Prepare for in Vitro Fertilization

In Vitro Fertilization (IVF) is a series of procedures used to treat fertility and other genetic problems to assist you in conceiving a child. IVF is the most effective form of assisted reproductive technology currently available, but your chances of conceiving through IVF depend on several factors, including your age and the cause of your or your partner’s infertility. There are steps you can take to prepare yourself for the procedure both physically and mentally for a higher success rate. A healthy, nutritional diet high in protein is important to maximize your egg production as a woman, whereas mentally you may need to prepare yourself for regular injections and fertility testing.

Steps

Understanding the Process

1. Understand the process of receiving IVF. Before you embark on IVF treatment, you should be well aware of the process of doing IVF to better prepare yourself and your partner, if you are going to do IVF with the support of a partner. IVF involves five main steps: ovulation induction, egg retrieval, sperm retrieval, fertilization, and embryo transfer. One cycle of IVF will take about two weeks and you may require more than one cycle to conceive. The process of receiving IVF involves three phases:
   • Phase 1: You will be given fertility shots to increase follicle production and stop your ovulation. You will have multiple visits to your doctor for blood tests and vaginal ultrasounds.
   • Phase 2: Once the eggs mature, there is minor surgery to retrieve them. An embryologist will prepare the eggs and place them in a petri dish. The sperm is then introduced by injecting a single sperm into each egg.
   • Phase 3: After the eggs are fertilized, the eggs’ cells continue to divide until Day 3 or Day 5, when the embryos are transferred. The embryos are screened for disabilities such as cystic fibrosis, muscular dystrophy, and Prepare for the Birth of a Child With Down Syndrome, if desired. You will then need to decide how many embryos you would like to transfer to your uterus, and if you would like the remaining embryos to be frozen.
   • Keep in mind the possibility of conceiving via IVF cannot be predicted, as each couple has possible factors, such as age and reproductive health, that can affect the success of the treatment. Your doctor should be able to give you a sense of the likelihood of pregnancy for you, based on your background and medical history. However, IVF is the most viable fertility treatment currently available and has been known to have a high rate of positive results.
2. Be aware of the risks of IVF. IVF is a costly procedure and can take up a lot of your personal time. It can also be stressful and mentally draining, especially if you and your partner are struggling to conceive and have to go through several cycles of IVF before getting pregnant. Stress and anxiety can become big risks during the IVF process. There are several medical risks when you use IVF, including:
   • Multiple births: IVF increases your risk of multiple births if more than one embryo is implanted in your uterus. If you become pregnant with multiple babies, you may have a higher risk of early labor.
   • A premature delivery and a low birth weight.
   • Ovarian hyperstimulation syndrome: This occurs when your ovaries become swollen and painful. This syndrome can occur due to the use of injectable fertility drugs. You may experience symptoms like abdominal pain, bloating, nausea, vomiting, and diarrhea. If you become pregnant, you may experience these symptoms for several weeks.
   • A miscarriage: Though the rate of miscarriage for women who conceive using IVF is similar to that of women who conceive naturally, the rate can increase as the age of the mother increases. Using frozen embryos during IVF has been known to slightly increase the risk of a miscarriage. ^{[citation needed]}
   • Complications during the egg-retrieval procedure: The doctor will need to use an aspirating needle to the collect the eggs and this could cause bleeding, infection, or damage to your bowels, bladder, or a blood vessel.
   • An ectopic pregnancy: This occurs when the fertilized egg implants outside the uterus, usually in the fallopian tube. About 2 to 5 percent of women who use IVF will have an ectopic pregnancy.
   • Birth defects: there is evidence that the rate of birth defects in IVF pregnancies is slightly higher than in spontaneous pregnancies, but the exact mechanism for this is unclear.
3. Discuss the financial obligations of IVF with your doctor. IVF is known to be one of the most expensive fertility treatments available. A basic IVF cycle in the U.S. can range from $18,000-$20,000. Most insurance companies will cover diagnostic testing, such as ultrasounds or a hysterosalpingogram, but many do not cover the IVF treatment itself. Your costs will depend on your individual needs, as well as the standard costs at your fertility clinic. The quote for your IVF treatment may include:
   • Fertility medication
   • Initial fertility tests
   • Ultra sounds and monitoring
   • Blood tests
   • You may also need additional treatments like ICSI, where a single sperm is injected directly into an egg, which can cost $1,000-$1,500, or PGD, where the embryos are genetically tested, which can be $3,000 or more. If you decide to freeze the embryos, you may need to spend several hundred dollars for the initial freezing and storage.
   • Your doctor should be able to provide you with a financial overview of your IVF treatment, and offer you any alternate sources of funding for your treatment if you cannot afford it. Some clinics offer IVF refund programs, where you pay a set fee (from $20,000-$30,000) and the clinic will refund part of your money if you do not conceive after three to four cycles. However, you should clarify what your clinic considers a positive result, as leaving the clinic pregnant does not guarantee a child. You may have a miscarriage or a complication, and miss your chance to receive the refund.
   • Some insurance companies also offer partial coverage of IVF treatment or fertility diagnostic procedures. Speak to your insurance company about covering the cost of IVF. You may need to switch to a clinic that is covered by your insurance company to receive financial support.
4. Have the support of your partner and/or close family members. IVF is a process that requires you have eight to ten injections a day, and go through many tests, as well as attend many doctor visits. During your IVF treatment, seek the support of your partner and/or close family members. You will need someone to learn how to inject you with fertility hormones several times a day, and you may need assistance when dealing with the side effects of these injections.
   • Side effects of the IVF treatment include skin irritation at the injection site, abdominal bloating, breast tenderness, headaches, and nausea. You will also be required to attend regular doctor visits during the IVF cycle to confirm your progress. Don’t be afraid to lean on the support of your partner and/or close family members as you go through the IVF process, especially if you are experiencing side effects from the injections.
5. Join an IVF support group. Many couples who are going through the IVF process find it useful to join a support group. Look online for a fertility support group in your area that focuses on IVF. IVF can be a stressful process and it can help to reach out to others who are experiencing a similar stress or anxiety to help you and your partner cope with any issues you may be experiencing.

