Infertility Tips

Fertility Drugs and IVF

In order for in vitro fertilization to be successful, assistance must be provided in the form of fertility drugs. These drugs are designed to stimulate and emulate hormones which normally regulate reproductive activities, to control the reproductive cycle and promote success with IVF. The primary drugs used in IVF include

- Gonadotropin (go-nad-oh-trow-pin) Releasing Hormone (GnRH) AgonistsAntagonistsGonadotropinshCGSolu-MedrolDoxycyclineProgesterone

- Progesterone is taken daily beginning two days after egg retrieval to support the embryo in the uterus until the placenta is able to make enough progesterone. This takes about 2 months.

- Doxycycline is given to the male partner during the woman's stimulation cycle to reduce bacteria that may be present in the sperm.

- Medrol is a steroid hormone given daily, for up to four days, to assist pre-embryo implantation in the uterine wall, following embryo transfer.

- Pregnyl, Profasi or Novarel is taken to help maturate the eggs and prepare them for retrieval. Gonal F, Bravelle, Follistim, Pergonal and Repronex are the most commonly used gonadotropins and they stimulate the egg follicle to ripen during inadequate follicular development.

Costs of IVF

In vitro fertilization is dependent on several factors, including:

• any prior infertility treatment
• location of the Fertility Clinic and any travel required
• time loss at work related to appointment and treatments
• actual IVF cost

1. Though usually considered separately, several other treatment options may have already been tried, including surgical repair of structural problems, use of fertility drugs and other assistive reproductive technologies, such as intrauterine insemination. The total for these treatments exceeds several thousands of dollars, and can be considered into the cost of the IVF procedure, since the result of these treatments led to IVF.
2. If travel is required for assessment, appointments and treatments, one should factor in these costs, as well, including: hotel, food and transportation.
3. Time loss from work should also be considered when calculating the costs of IVF. Since multiple appointments are necessary to complete the process, for the woman, missed work is a reality. If you do not have sick time, paid time off or family medical leave, this has a significant impact on your income.
4. The actual cost of the IVF is from $10,000 to $20,000 per treatment cycle. The success rate average if 35%, indicating it may take up to three attempts, or more, to achieve conception and viable pregnancy.

Role of In Vitro Fertilization in Fertility Treatment

There are many causes of infertility, including hormonal problems, structural or mechanical issues and medical conditions. There are also many different treatments available, to address the specific causes of infertility, such as hormone treatments or surgical correction of structural anomalies.

In vitro fertilization - IVF - is one type of infertility treatment, however it is not a first line treatment. Your Fertility Specialist will try other less invasive and less expensive options before choosing IVF, since many causes of infertility can be overcome with other treatment options.

IVF is best used for those situations in which a woman is trying to conceive and intrauterine insemination is not possible or effective, or in which donation of eggs or sperm is necessary to complete the process due to either male or female fertility problems within a couple.

How In Vitro Fertilization is Done

When a woman, or couple, and the Fertility Specialist determine that in vitro fertilization is the treatment of choice, there are several steps that must be taken to promote the greatest chance of success.

The primary steps in in vitro fertilization include:

1. Counseling - you will discuss the IVF process, risks and benefits, and outcome goals. Treatment consents will be signed, which may include consents for IVF and embryo transfer, micro-insemination, cryopreservation of resultant embryos and psychological treatment/evaluation.

2. Semen analysis - semen samples will be analyzed for: volume and consistently, sperm count, motility, structure and survivability

3. Testing - including ultrasound and hormone levels to establish baseline uterine and hormonal status, for the syncing of your IVF cycle

4. Fertility drugs - hormones will be provided to the woman, to stimulate egg production, including superovulation, where the ovaries produce more than one egg during a cycle. A greater number of eggs increases the chances for a successful IVF. Drugs will be added at different times during the IVF cycle, to prepare the uterus for implantation, promote egg and follicle development, and aid in egg retrieval or harvesting.

5. Egg Retrieval - eat or drink nothing 8 hours prior to your retrieval. Ultrasound is used to guide the needle as it enters the ovary for harvest, through the vaginal wall.

6. Fertilization - concentrated sperm is introduced to your eggs, in a petri dish or test tube

7. Transfer - with the use of a speculum, the procedure is similar to a Pap smear. An ultrasound guides placement of the embryos inside the uteris.

The steps related to IVF are fairly consistent, regardless of the Fertility Clinic that you use, due to the sequential nature of the human body in terms of fertility. Following the guidelines and instructions of your Fertility Specialist, will help to promote positive outcomes following IVF.

Alternatives to In Vitro Fertilization

Since IVF is not the first line treatment for infertility, there are other available options. Some of these options include:

• hormonal therapy - sometimes it is a hormonal imbalance that is preventing conception, and correction of this imbalance can result in successful pregnancy
• surgical intervention - if structural problems, such as blocked fallopian tubes or blockage of sperm ducts, are contributing to infertility, repair of these reproductive parts can successfully promote conception
• treatment of external causes - if acquired infection, radiation treatment for cancer or other externally generated cause of infertility is present, correction of these causes can aid in correcting infertility
• alleviation of medical conditions - cysts on the ovaries or testes, diabetes, pituitary tumor or other medical conditions can contribute to infertility and, when corrected, the result is a successful pregnancy and delivery
• counselling or therapy - if emotional factors are contributing to infertility, such as fear of failure, depression or anxiety resulting in erectile dysfunction or painful intercourse, counselling or other psychotherapy can help to relieve these symptoms, and promote sexual function and fertility
• other assistive reproductive technologies - intrauterine or intrafallopian insemination involve placement of sperm directly into the uterus or fallopian tubes during ovulation.