Preparation for IVF Treatment

Acceptance into an IVF Program

First things first, a complete medical evaluation. The family doctor would probably have already gone through the regular gamut of procedures that make up a primary fertility assessment. This information is needed by the fertility clinic. Other questions will be asked, such as personal habits, sexual life, abuse, abortions, drug use, lifestyle, and anything else that may seem important to the particular clinic. Psychological evaluations will also take place. After all of this information has been collected the descision will be made of whether or not the couple is eligable for IVF.
Once accepted into the program the couple will be explained about the financial, physical, and emotional commitments that the treatment will have. Different clinics require the couples pressence at different times for varying lengths of time. Inquiry about these issues should be done to make things clear.

The Nurse-coordinator/liaison

Expect to spend as much time with your program coordinator (usually a nurse) as you do with your doctor. It could be said that this person is in charge of the smooth flow of the IVF program. This person will be the contact person throughout the program, they will tell you every step of the way what to expect, and they will be the ones to answer any questions that may arise.
The client is encouraged to ask any questions they may have. Most clinics are good with this aspect. Some programs also have access for the couple to a counsellor. This is to properly address the psychological weight that burden the couple throughout.

Tests that may be done before IVF

AIDS

This test is usually a personal decision between the couple. This is recommended because the doctor has a medical, legal, and moral obligation to make every attempt to ensure that the baby to be is not starting life with a terminal illness.
Many clinics require that both partners take the test. Although you can never be forced to have this test.
Some people wonder about the chance of AIDS being contracted through the use of fertility drugs derived from the urine of menopausal women. The conditions to which these substances are put through in the process of becoming a purified drug make it not likely that any virus would survive.

Sperm Test

This test ensures that the sperm’s viability and motility are not abnormal.

Sperm Antibody test

If a man has antibodies to his sperm, this will obviously negatively effect the chances of fertilization. If this is the case it also greatly effects the way the sperm is prepared for the IVF process. If the concentration of sperm antibodies is very high it may mean that an intracytoplasmic sperm injection (ICSI) will be required. An ICSI is a process where a single sperm is captured in a thin glass needle and is injected directly into the egg.

Pelvic Exam

This checks the shapes and irregularities of the uterus and surrounding organs.
Fibroids, tumors, ovarian cysts, swollen fallopian tubes are found this way.
The position of the uterus (tipped forward (anteverted), backward (retroverted), or central (axial)), will be checked and will help with determining the position the woman will be in at transfer time.

Trial Mock Embryo Transfer

When the pelvis is checked, some clinics may introduce a catheter to the uterus via the cervix. This is to help with the length the catheter needs to be inserted during the real transfer. The ideal distance from the fundus of the uterus for the introduction is 0.5 cm.

Cervical Cultures

This is used to evaluate for microorganisms that cause various pelvic disease (gonococcus, chlamydia, ureaplasma). If an organism is found in either partner, both will be treated and retested to ensure the eradication of the disease before IVF is undergone.

Hysteroscopy or Fluid Ultrasonography (FUS)

Surface lesions that might interfere with implantation are detected by a routine hysteroscopy or FUS. These still should be done despite the fact that there was a recent normal hysterosalpingogram.
Polyps, fribroids, or tumors that may effect IVF success are found this way. This is a simple procedure that does not require any significant post-operative care.

Measurement of FSH (follicle stimulating hormone) and Estradiol on the second or third day of a natural menstrual cycle

On the second or third day of a menstrual cycle preceding IVF helps evaluate the potential ability of the woman’s ovaries to respond to fertility drugs. It also provides information that the doctor can use to select the most ideal dosage and schedule of fertility drugs to achieve an optimal response.

Pretreatment Consultation

Once the tests are completed, the whole process of the IVF will be discussed in full detail with the couple. The couple may have a couple of decisions to make, i.e. how many eggs they wish to have fertilized, what they want to do with any extra/excess eggs, how many embryos they want transfered into the uterus, and the big one, how do they want to deal with large multiple pregnancies.

Multiple Pregnancies

Enough embryos are transferred into the uterus to ensure the highest probable birthrate. Some clinics will only transfer a certain amount (3-4 or as many as six). As could be expected, this can result in multiple pregnancies. The incidence of twins in IVF women under 40 is approx. one in every four pregnancies, triplets is about one in every 20, and quadruplets is about one in every 50 (1).
The older the client undergoing IVF is, the more embryos they will be advised to treansfer.
Most women can tolerate a twin pregnancy, a pregnancy of a larger number threatens both the lives of the mother and the babies. For the mother, high blood pressure, uterine bleeding, and cesarean section complications are the risks. Premature birth is a regular occurence with multiples. This may result in brain damage, dangerously low birth weight, or even compromise the childs chance of survival.
Selective reduction of pregnancies is usually done defore the completion of the third month of pregnancy. It involves the injection of a chemical into one or more developing fetuses. They do not continue to develop which results in reabsorption by the mothers body. There is some evidence that points towards the body doing this process on it’s own, to sustain balance and ensure healthy pregnancies. Because of the risks involved, it is not recommended to preform this techniques when there are any less than three fetuses.

Must Read: Miscarriages Linked to Defective Sperm and Lower Sperm Counts