The Mommyish Definitive Guide To Infertility: In Vitro Fertilitzation

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IVF EGGIf you’ve undergone fertility treatments in an effort to get pregnant with no luck, at the very bottom of the making a baby via science bag of tricks is In Vitro Fertilization, or (IVF). IVF isn’t typically recommended by doctors without a medical reason until you have exhausted less invasive methods, like medication and Intrauterine Insemination.ย The IVF process is costly, time consuming and for many, very stressful. This is what it’s like to literally put all of your eggs in one basket when trying to conceive.

What is IVF?

Just the facts

Web MDย provides a straightforward description of the IVF process. After hormonal treatment to help a woman’s body develop more eggs, the eggs are retrieved. A doctor will combine those eggs with the partner’s sperm and allow them to grow under close observation. When they are ready, they will be put back into the uterus in hopes that they implant and fully develop.

The real deal

If you want to experience pregnancy and not use a surrogate or adopt, IVF is the last stop on the train of advanced reproductive technology. The good news is eggs which are retrieved but not used during the first round of IVF can be frozen for future attempts. If you are open to the idea of increasing your chances for having multiples, your doctor may be willing to transfer more than one embryo at a time.

What’s the success rate for IVF?

Just the facts

Success rates for IVF depend on a number of factors, including the reason for infertility, where you’re having the procedure done, and your age. WebMDย puts IVF success rates between 30-40% for women under age 35, with pregnancy rates declining as a woman’s eggs age.

The real deal

The numbers may seem grim, but your doctor will be able to give you a better idea of your chances for success based on your unique set of circumstances. They will also talk with you about how many embryos you want to transfer into your uterus, knowing that doing so increases your chances of having multiples.

Some doctors will recommend a process known as intracytoplasmic sperm injection, or (ICSI) to improve the odds of a sperm fertilizing an egg. In ICSI a sperm is directly injected into an egg in hopes of creating a viable embryo. ICSI may be an additional expense.

There have been studies done about the rate of birth defects in children born using IVF and ICSI. There is continued discussion about whether there is a significant increase in defects with the use of advanced reproductive technology and ย if any defects among these babies are the result of the procedures used or consequences of underlying fertility issues. Half of the eggs that were harvested for my IVF cycle where fertilized using ICSI and half fertilized naturally. By the day of transfer we had decided to put two embryos in. Of the two healthiest embryos, one was ICSI and one was not. Both embryos resulted in a child without birth defects.

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  1. Sherri

    November 7, 2014 at 2:38 pm

    This series is just super awesome and informative. I had a vague idea of what IVF was like – a classmate of mine in college was going through it – but I didn’t know all of the little details, so thanks. ๐Ÿ™‚

    I also now hope that I get pregnant easily via artificial insemination because shots and me just don’t mix. And I can’t really picture my wife giving them to me, either. ๐Ÿ™

    • coffeeandshoes

      November 7, 2014 at 2:55 pm

      I did shots with insemination, and they are really not as bad as they seem like they’d be! ๐Ÿ™‚ The ovulation stimulation shots (I used Follistim) are in a pen thing that resembles an EpiPen (I think?). The trigger shot can either be a smallish syringe that you give yourself in the stomach (Ovidrel) or can be a larger one that you have someone else give you, in either the butt or the thigh (Pregnyl).

      On the second go-round, we used the Pregnyl, because even the $20 or so in savings was worth it. My husband was a trouper with that shot, though I know he felt bad about causing me some pain. But the Ovidrel wasn’t bad at all (even though it was a syringe, and not the easy clicky pen I’d gotten used to giving myself in the stomach).

      Long story short (not my forte, obviously!) the shot options may not be as bad as you think – I promise! ๐Ÿ™‚

    • Megan

      November 7, 2014 at 2:57 pm

      Man, I wish clicky pen thing had been an option for me. The James Bond awesomeness of it maaay have been enough for me to do my own injections.

    • coffeeandshoes

      November 7, 2014 at 3:01 pm

      Haha – you know, I did feel very “If something goes wrong, Bond, inject this and wait a few minutes”, now that I think about it! Though the container for it is a cute lime green zip-up case that sits in the fridge staring at you, taunting you a little bit. ๐Ÿ™‚

    • Rosa

      November 7, 2014 at 3:02 pm

      Clicky pen ruled. Way better than the shots that required mixing.

