WHO NEEDS IVF?

Although its original intention was to treat women with tubal disease, in-vitro fertilization (IVF) can help couples overcome various types of infertility. For some diagnoses or conditions, such as tubal factor, IVF may be the first-line treatment. In other cases, IVF may be recommended only if simpler treatment fails. Below is a list of common indications for IVF treatment:

Tubal Factor (Damage to Fallopian Tubes) / Pelvic Adhesions

There are two options to treat patients with significant tubal damage and/or pelvic adhesive disease. The first option is to surgically repair the tubes and either get pregnant naturally or use Artificial Insemination or IUI to get pregnant. In many cases, however, surgery is not a good option as it may be very difficult to surgically fix the damaged tube(s) and/or the surgery may cause a high risk of an ectopic pregnancy. In these instances where the surgical option does not pose a high chance for success, the second option is to by-pass the tubes completely by using IVF as the treatment plan. Advanced Fertility Care Physicians will individualize the treatment plan for each patient or couple at our Mesa, Scottsdale and Glendale AZ offices, and if you have tubal damage, they will provide you detailed information on each option so that you can make an informed decision.

Endometriosis

Current scientific data about endometriosis shows that mild to moderate forms of endometriosis may be effectively treated with a combination of surgical and medical therapy. For more stages of endometriosis, including the presence of endometriomas, IVF is the optimal first line treatment and offers the highest pregnancy success rates.

Male Factor Infertility

One of the most significant advances in the treatment of infertility has been the ability for men with severe sperm abnormalities to achieve fertilization of the egg and successful pregnancy. IVF with addition of ICSI (Intracytoplasmic Sperm Injection) has enabled couples suffering from abnormal sperm, who would not otherwise be able to conceive, to be able to start a family. ICSI is often recommended if there is any suggestion of a sperm problem, if sperm are obtained surgically, or if there has been a prior failure of fertilization.

Diminished Ovarian Function & Age Related Infertility

During the course of woman’s normal reproductive life, her ovarian function decreases with age. In many cases, this reduced function can be overcome through the use of IVF alone, or in conjunction with techniques such as Assisted Hatching and ICSI. For some women, this decrease in ovarian function may start at earlier ages and requires aggressive treatment with IVF sooner rather than later.

Anovulation & Polycystic Ovarian Syndrome (PCOS)

The majority of patients with an ovulation and/or PCOS often conceive using less aggressive treatments such as ovulation induction with IUI. For some patients who are “high responders” to gonadotropin therapy, IVF offers an excellent prognosis and reduces some of the risks of higher order multiples.

Unexplained Infertility

Approximately 20% of couples will have no identifiable cause of infertility after completing a comprehensive evaluation. IVF is often successful even if more conservative treatments have failed, especially since some of these couples may have yet unidentifiable causes of infertility or sub-fertility.

Family Balancing (also known as Gender or Sex Selection)

For families that wish to have additional children of a particular gender after already having a previous child, PGD allows for selection of embryos to transfer based on gender. While not perfect, embryo biopsy with genetic chromosome determination prior to transfer of embryos can allow families choice in how they expand the family. Read more about PGD.

Genetic Diseases / Preimplantation Genetic Screening or Diagnosis (PGS or PGD)

One additional indication for IVF is to provide genetic testing on embryos prior to implantation. PGD or PGS is used for patients who are at risk for passing on genetic disorders to their offspring as a result of one or both of the partners being carriers for the disease. Diseases such as Cystic fibrosis and Thalassemia are 2 examples of the hundreds of diseases that can be tested for prior to embryo implantation. In addition, IVF with PGS is indicated for women with recurrent pregnancy loss related to chromosomal abnormalities or repeated failed IVF attempts. Learn more about PGD.

What is In Vitro Fertilization

In Vitro Fertilization (IVF) is a form of assisted reproductive technology (ART) that helps couples dealing with infertility conceive. The process involves extracting a woman’s eggs, collecting a sperm sample and combining the egg and sperm manually. After the egg and sperm have been combined in the laboratory, the embryo or embryos are transferred to the uterus. Although more costly, time consuming, and invasive than artificial insemination, IVF has excellent success rates for overcoming various types of infertility. Some of these include tubal factor, endometriosis, male factor infertility, age related infertility, diminished ovarian function, polycystic ovarian syndrome and unexplained infertility. Other implications for IVF are gender selection and preimplantation genetic screening for parents at risk for passing down genetic disorders.

 

There are additional options for IVF, like ICSI, PGD, assisted hatching, donor sperm, and a gestational carrier. Our goal is help you have a healthy baby, the least invasive, most cost effective way. The Advanced Fertility Clinic physicians will go over every possible option with you to guide you in making a more informed decision about the process that is right for you.

 

What is IVF?

IVF for male infertility

Sometimes, IVF for male infertility is the best treatment option. When the semen analysis is abnormal and identifies a male factor, it’s important to look for the cause. If the low sperm count appears to hormone-related, caused by an infection or related to a male anatomic abnormality, basic treatments may be used. If these do not work, or if it is a more severe case of male infertility, IVF is usually the treatment of choice.

Options other than IVF for male infertility

For hormonal imbalances like a low testosterone level, Doctor may choose medications like Clomid or fertility shots. The partners of men with decreased sperm counts and normal hormone levels will often undergo IUI. This is a simple and relatively inexpensive treatment for mild cases of male infertility.

Anatomical abnormalities that contribute to male infertility often require further evaluation by a urologist. Urologists are specialists regarding the male reproductive system. They will work with Doctor to determine what treatment is necessary.

If the sperm count is too low for IUI, IVF for male infertility may be the best treatment option. This treatment is a very successful option for couples with male factor infertility.

When do we recommend IVF for male infertility?

If a semen analysis reveals a very low concentration of normal sperm, Doctor often will recommend IVF for male infertility. This is because the chances of success are much better than with timed intercourse or IUI.

IVF is also a good option when there are multiple fertility factors, such as a low sperm count in combination with a blocked tube, difficulty in ovulation or advanced age of the woman. IVF can be the most effective treatment for couples in these situations by increasing the chance for fertilization of the egg.

The reason why is as follows:

How to Increase Chances of IVF Success

If you are looking to increase your chances of conceiving during IVF, here are 8 tips from 5 different fertility doctors.

 

1. Maintain a healthy weight.
"Maintaining a healthy weight is extremely important in fertility and IVF," says Linnea Goodman, MD, Assistant Professor of Obstetrics and Gynecology at the UNC School of Medicine. "We know that being obese (BMI >35) and underweight (BMI <19) increases time of conception by 2 and 4 times respectively, and negatively effects IVF success rates. Being overweight also makes monitoring the ovaries during IVF more difficult and increases the chance of complications during egg retrievals."

This is best implemented with changes in diet and activity with professional help.

"Working with dietitian, and in some programs enrolling in a cardio metabolic weight loss program can help achieve these goals," says Zaraq Khan, MD, reproductive endocrinologist at Mayo Clinic in Rochester, MN.