At some point in your journey to have children, you or your partner may have asked the question “Do we need help with conception?”. Maybe that is why you’ve found yourself reading this article. Perhaps you are just curious about your options in the event that there is a complication or special scenario that changes your chances of conceiving naturally. Whatever the reason may be, it’s important to understand your options. With IVF medicine and technology, a lot more is possible today, however, there is also a lot that must be done to make IVF a viable solution for those that need it. Read on to get an idea of what the IVF process entails so you can be prepared and informed on what you or your partner may experience.
If you and your partner have had trouble conceiving for over a year, you may need to start thinking about in vitro fertilization treatment. It is important to educate yourself about the IVF process and understand how it works. Doing so will make you feel empowered walking into the process and possibly increase the odds of your success.
There are a few key steps involved in the IVF process that are essential to understand. The below section is an overview of the main steps of a typical IVF cycle.
This first step is to stimulate your ovaries to produce as many healthy eggs as possible so they can be extracted from your body and used in the fertilization steps later on in the process. Fertility hormonal medications are usually started on the second or third day of a woman's menstrual cycle. Different IVF Physicians may use other medication protocols to yield results. The medications will stimulate the ovaries to produce multiple eggs. These hormones are usually taken for an average of 10 to 14 days. During the stimulation cycle, two to four follicle monitoring ultrasounds will be performed prior to the egg retrieval procedure to check on progress and make any necessary adjustments to the medication prior to retrieval.
The follicle sizes will grow with the help of hormonal medications. When the size of most follicles reaches 18 to 20 mm in average diameter and the estradiol hormone level is appropriately elevated, then it is time for the eggs to be retrieved. The egg retrieval procedure is performed under anesthesia by your IVF physician and then the eggs are taken to our lab for the following steps explained below.
The retrieved eggs are either incubated with sperm overnight or sperm is directly injected into each egg to fertilize it. A fertilized egg is called an embryo. An embryo goes through various stages of development and the fertilized embryos will be cultured over the next 5-7 days. These will then be biopsied and sent for PGT-A (preimplantation genetic testing). This test is intended to help eliminate any possible chromosomal abnormalities. After we know the embryo's results, you will then be ready to prepare for an embryo transfer cycle.
When it comes to a FET (frozen embryo transfer) cycle, each case can vary due to several factors. In a typical scenario, the embryo transfer procedure usually takes place between days 19 and 21 of the patient’s menstrual cycle. This is followed by a pregnancy blood test approximately 10 days post-implantation.
One key element to prepare for a successful IVF cycle is to have testing done ahead of time. This will help your physician to determine the best medication protocol for your specific case in order to maximize the chance of a successful outcome.
Before starting an IVF cycle, our IVF physician will order a panel of comprehensive medical and fertility tests based on your specific case. It is important to know what types of tests your physician requires and what types of medications will be ordered for you during the process. At PFCLA, our physicians typically order blood tests to check female patients’ ovarian reserves and look for any abnormalities. Male patients will also go through blood tests, and a semen evaluation is usually required prior to starting the IVF treatment.
Commonly recommended tests are listed below:
Semen Evaluation: The semen evaluation consists of a series of tests that evaluate the quality and quantity of the sperm and the semen, the fluid that contains them.
Ovarian Reserve Testing: AFC (Antral Follicles Count) means the sum of follicles on both ovaries. AMH (Anti-Mullerian Hormone) can also help determine ovarian reserve.
Uterine Lining Ultrasound: This ultrasound is the most common way to measure the thickness of the endometrium and rule out abnormalities in the uterus.
Infectious Blood Test Panel: includes Hepatitis B Core antibody, Hepatitis B Surface antigen, Hepatitis C antibody, Syphilis, HIV 1 and 2, Chlamydia, and Gonorrhea. Infectious diseases can cause infertility, so it is important to get tested for an infectious panel before starting treatment.
Other than having testing done prior to starting treatment, there are other things that you can do to prepare for an IVF cycle. Many of the following recommendations are not only great for improving your chances of a successful IVF cycle, but they are good for general health overall.
Sperm health can be improved by avoiding damaging environmental factors, such as smoking, heat exposure, heavy exercise, toxicants, certain drugs, or excessive alcohol. Reduce stress levels, and maintain healthy body weight by exercising and eating a healthy diet.
There are some supplements that a woman can take to help with preparing for IVF treatment.
Vitamin D: It is important to check your Vitamin D level to make sure that you do not have Vitamin D deficiency. Having enough Vitamin D could positively affect your body’s response to IVF treatment.
Prenatal vitamins: Prenatal vitamins are often recommended when you are trying to become pregnant.
CoQ10 and DHEA: CoQ10 and DHEA are believed to possibly have a positive impact on egg quality.
An unhealthy BMI can affect pregnancy rates, increases the risk of miscarriage, and may result in poor outcomes with IVF. Contact your doctor about what a healthy BMI is for you and work it out before you start trying to get pregnant. It will positively affect your IVF success chance and reduces the risk of complications once you are pregnant. One key factor related to a high BMI is an increased risk, or in some cases, the inability to use anesthetics necessary for your cycle.
Stress level and mental health affects your overall health and can also interfere with conception and IVF success. Mental and emotional stress can lead to added physical strain, which in turn can cause an additional impact on your body. It’s important to also maintain healthy sleep habits, which can often be affected negatively by added stress throughout your day.
It is important to monitor your daily caffeine intake. Excess amounts of caffeine could affect your ability to conceive during your IVF cycle. When you prepare for your IVF cycle, you should reduce or eliminate your caffeine intake.
When you prepare to start your IVF cycle, tell your fertility doctor about any medications you take. Some medications could potentially interfere with fertility drugs or cause hormonal imbalances. We recommend making a list of all the medications that you are taking including the common ones such as aspirin, ibuprofen, thyroid medications, and skin products. Medications for depression, anxiety, and other mental health conditions need to be mentioned to your IVF physician.
During your initial consultation, we recommend asking as many questions as you need to feel comfortable and confident to proceed. The IVF process is a very thorough and detailed one, and it’s important to be prepared for what the next few weeks/months may involve. It’s always best to speak to a medical professional that specializes in fertility medicine to assure that you are provided the best and most up-to-date medical information and practices available. Contact us today to get started.