IVF Consult 2014

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Information about IVF Consult 2014

Published on February 19, 2014

Author: rrckc

Source: authorstream.com

In-Vitro Fertilization: In-Vitro Fertilization An Introduction to IVF Reproductive Resource Center Why IVF ? Possible Indications : Why IVF ? Possible Indications Blocked or surgically absent fallopian tubes Abnormal Semen (Sperm) Results Endometriosis Failed conventional treatments (such as prior ovulation induction medication with intra-uterine insemination) Unexplained Infertility Diminished ovarian reserve (poor egg quality) Carrier of Chromosomal or Genetic Disease, such as cystic fibrosis (when used with PGD: Preimplantation Genetic Diagnosis) Recurrent Pregnancy Loss (when used with PGD: Preimplantation Genetic Diagnosis/PGS: Preimplantation Genetic Screening) Desire for High Pregnancy Success Rate and Low Rate of Multiples per treatment cycle Initial Consultation: Initial Consultation Male and female are both evaluated A thorough medical, surgical, social, and family history A semen analysis (SA) Physical Exam of the female Transvaginal ultrasound to evaluate the uterus and ovaries, including measurement of the Antral Follicle Count (AFC, resting follicles). The higher the AFC usually means a higher fertility potential Ovarian reserve testing (blood hormone measurements) performed on Menstrual cycle day 2, 3 or 4: Follicle Stimulating Hormone (FSH) and Estradiol (E2); Anti-Mullerian Hormone (AMH) Pregnancy rates are different for each couple depending on their diagnosis Initial Consultation: Initial Consultation Nursing staff will review history and give an overview of the IVF process An RRC physician will evaluate each couple A Financial Counselor will meet with you to discuss insurance/costs Counseling services for stress management and coping strategies are also offered Overview of IVF Assisted Reproductive Technologies: Overview of IVF Assisted Reproductive Technologies The IVF process takes approximately 6-8 weeks There are about 6-8 appointments during each treatment cycle At the initial consultation the male and female are evaluated and the treatment protocol is individualized Genetic Testing COUNSYL :  Genetic Testing COUNSYL Genetic testing is made available for the Male and Female through a blood test This tests for over 100 genetic diseases to see if the person is a carrier for any genetic disease 1-2 weeks for results Check with insurance company for coverage See www.Counsyl.com for more information Genetic Testing Preimplantation Genetic Screening (PGS) Preimplantation Genetic Diagnosis (PGD) :  Genetic Testing Preimplantation Genetic Screening (PGS) Preimplantation Genetic Diagnosis (PGD) This technology allows the most viable embryos for transfer to be chosen with the aid of DNA analysis Potential Indications for PGS/PGD Carriers of chromosomal or genetic disorders Recurrent Miscarriage Advanced Maternal Age (>35 years) Unexplained Infertility Unsuccessful IVF cycles Diminished Ovarian Reserve Elective/Voluntary IVF is performed as usual. Embryos at the blastocyst stage (culture day 5, 6, or 7) are biopsied by gently removing a few cells from each blastocyst Following biopsy, the embryos are vitrified (frozen) for a later thaw cycle while the biopsied material is sent off-site for analysis If you choose PGS/PGD, once results are back (approximately 10 days) and there is at least one viable embryo, a thaw cycle and transfer will be scheduled. This means there will be a time lag of 6-8 weeks before your transfer will take place www.Natera.com 6 Steps to the IVF Cycle: 6 Steps to the IVF Cycle Suppression Phase Ovarian Stimulation Phase Ultrasound Directed Ovarian Follicle Aspiration for Egg Retrieval IVF Laboratory/Embryo Culture Embryo Transfer Embryo Cryopreservation Suppression Phase Step #1: Suppression Phase Step #1 Call with the start of your menses defined as the first day of full flow (spotting does not count) Depending on your treatment protocol the woman will start on oral contraceptive pills (OCP’s) or Estrace (oral estrogen) and/or Lupron (leuprolide acetate) This phase is to prepare your ovaries for stimulation with fertility medications This helps with the timing of your cycle and promotes simultaneous development within the potential group of eggs Suppression Phase Cont’d: Suppression Phase Cont’d Before or during the suppression phase, the uterine cavity will be assessed through a sonohysterogram (SHG) and/or hystersalpingogram (HSG) Sonohysterogram (SHG): By ultrasound in the office, saline is infused into your uterus to assess the uterine cavity for polyps, fibroids and/or defects