Frequently Asked Questions
Smoking: Stop smoking before ovulation induction begins. It is best to discontinue tobacco at least 3 months prior to an IVF cycle. If you cannot stop "cold turkey", seek the care of your primary care physician. By products of tobacco have been demonstrated to be toxic to the oocyte (egg). Numerous studies have also demonstrated that smoking during pregnancy results in reduced birth weight and fetal compromise. There is some data that smoking can also lower pregnancy rates. We strongly recommend that all women, especially those undergoing fertility treatment, cease smoking.
Drinking: Alcohol is a drug, and should be avoided during infertility treatment and pregnancy. Please do not drink alcohol from the time fertility medications are initiated until the pregnancy test.
Medications: If you are taking any medication, prescription or over-the-counter, please inform your physician. Some medications may interfere with the fertility medications prescribed, some are not safe to use before an operation or medical procedure, and others might interfere with ovulation or pregnancy implantation. A prenatal or multivitamin will be prescribed; if you are not taking a vitamin with folic acid, please inform the ART nurses. Also, please note: DO NOT USE HERBAL SUPPLEMENTS DURING YOUR IVF CYCLE
An IVF cycle can be an emotional and stressful time for you and your partner. It may be helpful to have supportive personnel to speak to, such as friends and family, a clergy member, or a psychologist/therapist.
Heavy exercise such as aerobics, jogging, weight lifting etc. are prohibited during ovarian stimulation and until the pregnancy test results are known.
Acupuncture is permitted prior, during and after your IVF cycle but herbal supplements are absolutely prohibited.
The blood pregnancy test is performed 14 days after the egg retrieval.
If pregnant, you will be asked to return to the office for repeat blood work and eventually an ultrasound to ensure an ongoing successful pregnancy. After a fetal heartbeat has been confirmed, patients are referred to an obstetrician for the remainder of the pregnancy.
Usually we ask that patients wait one or two complete menstrual cycles before beginning another ART cycle. Sometimes tests are required that may delay subsequent cycles.
The miscarriage rate is about the same for ART as the general population. Many times older females undergo ART and their miscarriage rates are naturally higher. Since pregnancy testing is done two weeks after embryo transfer, we often know about spontaneous miscarriages in the very early stages of pregnancy. These miscarriages would probably go unnoticed in the general population.
Your physician will discuss this with you at the time of consent signing, but we usually follow the recommendations of The American Society for Reproductive Medicine guidelines:
Under 34 years old = 1-2 embryos
35-37 years of age = 2-3 embryos
38-40 years of age = 3 embryos
These numbers may vary depending on individual diagnosis and clinical circumstance.
A woman is born with a full complement of eggs. There are far more eggs than will ever be used during a normal lifetime and ART procedures have no measurable "lowering" effects.
Egg retrieval is a fairly rapid procedure. The length of the procedure depends on how many follicles are present. Also the accessibility of the ovaries will determine how long the procedure will take. Accessibility means how easy is it to reach the ovaries with the ultrasound probe, whether they have a tendency to move away from the probe and so on. The typical egg retrieval will take from 20-30 minutes.
We do our egg retrievals under anesthesia; our patients are asleep. Our anesthesia specialists use medications which heavily sedate you. You will be "asleep" however; you will not require a breathing tube. The beauty of this approach is that you will feel absolutely nothing, remember absolutely nothing, and will have few of or none of the typical side effects of anesthesia such as nausea and vomiting.
The data we have available tells us that it does not. There have been many women who have undergone multiple egg retrievals. The fact that they have responded to stimulation on subsequent occasions and produced eggs and pregnancies on these occasions implies that the ovaries are OK after egg retrieval. There have been some limited studies looking at the appearance of the ovaries in women who have had egg retrievals and subsequent laparoscopic surgery. In those patients, the findings were normal.
Vaginal bleeding is not uncommon after an egg retrieval. Usually this bleeding is from the needle puncture sites in the vaginal wall. It is usually minor and similar to a period or less. The bleeding experienced is analogous to the bleeding that will take place from an IV or from the arm after blood has been drawn.