Starting the IVF Process

1. Get screened by your doctor for any fertility issues. Before you begin IVF, your doctor will do several tests on you and your partner, if he is the sperm donor, to confirm your individual levels of fertility.
   • Your doctor may do an ovarian reserve test, which will determine the quantity and quality of your eggs. This can be done through a blood test conducted during the first few days of your menstrual cycle. The test results, as well as an ultrasound of your ovaries, can help your doctor determine how your ovaries will respond to fertility medication.
   • Your doctor may also conduct a uterine cavity exam, using a sonohysterography, where fluid is injected through your cervix into your uterus and an ultrasound is done to create images of your uterine cavity. Your doctor may also use a hysteroscopy, a thin flexible lighted telescope, and insert it through your vagina and cervix into your uterus to determine the state of your uterine cavity.
   • An HSG is another common procedure. Your doctor injects a dye through the cervix and takes x-rays to look at the shape of the cavity and to confirm that the fallopian tubes are open.
2. Have your partner's fertility tested. Your partner may need to undergo a semen analysis before the start of any IVF treatment if he is going to be the sperm donor. This will determine any fertility issues in your partner.
   • You and your partner will need to be screened for infectious disease, including HIV, before IVF treatment can begin.
3. Participate in a mock IVF cycle. About a month prior to your first IVF treatment, your doctor may ask you to participate in a mock cycle. This will show you that you and/or your donor are responding well to the hormone therapies.
   • During the mock cycle, your doctor will do an ultrasound 10-12 days into your estrogen enhanced cycle. This will help your doctor determine the depth of your uterine cavity and the technique that will be the most successful for placing the embryos in your uterus. You may also need to start taking birth control pills to regulate your cycle so you can synchronize with your donor’s cycle, if you are using a donor.
   • The doctor may also give you a gonadotropin releasing hormone, which will inhibit the surge of luteinizing hormone (LH) in your body. This will ensure the lining of your uterus is ready for the implanted embryo.

Adjusting Your Routine and Diet

1. Take omega 3 fish supplements and folic acid supplements. Omega 3 fatty acids have been shown to improve embryo morphology during IVF treatment. As well, folic acid is taken by pregnant women to improve the health of the fetus, and taking this supplement in preparation for the IVF treatment can prepare your body for pregnancy.
   • Supplements are not regulated by the Food and Drug Administration (FDA), so also choose supplements that have been third party tested for contaminants and recommended by your doctor. Your doctor can also recommend the proper dosage of each supplement.
2. Do mild to moderate daily exercise. Women who are overweight or in poor physical shape can have a lower risk of conceiving during an IVF cycle. Doing gentle exercise like daily walking or yoga can reduce any stress you may experiencing as you prepare for IVF and regulate your blood circulation. Mild to moderate exercise has been shown to have no negative effects on IVF treatments.
   • However, you should avoid strenuous activity and intense cardiovascular activities like running, jogging, or aerobics, as this could lead to a decrease in live births and pregnancy loss during IVF treatment.
3. Maintain a healthy sleep cycle. To increase your rate of fertility results, you should implement good nutrition and health practices at least four to six weeks prior to your first IVF cycle. This includes maintaining a healthy sleep cycle, with at least eight to nine hours of sleep a night.
   • Try to sleep in complete darkness, as this improves your body’s melatonin production. Melatonin is a hormone that helps with healthy follicle development. Getting melatonin naturally through a healthy sleep cycle is more beneficial than taking melatonin supplements.
4. Eat high quality, low fat foods. Treat your body like you are preparing for pregnancy and maintain a healthy, low fat diet, with high quality foods that are good sources of iron, potassium, and magnesium. Establish a diet that is high in leafy greens, fruits, vegetables, calcium, and protein.
   • Avoid starting a restrictive diet, like a low-calorie or a low-carbohydrate diet. Instead, maintain a healthy diet so you can maintain a healthy weight that will not put your IVF treatment at risk.
5. Limit your caffeine and alcohol intake. Just like if you were pregnant, you should restrict your consumption of caffeine and avoid drinking alcohol or smoking. This will ensure your body is at its healthiest before you start IVF treatment.

Tips

• When consulting with an IVF specialist, be sure to obtain a realistic estimate of the chances for success.
• There is evidence that using frozen embryos results in a higher pregnancy rate than a fresh cycle.

Sources and Citations

See also

• Know if You are Pregnant
• Get Pregnant Quickly
• Know the Earliest Pregnancy Signs
• Have a Girl
• Recognize Implantation Bleeding
• Get Pregnant With PCOS
• Prepare Yourself for a Healthy Pregnancy at 35 Years Old
• Tell Implantation Symptoms from PMS Symptoms
• Raise the Chances of Having a Boy
• Increase Fertility in Men

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