Everything You Want to Know About In-Vitro Fertilization

Before Louise Joy Brown was born in England in 1978, no one outside the scientific community had ever heard of in vitro fertilization.

Today, this is a household term known by millions.

Unlike artificial insemination, in vitro fertilization or IVF, is a combining of eggs and sperm outside the body, generally in a laboratory setting.

Once fertilized, the eggs are placed in the uterus.

IVF can be a costly and complex procedure, with less than 10 percent of all infertile couples completing the process. However, despite these obstacles, IVF has helped couples have almost a quarter of a million babies since 1981.

What Types of Infertility Can IVF Treat?

If you or your partner have been diagnosed with any of the following:

• Low sperm count
• Problems with ovulation
• Endometriosis
• Weak sperm (sperm that does not survive or cannot penetrate the cervical mucus)
• Antibodies which attack the sperm or eggs
• Any other type of unexplained fertility issues

IVF should never be the first choice, unless it is a case of complete blockage of the fallopian tubes. Doctors will choose other options first including, surgery, fertility drugs, or artificial insemination.

Questions to Ask a Fertility Clinic

If your doctor has told you that IVF might be right for you, there are a few questions you should ask the doctor and staff at the clinic of choice

• How much does it cost to store embryos?
• How long can they be stored?
• What is the pregnancy ration per embryo transfer?
• What is the pregnancy rate of couples in our age range?
• What is the live birth rate for all couples at your clinic?
• How much does this cost? (Be sure to ask if this includes hormone treatment)

How Does the Procedure Work?

1. First, the female is injected with hormones, so that the ovaries will release multiple eggs each month, not just one.
2. Once the doctor has determined that you are ready for egg retrieval, you are given more injections which ripen the eggs and begin ovulation. Timing is very important here since eggs must be removed just before they leave the follicles.
3. Most women are sedated or given full anesthesia so that the doctors can remove the eggs using ultrasound and a hollow needle. This will take approximately 30 minutes to one hour.
4. Eggs are then immediately mixed with sperm, which he will donate the same day as your eggs are being removed. The fertilized eggs are monitored for growth.
5. Usually within 5 days, the female returns so that eggs can be inserted into the uterus. Most clinics will transfer 3 embryos and hope at least one will survive.

You will stay lying down at the clinic for 6 hours, sometimes overnight.

What Are the Chances of Pregnancy?

On average, pregnancy is achieved in about 29.4 percent, depending on the age of the woman.

Embryos that are not used in the first try are frozen for later use. If you decide you do not want the other embryos, you can donate them to an infertile couple who cannot produce their own eggs or sperm. You can also ask that the embryos be destroyed.

How to Find the Best Fertility Clinic for You?

So you’ve spent months, years, and countless tears trying to conceive a child with no luck. Your doctor has recommended that you use a fertility clinic and, most likely, he gave you a list of clinics in your area.

How do you choose the right clinic for you? For many couples, the “right” clinic is not simply a matter of location. Like choosing the right doctor, a fertility clinic is very personal and, frankly, subjective.

What your friends think is a great clinic is not always the best for you. Of course, ask your friends, insurance company, support groups, and look at references, but the final decision should be based on what you think and how you feel.

Ask About the Doctor

Any health clinic is only as good as the doctors they hire. You will most likely be assigned to one doctor, but some clinics have a rotating schedule of doctors. If you aren’t comfortable with that, you need to choose another clinic.

Some important questions you should ask when choosing a doctor are:

• When and where was the doctor trained?
• Are they certified reproductive endocrinologists?
• Are they members of the ASRM? (American Society for Reproductive Medicine)
• Will you be able to email you doctor with questions?
• How long has the doctor and staff been working at the clinic?
• Which hospital are they affiliated with?

If you are seeing a specialist for male infertility, you should also ask if they have an andrologist on staff.

Questions to Ask Regarding Pricing and Financing

Although it might seem strange to ask about prices, the fact is that many of these treatments cost thousands of dollars. If your insurance isn’t covering it (and it probably isn’t) then price matters. Two clinics can have vastly different prices.

Some questions about prices and financing include:

• Do they accept insurance, and what types (if they do)?
• Will the staff handle insurance claims?
• Do they offer financing?
• Do they have a refund program? (some clinics offer a refund if you don’t become pregnant)
• How much do they charge for freezing and storing unused embryos?

Questions About the Procedures and Lab

You most likely have numerous questions on your own, but we are including some that you might not have considered, such as:

• What procedures can be done at this clinic?
• Are procedures done at this clinic or at a hospital? (If so, which hospital?)
• What procedures do they recommend for your particular case?
• Are donor or surrogacy options available?
• How many embryos do they typically transfer per cycle, and who gets to make this decision?
• Is the clinic a member of SART (Society for Assisted Reproductive Technology)?
• Do they report their successful pregnancies and live births to SART or the CDC or both?
• Does their lab have accreditation from the College of American Pathologists?
• What is their success rate? If they are members of SART, their rates will be listed on the SART website. If the clinic reports to the CDC, you can find out on the CDC website.

Other Things to Consider

Other considerations you might want to think about and ask are:

• What are the clinic’s hours and days of operation?
• How are calls handled outside of office hours?
• Is the clinic convenient for you? (if you will need to travel, are there hotels nearby?)
• Do you like the staff? Are they pleasant?
• Does the clinic offer anything else beyond the fertility treatment?
• Have you actually tried all possible fertility treatment options?

Keep in mind that you will be spending months working with this clinic and the staff. Be sure that you make the best choice for YOU.

References

In Vitro Fertilization (IVF): What is it? http://americanpregnancy.org/infertility/in-vitro-fertilization/
Duke Fertility Center https://dukefertilitycenter.org/treatments/vitro-fertilization
How to Choose a Fertility Clinic https://www.webmd.com/infertility-and-reproduction/guide/choosing-a-fertility-clinic
10 Best Fertility Centers https://www.parents.com/getting-pregnant/infertility/treatments/10-best-fertility-centers/

LoraM

Lora M. is the director of Fertility Health Services in San Diego, California and is the author of the different books  and audio CD series. Lora’s work is marked by a ready warmth and deep empathy for all those she serves. People from all walks of life have benefited from her keen ability to help them connect with their deepest selves — and experience their fullest potential for health, happiness and wholeness.