overtime producing eggs, there’s a small chance that you may face ovarian hyperstimulation syndrome, which can cause mild to severe symptoms.

    With all that’s going on inside you, it’s bound to be an unpredictable time for your body, but knowing what may be in the cards will inevitably help make it easier to bear.

    Because your body is creating multiple eggs, you may wind up with multiple births. Studies show that roughly 15 percent of IVF-induced pregnancies wind up with two or more implanted embryos. Likewise, if an IVF pregnancy doesn’t implant properly or some other complication arises, it’s not uncommon for a miscarriage or ectopic pregnancy to occur. An ectopic pregnancy occurs when an embryo cannot develop into a fetus because it implants outside of the uterus. This require surgical removal to prevent further damage or even life-threatening consequences. We’re not sure exactly how IVF and ectopic pregnancy are linked. So it’s best to be aware of this possibility.

    You may have heard about a dubious connection between IVF and cancer. While some research suggests a relationship between the two, digging a bit deeper reveals all kinds of statistical manipulation and fine print that reveals a minimal risk, if any at all, that cancer is in some way, shape or form connected to undergoing IVF. Again, though, it’s better to know than not. So feel free to reach out to your specialists with any additional questions. With all that’s going on inside you, it’s bound to be an unpredictable time for your body, but knowing what may be in the cards will inevitably help make it easier to bear.

    What Do I Do If My First IVF Cycle Is Unsuccessful?

    Sometimes, your first IVF cycle might not work. There are a number of reasons why this might be the case. Perhaps the ovaries were not able to produce more eggs, even with treatment. Some women are simply unable to do so, due to the presence of fewer eggs in their reserves. Age may be a factor in this lack of egg production and can also be a major reason why your IVF was unsuccessful in general. Women produce fewer eggs as time goes by, but this decline takes a sharp downturn around the age of 37 or so. Likewise, the quality of your embryo may not have been strong enough to properly implant into the uterus, possibly due to chromosomal or genetic abnormalities.

    However, even if your first IVF cycle isn’t a success, it doesn’t necessarily mean that all hope is lost. Depending on the result, your specialist may recommend a course of action that could boost your chances of a successful pregnancy. Changing to a different medication can offset an issue with ovarian stimulation or egg production, for example, or in the event of a problem with transferring the embryo, you can undergo a preimplantation genetic screening to ensure the embryos are healthy before moving on. Lastly, if there is no apparent cause behind it, your specialist may simply encourage you to try again. Only by working with your doctor can you decide what is the best way to handle an unsuccessful initial IVF cycle.

    Can I Get Pregnant Naturally After Using IVF?


    Once you and your partner have a child using IVF, you may worry that this procedure somehow makes it impossible or, at the very least, more difficult to get pregnant naturally in the future. This is a natural response, considering how IVF affects your body chemistry and is so intimately involved in the condition of your uterus. But rest assured that you can absolutely get pregnant a subsequent time after you’ve had a child through IVF. Despite everything you’ve endured to achieve fertilization and implantation successfully, a woman’s body is fully capable of forgoing the entire IVF process to get pregnant the old-fashioned way. In theory.

    Because, while IVF does not affect your body’s ability to get pregnant naturally, it also does not eliminate the issues that caused you to seek out IVF in the first place. You’ll have no guarantees that a natural pregnancy will occur, since you’ll be going it alone without the assistance that IVF provides. Nevertheless, the possibility always exists that you and your partner could get lucky and achieve a natural pregnancy, despite all the trouble you faced getting pregnant the first time. Just don’t expect IVF to have a lasting effect that magically makes it easier to get pregnant from that point onward.

    Answers Await

    If you’re facing infertility issues, know that you are not alone. Many other individuals and couples alike are working through these very same problems to have a baby, and IVF is one of the many tools you have to achieve your desired result: a beautiful baby boy or girl. Hopefully, we’ve managed to clear up some questions and/or misconceptions you have had about IVF. This process is so commonly recommended because of how effective it can prove to be, but we don’t suggest you decide on this as the right choice for your situation until you consult with your infertility specialist. If you do opt for IVF, we wish you the best of luck in adding a new member to your family soon.

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