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Top 10 Questions to Ask Your IVF Physician During Your First Visit

PFCLA
07 Apr 2022

Many patients report that their fertility journeys differ greatly depending on their clinic and physician. Because of this, it is always best to speak to your IVF physician and ask any questions that come to mind before you choose to begin your IVF cycle. This way you can be educated on the different approaches and find out what is best for you. 

But what to ask? This article will help you inform those questions.

Which is better for me if I have unexplained infertility: IUI or IVF?

Infertility can be caused by any number of reasons, including:

  • Ovulation-related infertility
  • Polycystic ovary syndrome (PCOS)
  • Primary ovarian insufficiency (POI)
  • Thyroid disease
  • Quantity and quality of eggs
  • Age
  • And Tubal-related issues

When it comes to determining the best method or procedure, the first step is to understand the difference between the two.

Intrauterine insemination (IUI) is a procedure where sperm is placed inside the uterus to ensure healthy sperm gets closer to the egg and increases the chances of successful fertilization. IUI requires functioning fallopian tubes and functioning sperm. 

After multiple failures of IUI cycles, depending on each physician’s advice and specific case, typically after 3-5 failed IUI cycles, your IVF physician would suggest the next method: IVF (In vitro fertilization).

With IVF treatment, patients will take fertility medications to stimulate the ovaries, multiple follicles will grow and once mature, the eggs will be retrieved and fertilized into embryos at our lab. The resulting embryo(s) are then transferred into the uterus. 

You and your IVF physician will make this decision together on whether IUI or IVF is better for you. 

2. Is there an age limit for treatment?

Many clinics set their own age limit and typically have different reasons for their reasons for doing so. At PFCLA, we do not set an age limit for patients who want to undergo IVF treatment; however, it is very important to speak to one of our specialists first to discuss your individual case and treatment plan. 

In the IVF world, success rates decrease with age as the risk of pregnancy complications rises. We examine each patient on an individual basis, and we consider a number of factors to determine the likelihood of success. Our experienced physicians and professional staff will help you every step of the way to maximize your chance of success. 

3. What tests need to be done before starting IVF treatment?

It is important to know what types of tests that your physician requires and what types of medications will be ordered for you during the process. At PFCLA, our physicians typically order blood tests to check female patients’ ovarian reserve and look for any abnormalities.  Male patients will also go through blood tests and a semen evaluation is usually required prior to starting the IVF treatment.  These pre-cycle tests can be done at our clinic or at your local facility to reduce your travel if you do not live in the Los Angeles area. 

4. How long is the IVF process expected to take from start to finish?

The average time for the egg retrieval stimulation cycle ranges from 10-14 days, but each case can vary depending how the patient’s body reacts to the medications.  This timeframe starts when the patient begins medication used for ovarian stimulation to the egg retrieval procedure. 

After embryos get fertilized and biopsied, it takes around two weeks to receive the genetic testing results, after we know the embryos results, you will then be ready to prepare for an embryo transfer cycle.  When it comes to a FET (Frozen embryo transfer) cycle, each case can vary due to several factors. In a typical scenario, the embryo transfer procedure usually takes place between days 19 and 21 of the patient’s menstrual cycle.  This is followed by a pregnancy blood test approximately 10 days post-implantation. We will continue to follow up with the pregnancy until the 10 weeks OB ultrasound.  Typically, after 10 week’s OB ultrasound, you will then be discharged to her OB’s care. 

5. Does your clinic perform fresh or frozen embryo transfers?

Frozen embryo transfers have a higher success rate than fresh embryo transfers. 

Most patients are advised to proceed with frozen embryo transfer. With a frozen embryo transfer, you already have embryos created and preserved for use as needed. Because of this, you will not need to go through another egg retrieval cycle if the first attempt fails.  When you choose to freeze your embryos, PGT (Preimplantation genetic testing) can also be performed on the embryos to check for any chromosomal abnormalities; allowing you to know which embryos have normal chromosomes will eliminate chromosome related diseases and increase success rate of having a healthy baby.  You will also have an option of gender selection by choosing to have PGT-A  testing done. 

6. Do you recommend a single embryo transfer or a multiple embryos transfer?

In the past, IVF experts used to rely on Multiple Embryo Transfers to increase success rates.  The idea was that if you implant more than one embryo, that the strongest or best would be likely to succeed. 

Today, however, the approach is quite different. With today’s technology and pre-implantation genetic testing (PGT-A) involved, a Single Embryo Transfer procedure is most highly recommended by our physician to reduce the risks of twins, high-risk pregnancies, and miscarriages.  

Our IVF physician prefers to select and transfer one good quality embryo for better pregnancy success rates. 

7. Do I need PGD or PGS?

PGD testing is also called PGT-M testing, and PGS testing is also called PGT-A testing nowadays.

PGT-A tests all 23 pairs of chromosomes for structural/numerical abnormalities.  

PGT-M is performed when there is a specific concern or need in relation to a singular mutation.  PGT-M tests are often performed when there is a rare disease that isn’t commonly found and typically require the use of a probe, or a customize panel that uses samples from the sperm/egg sources, as well as the embryo. In some cases, other members of the biological family to the sperm/egg sources may also be needed. 

For both tests, it’s important to note that they are performed after embryo creation but before implantation. Part of the pre-cycle lab work includes a genetic carrier screening; this screening will tell us if a couple needs additional PGD (PGT-M testing) on top of PGT-A testing. 

8. How much does treatment cost?

Infertility treatment can be expensive. At PFCLA, we provide the best possible care with transparent costs throughout your journey.  Costs include: 

  • Pre-cycle lab work
  • Fertility medications
  • IVF cycle fees depending on the cycle types
  • Outside lab charges
  • and shipping costs 

Our financial department staff will provide options of different cycles and explain all cost details. To learn more about the costs, please click here.  PFCLA also provides options for financing.

9. What are the options for embryos that won't be used? 

Our clinic will not discard any unused embryos without your permission. You can keep them in storage for future use, donate them to other patients who are looking for donated embryos, or donate for research.  When you start the treatment, we will send you a disposition of embryo consent with all options provided, and you can make your own decision.

10. Are there any side effects to treatments?  

As part of the IVF treatment process, multiple medications and certain medical procedures are required, which can result in some side effects.  Injections could cause pain; fertility drugs can cause mood swing and some abdominal pain and mild bloating during the process.  In a small percentage of cases, Ovarian hyper-stimulation syndrome (OHSS) could happen, typically the symptoms will go away in 5-10 days, in some severe cases, certain procedures could need to be done to control the OHSS.  If you experience any symptoms or uncomfortableness, our medical staff is always available to be contacted and provide solutions.

Book a consultation with an IVF physician to learn more

To prepare for your initial visit and understand more about the IVF process, book a consultation here.

Note: This is not intended to be a substitute for professional medical advice, diagnosis or treatment. Information provided is for general educational purposes only and is subject to change without notice. Speak to your doctor directly with any questions you may have regarding a medical condition. Any information contained herein does not replace any care plan as determined by a physician. 

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