• IVF FAQs
  • IUI FAQs
Q: Will the IVF technique damage my ovaries?
A: There is no evidence to suggest that either normal laparoscopy or ultrasound egg retrieval damages the ovaries. In fact, some reports in the medical literature suggest that following ovarian biopsy, pregnancies occur in couples with a long-term history of infertility.
Q: If an egg is not retrieved or if the technique does not produce a pregnancy on the first attempt, how soon can the procedure be repeated?
A: This depends on the individual. The primary reason for delay is to allow the patient's normal menstrual cycle to resume, which may take 2 to 3 cycles.
Q: How many times will IVF be repeated per couple?
A: There is no specific number. This is determined by the couple together with the physician.
Q: Can we have intercourse during the two-week period before an IVF procedure is performed?
A: Most definitely. We recommend that the husband refrain from ejaculation for at least 48 hours, but for no more than 5 to 6 days preceding egg retrieval. This precaution assures that the semen sample obtained for IVF will contain a maximum number of healthy, motile sperm.
Q: After the IVF procedure, how long must we wait to have intercourse?
A: Although a definite time of abstinence to avoid damage to the pre-embryo has not been determined, most experts recommend abstinence for two to three weeks. Theoretically, the uterine contractions associated with orgasm could interfere with the early stages of implantation. However, intercourse the night before pre-embryo transfer is acceptable. Some physicians will advise intercourse before transfer as they feel that this will improve the chances of a pregnancy.
Q: When can we have intercourse after embryo transfer and if I am pregnant?
A: After embryo transfer, we ask that you refrain from intercourse until your pregnancy test, which is approximately 14 days later.  If you are pregnant, as long as you are not experiencing bleeding or discomfort, intercourse is okay after we are able to detect the baby’s heartbeat.  This will be approximately two weeks after your positive pregnancy test.
Q: What about other activities? How soon can I resume my normal routine?
A: The IVF team recommends that the patient be sedentary for a full 24 hours following pre-embryo placement in the uterus. Strenuous exercises such as jogging, horseback riding, swimming, etc. should be avoided until pregnancy is confirmed. Otherwise, the patient is free to return to her regular activities.
Q: How soon will I know if I'm pregnant?
A: Pregnancy can be confirmed using blood tests about 1f days after egg aspiration. Pregnancy can be confirmed by ultrasound 30 to 40 days after aspiration.
Q: Is IVF covered by insurance companies?
A: Unless your health insurance policy provides infertility coverage it is unlikely that IVF coverage is provided. Frequently insurance policies will cover infertility but exclude IVF. This has been successfully challenged in the legal system. Consultation with your lawyer may be necessary to review you insurance companies refusal to provide IVF coverage. If, however, IVF is combined with surgical procedures used for diagnosis, insurance carriers may pay for much of the procedure. However, coverage will depend on the terms of your policy. For infertility alone, most insurance policies will not provide coverage.
Q: What side effects, if any, can these drugs cause?
A: No pronounced side effects have been associated with any of these drugs. However, the patient should inform the physician of ANY allergies she has or of any previous adverse reactions to drugs.
Q: Will I have an egg in every follicle?
A: It varies from patient to patient . As many as half of the follicles may not contain an egg in some patients.
Q: Is there a possibility of multiple births with IVF?
A: Yes, when multiple pre-embryos are transferred. 25%. of pregnancies with IVF are twins. (In normal population, the rate is one set of twins per 80 births.) Triplets are seen in approximately 2-3% of pregnancies.
Q: Is there a higher risk of birth defects with a child born from IVF?
A: The simple answer is no. Children born from IVF are no more inclined to any particular birth defect than those conceived naturally. There are no known ill effects. Abnormal pre-embryos, even those produced through normal fertilization, do not seem to mature. However, any long-term effects of IVF remain to be determined.
Q: How much time does the entire procedure require?
A: Approximately three weeks (all as an outpatient). Fertility drugs are administered to stimulate the ovaries. Then during the four to six days prior to ovulation, the patient is monitored by ultrasound as well as by hormone levels.
Q: What is your age cut-off for doing IVF with your own eggs?
A: We do not offer IVF for patients older than 45. Physician will recommend an appropriate fertility treatment for you depending on your medical history and FSH levels.
