Everything You Need to Know Before You Do IVF

When you're trying to conceive, in vitro fertilization can bring you one step closer to getting pregnant, but the process can feel intimidating if you're unsure what's involved. Here's what to know, even before your first doctor's visit. 
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Making the decision to do in vitro fertilization (IVF) is both exciting and nerve-wracking. On one hand, the procedure puts you a step closer to getting pregnant. On the other, not knowing what to expect and worrying about whether it will work or not is stressful. So that you can be prepared, here’s what you should know.

IVF requires a lot of time and work.

“IVF is a labor-intensive process with multiple doctor’s visits,” Eve Feinberg, M.D., medical director of Northwestern Medicine Fertility and Reproductive Medicine Highland Park. Here’s the IVF process step-by-step: For 10-12 days, you’ll take fertility medications (usually self-administered shots) to stimulate the ovaries to produce multiple eggs. “During that time, you’ll have to go to the doctor’s office for bloodwork and ultrasounds almost daily,” says Dr. Feinberg. Once the stimulation phase is done, the doctor will remove the eggs from your ovaries (under general anesthesia) and combine them with your partner’s sperm in a laboratory. Three to five days after the egg retrieval, one or more embryos will be placed back into your uterus (any extras may be frozen for future IVF cycles). Two weeks later, you’ll return to the doctor for a blood pregnancy test to determine if the IVF worked.

You should get your health in check beforehand.

“Achieving a healthy weight, limiting alcohol intake, and quitting tobacco and other substance use can greatly improve IVF success rates,” says Deidre D. Gunn, M.D., an assistant professor of reproductive endocrinology and infertility at the University of Alabama at Birmingham. Also, try to get medical conditions like high blood pressure and diabetes under control before you attempt to get pregnant.

There are ways to make it more affordable.

A single cycle of IVF (using your own eggs and your partner’s sperm) can cost upwards of $12,000. Most insurance companies don’t cover it (only five states—Connecticut, Illinois, Massachusetts, New Jersey and Rhode Island—require insurance providers to cover IVF)However, some may offer certain fertility benefits, such as coverage for ultrasounds and lab work, even if the procedure itself isn’t covered, Dr. Gunn says. In addition, fertility clinics work with lenders to offer financing options, some pharmaceutical companies give discounts on medications, and doctors can sometimes provide free samples. There are also some programs, such as the Kevin J. Lederer Life Foundation, founded by Dr. Feinberg, that grant free IVF cycles or financial assistance.

You will experience side effects.

Remember, you’ll be pumped full of hormones, so expect to feel more emotional during your IVF cycle. Minor physical side effects such as pressure, cramping or bloating in the pelvic area, breast tenderness, and discomfort from fertility injections may also occur, says David Diaz, M.D., a reproductive endocrinologist and fertility expert at MemorialCare Orange Coast Medical Center in Fountain Valley, California. In some cases, IVF can cause ovarian hyperstimulation syndrome (OHSS), which occurs when the fertility drugs cause a woman to make too many eggs. Symptoms can include weight gain, severe pain or swelling in the abdomen, dizziness, shortness of breath, nausea, and vomiting. OHSS normally resolves itself; however, if you experience these symptoms, contact your doctor immediately.

You may have the option of gender selection.

If your IVF cycle includes pre-implantation genetic testing, which screens the embryos for chromosomal defects, part of the chromosome report includes the sex of the embryos, says Susan Hudson, M.D., a reproductive endocrinologist at Texas Fertility Center, in New Braunfels. Some clinics will let you choose the sex you prefer to implant, while others don’t and only transfer the best quality embryo, she says.

There’s a slight risk of pregnancy or birth complications.

Having more than one embryo implanted during IVF raises your chances of getting pregnant with multiples, which increases the risk of premature labor and low birth weight. To reduce that risk, Dr. Diaz recommends getting genetic screening on embryos and then having only one transferred to your uterus.

Babies born from IVF also have around a 1-2 percent higher risk of birth defects than that in the general population. However, Dr. Hudson says, the evidence is getting stronger that this is more likely related to the nature of the infertility than the infertility treatment itself.

IVF doesn’t guarantee you’ll get pregnant.

Unfortunately, IVF doesn’t work for everyone. Some people get pregnant the first time, others need to repeat the process a time or two, and some couples aren’t successful even after multiple attempts. Whether or not IVF is successful depends mostly on your age, Dr. Feinberg says. According to the latest national data from the Society for Assisted Reproductive Technology (SART), the IVF success rate for women using their own eggs was 48 percent for women under age 35 and dropped to only 3 percent for women over age 42.

SART’s fertility calculator can help predict your chances of success based on your personal situation and fertility diagnosis.

But that doesn’t mean all hope is lost.

If your odds of achieving pregnancy through IVF are low (or you’ve already tried a cycle or two unsuccessfully), there are other options to consider, including using donor eggs, donor embryos [from families who used IVF and donated their spare embryos after completing their family], or donor sperm, Dr. Hudson says. That means it’s still possible for your baby dreams to come true.

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