    • coffeeandshoes

      November 7, 2014 at 3:04 pm

      Yes!! The mixing of the Pregnyl was stressful (trying to remember all those directions was high pressure!) and I much preferred dialing the right dosage on the cartridge in the pen.

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    • Drstephaniedvm

      November 8, 2014 at 4:43 pm

      Just for clarity the Folistim pen is like an insulin pen mor than an epi-pen. Folistim and insulin go subcutaneously whereas an epi-pen gives an IM injection.

    • coffeeandshoes

      November 8, 2014 at 5:53 pm

      Ah, ok. I don’t have any experience with shots (other than at the doctor’s office) so I didnt realizr that not all pen-like devices are created equal. ๐Ÿ™‚

    • Nica

      November 7, 2014 at 5:50 pm

      Ummmm, I was the BIGGEST needle-phobe EVER before starting fertility treatments. Like wanted to pass out when I saw them – that bad. It’s amazing how quickly you can adjust when you absolutely have to. Now, I give shots to myself like a pro. That said, I just did Lupron, Menopur and Follistim, all of which have pretty small, subcutaneous needles. The Follistim is a pen like needle that’s so tiny you literally don’t even feel it go in. The only ones I never mastered were the intramuscular ones – the trigger shot and the PIO. They’re very hard to do on yourself well as putting the needle in completely straight is integral to not having pain and bruising at the injection site and it’s hard to do that to yourself (though you can if you absolutely must) So, hubs stepped up and was a pro in no time. I believe you will rise to the occasion. I know we did! Good luck.

    • Wholockkie Head

      November 8, 2014 at 12:20 pm

      Luckily I didn’t have an intramuscular shots (I didn’t even have to do progesterone in oil, they prescribed suppositories instead.) But I was terrified of needles and made my husband give them to me. Then I had to start a new med one day while he was at work and it HAD to be done at that time, so I hyperventilated a bit and gave it to myself, I barely felt it and was pretty proud of myself. You’ll be able to do it, even if you think you can’t. Good luck.

  2. LotteryTicketRetirementPlan

    November 7, 2014 at 2:49 pm

    “It is likely that you will change into a gown (medical, not ball)”

    Just a little IVF humor…

  3. Hokie Beth

    November 7, 2014 at 3:02 pm

    Our embryos got wheeled into the room in an incubator. My husband gets to look at each embryo before it was transferred in a microscope. He always says it’s ours because it’s bald like him. ๐Ÿ™‚
    Plus the embryologist at our lab is a Hokie, so we get to talk Virginia Tech stuff while they’re doing all their prep work. She’s cool.

    • Megan

      November 7, 2014 at 3:12 pm

      That’s cool that he got to look at them first! I like hearing how other clinics handle the embryo transfer.

  4. Personal

    November 7, 2014 at 3:04 pm

    Best of luck to those of you ttc. I finally had my successful pregnancies after my 14th and 15th medicated cycles, transfers 9 and 10. And it was totally worth it.

  5. Rosa

    November 7, 2014 at 3:06 pm

    I got to have a valumn for my second ivf transfer. I have a twisty tricky cervix that they literally mapped out before hand to make the transfer go more smoothly. I’m not sure if it’s what made that ivf work, but it didn’t hurt.

    • Wholockkie Head

      November 8, 2014 at 12:29 pm

      My RE prescribes a valium for transfer too. They said it helps relax the uterus so you don’t cramp as much and there is less pain after. I had no cramping or pain and I really believe it was because of the valium, because I had a LOT of pain with my HSG, which is very similar to a transfer.

    • Hokie Beth

      November 8, 2014 at 7:46 pm

      Love the Valium ๐Ÿ™‚ my RE give extra so if you want to keep the relaxation up over the weekend after the transfer you can. I finally took him up on this after this last transfer and had half a pill Thursday night and Friday night; slept great!

  6. Alex Lee

    November 7, 2014 at 3:13 pm

    I’m curious about the number of embryos implanted. The article says “blobs” which indicates plural, so:

    Did the doctor ask or suggest any optimal number of embryos implanted or was it more of “I’ll take a number two with fries and a Coke.”?

