Category: Fertility Blog & Information

How Long Is the Process of IVF?, Inovi Fertility Clinic in Houston, Texas

How Long Is the Process of IVF?

Are you experiencing difficulty having a child? If so, you’re not alone. Reports show that up to one in eight couples struggle to become pregnant.

In America, 33 percent of people have had fertility treatment or know someone who has. One method involves in-vitro fertilization (IVF). Have you thought about this option and wondered how long the process of IVF takes?

Keep reading to learn more about IVF and the usual timeline.

Definition of Infertility

Infertility means not getting pregnant after one or more years of unprotected intercourse. A woman’s fertility decreases with age. Thus, doctors begin infertility treatment in women over the age of 35 after six months or after 12 months for women 34 years of age or younger.

If you believe you’re having problems with infertility, talk to a fertility specialist. A Reproductive endocrinologist specializes in treating infertility. They also treat women who’ve had two or more spontaneous miscarriages.

IVF offers a good fertility treatment option for couples with the following diagnoses:

  • Absent or blocked fallopian tubes
  • Abnormalities of sperm shape or movement, or low sperm counts
  • Pelvic abnormalities or scarring
  • Severe endometriosis
  • Risk for future genetic disorders
  • Repeated miscarriages
  • Unexplained infertility
  • Failed fertility treatment with Clomid, Letrozole, or Intrauterine insemination (IUI)

It’s important to discuss any serious medical illnesses with your IVF doctor. This may alter your potential for success or even make pregnancy dangerous for you.

Several issues can affect IVF success rates, including ovarian dysfunction, fibroid tumors, or polyps. Uterine or hormone level abnormalities can also lower your chance for IVF pregnancy.

The First Step in Infertility Treatment

Your doctor will first complete an evaluation and examination. The goal is to look for reasons that you’re having trouble conceiving.

Your doctor may also test for medical conditions such as diabetes and hypertension. It’s also important to assess your general health including your Body Mass Index (BMI).

Being overweight increases stress on the IVF process. This can cause miscarriages or preterm births, and lower your chances for success.

If you have a high BMI, counselors will help you work on managing your weight. The goal is to achieve a healthy BMI before taking the next step.

Benefits of In-Vitro Fertilization

Your provider will help you decide if IVF is a good choice for you. It can offer the best chance for successful treatment for those who’ve failed previous infertility options.

IVF helps women with low ovarian function or low egg counts, blocked fallopian tubes. For couples with male infertility or who have not gotten pregnant with multiple cycles of clomid or letrozole, IVF provides an opportunity to become pregnant.

Some women wish to freeze their eggs or embryos (fertilized eggs) to postpone pregnancy and preserve fertility. This choice allows couples to delay pregnancy due to cancer or other health problems. They may also have other reasons for wanting to wait to start a family.

IVF has become a popular option for same-sex couples to have a baby.  IVF can triple the success of pregnancy and reduce the risk of twins or triplets.

Preparing for IVF

Take a complete list of your medical history and medications to your appointment. You’ll meet the infertility specialist and team for a consultation. The following tests are commonly ordered to look for causes of infertility:

  • Blood tests for Anti-Mullerian Hormone (AMH), Follicle-Stimulating Hormone (FSH), and Thyroid Hormones (TSH, T4) levels
  • Semen analysis to check for quality and count
  • Genetic testing to see if you and your partner are carriers for common genetic conditions
  • Specific genetic testing if one partner is at risk or has a specific genetic condition
  • Blood tests to screen for infectious diseases
  • Blood tests to screen for immunity to CMV, Rubella, and Varicella
  • Blood typing

Imaging tests will be performed to examine the uterus, ovaries, and fallopian tubes. These may include hysteroscopy and/or saline infusion sonohysterography (ultrasound). You may have a hysterosalpingogram to test for fallopian tube blockage or dilation.

Ovarian Reserve Testing checks the quantity and quality of the eggs. It is also used to get an idea of how you may respond to treatment.

