Most Common IVF Questions From Readers—with some answers

December 4, 2012Carole No Comments »

I get lots of questions from my readers, either in the comment box beneath the posts or via my contact email. I thought it might be helpful to  cross reference the most common questions with posts that address these topics. I do have a search box to find specific posts and posts are broadly arranged into topics but it still is not always easy to find answers to specific questions. (If anyone is aware of a Word Press widget that provides a better search box, let me know.

Will I get pregnant using these embryos? (patient pictures attached). I get this one a lot. My most visited post is Embryo stages, progression and pregnancy outcome, which contains photos of ideal embryos at each stage from fertilized egg to blastocyst. There are over 200 comments on these posts–questions from patients and answers from me.

Even if I was in the lab with your embryos from fertilization to transfer and had access to your entire medical record, I still can’t answer your question , “Will I get pregnant from this transfer?” But  I can tell you that the major factors that determine whether you are likely to become pregnant once you  have a fertilized egg are:

  • Maternal age: Increasing maternal age means decreasing pregnancy rate, see CDC national summary table here.
  • Embryo metabolic health: Can the embryo hit developmental milestones on time?
  • Embryo genetic health: Does the embryo have an abnormal number of chromosomes which will curtail development and cause  problems such as embryonic loss, implantation failure, fetal loss or genetic problems (Down’s syndrome) if the pregnancy does survive?  Abnormal chromosomes can be present in the egg or the sperm or may arise through faulty DNA replication during cell divisions in the early days of embryo development.
  • Uterine health: Is the uterus free of structural abnormalities such as fibroids, polyps or a septum between the walls of the uterus that can interfere with implantation? Is the uterus receptive to the embryo on a molecular level? There are molecular receptor interactions between embryo and uterine lining cells and cellular remodeling responses in the uterine cells that must occur properly for implantation to occur and the pregnancy to become established.
  • Overall maternal health

Previous relevant posts that discuss these issues are listed below:

Female infertility Diagnosis: Plumbing Problems

Female Infertility Diagnosis: Ovarian Reserve

Fertility Diet: Can nutrition affect fertility?

Please don’t sabotage your IVF cycle

What is aneuploidy?

The embryo beauty pageant and why your eggs don’t care if you yoga.

Genetic testing on embryos part one.

Genetic testing part two: MIcroarray assays may deliver on clinical promise.

Q From U: Endometrial Receptivity

Q from U: Embryo Fragmentation

Understanding the Gardner Blastocyst Grading Scale

What else can I do to become pregnant? More IVF? Less IVF? Something else? This is usually the question that comes after a long description of numerous previous failed IUI or IVF attempts (3-10) at one or more clinics. Some patients are stuck in IUI mode  and don’t know if they should move on to IVF. Others are done in by numerous repeat IVF cycles and want to know -will a new clinic be better? These types of questions are the hardest for me to answer because I know that at some point IVF is just not working for some of these patients. Sometimes IVF failures are due to the clinic or doctor but  IVF can’t solve every problem. The most I can do is try to explain what IVF is good for and what it is not good for. Because my crystal ball is on back-order from Amazon, I am left with a lousy toolkit that only offers current technology, hope for the future and traditional choices like adoption and possibly accepting childlessness as  another road, reluctantly traveled, to personal happiness when ART doesn’t work. General rule of thumb: do 3 IVFs at most, then go on to other options unless you have endless financial and emotional resources to use on IVF cycles with diminishing chances of success.

Ten things about IVF you must know

When to move on to IVF (from IUI)

When is it time to stop IVF

IVF: What it can and can’t do.

IVF: Risks, Benefits and Alternatives

Q from U: When IVF fails, follow-up questions.

Is IVF working well for you? What are the signs of a good IVF cycle?

Can alternative medicine complement IVF treatment?

Should I use donor gametes? Often after 2-3 failed IVF cycles with their own gametes, patients choose to use donor gametes or accept a donated embryo transfer. Using an egg donor is a costly option and although more likely to succeed technically is still not guaranteed to succeed. Receiving a donated embryo is usually a lower cost option because the patient pays for a less expensive (compared to IVF) transfer procedure and some minimal monitoring. Sperm donation is the least expensive option available and if male factor is the only problem, IVF is usually not needed (huge savings!) and insemination may suffice.

Third party reproduction is an attractive option technically and in some cases financially but carries with it a lot of emotional baggage. Third party reproduction has a lot of “down the road” issues that must be considered at the beginning of treatment because some decisions are irrevocable. For instance, the decision to use anonymous gametes comes with it the question of do you disclose the fact of donor conception to the child or other family members? When and how do you disclose this information? Most importantly, if you or your donor-conceived child develops a strong need for more information and maybe even contact with that donor years from now–have you created an arrangement that allows for that possibility?

Third Party Reproduction

 Mixed Blessings: Family Members and Third Party Reproduction

Unintended Consequences: Rethinking Third Party Reproduction

Talking to your donor-conceived child about their conception

Buyer beware: Not all donor sperm are fully tested.

Unintended Consequences of Anonymous Sperm Donation

Who’s my Daddy? The issues of anonymous sperm donation

Fun Facts about the FDA and Third Party Reproduction

 Embryo Donation Registry: An idea whose time has come?

I hope that this cross-indexing of questions and relevant posts is helpful to you. I have organized many of these posts and others into an ebook as well, called Fertility Lab Insider available from Amazon ($2.99) . If you read my blog and have been helped by the information, buy the ebook. If the hundreds of you that have emailed me privately for advice or have posted questions for me in the comment boxes beneath posts  have been helped by my responses- and your kind Thank-yous suggest that you have–please buy the book. If you bought the book and liked it, consider writing a short Amazon review on the Amazon purchase link page to let other Amazon users know about Fertility Lab Insider. See previous Amazon reviews here.

If you do buy the ebook, you are supporting the website hosting fees so I don’t have to put ads on my site. I have had multiple inquires from providers- physicians, clinics, device makers etc, who want to sell their wares or services through this site. I have declined their offers because I don’t like ads and I think my readers probably agree. So I have adopted the NPR model-minus the government funding! If you like the site, buy the ebook-  it’s the best way to send me some love and keep the website up. Thank you and Best Wishes!

© 2012, Carole. All rights reserved.

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