Q: How much does IVF cost?
A: The cost of IVF depends on the treatment and options selected.
Q: How long does it take to get started with IVF?

A: we break down the IVF treatment into phases: 
Phase One involves your initial consult and diagnostic evaluation. This can take days, but usually takes weeks or even a couple of months (depending on your menstrual cycle, logistical and financial details such as your travel schedule, availability, insurance requirements, etc.) 

Phase Two is your cycle planning stage, which is heavy on logistical details such as obtaining IVF medications and learning how to mix and administer them. There is also blood work to be done, consent forms to be signed, payment to be made as well as other details to attend to during this phase.
Phase Two can last days, weeks or months, depending on your schedule, insurance, and availability.

Phase Three is the start of the cycle and usually lasts about two weeks. During this time you will be taking injectable medications and return to GIVF every couple of days for monitoring.

Phase Four is egg retrieval and embryo transfer. There are three to five days between the time when eggs are retrieved and embryos are put back into the uterus. 

Phase Five is a pregnancy test and beyond.

Q: What are my choices if my tubes have been tied?
A: Basically there are two choices, surgery to try and repair the tubes or IVF. There are pros and cons to each choice and often the best choice depends on your unique situation. Surgery offers the option of attempting pregnancy naturally indefinitely without repeated treatments, but carries the rare risks of surgery and in some cases is not successful depending on the type of tubal ligation or tubal damage done initially. IVF offers the chance for pregnancy without having to undergo an operation and maintaining contraception or birth control against future pregnancies after completion of your family.
Q: When will my egg retrieval be scheduled?
A: We won’t know the exact date of egg retrieval until two days prior to the procedure. We typically estimate it about 12-14 days from the start of your IVF cycle.
Q: Can I exercise while going through treatment?  What can I do?
A: Some exercise is acceptable during in-vitro fertilization treatment, but as the IVF treatment cycle progresses, only low impact exercise (such as walking) is recommended.  The ovaries may become enlarged from the fertility medications you will be taking, and high impact exercise may put you at risk for ovarian torsion, a condition in which the ovary can twist on itself. This is a very rare but serious side effect.
Q: What constitutes day one of my cycle?
A: Day one of your cycle is considered your first day of heavy full flow bleeding, not spotting.  If this occurs after 12 p.m. (noon), the next day is considered day one.
Q: When is IVF Needed?
A: Because the IVF process bypasses the fallopian tubes (it was originally developed for women with blocked or missing fallopian tubes), it is the procedure of choice for those with fallopian tube issues, as well as for such conditions as endometriosis, male factor infertility and unexplained infertility. A physician can review a patient’s history and help to guide them to the treatment and diagnostic procedures that are most appropriate for them.
Q: Is the egg retrieval procedure painful?
A: No, not generally.  It lasts approximately 20 to 30 minutes, and IV sedation is administered so that you will not be awake.  Some patients have mild cramping after the procedure and are discharged with a prescription for pain medication.
Q: How soon can out of town patients travel home after IVF treatment?
A: Most of our out of town patients return home the day after the embryo transfer -- there is no medical reason to stay after treatment. All types of travel are safe. Sitting for an extended period of time will not affect chances of pregnancy. We recommend that patients traveling by air drink plenty of fluids, as circulated air can be quite dry, and dehydration should be avoided.
Q: What are the chances of pregnancy with frozen embryos?
A: In general, the success of frozen-thawed embryo transfer procedures depends on three factors: 
  • The quality and survival of the frozen-thawed embryos. In general, we only freeze good quality embryos so the current rate of survival is greater than 90%.
  • The age of the woman who produced the eggs. In patients under the age of 37, the chances of pregnancy with frozen-thawed embryos are similar to a pregnancy with fresh embryos. In patients 37 years or older, pregnancy chances with frozen-thawed embryos decline in conjunction with declining fertility in general, but still can be quite good. As always it is best to discuss a woman’s individual situation with their physician.  
  • The status of the uterus in the woman receiving the embryos. A healthy endometrial lining free of any interfering fibroids or polyps provides a sound environment for embryo implantation.
Q: What are the options if a woman’s own eggs are not producing a pregnancy?