An Antral Follicle Count (AFC) is a pelvic ultrasound performed early in your cycle. This provides a count of the number of eggs available for use in IVF.

Anti-Mullerian Hormone Test (AMH) measures the hormone released from the ovaries. This test also gives an estimate of the number of eggs (oocytes). These tests are often completed on certain days of your menstrual cycle.

Develop a Treatment Plan

After completing these tests, you will discuss the results with your doctor. You may also meet with a genetic counselor if indicated. The next step is developing your individual IVF plan.

Some individuals use a third party as part of their reproduction plan. This may involve choosing an egg donor, sperm donor, or gestational carrier. Those choosing this plan will undergo counseling with a reproductive psychologist as well.

The last step is meeting with the financial counselor. They will review the costs for IVF treatment and your level of insurance coverage. If your insurance doesn’t cover IVF, you will learn about other financing options.

Timeline for the Process of IVF

The first step involves optimizing your hormone levels. You’ll take oral contraceptive pills or estrogen (Estrace) for two to three weeks.

After starting your menstrual cycle, your doctor will have you take gonadotropin injections daily. This may include FSH, LH, and a third medication such as Ganirelix or Micro-Dose Lupron. The goal is to stimulate egg production and keep you from ovulating early.

You’ll have regular hormone level checks and ultrasounds. This lets you, your partner, and the doctor watch the egg’s growth.

Once the eggs are mature, the doctor removes the eggs from your ovaries. Ultrasound-guided equipment allows the doctor to perform this procedure in the office. This describes the process known as IVF or Egg Retrieval.

Next, the doctor directly injects the sperm into the eggs. In some cases, the egg and sperm are put together and allowed to interact and fertilize.  This creates an embryo.

These embryos are then incubated for five to six days. Next, they’re frozen for six to eight weeks. This increases the pregnancy success rate and allows for genetic testing if you wish.

The final step involves transferring the embryo into your uterus. You can then take a simple pregnancy test 10-11 days after IVF to see if you’re pregnant. It’s important to know that many women may need more than one IVF treatment to achieve pregnancy.

IVF care 

Once you become pregnant, you’ll take fertility hormones for the first six to seven weeks. This helps nurture and support the embryo’s growth. You will also have an ultrasound to confirm your pregnancy and give you a due date.

Future ultrasounds and examinations will take place to check on the baby’s progress. Before, during, and after IVF, it’s important to focus on eating healthy, balanced meals. You also need to drink plenty of water and get seven to eight hours of sleep each night.

Ask your provider about exercising. Many women are encouraged to keep exercising throughout the pregnancy but you may need to reduce the intensity.

Many doctors prescribe prenatal vitamins for two to three months before IVF. This builds up your folic acid level which prevents birth defects in the brain and spinal cord. Some doctors suggest that male partners take prenatal vitamins to boost sperm health.

Giving Birth

Some women wonder if they can have a “normal delivery” after getting pregnant with IVF. The method that achieved pregnancy doesn’t impact the delivery. You have the same ability to have a normal delivery as a woman that conceived naturally.

Every pregnant woman has the potential for unexpected events in pregnancy. This may lead your doctor to recommend a cesarean (C-section) delivery. Reasons for a C-section include the following listed below.

Extended Labor

If your labor doesn’t progress or stalls, you may need a C-section. This means first-time moms have been actively laboring for over 20 hours. For women who’ve given birth before, prolonged labor is when it exceeds 14 hours.

Despite the long labor, the cervix doesn’t dilate (open) and efface (thin). Prolonged labor is one of the most common reasons for C-sections.

Incorrect Positioning of the Baby

In normal circumstances, the baby’s head should be pointing down to pass through the birth canal. Sometimes the baby’s feet are down (breech) or they’re sideways (transverse).

In this case, if the doctor can’t turn the baby, the baby can’t deliver normally. A C-section ensures a safe birth.

The Baby Is In Distress

When the baby can’t get enough oxygen it is called fetal distress. This is an emergency that requires a C-section to safely deliver the baby. Further assessment will take place to ensure there are no further problems.

