FAQ
IVF Questions
What protocols do we use for poor responders?
We are willing to try any protocol that has been shown to be effective in treating patients with low ovarian reserve. We often use the estrogen primed antagonist protocol or the microdose Lupron flare protocol. In our experience, however, even these protocols will be of little benefit if the total number of antral follicles is less than 5.
Is there a weight limit in order for me to undergo IVF?
Because our program is office based, we insist that our patients meet certain weight criteria before they can proceed with IVF at our center. Generally, the BMI (Body Mass Index) of less than 40 is desirable for safety reasons.
Do fertility drugs increase the risk of ovarian cancer?
The scientific data currently does not support a direct causal relationship between fertility drugs and ovarian cancer.
Does IVF treatment lead to a higher rate of birth defects?
Past research has not found an increased risk of birth defects with IVF treatment. However, in 2001 a large study concluded that the rate of major birth defects in babies conceived via IVF was twice that of babies conceived naturally (8.4% vs. 4%, respectively). Another way to look at this, however, is that a couple has more than a 90% chance of having a healthy baby via IVF. Also for many people, IVF is the only option available to have a child.
Why do I have to take birth control pills?
Taking birth control pills prior to start of the treatment cycle helps to suppress the pituitary to prevent premature ovulation later on. The pill also eliminates any ovarian cyst left over from previous cycles. Moreover, the pills can also lead to better follicular development due to its suppression of testosterone production in the ovaries. Finally, the pill gives us some flexibility in scheduling patients into groups for better efficiency.
Why am I spotting during the pill?
The pill has two hormones, an synthetic version estrogen and a progestin (synthetic version of progesterone). The progestin can make the uterine lining to be thin and fragile, making it easy to slough off. However, the bleeding does not mean that anything is wrong, and you should continue taking the pill as instructed.
When do I stop the pill?
You should not stop taking the active pills until instructed. All patients in a group will stop the pill on a predetermined day. If you run out of the active pill before this date, you should call us to get more pills.
Why do I have to take Medrol and Doxycycline?
Medrol is a light steroid that is used to prevent ‘inflammation’ of the uterine lining that can cause it to reject the embryo. Doxycycline is an antibiotics to prevent infection from the retrieval and to ensure that the uterus is free of bacteria before embryo transfer.
Does the egg retrieval procedure hurt?
Our board certified anesthesiologists will make sure that the procedure is comfortable for you. We had many patients who were surprised at how easy the process was. You may feel mild cramps afterward, but you should be able to walk out of the clinic after 30 minutes of rest.
How much work will I miss during my IVF cycle?
We try to make the IVF monitoring process as convenient for our patients as possible. During the 7-10 days stimulation period, you will likely come to the clinic 4-5 times for sonogram and blood work. You need to be off from work for only 2 days, on the day of egg retrieval and on the day of embryo transfer. Most patients will take another day off following the day of embryo transfer.
Should I worry if I spot after my transfer day or in the days before the pregnancy test?
No, spotting after transfer may be the result of implantation. You should have a pregnancy test even if you have heavy bleeding to confirm.
How do I inject my medications?
All injectable medications for the IVF cycles can be given subcutaneously at our center. We do not use intramuscular progesterone. For specific instructions on method of injection you can visit the pharmacy links listed elsewhere in this web site.
What form of progesterone supplement can I use?
We prefer that you use the vaginal progesterone supplement rather than the intramuscular injection (the oral route is ineffective). Our decision to use vaginal progesterone is based on numerous scientific researches that showed the superiority of the vaginal route over the intramuscular or oral route in endometrial maturation. Once placed inside the vagina, progesterone is absorbed quickly by the local vessels and brought to the uterus where it prepares the endometrium for the implantation process. The level of progesterone within the endometrium is highest with vaginal progesterone. Progesterone vaginal supplements can be used as Prometrium (200-mg three times a day) or as Crinone 8% (once a day), and can be started the day following egg retrieval.
Why do I need to use estrogen after embryo transfer?
Estrogen is added back to help maintain the hormonal balance within the endometrium. During egg retrieval, estrogen producing cells are aspirated along with the eggs, so there is a tendency for estrogen levels to drop. If the estrogen level within the endometrium is too low in relative to the progesterone level, destabilization of the lining can occur to cause bleeding.
I am newly pregnant but am bleeding, what happened?
It is quite common for IVF patients to bleed after they become pregnant. It is possible that the endometrium in IVF cycles is made less stable from exposure to high levels of hormones and drugs. In the majority of cases, however, the bleeding will eventually stop and the pregnancy will continue uneventfully. There is really not much we can do but to wait and hope for the best at this early stage of pregnancy.