A: The ability to use a donor egg has enabled thousands of women to become pregnant when they otherwise might not have had this opportunity. While a woman’s eggs may not be viable, very often the uterus is completely healthy and capable of supporting a pregnancy. In these cases, egg donation with IVF has high success rates. This procedure follows the same protocol as IVF, except the intended parents select a donor and use the donor's egg to create the embryo.
Q: What is the percentage of success with each treatment cycle?
A: The possibilities of success with IVF vary from patient to patient.  Your  Doctor can best predict the outcome in your case after a complete evaluation, which includes reviewing your history and any prior response to fertility medications.
Q: What if a woman is not capable of carrying a pregnancy?
A: Various medical conditions may make it impossible for a woman to carry a pregnancy. Reproductive medicine provides the option of enabling another woman, known as a gestational carrier (formerly called a surrogate) to carry the child of a woman who cannot sustain a pregnancy. There are two types of gestational carriers:
  • A traditional gestational carrier becomes artificially inseminated with the sperm of the intended father and uses her own eggs to fertilize the embryo. Many fertility centers, including Pacific Fertility Center do not offer traditional surrogacy. The legal issues and complicated past history of parental rights with traditional surrogacy have led us to discourage this option.
  • gestational carrier with IVF does not contribute any of her own genetic material. In this case, the egg as well as sperm are extracted from the prospective parents, fertilized in the laboratory with IVF and then implanted into the uterus of the surrogate.

A gestational carrier may be appropriate for those in the following situations:

  • No uterus
  • Abnormal uterine cavity
  • Several recurrent miscarriages
  • Recurrent IVF cycles have not produced a pregnancy
  • Medical conditions would make pregnancy dangerous for the mother or her baby. 
Q: How much does in-vitro fertilization (IVF) treatment cost?
A: Your costs for IVF will depend on how much medication you need, whether your insurance covers a portion of treatment, and other factors. Our staff will work closely with you to help you manage your costs.
Q: How long do I have to take the fertility injections?
A: The length of time that you will be taking the injections will depend on the in-vitro fertilization (IVF) protocol chosen for you by your Doctor.  Typically, patients receive injections for 7 to 10 days, but some must take them for a little longer.
Q: How many monitoring visits will I have while I am in treatment?
A: This will depend on your individual response to the medications
Q: Can I take herbal supplements?
A: Herbal supplements are not recommended and may cause unknown effects.
Q: Can I color my hair if I am going through treatment or think I am pregnant?
A: During the first two weeks of each IVF cycle, hair coloring is allowed.  However, from mid-cycle on, including waiting to find out if you are pregnant, it is best to wait until after 12 weeks to receive a hair color treatment.
Q: Can I get my nails done if I am going through treatment or think I am pregnant?
A: Having a manicure or wearing artificial nails will not cause any harm during IVF treatment or pregnancy, but make sure your nails are treated in a well-ventilated area.
Q: Can I travel during my IVF treatment?
A: No. It is imperative during the monitoring phase of your treatment cycle that you be available for multiple appointments to assess the growth of your follicles
Q: Is bleeding expected after the egg retrieval?
A: Vaginal bleeding is not uncommon after an egg retrieval. Usually this bleeding is from the needle puncture sites in the vaginal wall. It is usually minor and similar to a period or less. The bleeding experienced is analogous to the bleeding that will take place from an IV or from the arm after blood has been drawn. Unfortunately there is no way to put Band-Aids on the vaginal puncture sites!
Q: Is it normal to retrieve an egg from every follicle?
A: Not necessarily. Although we will usually get an egg from most mature sized follicles, most women will have a mixed group of follicles after ovulation induction. Some of those follicles will have immature eggs or post mature eggs, which may not be identifiable so they will seem to have been "empty" follicles.
Q: Is the embryo transfer painful?
A: The embryo transfer does not require any anesthesia. It is performed using a speculum that allows the doctor to see the cervix, (like a Pap smear) and is very similar in technique to an intrauterine insemination (IUI). Usually the woman feels only the speculum and nothing else.
Q: Is bed rest recommended after the embryo transfer?