Known Birth Defects

If the baby has known birth defects, they may need delivery by C-section for their safety. Examples include problems such as excess brain fluid or congenital heart disease.

Mothers With Previous C-Sections

Almost all women who previously had C-sections can deliver vaginally. It’s important to discuss the delivery options with your doctor. They’ll consider the reason for your previous C-section and any current risk factors.

Mother With a Chronic Health Condition

If you have a chronic health condition, you need to talk to your doctor about delivery options. C-sections may present fewer risks for certain individuals.

Some potential reasons include gestational diabetes, high blood pressure, and heart disease. Certain infections such as HIV or genital herpes may make a C-section the safer choice.

Are You Interested in Considering IVF?

This article provided a comprehensive overview of the timeline and process of IVF. If you’re interested in this option, speak with a specialist.

Dr. Krotz is world-renowned for his work in fertility care and research. Now he provides expert care to patients in Houston, Texas. Schedule an appointment today to discuss your options with Dr. Krotz.

How Can a Same Sex Female Couple Have a Baby? The Ultimate Guide

Getting married and having children is something many of us look forward to from the time we ourselves are children. We play with baby dolls and cuddle relatives’ babies, dreaming of the day we can have our own. But if you are in a same-sex female relationship, you may find yourself asking the question, “How can a same-sex female couple have a baby?”

Thanks to the miracle of modern medicine, lesbian couples can now not only adopt children but give birth to their own. Read on to learn more about the different options available for lesbian couples looking to become parents.

Pregnancy vs. Adoption

Before we dive into the different ways lesbian couples can have a baby, let’s talk a little about the pregnancy vs. adoption question. Adoption is an obvious solution for same-sex couples looking to have a baby and in many cases, adoption is a win-win situation; the couple gets to raise a child, and a child who needed a good home and parents gets an amazing family.

Most couples however will want to have a baby that is genetically their own or want the experience of pregnancy and delivery. In these cases, it is possible for same-sex female couples to have a baby that is related to one of the partners.  As we will discuss more later, it may someday be possible for same-sex couples to have a baby that is genetically both of theirs.

Selecting a Sperm Donor

Most of the options for same-sex female couples to have a baby involve intrauterine insemination using a sperm donor.  During this process, couples will select a sperm donor from a donor sperm bank with the assistance of a fertility clinic.  Once the donor sperm is selected, the sperm will be sent to the fertility clinic.  The sperm donor, usually anonymous, will serve as your baby’s biological father.

You can also ask for a sperm donation from close friends if you feel comfortable doing so although involving someone you know is not as easy as it may at first seem.  Some same-sex male couples are even interested in serving as sperm donors in a co-parenting situation, which we’ll discuss later.

Donor Intrauterine Insemination

Donor intrauterine insemination happens in a fertility clinic under the direction of the physician. Be sure to talk to your doctor about what you can do before the appointment to give things the best chance to go right.  These procedures often involve taking medication such as Clomid to stimulate your ovaries and involve close monitoring by your doctor.  When your doctor determines that you are ready, the intrauterine insemination will be performed which is relatively painless.  In this procedure, a catheter is inserted through your cervix and the donor sperm gets injected directly into your uterus. This increases the chance of your becoming pregnant (compared to normal intercourse), especially since it bypasses the issue of poor cervical mucus.

In Vitro Fertilization 

In vitro fertilization is one of the most popular options for same-sex couples looking to have a baby. This process is more involved and costly than intrauterine insemination with donor insemination. However, it can triple your chance of becoming pregnant and lessen the risk of twin or triplet pregnancies which is safer for your health.

During in vitro fertilization, a doctor will harvest eggs directly from your ovaries after giving you fertility medication to promote egg development. They will then inject sperm directly into the eggs or will allow them to interact and fertilize in a lab. These embryos will be incubated for 5 days and then frozen for transfer back to your uterus in the following 6-8 weeks.  The freezing process results in higher pregnancy rates and allows your embryos to be genetically tested, if you desire, prior to returning them to your uterus.

