Infertility & IVF – Frequently Asked Questions
Normally, young couples with unexplained infertility or minor sperm problems start with IUI but even they may be advised to consider IVF in certain circumstances such as when the fallopian tubes are blocked or when there is ovulation problem. To know about the right treatment for you, it is imperative that you get the recommended investigations and then have a qualified doctor review those reports.
Intracytoplasmic sperm injection (ICSI) is an extra step in the IVF procedure in which a single sperm cell, is directly injected into the egg cell for embryo formation. ICSI will be useful if you have low sperm count or low sperm motility. It is also recommended if you have abnormal sperm morphology, which may make it difficult for the sperm to penetrate the egg naturally.
Age is an important factor for success in IVF, especially for women. Although it varies from person to person, usually the fertility levels in a female start to decline after the age of 35, and it becomes harder to conceive, even with IVF, as you grow older.
There is no cut-off age as women upto the age of 72 have conceived with IVF. However, given the ethical and medical concerns, many doctors do not offer IVF to women after 50 or 55 years.
You may choose to opt for reversal tubal ligation reversal, but the chances to conceive naturally even after the surgery remain small, because there is a possibility of remnant scar tissue that blocks the tubes. IVF is the ideal solution for women with blocked or closed tubes.
The chances to conceive twins are higher with IVF because of multiple embryo transfer. However, no doctor can guarantee twins as it depends upon how many embryos successfully attach with the uterine wall and start to grow.
The first step is to consult with a fertility doctor (either in person, or online through our system), get the required fertility tests done. Based on the investigation reports, your doctor will formulate your treatment plan and give you a timeline to start the treatment.
There are two approaches to IVF—agonist and antagonist. The antagonist cycle is more commonly performed; it takes 18-22 days. In the agonist cycle of IVF your natural hormones are first suppressed, and it may take an additional 12-28 days. Once you have completed all the investigations, the doctor will tell you which approach is to be followed in your situation and how many days you should plan for.
While intensive monitoring of ovarian stimulation in an IVF cycle is controversial, many doctors will advise one or two ultrasound scans to ensure the stimulation drugs are bringing the desired results. Ultrasound monitoring is even more important when women with PCOS undergo IVF.
You will normally register at the front desk and then meet with a nurse/counsellor, who will take your medical history, and explain the process briefly. In some clinics, the blood tests and semen analysis are done before you meet with the doctor, (if you don’t already have valid reports), while in other clinics, you meet the doctor first and the tests are done later. Typically, the doctor will also do an ultrasound scan to assess your uterine lining, during your first consultation. Based on your medical history, family goals, and all these reports and findings, the doctor will advise on your IVF treatment plan.
It is good for both partners to come for the consultation, as infertility could be a male or female issue. If, however, your husband is not able to accompany, you can try to get his semen analysis report along for assessment.
Preparation for IVF
If you are overweight, losing some kilos before IVF will not only enhance your chances of getting pregnant but also allow for a healthy pregnancy.
Most of anovulatory infertility cases are attributed to PCOS, and women with this condition are considered good candidates for IVF.
Irregular periods are an indication of potential fertility problems. The doctor will perform a few blood tests and advise some pills to regulate your period cycle, before starting your actual IVF cycle.
There are certain foods for improving your fertility and also some lifestyle practices that could help raise your chances of conceiving. However, if there is a significant problem in conceiving, you should not wait too long to seek medical intervention. Time is an important factor when you are trying to conceive. Some patients spend too much time relying on alternative therapies and supplements that they actually jeopardize their chances of conceiving, even with ART.
Semen analysis is done to check the number, motility, and morphology of the sperm. It can be done on any day but you are required to abstain from releasing sperm for 3-5 days before your sperm test.
The cost of IVF varies with countries, cities, and clinics. Infertility Aide works only with highly credible doctors across Asia and Europe and we offer IVF packages from $4,000 – $7,500.
There are several ways to reduce IVF costs — check your insurance, find a place where medications may be cheaper, or just plan a trip to a country where IVF is affordable.
Fertility tests for women include hormone analysis, uterine examination, scans, etc. These can cost anywhere between $200 – $1,000. However, if you have medical insurance, the out of pocket cost for fertility testing in some countries may be less than $100. In some cases, a hysteroscopy, x-rays, MRIs may also be required in which case the cost will increase. For men, basic semen analysis may cost $10 – $40.
Success in IVF
The wide global average success rate of IVF is 35%-50% but it largely varies with age and your individual health factors. Younger women generally have better chances of success with IVF as compared to women over 40, whose ovarian reserve and egg quality may have deteriorated due to age related factors. Similarly, men with normal sperm factors have better chances of success with IVF. The doctor’s expertise, clinic standards, and the sophistication of techniques used are also some factors that impact the success of your IVF cycle.
You can maintain stable weight at a normal BMI, improve your diet and lifestyle, avoid stress, quit smoking, look into optimizing sperm health, take the required vitamins and supplements, and make sure to consult with only a reputed, skilled, honest doctor and a credible clinic for IVF.
The laws related to embryo transfer in IVF are variable from country to country. While some doctors advocate for the transfer of a single euploid embryo for best results, others routinely transfer two or more embryos. The number of embryos to be transferred also depends upon your personal factors such as the quality of embryos, your age, and your personal health.
Transferring more than the recommended number of embryos may actually jeopardize your chances of a successful pregnancy. Research has indicated that the live birth rate was actually lowered with the transfer of more than two embryos.
The quality of embryos mostly remains the same, given sophisticated freezing and thawing techniques today. However, more doctors are favoring frozen embryo transfers over fresh today. IVF hormones can be harsh on the body and by choosing fresh embryo transfer you are allowing the body to return to its normal situation in preparation for receiving the embryo.
While some doctors advise the patients to rest for 24 hours after their ET, but there is no conclusive evidence to suggest that bed-rest after ET is helpful in conceiving. You can discuss with your doctor and return to work or fly-out of the destination even the next day.
It is believed that intercourse may affect the embryo implantation adversely and generally clinics advise abstinence of 1-2 weeks after the procedure. Even though several studies have found that intercourse during the IVF cycle does not affect the chances of pregnancy, most women say they would not really enjoy sex immediately after all the invasive medical procedures.
If you are used to working out daily, you can resume your normal workout routine, but excessive exertion must be avoided.
There is no conclusive scientific evidence to suggest that your IVF may fail because of stress of anxiety.
It is advisable to freeze all the top-quality, unused embryos for future use so you don’t have to repeat the whole process in case the IVF cycle fails or you want to plan another pregnancy in future.
Sometimes even not-so-good embryos result in pregnancy so you can definitely consider the transfer and take a chance. However, you may not want to spend any money on freezing embryos that the doctor and embryologist suggest are unlikely to result in a pregnancy.