FAQ

It is very important that you do not wait too long to seek treatment. On the other hand, you and your partner should have sufficiently long "exposure" to pregnancy before spending time, money, and emotional energy on fertility tests and treatment. Please note that there is no distinction between having unprotected intercourse and "trying" to conceive. They both represent "exposure" to conception.

 

Female fertility begins to decline many years prior to menopause despite continued regular menstrual cycles. As a woman ages, the remaining eggs in her ovaries also age, rendering them less capable of fertilization and of being able to develop into normal embryos.

 

The following table illustrates the recommended length of "exposure”, in relationship to the female partner's age, before consulting a Reproductive Endocrinology and Infertility (REI) specialist.

 

Length of "Exposure" before Seeking REI Specialist

	No Exposure	1 to 3 months	4 to 6 months	7 to 9 months	10 to 12 months	13 or more months
Female Age 35 or Less	Begin sexual activity without contraception	Continue sexual activity	Continue sexual activity	Continue sexual activity	Continue sexual activity	Consult REI Specialist
36 to 37	Begin sexual activity without contraception	Continue sexual activity	Continue sexual activity	Continue sexual activity	Consult REI Specialist
38 to 39	Begin sexual activity without contraception	Continue sexual activity	Continue sexual activity	Consult REI Specialist
40 to 41	Begin sexual activity without contraception	Continue sexual activity	Consult REI Specialist
42 to 44	Consult REI Specialist

 

Your state of health can play an important role when trying to conceive. Please see the How to Optimize Your Fertility Potential page and try to follow the recommendations as closely as possible.

The decision which treatment is the most appropriate for you is based on your past reproductive history, results of your fertility testing, and the outcome of any previous reproductive treatments you may have had. You may need In Vitro Fertilization or Soft-IVF™ treatment if any of the following apply to you:

1. The female partner is between the ages of 39 and 43.
2. You have been sexually active without contraception for a year and a half or more.
3. There may be male factor infertility present.
4. You have a history of tubal blockage or pelvic adhesions.
5. You have a history of endometriosis.
6. You have a history Polycystic Ovary Syndrome (PCO) and have not successfully conceived with oral or injectable ovarian stimulation.
7. You were told that your infertility is unexplained.
8. You did not become pregnant with intrauterine insemination (IUI) cycles.
9. You did not become pregnant with ovarian stimulation cycles with oral or injectable medications.
10. You have had three or more miscarriages.

It takes approximately 6 to 8 weeks from the beginning of your treatment to the egg retrieval and embryo transfer. Please see IVF Protocol for detailed description of the sequence and timing of procedures in the In Vitro Fertilization treatment.

Treatments that require ovarian stimulation (IVF, Soft-IVF™, Gender Selection, Genetic PGD, and Gestational Surrogacy) require a resting cycle before another cycle of treatment can start. It does not make a difference whether you rest your ovaries just for one cycle or several menstrual cycles.

 

Other treatments (Egg Donation and Cryopreserved Embryo Transfer) do not require a resting cycle, and your new treatment cycle can start right away.

We normally do not recommend more than four cycles of IVF, Soft-IVF™, Egg Donation, and Gestational Surrogacy treatment. The number of treatment cycles you should plan for is ultimately a personal choice, but we will help you with your decision. The lower the probability of a successful pregnancy per cycle of treatment, the more cycles of treatment you should be planning for.

 

Once you have completed your treatment prerequisite, we will be able to estimate your probability of success and help you with your decision.

Please see the Fertility Test page.

The probability of a successful pregnancy depends on the likelihood of being able to produce high quality eggs and sperm. Most patients should expect a 25% to 50% probability of a successful pregnancy per cycle of In Vitro Fertilization at Bay IVF Center.

 

Most patients can increase their pregnancy probability having more than just one cycle of treatment. A treatment cycle represents completion of ovarian stimulation, egg retrieval and embryo transfer.

 

The following graph illustrates the increase in successful pregnancy probability if you plan to have more than one cycle of treatment.

 

 

In this example, we used an arbitrary 35% successful pregnancy probability per In Vitro Fertilization treatment cycle. Your actual odds of pregnancy could be higher or lower.

Dr. Polansky, board certified in Reproductive Endocrinology and Infertility (REI) in 1986, is at a stage in his professional career which allows him to donate his expertise. You will never be charged for his medical care. You will only be billed for the laboratory portion of your tests and treatment. Your total cost per cycle of treatment will be substantially less than prevailing reproductive treatment fees.

Most patients should expect minimal, if any, side-effects from the In Vitro Fertilization treatment. The medications we use may have the following side-effects:

 

Lupron is used to prevent premature ovulation. It has minimal, if any, side effects, most commonly transient headaches, possible hot flashes and body fluid retention. Localized skin reaction at injection site may occur.

 

FSH is used to stimulate the development of multiple eggs in the ovaries. Mild degrees of ovarian overstimulation are common side effects of this medication. A more pronounced overstimulation is characterized by abdominal bloating, weight gain (due to body fluid retention), and mild to moderate pelvic and/or abdominal discomfort. This is a self-limiting condition and does not require treatment. Severe ovarian overstimulation is rare. The swollen ovaries can cause moderate to severe pain usually lasting a few days. Localized skin reaction at injection site may occur.

 

HCG is necessary for the final stages of egg maturation. It is also used to increase the probability of embryo implantation. In some cases, HCG can contribute to ovarian overstimulation. Localized skin reaction at injection site may occur.

