IVF Cycle

Q:  Do you guarantee that I’ll get pregnant?  
A:  No one on earth can make that promise to you, but we will be honest and up front about how and if we can help make your parenting dreams come true. Keep in mind that a multitude of factors affect a person’s ability to conceive. Identified contributors often can be corrected or circumvented, but unknown causes of infertility may continue to be road blocks. Our assisted reproduction approaches like in vitro fertilization bypass several of the stages of natural conception, allowing some couples to get pregnant even if no one can uncover why they can’t conceive on their own. The Fertility Center’s health care fees are lower than many clinics in the Southeast, and we prefer to offer more affordable services to all patients rather than money-back guarantees to some.

Q:  Why am I on birth control pills if I’m trying to get pregnant?
A:  Women who plan to participate in an upcoming IVF cycle take birth control simply to regulate and schedule their menstruation. Timing is critical in the IVF world, especially in relation to when eggs are retrieved and embryos are transferred. Our doctors need to control when a woman’s period begins so that stimulation medication can be administered at just the right time for optimal response. Also, a dozen couples or more may participate in the same IVF cycle during any given month, so scheduling allows us to ensure adequate space in our procedure and recovery rooms as well as in the embryology laboratory.

Q:  Are generic brand prenatal vitamins just as good as prescription ones?
A:  Over-the-counter prenatal vitamins are good, but prescription varieties are better at balancing out nutrition deficiencies and preparing the body for conception. You won’t find any brand on a local discount store shelf that can compete with the effectiveness and efficiency of a prescription-strength vitamin. This is a simple way that you can give your baby the very best, even before he or she is conceived.

Q:  Do in vitro babies have more birth defects or health problems?
A:  Nearly all infants who have been born following in vitro fertilization appear normal at birth. At the same time, congenital abnormalities, birth defects, genetic abnormalities, mental retardation and other possible deviations from normal may occur in children born following IVF just as they may occur in children resulting from natural fertilization. At present, there does not appear to be any increased risk of birth defects related to IVF, although multiple births may be complicated by prematurity. A pregnancy following IVF usually has a successful outcome but, like any other pregnancy, may end in miscarriage or stillbirth. There is no evidence that IVF increases the frequency of these losses.  Even a tubal pregnancy is possible following IVF but less likely than in natural conception.

Q:  Can a single woman who wants to get pregnant using donor sperm make an appointment?
A:  Of course. The Fertility Center does not discriminate against patients or withhold treatment based on marital status or sexual orientation. Unmarried men and women as well as same-sex couples use donor eggs and donor sperm to achieve pregnancy success through this practice.

Q:  What are the risks associated with an IVF procedure?
A:  Most IVF cycles proceed without difficulty, but factors beyond the Fertility Center’s control also are a possibility. The most common disappointment is when a transferred embryo fails to implant in the uterus, so no pregnancy occurs. Even if implantation occurs, the embryo may not grow or develop normally, and spontaneous abortions or miscarriages may occur. Natural ovulation can happen before eggs are retrieved from the ovarian follicles. Pelvic scarring, abnormal anatomy and technical problems can prevent recovery of some or all of the eggs as well as transfer of viable embryos. The eggs retrieved may not be mature or viable for fertilization. Sometimes, men cannot produce the semen sample needed to fertilize the eggs on the day of retrieval, or the quality of the semen sample produced is too poor to allow for fertilization. Even after fertilization, embryos may not grow or divide so the scheduled transfer cannot take place. Other rare risks for women include injury to organs, internal bleeding and infection. Additionally, adverse laboratory conditions, equipment failure, bacterial contamination, human error and/or other unforeseen factors may result in loss or damage to eggs, sperm sample and embryos.

Q:  What does a transvaginal ultrasound feel like? 
A:  The lubricated scanning probe is similar to a tampon being inserted just at the opening of the vagina. Most women describe feeling pressure without any pain. This technology allows medical professionals to evaluate the uterine lining, monitor ovulation, diagnose conditions and visualize procedures.

Q:  I’m sore! Can progesterone injections be given somewhere other than my backside?
A:  Unfortunately, no. Given into the arms or legs, these injections can render your limbs temporarily useless. To minimize soreness, use a heating pad on the upper hip injection site before and after administering the shots and rotate between hips with every other injection.

Q:  Can I pick the sex of my baby?
A:  Sperm are the determining factor when it comes to baby gender. New technologies such as preimplantation genetic diagnosis and sperm separation are helping many couples reduce the probability of chromosome disorders and debilitating diseases. Rare situations that involve using these procedures for family balancing are evaluated on a case-by-case basis at the Fertility Center. Thousands of dollars in additional costs are involved, and no guarantees can be made about a baby’s ultimate gender.

Q:  How can I avoid having multiples?
A:  The national stories you may have heard about high numbers of multiples usually are the result of patients not being monitored closely or at all while taking stimulation medications. The Fertility Center’s female patients who take medications to stimulate egg production undergo ultrasound scans and lab work frequently, even daily at times to assess ovarian response. Mature eggs are removed before ovulation and fertilized in the laboratory. These protocols help control the number of possible resulting pregnancies. Each patient talks with her doctor to determine how many embryos will be returned to the uterus to hopefully implant. Typically, two at most are transferred, but some patients request three or more against doctors’ recommendations. Identical twins are always a possibility, since even a single embryo can split on its own. Each year, one or two of our patients may carry a set of triplets to term. Some couples choose to selectively reduce the number of embryos that implant, but Fertility Center patients who wish to explore that option are referred to high-risk specialists. 

Q:  Do you really freeze eggs that can be used later?
A:  Cryopreservation involves freezing and storing at an extremely low temperature such as liquid nitrogen to keep sperm, eggs and embryos viable until being thawed for fertilization or transfer months or even years later. Men who are fighting cancer often have their sperm preserved prior to treatments that may render them sterile. Women who take stimulation medications may have more eggs retrieved than the one or two needed for transfer that month. Couples can choose to freeze extra eggs or go ahead and fertilize those eggs with resulting embryos frozen and stored for future use. Fewer ethical issues are involved with discarding unused frozen eggs compared to allowing frozen embryos to expire. Cryopreservation is available on site at our Chattanooga facility and helps make multiple attempts at conception more economical for patients since an IVF cycle with frozen embryos is less costly than a cycle with “fresh” embryos.

Q:  Why do some couples need an egg donor?  
A:  Donors are used by women whose eggs are not viable because of the effects of age, genetic disease or hormonal irregularities. Women who have healthy ovaries and regular menstrual cycles but do not respond to fertility medications also will consider choosing an egg donor. Couples with unexplained infertility that have not become pregnant using assisted reproduction techniques often considering trying another cycle with donor eggs. Overall, donor egg cycles have higher success rates than IVF cycles with women using their own eggs.

Q:  How do you choose your egg donors?
A:  Potential egg donors must be non-smokers between the ages of 21 and 33 with no new tattoos or piercings within six months of applying. Each undergoes extensive medical and psychological screenings (including blood work and a physical exam) with embryologists, doctors and mental health professionals. Participation also requires notarized consent forms.