Choosing the Right Treatment
Choosing the right treatment can be very difficult unless a thorough infertility investigation has been carried out to identify your unique fertility needs and requirements. Each patient is different from the other, therefore, a single prescription will not fit everyone. For this end, the following strategy will be useful when planning your treatment:
– Younger patients with no prior testing or infertility treatment history should start with the initial testing process described in “Interpreting Test Results” section. Based on these test results, and the patients age, a less invasive treatment option such as IUI may be chosen as opposed to the more invasive IVF procedure. However, older patients (aged above 35) are not recommended IUI treatment is it has much lower chances of success compared to IVF treatments.
– Patients with a history of treatment failures will be subjected to further infertility investigation, as outlined in our “Interpreting Test Results” section. Should these test results indicate that the patients’ own eggs and sperm might be viable for treatment, then IVF treatment will be recommended. The protocol of treatment and the precise dose of medication to be administered will depend on your age, your unique hormone levels and previous treatment history.
If there is any reason to suspect a genetic cause for prolonged periods of infertility and possibly repeated IVF failures, after the necessary testing has been performed, the couple might be advised to have PGD (Pre-implantation Genetic Diagnosis) testing on their embryos in order to separate the genetically healthy embryos from the genetically abnormal ones prior to the embryo transfer procedure.
IVF with Egg Donation is also recommended for couples with a female factor infertility where the female patient’s eggs do not allow for fertilization or pregnancy to occur for any reason. For more information, please visit our “IVF with Egg Donation” section.
IVF with Sperm Donation is recommended for couples with male factor infertility where the male partner’s sperm is unable to fertilize the female partner’s eggs due to count, motility or morphology issues or this treatment can be chosen for any genetic condition that the male partner is at risk of transferring to his offspring.
– Patients in more advanced fertility ages, but who still ovulate may be recommended Mini IVF or a minimal stimulation protocol in order to obtain less number of eggs but without compromising the quality by subjecting them to higher doses of medication. In a higher age bracket, the ovarian reserve tends to have been severely depleted and the existing reserves are very delicate and sensitive to the IVF protocols. Alternatively, IVF with Cytoplasmic Transfer can be recommended for this age group in order to allow for a chance of pregnancy with own eggs.
Please keep in mind that these are only meant for guidance and we do not, in any way, aim to diagnose or recommend treatments on this website. For more accurate recommendations and guidance, we will need to review your test results as well as your history of infertility along with any details that might be relevant so that we can offer you customized recommendations.
Tips for IVF Success
Even though each IVF treatment is different in itself, there are a number of measures that can be taken in order to maximize your chances of success. In some cases, things that might sound small could make a world of difference in IVF treatment. So let’s be on the safe side and do our part:
1- INITIAL SCAN: Have an ultrasound scan at your gynecologist’s office. This is to make sure there are no fibroids or polyps in the uterus that could jeopardize your chances of success. Also, women who are not undergoing egg donor IVF treatment should make sure there are no cysts in the ovaries that could potentially affect their egg count/quality.
2- INVESTIGATION: If you have previously had a number of miscarriages (with or without IVF), it makes sense to investigate the cause. In most cases where women have repeated miscarriages, there is a genetic reason behind it. Some gene mutations affect your blood circulation and cause you to have a miscarriage (especially up to 12 weeks). These genetic tests include testing for mutations in MTHFR C677T, MTHFR A1298C, Factor V Leiden (G1691A), Factor II (G20210A), and PAI I 4G/5G.
3- VITAMINS and DIET: It is important that your take essential vitamins and nutrients prior to and during pregnancy. A supplement such as “pregnacare” includes Folic Acid, B6, B12 and Zinc supplements, which are proven to reduce the likelihood of a miscarriage and support healthy development of your baby. It makes sense to start using such a supplement at least a few feeks prior to your embryo transfer stage. Your eating habits can also have an impact on your fertility levels as well as pregnancy outcomes with fertility treatments. It has been shown that eating alkaline rich foods will help your chances of success by making your body’s pH level more pregnancy friendly. Avoiding alcohol, cigarettes and certain foods can also help.
4- HORMONE TESTING: For women undergoing IVF treatment using their own eggs, it is important that certain hormone tests are done prior to using any IVF medication. These hormone tests include:
AMH, FSH, LH, Estradiol, TSH and Prolactine. Based on these hormone test results, we will be able to assess your ovarian reserves and egg quality. Also, it these results will be important in identifying your treatment protocol and the dose of medication that needs to be administered.
5- IVF FAILURES: For patients who have had several failed IVF attempts, with no history of pregnancy, it makes sense to have an endometrial biopsy around days 18-21 of menstrual period. An endometrial biopsy will tell whether there is any condition that might prevent implantation and a successful pregnancy. There are also other infections that need to be checked for in this case.
6- INFECTIOUS DISEASES: Prior to embryo transfer, it is vital that certain infectious disease tests are done on both parents. The purpose of these tests is to make sure the newborn does not receive any infection from his/her parents. Some of these test are routine tests, which most of you do not have, such as Anti-HIV, Anti-HCV. These can be done at our clinic prior to embryo transfer. However, some other test results, such ac CMV IgG and Chlamidia might require the use of antibiotics for a certain amount of time prior to emrbyo transfer, therefore, it is important for the female patient to have tested for CMV IgG and Chlamidia once the IVF decision has been made.
7- AVOID STRESS: One of the biggest enemies of IVF treatment is stress. Avoid stress as much as you can when going through IVF treatment. You can take up yoga classes, or join the gym or start a book club, anything that will help you avoid stress will add a couple of percentages to your chances of success.