Reciprocal IVF and Surrogacy

Some same-sex couples opt to use a procedure called reciprocal IVF to have a baby. Rather than one partner donating the eggs and carrying the baby, one partner will donate the eggs which will be implanted into the other partner’s uterus. This is a good option for couples who want both parents involved in the pregnancy and birth process.

In some cases, same-sex couples may also choose to have a surrogate carry their baby. This is most commonly done when one or both partners have problems with their uterus or if it not safe for either of them to become pregnant due to medical reasons.  The donated egg from one partner may be implanted into another person who will carry the baby for them. However, this process can be very costly and can have some tricky legal ramifications, so it requires some careful forethought.

Co-Parenting

In some cases, same-sex female couples may choose to arrange a co-parenting situation with a same-sex male couple. Both couples want children and cannot have them through traditional methods, so they team up and form a close-knit parenting team.

In a co-parenting situation, one of the partners from the same-sex male couple provides the sperm donation for the artificial insemination procedure. One of the partners in the same-sex female couple carries the baby and gives birth.  All four parents then work together to raise the child.

Co-parenting can be an amazing option for those who want their child to know their biological father, but it can be complicated from a legal and practical standpoint. If you and your partner plan to go this route, you will need to have extended discussions with your co-parents about how you will handle everything from living situations and custody to schooling, discipline, and finances.

Transgender Partners

If one partner in a same-sex female couple is a transgender woman, you may be able to have a child that is genetically connected to both of you. If that partner is pre-transition, their body will still be producing sperm. Depending on their medical situation, that sperm may be healthy enough to fertilize the other partner’s egg or frozen for later use during intrauterine insemination (IUI) or In Vitro Fertilization (IVF) treatment cycles.  In this situation, you have more options for conceiving. You will need to consult with a doctor to figure out what the best option is for you and your partner.

Adoption 

Of course, adoption can always be a wonderful option for same-sex female couples interested in having a baby. At any given time, there are more than 125,000 children in the foster care system who are eligible for adoption. You can give these children a loving home with your partner.

If you decide to adopt, be aware that you may fight some lingering bias against same-sex couples in the system. Some social workers may want to make extra demands or try to give you only “problem” children. Know your rights and be prepared to stand up for them during the adoption process – you have just as much right to adopt as anyone else.

Ongoing Research

There is some ongoing research that may one day make it possible for same-sex couples to have a child that is biologically connected to both of them. In 2018, a scientist at the University of Cambridge announced that their lab had a mouse pup that was born to two fathers. It may be possible to use stem cells from one parent to create a sperm with a woman’s DNA in it.

This research is ongoing, and it will be a long time before this procedure is medically approved for human use. Mice are much less complex than humans, and a lot more experimentation will be necessary. But someday, same-sex couples may be able to have a baby that is biologically both of their children.

Deciding on the Best Method for You

There is no one right answer to what the right way to have a baby is. Which method you choose will depend on your and your partner’s wishes and on each of your medical situations. There are a lot of factors that will impact your decision.

Start by sitting down and having a conversation with your partner about what you both want from your parenting experience. Discuss your financial resources and what you know of your reproductive health, then make an appointment with your doctor to discuss the best medical options for both of you.

Answer, “How Can a Same-Sex Female Couple Have a Baby?” 

There are many right answers to the question, “How can a same-sex female couple have a baby?” From intrauterine insemination to adoption to co-parenting, you have a lot of options available to you. Which one you choose will be a personal discussion you and your partner will need to have.

If you’d like to get started on your parenthood journey, check out the rest of our site at Inovi Fertility and Genetics Institute. We’re committed to achieving the highest success rates while providing personalized care to our patients. Schedule an appointment today and take the first step in your journey towards becoming

Intracytoplasmic Sperm Injection Procedure

What is Intracytoplasmic Sperm Injection (ICSI)?

