When is IVF Needed?
IVF was originally developed for women with blocked tubes or missing fallopian tubes and it is still the procedure of choice for these situations. It is also used when other conditions are present, including endometriosis, male factor infertility and unexplained infertility in which no medical cause for infertility can be found. Our physicians will review your history and help to guide you to the treatment and diagnostic procedures that are most appropriate for you.
How long do I have to take the fertility injections?
The length of time that you will be taking the injections will depend on the in-vitro fertilization (IVF) protocol chosen for you at our Clinic. Typically, patients receive injections for 7 to 10 days, but some must take them for a little longer.
How many times will IVF be repeated per couple?
There is no specific number. This is determined by the couple together with the physician.
Is the embryo transfer painful?
The embryo transfer does not require any anesthesia. It is performed using a speculum that allows the doctor to see the cervix, (like a Pap smear) and is very similar in technique to an intrauterine insemination (IUI). Usually the woman feels only the speculum and nothing else.
Is bed rest recommended after the embryo transfer?
It is really not clear that prolonged rest after transfer is helpful. In nature, the embryo floats freely in the endometrial cavity for a number of days before implantation and it will do the same in an IVF cycle. We do recommend that you take it easy following transfer for the rest of the day, but routine work activities can be resumed the next day. If there is an increased risk of Ovarian Hyperstimulation, we will recommend prophylactic bed rest.
How soon after IVF can a pregnancy test be performed?
Since hCG is used to finalize egg maturation, a pregnancy test (which is a measurement of hCG hormone in the urine or blood) will be positive for a number of days following egg retrieval. Some women will metabolize the hormone quickly and it will be out of the blood stream in about a week, while others may take up to 9 or 10 days to do so. We therefore recommend that a pregnancy test not be performed until 12-14 days after the egg retrieval.
Can anything be done to improve embryo quality?
Ultimately the answer is no. If an embryo is of poor quality because it is genetically abnormal, there is nothing that can be done to salvage it. However, there are procedures that we do that can improve the chances of a borderline embryo. These include carrying use of Metformin and assisted hatching. It has been shown that procedures such as these can increase implantation rates in couples with a poor prognosis
If an egg is not retrieved or if the technique does not produce a pregnancy on the first attempt, how soon can the procedure be repeated?
This depends on the individual. The primary reason for delay is to allow the patient’s normal menstrual cycle to resume, which may take 2 to 3 cycles.
After the IVF procedure, how long must we wait to have intercourse?
Although a definite time of abstinence to avoid damage to the pre-embryo has not been determined, most experts recommend abstinence for two to three weeks. Theoretically, the uterine contractions associated with orgasm could interfere with the early stages of implantation. However, intercourse the night before pre-embryo transfer is acceptable. Some physicians will advise intercourse before transfer as they feel that this will improve the chances of a pregnancy.
What about other activities? How soon can I resume my normal routine?
The IVF team recommends that the patient be sedentary for a full 24 hours following pre-embryo placement in the uterus. Strenuous exercises such as jogging, horseback riding, swimming, etc. should be avoided until pregnancy is confirmed. Otherwise, the patient is free to return to her regular activities.