 

Progesterone is used to supplement your own progesterone production. It is given as a vaginal capsule. Typically there are no side effects, however, vaginal dryness and vaginal wall localized irritation may occur.

 

Doxycycline is a broad spectrum antibiotic used to eliminate possible bacterial contamination of the abdominal cavity, semen, and the uterine cavity. Very few people are allergic to Doxycycline. A common side effect is transient nausea and possibly vomiting, especially if the medication is taken on an empty stomach. Photosensitivity manifested by an exaggerated sunburn reaction has been observed with Doxycycline; excessive sun exposure should be avoided.

 

Demerol/Fentanyl are narcotic medications used for pain control during the oocyte retrieval procedure. The possible side effects include lightheadedness, dizziness, sedation, sweating, nausea and possible vomiting.

 

Diazepam is used for relaxation and, in conjunction with Demerol, for pain control. The most commonly reported side effects are drowsiness and fatigue.

 

Xylocaine is used as a local anesthetic during the oocyte retrieval procedure. The side effects are rare and may include lightheadedness, transient drowsiness, and dizziness.

 

Medrol is a corticosteroid. It is given in a small dose to protect embryos from being attacked by immune cells. It is given only if the eggs or embryos have Intracytoplasmic Sperm Injection (ICSI) or Assisted Hatching. Since the Medrol dose is very low, it typically has no side effects.

Any patient undergoing ovulation induction is at risk of developing OHSS, although some more than others. Ovarian hyperstimulation syndrome may be classified as mild, moderate or severe by symptoms and signs.

 

The symptoms usually begin four to five days after the egg retrieval. A majority of women have a mild or moderate form of the syndrome which invariably resolves within a few days. Patients may complain of abdominal discomfort and mild abdominal swelling. In a small proportion of women, the degree of discomfort can be quite pronounced. If a pregnancy occurs, it may delay recovery.

There may be more embryos than the future parents wish to have transferred. It is possible to cryopreserve (freeze) these embryos and store them in liquid nitrogen. The majority of the embryos should survive the cryopreservation and thawing process. The implantation rate of the surviving embryos is similar to the "fresh" embryos.

There is no time limit on storing cryopreserved embryos. They are stored in liquid nitrogen at close to absolute 0 degree temperature, and do not “go bad”. Also, your uterus does not “grow old”. Theoretically, there is no limit on the age of frozen-thawed embryos recipient. Since pregnancy complications, not related to the uterus, increase significantly with age and could compromise the mother's and baby's health, you must be 49 or younger at the time are transferring your frozen-thawed embryos at Bay IVF Center.

There is an extensive number of published reports documenting no correlation between babies conceived with medical intervention and birth defects. These are real and natural babies conceived with a little assistance. They will kick, spit-up, scream and keep you up all night just like any other baby.

This will probably not disturb your treatment. If you realize that you missed a dose before your next Lupron injection is due, take the missed dose when you remember and continue with your regular schedule. If you realize that you missed a dose when your next Lupron injection is due, skip the missed dose, do not double-up, and continue with your regular schedule.

Since we use powerful pain medications to help minimize the discomfort, most patients will experience only minimal to mild menstrual like cramping during the procedure.

Please see the Unexplained Infertility page.

Please see the Endometriosis page.

Please see the Polycystic Ovary Syndrome (PCO) page.

Please see the Fertility Test page.

Premature ovarian failure refers to a loss of normal function of the ovaries before the age of 40. The ovaries can no longer produce normal quality eggs and female hormones estrogen and progesterone.

 

There is no known cure for premature ovarian failure and most patients will need Egg Donation treatment to conceive successfully.

Please see the Uterine Receptivity page.

Please see the Intracytoplasmic Sperm Injection (ICSI) page

Please see the Assisted Hatching page.

You may consider adding Pre-implantation Genetic Diagnosis (PGD) to your In Vitro Fertilization, Egg Donation, or Gestational Surrogacy treatment. If you do, you will not need to do amniocentesis if you conceive.

 

Adding PGD to these treatments has not been shown to improve the probability of a successful pregnancy. Most couples decide not to combine the PGD procedure with their treatment.

The jury is still out on whether acupuncture can increase one’s fertility potential. Two recent studies found an increase in conception rate among women undergoing acupuncture. A third study did not find a statistically significant improvement. It is possible to conclude from the available studies that acupuncture is safe for women undergoing advanced reproductive treatments.

Yes, you can take Tylenol, Sudafed (regular), and Robitussin DM.  Please contact our office for any other questions or suggestions.

Yes, you can take the injectable form of the flu vaccine.

Once pregnancy is achieved, we recommend that you do not eat uncooked fish (e.g., sushi) or undercooked fish, shellfish, eggs or meat.

To prevent becoming infected with toxoplasmosis, an infection that isn't serious for you but can pose a danger to your developing baby, once you become pregnant you should not change the litter of a cat litter box. We also recommend that you use gloves and mask when you garden. Be cautious around sand in parks or playgrounds.

Once your embryos have been transferred,, we recommend that you do not dye your hair through the first trimester.

Once your embryos have been transferred, we recommend that you do not soaking in a hot tub or use a sauna, due to high temperature.

It is not necessary from the conception point of view.  The embryo stays unattached in the endometrial cavity for two to three days before it implants.  Exercising and normal daily activities will not inhibit the embryos from attaching. The biological quality of the embryo will decide whether or not it will implant and continue to a healthy baby.

Insurance plans vary greatly. In order to determine if you have coverage for infertility treatments, we can call your insurance provider for you to confirm what, if any, benefits are available. You can also inquire by writing to your insurance provider.