In vitro fertilization, IVF, is a fertility treatment. The process includes the woman taking medication to cause her ovaries to develop multiple mature eggs, which takes about two weeks. She will also take other medications that promote the growth of follicles, which are fluid-filled sacs in the ovaries that contain the eggs, as well as medication to prevent the follicles from ovulation, which would release the eggs. IVF is typically pursued by intended parents who are unable to conceive on their own, though some couples with no history of infertility seek IVF for family balancing. The only way to determine the gender of the embryos is through IVF with PGS, a test that is done prior to implanting the embryo in the uterus.
Yes. There are medications that are required to do an IVF cycle, which will need to be administered by injection. We will provide instructions so you and/or your spouse will be able to give your injections.
Each IVF treatment cycle, or “cycle” is an attempt at pregnancy. The cycle spans from the day the woman starts IVF medication through the retrieval of the egg and transfer of the embryo. A “family balancing cycle” refers to a patient who is undergoing IVF for family balancing purposes.
A board-certified obstetrician-gynecologist who has had additional training and subspecialty board certification in reproductive endocrinology and infertility is a Reproductive Endocrinologist. They are sometimes referred to as a “RE,” versus an “OB.” Your appointments through New Fertility will be with a Reproductive Endocrinologist or RE.
PGD stands for Preimplantation Genetic Diagnosis, which is a genetic test to improve the chances of success during pregnancy and delivery. PGD is performed on cells removed from the embryos to avoid any genetic diseases, for which the couples pose a risk, and to help select the best embryos to achieve pregnancy.
Couples who are at risk for specific genetic disorders or chromosomal abnormalities, or women who have had several miscarriages or a prior pregnancy with a chromosome abnormality may benefit the most from PGD, though it may be considered in all IVF cycles. Individuals who may produce embryos with higher rates of chromosomal abnormalities may include women over 38 years of age and men with certain types of sperm abnormalities. The test used to determine this is also known as PGT-A. For a person who carries a structural rearrangement of the chromosomes, PGD can also identify which embryos have a normal amount of chromosomal material. This test is known as PGT-SR. PGD can be used to identify which embryos may be affected, unaffected, or a carrier when there is a 25-50% chance to have a child affected with a specific genetic disease. Using PGT-M, only embryos without the disease will be transferred to the uterus.
Embryos are created in the laboratory and given 5-6 days to grow. Then, a biopsy is done on all embryos which have developed appropriately. During the biopsy procedure, a few cells from the trophectoderm, or outer layer of cells of the embryo, and tested for abnormalities, while the embryos are stored. One of New Fertility’s counselors will discuss PGD test results with the woman/couple and a frozen embryo transfer cycle is planned for use of the embryo(s). The medical and genetics team will provide their advice into the decision regarding selection of embryos for transfer into the uterus.
After the PGD testing, if embryos are available for use, pregnancy will be attempted by transferring one or two into the woman’s uterus. If you wish, you may select embryos of the desired sex. You and your physician will help make the decision together regarding the number of embryos to transfer. Your physician will estimate the risk for twin or triplet pregnancy, which will be dependent on the number of embryos transferred. The remaining normal embryos may be frozen for your own use, discarded, or donated for laboratory use. Any embryos which are abnormal or not able to be used may be discarded or donated for laboratory use.
According to several hundred thousand live births in humans, as well as many years of data from PGD in animals, there is no increase in birth defects over that in the general population from PGD. Children who are born after PGD do not show any detrimental effects on growth or neurological development during the first few years of life. Fewer pregnancies ending in miscarriages due to chromosomal disorders can be expected because abnormalities are identified before the embryos are transferred. The embryo is able to develop into a complete and normal pregnancy following the removal of a few trophectoderm cells of the early embryo.
The couple and the medical team will make the decisions together regarding which embryos will be transferred and how the remaining embryos will be used. Embryo morphology (appearance) is helpful in embryo selection for transfer; however, embryos with significant chromosomal abnormalities have normal morphology. Therefore, the combination of both PGD test results and embryo morphology will provide the highest likelihood of a successful pregnancy.
There are many variables that determine the likelihood of pregnancy from an IVF/PGD cycle, including reproductive history, age, and medical considerations. Even though there is often no history of infertility in family balancing patients, there is no guarantee that the procedure will result in pregnancy. Your physician will review the results of your consultation and diagnostic testing and discuss your chances for success.
It may take a couple approximately three months from the time of the initial consultation to complete the pre-cycle workup and the first full cycle. This timeframe will vary depending on your test results and the IVF protocol that the physician recommends. The stimulation phase of the IVF will require the woman to attend early morning appointments an average of 5-6 times over a 10-14 day period. The male partner is welcome to attend any of the appointments, but is only required on the day of egg retrieval to collect his specimen.
We’ve had many families who have successfully become parents.
Please feel free to contact us if you have any questions about our IVF program or the process involved.
We look forward to hearing from you!