A: It is really not clear that prolonged rest after transfer is helpful. In nature, the embryo floats freely in the endometrial cavity for a number of days before implantation and it will do the same in an IVF cycle. We do recommend that you take it easy following transfer for the rest of the day, but routine work activities can be resumed the next day. If there is an increased risk of Ovarian Hyperstimulation, we will recommend prophylactic bed rest.
Q: Can anything be done to improve embryo quality?
A: Ultimately the answer is no. If an embryo is of poor quality because it is genetically abnormal, there is nothing that can be done to salvage it. However, there are procedures that we do that can improve the chances of a borderline embryo. These include carrying use of Metformin and assisted hatching. It has been shown that procedures such as these can increase implantation rates in couples with a poor prognosis.
Q: What is done with any "leftover" embryos?
A: Embryos which are not transferred in the retrieval cycle are maintained in culture to see if they develop properly. If they do, they will be cryopreserved, if that is your wish.
Q: How soon after IVF can a pregnancy test be performed?
A: Since hCG is used to finalize egg maturation, a pregnancy test (which is a measurement of hCG hormone in the urine or blood) will be positive for a number of days following egg retrieval. Some women will metabolize the hormone quickly and it will be out of the blood stream in about a week, while others may take up to 9 or 10 days to do so. We therefore recommend that a pregnancy test not be performed until 12-14 days after the egg retrieval.
Q: How long of a wait is recommended between a failed IVF cycle and trying again?
A: We would recommend at least one full menstrual cycle of waiting before undergoing IVF a second time. We know that it can take up to 6 weeks for inflammation to resolve; therefore, it is reasonable to wait a similar amount of time before restarting the process.
Q: What is an IUI and how is it done?
A:  IUI is the depositing of washed motile sperm into uterine cavity using a very thin flexible  plastic catheter , through cervix, IUI is a first step, cost-effective method to enhance the fertility in a woman with patent fallopian tube. The whole process doesn't take very long - it usually only requires the insertion of a speculum and then the catheter, a process that maybe takes a couple of minutes.
Q: When is the best timing for an IUI?
A: Ideally an IUI should be performed within 6 hours either side of ovulation -- for male factor infertility some doctors believe after ovulation is better, otherwise chances of success are higher with insemination before ovulation with the sperm waiting for the egg. When timing is based on an hCG injection, the IUIs are usually done between 24 and 48 hours later.
Q: What is the success rate for IUI?
A: Searching through about a dozen medical journal articles and a number of web sites resulted in a rather wide range of statistics. Multiple follicles resulted in as high 26% success. So, ovulationdrugs if anovulated with IUI   Another influencing factor is sperm count. Higher sperm counts increase the odds of success; however, there was little difference between success with good-average counts and those with high counts. The overall success rate seems to be between 15-20% per cycle, judging from the articles which will be abstracted below. The rate of multiple gestation pregnancies is 23-30%.
Q: Where is the sperm collection done?
A: The sample is collected through ejaculation into a sterile collection cup/jar. If you live close to your clinic -- within 20-30 minutes drive -- you might be able to collect the sperm sample at home, otherwise the clinic will provide you with a room in which to collect it.
Q: How long does washed sperm live?
A: The washed sperm can live 24-72hours; however, it does lose potency after 24 hours. Sperm can live up to 5days in fertile mucous, 2-3 days being pretty common, so combining IUI with intercourse may provide better coverage.
Q: Do I have to lay down after an IUI?
A: You don't have to lay down because the cervix doesn't remain open, but most doctors let patients lay down on the table for 15-30 minutes after the procedure.
Q: Do I need to take it easy after an IUI?
A: Most people don't need to, but if you had cramping or don't feel well afterward it makes sense to take it easy for awhile. Some people reduce their aerobic activity and heavy lifting during the luteal phase in hopes it will increase the chance of implantation. It is more important to take it easy for a bit after IVF, as that is a more invasive process.
Q: How long before an IUI should the male abstain from intercourse/ejaculating and store up sperm?
A: This depends on your individual situation, but it should be less than 72 hours since his last ejaculation in order to ensure the best motility and morphology. Where low sperm count is the reason for IUI, it is generally best to wait 48 hours between ejaculation and collecting sperm for the IUI. With no sperm count issues, it makes sense to wait about 24 hours.