    Thank you.

    • Megan

      November 7, 2014 at 3:21 pm

      Ha! That would be awesome but sadly, no. My Dr. called me the day before to discuss the pros and cons of putting in one versus two. Given my circumstances and the fact that he thought I was a good candidate, he wouldn’t consider doing three or more and he gave me many ” warnings” that I could end up with twins. (seeing as how things turned out I’m glad he didn’t transfer more) Before they loaded up the tubing to transfer them they asked me again to make sure.

    • Personal

      November 7, 2014 at 3:59 pm

      Sorry to be too pedantic, but the doctor transfers embryos. If the woman is very, very lucky, they implant (which means to burrow in and start to grow). It’s a commonly misused word in the press.
      If any doctor ever learned out to ‘implant embryos’ he’d become an instant success.
      A lot depends on age and number of attempts. If the intended mother is older or has immune issues (new territory that has now been recognized as causing lots of failed IVFs) they may transfer more than one or two. If it’s a first try and the diagnosis is something like blocked tubes, most REs will recommend transferring only one.

    • Rosa

      November 7, 2014 at 4:15 pm

      The doctor transfered two embryos five day embryos on our successful IVF. They would have only transfered one but it was our second attempt. More than two was never an option. They made sure to make us understand that by tranfering two, that we had a high likelihood of multiples.

    • Hokie Beth

      November 7, 2014 at 5:23 pm

      It depends on your age and diagnosis. My eggs are 31 years old and our infertility is unexplained. I have a 35-40% chance of getting pregnant with one, a 50% chance with two. But if I transfer two, I have a 25% chance of twins. My doctor talked to me about the pros and cons of each and I decided to transfer one.

    • Nica

      November 7, 2014 at 5:38 pm

      Yes, very contingent on your own situation. For my successful cycle, I had five beautiful blastocysts. Because I was open to multiples initially, we (me, my DH and my RE) decided to transfer 2 of them, knowing there was an approximate 30-40% chance of twins. Well, only 1 took and that’s my first son. To be clear, the RE only TRANSFERS embryos — it’s up to God, Allah, Mother Nature, whoever you believe in — as to whether or not they implant.

      Then, when we wanted to try again, I had three blasts frozen from my successful cycle. My doc really wanted me to transfer two of them given the results from my first transfer. But, the risk of multiples was too high for comfort and, against my RE’s recommendation, we did a single frozen embryo transfer. Well, that is my 2nd son…

      We’re still deciding if we want to try for another. Time will tell…

    • ChickenKira

      November 7, 2014 at 5:50 pm

      Depends on the doctor and where you are.
      I’m in Australia and did IVF 2 years ago, we could only transfer one, as there are laws preventing multiple embryo transfers for women under 35 (and for those over 35, no more than 2 may be transferred) if you want to transfer more than one, then you needed to appeal to a tribunal.
      I think these regulations came in light of the Kate Gosselins and Octomums of the world, it’s just not safe for the woman or the foetuses to have that many being carried. Australia also has had higher then average IVF success rates in the past couple of years and I do know that my doctor did speculate that single embryo transfers may play a role in that, after all, less chance of your body going “WOAH WHAT THE FUCK IS THIS? NO. STOP, GO AWAY, REJECT REJECT REJECT”

    • Kite

      November 10, 2014 at 2:06 am

      In Australia, got transfer at 38, the clinic did NOT want to do more than one unless I was over 40. Interesting that laws/guidelines potentially allowed more. Not that I would have taken it.

  7. Nimue

    November 7, 2014 at 3:46 pm

    Does anyone have advice when dealing with problems on the man’s side. There doesn’t seem to be nearly as much info on it and all of the treatments still seem to lie pretty heavily with me.

    • Personal

      November 7, 2014 at 3:54 pm

      All the treatments WILL still lie heavily on you. Sad but true. Men are told to switch to boxers instead of briefs, eat healthy foods, stop or cut back on smoking and drinking, avoid hot baths, etc, but the shots and the WORK will be yours. ๐Ÿ™ But, as I said above, it. is. worth. it. Stay strong.

    • Rosa

      November 7, 2014 at 3:59 pm

      I was literally about to write to exact same thing you just wrote.

