IVF: Personalized and Monitored Process
In Vitro Fertilization (IVF) is a process in which fertilization occurs in a petri dish. IVF involves several stages that are carefully timed requiring close monitoring to maximize the success for each patient. The following is an overview but the details will be different for every patient because we individualize treatment based on your specific fertility situation.
Before starting your IVF cycle the following will be done:
- Blood tests for hormones and overall health. Specific hormone tests for egg quantity may include Anti-Mullerian Hormone (AMH) or cycle day 3 follicle stimulating hormone (FSH) and estradiol, which are helpful in determining success rates and the dose of medication. Other tests include a metabolic panel, complete blood count, Vitamin D level, thyroid testing, and prolactin level. If any of these are not in the normal range, corrective treatment will be prescribed prior to initiation of the cycle. Blood testing for certain infectious diseases is also required and will be ordered. Genetic carrier screening blood tests are always recommend because if we know to look for a genetic problem in an embryo we can prevent some serious birth defects.
- Imaging of the ovaries, tubes, and uterus. The antral follicle count (AFC) is performed by pelvic ultrasound and is another important test for egg quantity just like the AMH or FSH/estradiol blood tests (see above). We usually use both the AFC and AMH to determine IVF success rates and medication doses. A pelvic ultrasound also provides information about a) the shape of the uterus, including the presence of any fibroids, b) any sign that tubes may be blocked e.g. if the tube(s) are filled with fluid, and c) if any large ovarian cysts are present. Either a 3-D saline infusion sonohysterogram (abbreviated as SIS or SHG) or an office hysteroscopy check for abnormalities inside the uterine cavity, such as fibroids or the presence of a septum (fibrous wall). If any abnormality is found that is felt to be significant enough to compromise the chance of achieving a successful pregnancy, corrective surgery may be recommended prior to starting an IVF cycle.