Eligibility for an IVF Cycle

IVF or in vitro fertilization may be appropriate in cases where other infertility treatments have failed, or in instances where blockages of the fallopian tubes, physical abnormalities of the reproductive system or ovarian dysfunction make it very unlikely or impossible for sperm to unite with an egg within the female’s body (in vivo). IVF also is appropriate in some cases where sperm production is limited or natural insemination is blocked as a result of structural anomalies of the male reproductive system, disease or sterilization procedures. Finally, with the advent of preimplantation genetic diagnosis, IVF combined with PGD may be an alternative for couples who might otherwise refrain from procreation because of the risk of transmitting genetic diseases.

Often, screening has occurred as the first step in your infertility treatment at IRMS. However, this may not be the case, certain tests previously completed may have to be repeated or additional tests might be required. Regardless, before IVF, the following tests must occur:

Medical screening, baseline ultrasounds and blood work – to determine hormone levels, absence of substance abuse, sexually transmitted, or other diseases, and her physically able to undergo follicle stimulation and oocyte retrieval.

Screening of the female includes:

1. Blood tests
   -Antisperm antibodies
   -CBC and CMV
   -Hepatitis B and C
   -HIV Screens
   -Chemistry Profile
   -Rubella
   -Syphilis
   -Blood type and Rh factor
   -FSH (follicle stimulating hormone)
2. Examination
   -Catheter check
   -Chlamydia and gonorrhea cultures
   -Mycoplasma/ureaplasma culture
   -Pap Smear
3. Special Testing
   - Prep cycle (to determine your response to stimulation medications)
   -Cavity check by hysteroscopy, hysterosalpingogram or sono-hysterogram
   -Mammogram (age 35 or family history)
   -A system review and evaluation by an internist if indicated, for patients with medical problems
   -EKG
   -Chest X-ray
   -Two hour glucose tolerance test (GTT)

Clinical screening required for the male partner includes a physical and blood tests, similar to the females’, and:

1. Semen Testing
   -Antisperm antibodies
   -Semen analysis
2. Special Testing (if indicated)
   -Canavan’s disease
   -Cystic fibrosis (for those of Jewish or Caucasian descent)
   -Gaucher’s syndrome
   -Tay Sach’s Disease (for those of Jewish descent)
   -Hemoglobin
   -Electrophoresis
   -Blood Type and RH Factor

Genetic screening and chromosomal analysis – when indicated, to identify individuals carrying genetically transmitted diseases such as cystic fibrosis, sickle cell anemia and Tay Sachs disease.

Psychological screening and counseling – if required, to discover whether a couple understands and is willing to deal with the physical, emotional and legal ramifications of IVF.

 

Making the Decision to Proceed with IVF

Following a thorough examination and, in some cases, alternative courses of treatment, your physician may recommend IVF. Our medical team will inform you of the clinical implications and risks associated with ovarian stimulation, egg retrieval and other related procedures. It is important that you carefully consider all emotional, social, moral and ethical ramifications before proceeding.

Although we do not routinely require psychological screening and treatment, we encourage you to talk to our psychologist. We also offer emotional support groups to assist you with this important decision and the issues you face during treatment. Common considerations are the:

• Issues associated with self-esteem, body image and the social, emotional and financial ramifications of treatment.
• Implications of conceiving a child through IVF, on the couple and the child.
• Risks associated with an IVF cycle, including medication side effects, multiple births or multifetal reduction to limit the number of pregnancies after successful embryo transfer.
• Issues related to disclosure to friends and family.

Once you have made the decision for infertility treatment, you will meet with an IVF nurse and financial coordinator. This consultation, lasting approximately two hours, includes discussion of the requirements and costs associated with your cycle. The nurse will provide you with medication prescriptions and important information about the IVF process, proper timing and administer of medications, duration of your treatment and your role in its success.

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