In vitro fertilization is a process that begins with a full battery of diagnostic testing.

Modern medicine in general is amazing, and the strides made in helping families dealing with infertility are among those amazing advances. But if you are considering in vitro fertilization or other fertility treatments as part of the journey toward expanding your family, you may have more questions than answers. And you may also feel alone in your quest.

Selecting a Fertility Doctor (Reproductive Endocrinologist)

Before picking a fertility doctor, having a quick appointment to meet with him or her and ask questions is a great idea. While most couples want to know the doctor’s success rates or pregnancy rates, it’s also important to ask:

  • About the program’s philosophy
  • What type of diagnostics are required to assess the cause of the infertility prior to initiating treatment?
  • If IVF is required, does the program do fresh versus frozen embryo transfer?
  • Does the program offer preimplantation screening?
  • Is a diverse treatment approach offered?
  • What and how do they formulate treatment plans for individual couples?

What Should You Know about IVF?

It is a process. An IVF procedure may be completed by a reproductive endocrinologist (a fertility doctor). The process begins with a full battery of diagnostic testing. Those tests may include:

  • An endocrine (or hormonal) profile
  • Ovarian assessment (antral or resting follicle count)
  • Tubal assessment
  • Uterine evaluation
  • Semen analysis
  • Inherited genetic disease screening for things like cystic fibrosis and spinal muscular atrophy

Once all the testing is complete, the actual IVF cycle may begin. During an IVF cycle, the woman injects daily doses of gonadotropins and follow-up is performed over a 9 to 11 day interval. That follow-up includes an ultrasound, as well as blood work to monitor estradiol levels and the woman’s progress. The physician can then adjust the medication doses as needed.

How IVF Can Help

IVF has helped many women become pregnant and many causes of infertility can be overcome with the procedure including:

  • Fallopian tube damage
  • Previous tubal ligation (sometimes known as “getting your tubes tied”)
  • Male factors (like low sperm count or motility)
  • Pelvic endometriosis
  • Unexplained infertility
  • Recurrent pregnancy loss
  • When the prospective parents are known inherited genetic disease carriers who require IVF and/or PGD (preimplantation genetic diagnosis)

There are additional options besides IVF but those options are for a certain subset of couples, such as a female partner 34 or younger with open (fallopian) tubes and a male partner with normal sperm parameters. Such couples may be candidates for ovulation induction with intrauterine insemination or timed intercourse.

Typical IVF Process

A typical IVF cycle includes the following steps:

  • Ovulation induction — The woman receives hormone injections prescribed by her physician that stimulate her ovaries to produce mature eggs
  • Egg retrieval — A procedure where the mature eggs are removed
  • Fertilization and embryo culture — Retrieved eggs are placed in an incubator and fertilized with sperm; preimplantation genetic diagnosis and screening are available to identify which embryos are free of abnormalities and more likely to achieve the goal of a healthy pregnancy
  • Embryo transfer — Embryo(s) may be transferred after egg retrieval and are placed into the uterus using a catheter inserted through the cervix.

Finding Support Systems

RESOLVE: The National Infertility Association and its network of peer-led support groups and resources provides a vast support system.

To find the closest RESOLVE support group near you, call 866-NOT-ALONE (866-668-2566).

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Choosing the right fertility doctor is a very personal decision. Each situation is different, so choose the right option for you.
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