It is a miracle that we’ve advanced to the point where single-cell surgery is not only possible but for experts even routine.
Despite IVF (in vitro fertilization) being one of the most advanced treatments for infertility, for many going through it, IVF is far simpler than they expect. I often repeat the advice I got from a patient a decade ago who said, “You can have all the fear of flying you want, but what matters is if the pilot has a fear of flying. As long as you get on the plane, the rest is up to the pros.” Similarly, just as you don’t need a pilot’s license or an aeronautics degree, you can get good IVF outcomes without understanding much of the underlying science.
That being said, there are some parts of IVF that when explained make it easier to understand why it works and how to channel your energy in to things that matter most. For example:
Who gets pregnant?
There can be subtle factors, but the overwhelming determinant is how many eggs you have (figured out through testing) and whether the eggs are good quality (age is the best, but a limited proxy). If at 30 you need 4 eggs to get one good blastocyst with a roughly 50% chance of taking, the person getting 8 eggs averages 2 chances, while the person getting 20 eggs averages 5 chances. Nothing is 100%, but the person getting 20 eggs typically does better than the person getting 8.
What medications do I take?
Though each fertility specialist has his/her own recipe, most of it boils down to a few core treatments:
- -FSH: (Follistim, Gonal-F) The “quantity” medication (how do we get enough eggs)
- -LH: (Menopur which also has FSH) The “quality” medication (how do they mature appropriately)
- -GnRH agonist/antagonist: (Lupron, Ganirelix) How you avoid ovulating early
- -Estrogen/progesterone: How you synchronize the ovaries and lining before retrieval and support it after transfer
These have to be customized to each woman’s anatomy and fertility, and more is not always better. For example, too much FSH adds cost, risk for hyperstimulation, and may force retrieving eggs before they reach ideal quality.
Do I need PGT-A?
Preimplantation genetic testing for aneuploidy (i.e. identifying Down syndrome and other changes in chromosome numbers) won’t change whether an embryo has 46 chromosomes or not. If 2 out of 5 embryos would ultimately implant, PGT-A won’t change that but adds cost from testing. However, PGT-A can tell you which embryos are most likely to implant, reduce the risk of miscarriage, guide future family planning, and depending on clinical style possibly reduce the risk for multiples. Though many women worry IVF creates twins (and some even want this), the chance of multiples entirely relates to how many embryos are put back, so if a woman has a single embryo transferred, the chance of (identical) twins is ~1%.
How can I make sure that I’m pregnant with IVF?
No one can give a 100% guarantee for pregnancy, not even with donor egg, donor sperm, and a gestational carrier (“surrogate”). However, many women have 70-80%+ chances with a single cycle. If eligible, we even offer “Reassurance packages,” where if not bringing home a baby, 100% of our IVF fees are refunded.
When you want a baby and things aren’t working easily, there can be a lot of questions.
Know that you are not alone, there are straightforward answers and we can help you on your journey to the family of your dreams. We’re all about Positive Steps and are happy to be your guide on the way!
J. Preston “Pres” Parry, MD, MPH
From simple explanations, to high tech solutions, or a simply a fresh perspective if what you’ve been doing on your own or with a doctor hasn’t worked, come see us in our Monroe, Shreveport, Madison, Starkville or Hattiesburg MS offices.