In-Vitro Fertilization (IVF) is a fertility treatment where eggs are removed from the ovaries and fertilized with sperm in a laboratory. The fertilized egg is placed in the uterus to implant. While this is a fairly common procedure, patients often have many questions about the risks, benefits, and steps that go into the procedure. Here are some of the frequently asked questions about IVF and answers from our experts in IVF in North Carolina.
Common questions related to In Vitro Fertilization (IVF) and Pregnancy
What Are The Risks?
There are many in vitro fertilization pros and cons to think about when discussing fertilization treatments. Here are a few risks to take into consideration when choosing IVF.
- Multiple births due to multiple embryos being placed in the uterus
- Premature delivery and low birth weight
- Egg-retrieval procedure complications
- Ectopic pregnancy
It’s always best to talk with your doctor at NCCRM about the pros and cons of reproductive technology.
Why Is It Done?
IVF can be done for many reasons that can involve:
- Blocked Fallopian tubes
- Male infertility
- Ovulation disorders, premature ovarian failure, and uterine fibroids
- Fallopian tube removal
- Genetic disorders
- Unexplained infertility
And more. No matter why you’re thinking about fertility treatments, it’s important to talk with your doctor to make an informed decision.
Will the IVF technique damage my ovaries?
There is no evidence to suggest that either routine laparoscopy or ultrasound egg retrieval damages the ovaries. Some reports in the medical literature indicate that following ovarian biopsy, pregnancies occur in couples with a long-term history of infertility.
Will scar tissue around my ovaries make it impossible to retrieve the eggs?
Not ordinarily. The surgeon must be able to visualize the follicles to guide the needle to the proper spot for egg retrieval, whether by sonographic (ultrasound) or surgical methods.
How many embryos do you transfer?
That depends on each patient and the quality of the embryo. Our team at NCCRM will meet with you to make this decision. Ultimately, it is up to each couple.
What if I ovulate before oocyte (also called egg or ovum) retrieval?
Once ovulation has occurred, it is no longer possible to retrieve the eggs. The entire team of physicians, nurses, and embryologists will closely monitor your cycle to prevent premature ovulation.
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.
How many times will IVF be repeated per couple?
There is no specific number. This is determined by the couple together with the physician.
Can we have intercourse during the two weeks before an IVF procedure is performed?
Yes. We recommend that the husband refrain from ejaculation for at least 48 hours, but for no more than 5 to 6 days preceding egg retrieval. This precaution ensures that the semen sample obtained for IVF contains a maximum number of healthy, motile sperm. For those couples who have male factor issues, please speak with your IVF coordinator for more information.
After the IVF procedure, how long must we wait to have intercourse?
Although a definite time of abstinence to avoid damage to the embryo has not been determined, most experts recommend abstinence for two to three weeks after egg retrieval. Theoretically, the uterine contractions associated with orgasm could interfere with the early stages of implantation.
What about other activities? When can I return to my routine?
At NCCRM, our physicians recommend that the patient be sedentary for a full 72 hours following the transfer process. Strenuous exercises, such as jogging, horseback riding, and swimming, should be avoided until pregnancy is confirmed. Otherwise, the patient is free to return to her regular activities.
How soon will I know if I’m pregnant?
Pregnancy can be confirmed using blood tests about 14 days after egg aspiration. Pregnancy can be confirmed by ultrasound 30 to 40 days after aspiration.
I had my tubes tied (tubal ligation) several years ago. Would I be a candidate for IVF?
Yes. You may also be a candidate for tubal reversal surgery, which we perform here at NCCRM. Whether your tubes were obstructed can determine the success of tubal reversal surgery. Our physicians will help determine the best course of action: IVF or tubal reversal.
Do insurance companies cover IVF?
Unless your health insurance policy provides fertility coverage, it is unlikely that IVF coverage is provided. Frequently, insurance policies will cover fertility diagnosis but exclude IVF. If, however, IVF is combined with surgical procedures used for diagnosis, insurance carriers may cover a significant portion of the procedure. However, coverage will depend on the terms of your policy. For infertility alone, most insurance policies will not provide coverage. Our financial coordinators can help determine what your policy allows for treatment and medications.
What drugs are given to stimulate the ovarian follicles and to maintain the lining of the uterus prior to implantation of the embryo(s)?
Depending on your plan of care determined by the NCCRM fertility specialists, four to five medications usually are given: 1. Leuprolide acetate (Lupron), an injectable drug that blocks secretions of the pituitary gland, thereby optimizing the number of oocytes retrieved; 2. Human menopausal gonadotropin (Pergonal or hMG) or Follicle-Stimulating Hormone (Metrodin or FSH), hormones that stimulate ovarian activity, are injected daily for approximately 6-10 days before the procedure. 3. Human chorionic gonadotropin (hCG), a hormone that mimics the action of the hormone which naturally induces ovulation, is injected 34 to 36 hours before retrieval and may be used after retrieval to supplement natural progesterone production. 4. Progesterone, a natural hormone that enables the uterus to support pregnancy, may be used as a daily injection after egg retrieval.
What side effects, if any, can these drugs cause?
No pronounced side effects have been associated with any of these drugs. However, the patient should inform the physician of ANY allergies she has or of any previous adverse reactions to medications. Our staff at NCCRM closely monitors our patients during their cycles to ensure they don’t experience hyperstimulation, which can occur when using follicle-stimulating hormones. We typically treat those patients in our office and, on occasion, in the hospital.
Will I have an egg in every follicle?
It varies from patient to patient. In some patients, as many as half of the follicles may not contain an egg.
Is there a possibility of multiple births with IVF?
Yes, when multiple embryos are transferred, 25% of pregnancies with IVF are twins. (In normal population, the rate is one set of twins per 80 births.) Triplets are seen in approximately 2-3% of pregnancies.