Not necessarily. Although we will usually get an egg from most mature sized follicles, most women will have a mixed group of follicles after ovulation induction. Some of those follicles will have immature eggs or post mature eggs, which may not be identifiable so they will seem to have been "empty" follicles.
The embryo transfer does not require any anesthesia. It is performed using a speculum that allows the doctor to see the cervix, (like a Pap smear) and is very similar in technique to an intrauterine insemination (IUI). Usually the woman feels only the speculum and nothing else.
It is really not clear that prolonged rest after transfer is helpful. In nature, the embryo floats freely in the endometrial cavity for a number of days before implantation and it will do the same in an IVF cycle. We do recommend that you take it easy following transfer for the rest of the day, but routine work activities can be resumed the next day. If there is an increased risk of Ovarian Hyperstimulation, we will recommend prophylactic bed rest.
Ultimately the answer is no. If an embryo is of poor quality because it is genetically abnormal, there is nothing that can be done to salvage it. However, there are procedures that we do that can improve the chances of a borderline embryo. These include use of Metformin and assisted hatching. It has been shown that procedures such as these can increase implantation rates in couples with a poor prognosis.
In some cases yes. We have good data showing that in some groups (e.g. women over 38 years of age, previous failed IVF cycles, unusually thick zonae pellucida) assisted hatching will increase the implantation and pregnancy rates. There has only been one study carried out looking at the impact of performing assisted hatching on every single embryo of all couples and the conclusion was that it did not increase the expected pregnancy rates.
Embryos which are not transferred in the retrieval cycle are maintained in culture to determine if they develop to the blastocyst stage. If they do, they will be cryopreserved, if that is your wish.
Since hCG is used to finalize egg maturation, a pregnancy test (which is a measurement of hCG hormone in the urine or blood) will be positive for a number of days following egg retrieval. Some women will metabolize the hormone quickly and it will be out of the blood stream in about a week, while others may take up to 9 or 10 days to do so. We therefore recommend that a pregnancy test not be performed until 12-14 days after the egg retrieval.
We would recommend at least one full menstrual cycle of waiting before undergoing IVF a second time. We know that it can take up to 6 weeks for inflammation to resolve; therefore, it is reasonable to wait a similar amount of time before restarting the process.
World Infertility & IVF Hospital is dedicated to:
Compassion:We know reproductive issues can be emotionally difficult. We believe in listening and respecting your concerns. We will answer your questions and empower you with knowledge, understanding, and involvement in your care.
Experience:We have helped thousands of couples have children successfully over the past 35 years. Each couple is unique. For example, some couples will conceive successfully with enhanced ovulation (development and release of an egg) or insemination (preparing sperm and placing it into the uterus). Some couples may need surgery to become pregnant. For other couples, in vitro fertilization (IVF) and other Assisted Reproductive Technologies (ART) may be needed. Each couple is uniquely evaluated to determine the most effective, safest and cost-conscious way to achieve a successful pregnancy.
Excellence:World Infertility & IVF Hospital in Lajpat Nagar, Delhi features onsite state of the ART facilities for comprehensive reproductive evaluation & treatment of Female & Male infertility. Superior experience, personnel & facilities with dedicated focus produce consistent excellence & success.
If you have any of the following Questions, you have come to the right place!
Why haven’t I gotten pregnant?
Do I need to see a fertility specialist (infertility doctor)?
What are my treatment options? Do I need medications, IUI, or surgery? Does my spouse need treatment? Is IVF (In Vitro Fertilization) needed or just an option, or is IVF unnecessary, why? How can one optimize the chance of IVF working? What are the different options within IVF? For example, what are the different protocols? What is meant by the different stimulation methods "regular" "minimal" "natural"? What is ICSI? What is PGD with aCGH?
Why do I miscarry?
By understanding the issues & treatment options, you can proceed with confidence! (Your specific issues, options, and questions will be clearly discussed at your Appointment. For General Information, Please visit hospital or call on our toll free number.)