Q: How soon after an IUI can I have intercourse?
A: Usually you can have intercourse anytime after an IUI. In fact, most doctors suggest having intercourse, when that is an option, soon after the last IUI to help make sure ovulation is covered. Your doctor may suggest waiting 48 hours to resume relations if you had any bleeding during the IUI or if a tenaculum is used.
Q: Can the sperm fall out?
A: Once the sperm is injected into the uterus, it does not fall out. There can, however, be increased wetness after the procedure because of the catheter loosening mucus in the cervix and allowing it to flow out.
Q: How come I feel wetter after the IUI -- like the sperm is falling out? 
A: The catheter loosens cervical mucus and lets it come out more easily. It is common to see more fertile mucus after an IUI for this reason.
Q: How many follicles give my best chance of getting pregnant? 
A: According to different studies, either 3-4 follicles gives one the best chance of getting pregnant, while more follicles beyond that simply increases the risk of multiples. The U.S. study said 4 follicles, while other countries have data stating 3. The U.S. has a higher rate of multiple births, so 3 may be more likely to be the correct answer.
Q: Does IUI make sense when there isn't a sperm count problem?
A: IUI can help on Clomid cycles where cervical mucus is a problem, and IUI increases the chance of success on injectible cycles no matter what the sperm count. It does make sense to try IUI if you can and haven’t had success with intercourse.
Q: How many IUIs should I try before moving on to IVF?
A: It depends on what you can afford and what meds you are doing. One might do 3-4 IUIs on Clomid before moving on to injectibles, then do 3-4 cycles on injectibles. If one doesn’t have success after four good ovulatory cycles on injectibles with well-timed IUI, it would be time to consider IVF.
Q: Can IUI be done at home?
A: An IUI shouldn't be done at home because the sperm needs to be washed to prevent infection -- i.e., separated from the semen. A vaginal insemination can be done at home, but is no more successful than intercourse. Some doctors are willing to instruct on doing ICI (intracervical insemination) at home, but it should not be attempted without being taught proper technique. Getting semen or air into the uterus could be quite dangerous -- perhaps life-threatening.
Q: Is bleeding common after an IUI?
A: It doesn't usually happen, but it isn't uncommon. It is most common to have some bleeding if the doctor had trouble reaching the cervix. Some women also have light bleeding with ovulation.
Q: How long does it take for Fertilization and for implantation ?
A: Fertilization occurs within 24 hrs after ovulation while implantation takes about 5-10 days after ovulation.
Q: Can IUI work after tubal ligation (having "tubes tied")?
A: No. A tubal ligation is effective birth control because it prevents the sperm and egg from meeting. The process that leads to pregnancy is having an egg released from a follicle in the ovary and then beginning the journey to the uterus through the fallopian tube. Sperm will travel from the vagina, through the cervix, through the uterus, into the tube where fertilization occurs. IUI bypasses the need for the sperm to travel through the cervix, but that's it. It doesn't get the egg to the other side of the obstruction, so fertilization won't take place. The only way to get pregnant after tubal ligation is by having reversal surgery or an assisted reproduction technology that includes egg retrieval, such as in vitro fertilization (IVF).
Q: Can I take pain medications before or after the procedure?
A: Most women don’t need medication for pain associated with IUI. If there is cramping, it is best to avoid mediations, but Tylenol is considered safe (but maybe not that helpful for cramps.
Q: What precaution lady should take during an IUI cycle ?
A: Before an IUI cycle, avoid heavy exercise, jogging or high impact aerobics. 
Little rest just after the IUI procedure is advisable. For little pain a simple pain killer like Ibuprofen can be taken.
Q: What is donor IUI ?
A: Single women, couple with male partner has no sperm or very poor semen analysis and cannot afford expensive treatment like ICSI, donor IUI is an option. Some time, it is also used when there is an inheritable genetic problem which could be transferred from the male.
Q: When is IUI used ?
A:  IUI is a fertility treatment often selected by the couple, with atleast one patent fallopian tube and who have been trying to conceive for atleast one year. IUI also be selected as a fertility treatment with any one of the following conditions.
  • low sperm count
  • decreased sperm motility
  • A hostile cervical condition [too thick cervical mucus]
  • sexual dysfunction.
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