Is there an increased chance of birth defects if I become pregnant through IVF?
There are no known ill effects. Abnormal embryos, even those produced through regular fertilization, do not seem to mature. However, any long-term effects of IVF remain to be determined.
How much time does the entire IVF procedure require?
Approximately three to six weeks (all as an outpatient). Fertility drugs are administered to stimulate the ovaries. Then, during the four to ten days before ovulation, the patient is monitored by ultrasound as well as by hormone levels.
What happens to any extra embryos?
Patients will have several options regarding the disposition of the remaining embryos. One option is to freeze embryos for your later use. Other options include donating or simply disposing of them. Excess embryos, if any, belong to you, and you will determine what is to be done.
Will I need a high-risk OB because I conceived with an IVF procedure?
A high-risk OB is only needed when there are complications that put the mother or baby at increased risk, or in the case of multiple births. Other than a higher incidence of multiple births, IVF does not increase the risk to the baby.
Is there a higher miscarriage rate for IVF patients?
The miscarriage rate is about the same for IVF as the general population. Many times, older females undergo IVF, and their miscarriage rates are naturally higher. Since pregnancy testing is done two weeks after embryo transfer, we often know about spontaneous miscarriages in the very early stages of pregnancy. These miscarriages would probably go unnoticed in the general population.
Am I depleting my store of eggs by undergoing IVF?
A woman is born with a full complement of eggs. There are far more eggs than will ever be used during a normal lifetime, and IVF procedures have no measurable “lowering” effects.
How much does IVF cost?
The cost of IVF can vary widely depending on many factors, such as location, clinic, and insurance coverage. On average, a single cycle of IVF can cost anywhere from $12,000 to $15,000. However, NCCRM, a highly-rated fertility clinic in North Carolina, offers financing options and payment plans to help make IVF more affordable.
What can be done to improve sperm quality?
Sperm quality on the day of egg retrieval is often related to what happened in the male’s body 3 months ago. This is because sperm development takes 3 months. Listed below are guidelines to help ensure the semen specimen is of the best possible quality.
- A fever of 101 degrees Fahrenheit or higher within 3 months before IVF treatment may adversely affect sperm quality. Sperm count and motility may appear normal, but fertilization may not occur. If you become sick during the IVF cycle, please notify the nurse and take Tylenol to keep your temperature below 101 degrees Fahrenheit.
- Keep the use of alcohol and cigarettes to a minimum before and during IVF treatment. Do not use any “recreational” drugs.
- If you have taken any prescription medication within the last 3 months, please notify the IVF nurse.
- Do not sit in hot tubs, spas, Jacuzzis, or saunas during or 3 months before the IVF cycle.
- Do not begin any new form of endurance exercise during or 3 months before the IVF cycle. Moderate physical activity is acceptable and encouraged.
- Avoid all testosterone, DHEA, and Androstenedione/Androstanediol hormone-containing supplements.
- Tell your infertility physician if you have ever had genital herpes or suspect you may have been exposed to genital herpes in the past. Also, tell your physician if you have pre-lesion symptoms, develop a lesion, or have healing lesions before or during the IVF cycle.
- Refrain from ejaculation for 2-3 days, but not more than five before collecting the semen sample for the IVF cycle. The IVF nurse will have your specific instructions from the embryologist.
Can being overweight affect my chances of conceiving?
Yes. Obesity has reached epidemic proportions in this country, with 31 percent of white, 38 percent of Hispanic, and 49 percent of African American women considered overweight or obese (2002 Statistics). Obesity is defined as a body mass index (BMI) greater than 30kg/m2, while overweight is defined as a BMI of 25 –30 kg/m2. (Calculate your body mass index here.) Obesity has been linked to multiple medical problems, including infertility. Infertility in obese and overweight women is primarily related to ovulatory dysfunction.
The information provided within this website is not intended as medical advice. It should never be substituted for a consultation with a healthcare professional. Please contact your physician or visit NCCRM with questions or concerns about your health condition.
How Successful is IVF?
The success of IVF varies depending on several factors, such as the woman’s age, the reason for infertility, and the number of embryos transferred. The success rate for women under 35 is about 40-45%. This decreases as a woman ages, with a success rate of about 10-20% for women over 40. If you have questions about how effective is IVF, your fertility clinic is happy to assist.
How Long Does the IVF Process Take?
The IVF process can take several weeks to complete. It begins with a woman taking medications to stimulate egg production. Once the eggs are mature, they are collected from the ovaries and fertilized with sperm in a laboratory. The fertilized eggs are then monitored for several days, and the healthiest embryo is selected for implantation. The IVF process can take anywhere from four to six weeks.
What Are the Risks Associated With IVF?
Like any medical procedure, IVF comes with some risks. The most common risks include multiple pregnancies (due to the transfer of more than one embryo), ovarian hyperstimulation syndrome (OHSS), and ectopic pregnancy, where the embryo implants outside the uterus. However, these risks are rare and can be minimized with careful monitoring and management.
Can IVF Be Used for Gender Selection?
In some cases, IVF is used for gender selection. This is typically done for medical reasons (such as to prevent the transmission of a genetic disorder) rather than for personal preference.
Is IVF Right for Me?
IVF may be a good option for couples who have been trying to conceive for a year or more without success or for women with certain medical conditions that make it difficult to conceive naturally. However, IVF is not the right choice for everyone, and discuss your options with your doctor.
North Carolina Center for Reproductive Medicine | IVF in North Carolina
While IVF is a common infertility treatment, there are many factors to consider when deciding if IVF is right for you. However, the experts at NCCRM are dedicated to assisting you in making the right decision that’s right for you and your family. For more information about IVF in North Carolina and other fertility treatments, contact the experts at NCCRM today.