Hystersalpingogram (HSG): A radio-opaque contrast (“dye”) study in the Radiology department to assess the status of the fallopian tubes and to assess the uterine cavity for polyps, fibroids and/or defects Trial Embryo Transfer: An ultrasound guided measurement will be taken for use on the day of the embryo transfer. HSG: HSG Home Pregnancy Test: Home Pregnancy Test It is very important to take a home pregnancy test prior to starting these medications, even if you have your period. It is also important to take this test prior to an HSG or SHG. These medications may be harmful to a developing fetus Ovarian Stimulation Phase Step #2 : Ovarian Stimulation Phase Step #2 To accomplish our goal of one healthy baby, it takes multiple eggs The goal of ovarian stimulation is to achieve development of multiple mature follicles. A follicle is a type of ovarian cyst which potentially contains one egg Ovaries are stimulated with fertility medications which are self-administered at home by a very small needle (subcutaneous “SubQ” injection) most often into a small gentle pinch of abdominal skin During the stimulation phase you are monitored with ultrasound and blood tests to check estrogen and progesterone levels and to measure ovarian follicles During the stimulation phase the dosage of your medications may change depending on the response of your ovaries. This phase may last approximately 8-12 days   Cancellation of an IVF Cycle: Cancellation of an IVF Cycle At RRC your treatment plan is individualized based on your age, diagnosis, Ovarian Reserve Labs (FSH, E2, AMH), previous stimulation, and ovarian volume Ovaries do not always respond the way we would like them to Too many or too few follicles may be produced Our priority is always your safety. Of course we also strive to deliver the highest possible pregnancy rates the with the most cost-effective and time-efficient treatment In some cases cancelling your cycle and starting over with a different treatment protocol may occur for many reasons; this allows us to achieve a better response and improve your chances for success Egg Retrieval Step #3: Egg Retrieval Step #3 Ultrasound Directed Follicular Aspiration (UDFA) is the aspiration or removal of your eggs UDFA is performed under anesthesia with IV sedation After the eggs are retrieved the embryology team performs ICSI (intracytoplasmic sperm injection) and/or conventional insemination to assist the fertilization process Your partner will know how many eggs were retrieved following the procedure You will need to take the day off of work and the next day following UDFA Follicles: Follicles Not every follicle contains an egg Not every egg retrieved is mature Not every mature egg will fertilize Not every fertilized egg will grow to the blastocyst stage Not every transferred blastocyst will result in a pregnancy Not every pregnancy will result in a live birth IVF Laboratory Step #4: IVF Laboratory Step #4 Fertilization and Embryo Growth Within a few hours after the eggs are retrieved, the eggs are placed with sperm using ICSI (intracytoplasmic sperm injection) and/or conventional insemination The next day the embryologists evaluate each egg for evidence of fertilization Once the egg is fertilized the eggs are now called embryos Over the next few days, the embryos grow and divide The Laboratory T eam will contact you with a F ertilization Report on Day 1. Further reports will be provided as needed. Embryo Transfer Step #5: Embryo Transfer Step #5 Using a narrow, soft, and flexible catheter, the embryo(s) are carefully returned into your uterus 5 days after the egg retrieval No anesthesia is necessary for the embryo transfer An oral medication may be taken to help you relax After your transfer you will go home and rest that day and the next A blood pregnancy test (Quantitative B-hCG) will be drawn 8 days after the transfer Embryo Freezing Step #6: Embryo Freezing Step #6 Any remaining embryos after the transfer will be evaluated and considered for vitrification (freezing of the embryos) The vitrification of embryos allows you the possibility to achieve additional pregnancies in the future with a frozen embryo transfer (FET) FET cycle allows pregnancy without having to repeat the entire IVF process. FET cycle takes approximately 6-8 weeks Embryos are cryopreserved and stored at RRC for up to 5 years and then shipped to a long term embryo storage center Conclusion: Conclusion We look forward to working with you and helping you bring a little miracle into this world PowerPoint Presentation: You are your own best advocate. Ask and Understand We look forward to seeing you soon!

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