    • Nimue

      November 7, 2014 at 4:04 pm

      Yeah, that seems to be what I am getting out of all this. What a racket ๐Ÿ˜‰

    • coffeeandshoes

      November 7, 2014 at 3:54 pm

      The treatments for sure lie with the woman, even if her tests all come out just fine. Basically the treatments involve making the woman’s body extra hospitable to the sperm, particularly if the counts are low, etc. But our RE said that my husband could go to a urologist for testing if needed, though he didn’t recommend that in our case (not that it would’ve been bad – just not something he thought would be overly helpful). He cautioned that that process takes a while, though, and the findings may not be super conclusive.

      My husband took multivitamins for men, and whether or not that helped, we can’t say, but it can’t hurt. ๐Ÿ™‚

    • Rosa

      November 7, 2014 at 4:01 pm

      Did they do a sperm count test at your RE?

    • coffeeandshoes

      November 7, 2014 at 4:44 pm

      Yes and no ๐Ÿ™‚ It was at the local Andrology/IVF center, but the results went to the RE, and he discussed with us.

    • Rosa

      November 7, 2014 at 4:11 pm

      The only options I know to raise sperm count are surgery to fix a vericolcel (not sure how to spell it) with can raise sperm count but it’s not a guaranty, clomid can also raise sperm count but also not a guaranty or IVF with ICSE (you don’t need a high sperm count if they are going to inject the sperm directly into the egg)
      The doctor did highly recommend a vitamin D supplement for my husband.

    • Rachel Sea

      November 7, 2014 at 4:21 pm


    • ShinyR

      November 7, 2014 at 4:31 pm

      Thank you. I fixed it.

    • Rachel Sea

      November 7, 2014 at 5:02 pm

      Cool. Normally I’m not enough of a pedant to correct spelling, but I thought this time you might want it.

    • Rachel Sea

      November 7, 2014 at 4:20 pm

      There are procedures men may undergo, such as needle extraction of sperm, or surgery for varicose veins, but they aren’t nearly as involved, and they are much more specific to each guy. The woman’s side is much more of an assembly line.

    • Nimue

      November 7, 2014 at 4:21 pm

      Oh, I like the way you phrased this. Cause that is totally how I feel. It’s clearly like checking boxes. I am going to use that.

  8. Rachel Sea

    November 7, 2014 at 4:17 pm

    I was an ovum donor, so I went through retrieval a couple times. It wasn’t difficult to do, but it affected my body much more than I expected it would before my first round. By the day of the procedure my ovaries felt like water balloons and I looked 4 months pregnant (on average, I produced 23 follicles). I couldn’t button my jeans or sit upright, my abdomen was so full. I learned after the first one that I needed to take both days on either side of the retrieval off from work, because I was hugely uncomfortable unless I was reclined. I hadn’t realized just how much I was going to bleed afterwards, and thank goodness the hospital had pads handy, otherwise I’d have had underpants full of paper towels for the ride home.

  9. ChickenKira

    November 7, 2014 at 5:53 pm

    Our embryo stuck to the catheter during transfer.
    Doctor: It’s rare for an embryo not to go in, I’ve been doing this for decades and I’ve only had two stick to the catheter, but we always check just in case
    Lab tech: And this one has stuck
    Doctor: Okay, make that three in my career

    She’s 16 months now and is still stubborn, so, you know, it’s not like we didn’t have a warning.

  10. ohladyjayne

    November 8, 2014 at 9:52 am

    My goodness, reading this brought back so many memories of how much IVF sucks. If it works, it’s worth it, but oh man.

    I too did the toilet check for embryos. I knew it was ridiculous but I couldn’t stop.

  11. Kite

    November 10, 2014 at 2:17 am

    Points of difference in my experience – all injections went in the belly, all done myself every night. Also, implantation was extremely quick and casual, no full bladder needed, verbally confirm your details, take off your undies, hop up on the table, wham bam thankyou ma’am.

    Also, if you use a sperm donor in Australia, you can’t donate the embryos to another person, sadly, it’s to limit the amount of families per donor, plus consent issues. Suppose I can probably eventually donate any left over to research.

    Between my partner and myself we had four implantations that resulted in four pregnancies, but the fresh ones both resulted in miscarriage.

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