Many patients say that their fertility journeys differ greatly depending on their clinic and fertility specialist; therefore, it is always best to speak to your fertility specialist and ask any questions that come to mind before you choose to begin treatment.  This way you can be educated on the different approaches and find out what is best for you.

But what to ask? This blog will help you with where to start when asking questions to your fertility specialist.

1.  Which is better for me if I have unexplained infertility: IUI or IVF

Infertility can be caused by any number of reasons, including:

  • Ovulation-related infertility
  • Polycystic ovary syndrome (PCOS)
  • Primary ovarian insufficiency (POI)
  • Thyroid disease
  • Quantity and quality of eggs
  • Age
  • Tubal-related issues

When it comes to determining the best method or procedure, the first step is to understand the difference between the two.

Intrauterine insemination (IUI) is a procedure where sperm is placed inside the uterus to ensure healthy sperm gets closer to the egg and increases the chances of successful fertilization. IUI requires functioning fallopian tubes and functioning sperm.

If you are experiencing multiple failures of IUI cycles, depending on your fertility specialist’s advice and specific case, your specialist may suggest the next method: IVF (In vitro fertilization).

With IVF treatment, patients will take fertility medications to stimulate the ovaries, multiple follicles will grow and once mature, the eggs will be retrieved and fertilized into embryos at our lab. The resulting embryo(s) are then transferred into the uterus. You and your fertility specialist will make this decision together on whether IUI or IVF is better for you.


2.  Is there an age limit for treatment?

Age limits are determined by each clinic individually; however, it is very important to speak with your fertility specialist first to discuss your individual case and treatment plan.

IVF treatment success rates decrease with age as the risk of pregnancy complications rises. Each fertility clinic will examine each patient on an individual basis and will consider several factors to determine the likelihood of success. Fertility specialists and their staff will help you every step of the way to maximize your chance of success.


3.  What tests need to be done before starting IVF treatment?

It is important to know what types of tests your fertility specialist requires and what types of medications will be ordered for you during the process. Fertility specialists typically order blood tests to check for female patients’ ovarian reserve and look for any abnormalities.  Male patients will also go through blood tests and a semen evaluation is usually required prior to starting the IVF treatment.  These pre-cycle tests can be done at your clinic.


4.  How long is the IVF process expected to take from start to finish?

The average time for the egg retrieval stimulation cycle ranges from 10-14 days, but each case can vary depending on how the patient’s body reacts to the medications.  This time frame starts when the patient begins medication used for ovarian stimulation for the egg retrieval procedure.

After the embryos are fertilized, it takes up to 2-4 weeks to receive the genetic testing results, after the embryos results are known.  Then there is the time needed to prepare for the embryo transfer cycle.  When it comes to a FET (Frozen embryo transfer) cycle, each case can vary due to several factors. The embryo transfer procedure takes place followed by a pregnancy blood test approximately 14 days post-implantation.


5.  Is fresh or frozen embryo transfers better?

Frozen embryo transfers have a higher success rate than fresh embryo transfers.

Most patients are advised to proceed with frozen embryo transfer. With a frozen embryo transfer, you already have embryos created and preserved for the use and an egg retrieval is not needed.

When you choose to freeze your embryos, PGT-A (Preimplantation Genetic Testing for Aneuploidies) can also be performed on the embryos to check for any chromosomal abnormalities; allowing you to know which embryos have normal chromosomes will eliminate chromosome-related diseases and increase the success rate of having a healthy baby.  You will also have an option of gender selection by choosing to have PGT-A testing done.


6.  Do I need PGT-A testing?

PGT-A tests all 23 pairs of chromosomes for structural/numerical abnormalities.  You might want to consider PGT-A if you are undergoing IVF, especially if you are 35 years old or above as aneuploidy risk increases with age, or if you have had previous pregnancy losses. PGT-A may help reduce your chance of miscarriage or abnormal pregnancy.


7.  What are the options for embryos that won’t be used?

Clinics will not discard any unused embryos without your permission. You can keep them in storage for future use, donate them to other patients who are looking for donated embryos or donate them for research.  When you start the treatment, we will be sent a disposition of embryo consent with all options provided, so you can make your own decision.


8.  Are there any side effects to treatments?

As part of the IVF treatment process, multiple medications and certain medical procedures are required, which can result in some side effects.  Injections may cause pain; fertility medication may cause mood swings and some abdominal pain and mild bloating during the process.   If you experience any symptoms or uncomfortableness, please contact your fertility clinic and they can provide you with solutions.

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