Getting pregnant can be more challenging than it seems, with recent studies suggesting that about 1 in every 7 couples have difficulty conceiving.

Before a sperm can fertilize an egg, the head of the sperm has to attach to the outer layer of the egg. It then pushes through the outer layer into the cytoplasm of the egg and moves towards its center (nucleus) where fertilization takes place. However, sometimes the sperm may fail to penetrate the egg’s outer layer for several reasons discussed below.

But there’s still hope for couples with who have trouble conceiving naturally or with intrauterine insemination  – intracytoplasmic sperm injection (ICSI). This medical procedure involves the direct injection of a sperm cell into an egg outside the woman’s body.

Read on to learn more about the ICSI procedure.

Why is ICSI Performed?

There are several reasons for ICFI, including:

Low Sperm Count

Also known as oligospermia, low sperm count means that the semen ejaculated during intercourse contains fewer sperm cells than normal. When the semen contains zero sperm cells, the condition is known as azoospermia.

There a range of causes of low sperm count such as:

  • Depression
  • Excessive alcohol and drug use
  • Infections
  • Varicocele
  • Ejaculation problems
  • Hormone imbalances
  • Undescended testicles
  • Overheating of the testicles

If a man’s sperm count is less than 15 million sperms per milliliter of semen, it’s considered lower than average.

Low sperm counts significantly reduce the chances of a sperm cell fertilizing the egg and therefore lessens the chance of pregnancy. Fortunately, during ICSI sperm is directly injected into the eggs, increasing the odds of fertilization and pregnancy.

Abnormal Sperm Morphology

Sperm morphology is the shape and size of the sperm, and it’s one of the top factors used to evaluate fertility in men. Healthy sperm have oval heads with long tails. Abnormally shaped sperms have head and/or tail defects that reduce their effectiveness.

For example, a sperm cell may have a double or crooked tail or a misshapen head. These morphological defects affect the sperm’s ability to reach, penetrate, and fertilize the egg.

Low Sperm Motility

Sperm motility is the ability of sperm to swim efficiently to the egg. Good motility is a crucial factor in the fertilization process.

There are two main types of sperm motility – progressive motility and non-progressive motility.

Progressive motility means that the sperms are mostly moving in a straight line or large circles.

Non-progressive sperm motility, on the other hand, means that the sperm don’t swim in a straight line. For sperm to swim through the woman’s reproductive tract and fertilize the egg, it needs to have progressive motility of at least 25 micrometers per second.

Men whose semen analysis demonstrates a lot of non-progressively motile sperm have asthenozoospermia, the inability of the sperm to swim efficiently to the egg.

Unsuccessful IVF Procedures

In Vitro Fertilization (IVF) is an egg fertilization process where the egg is incubated with many sperm cells outside the woman’s body to allow fertilization to occur.

If a couple has had standard IVF procedures before and none of the eggs were fertilized, ICSI may be a viable option for them.  ICSI is a procedure that is added to the IVF procedure so that sperm are injected into the eggs instead of just being placed next to the eggs.

Vasectomy Reversal Failure

For men who previously had a vasectomy but later changed their mind, vasectomy reversal is a cost-effective option to regain fertility. This procedure reconnects the vas deferens, tubes that carry sperm from the testicles to the man’s prostate where they enter the semen.

After the procedure, a man can get his partner pregnant. However, pregnancy rates after vasectomy reversal can be as low as 30 percent. If a couple is unable to get pregnant after a vasectomy reversal, surgically collected sperm (testicular or epididymal) can be harvested and directly injected into the egg for fertilization.

Blocked Tubes

Apart from a failed vasectomy reversal, the surgical collection of sperm may be necessary if there’s a blockage that prevents sperm from reaching the semen. This can be due to injury, disease, a genetic disorder (e.g. Cystic Fibrosis), or even an extremely low sperm count.

How is ICSI performed?

An intracytoplasmic injection is when the sperm gets injected into the cytoplasm of a mature egg with a tiny needle known as a micropipette. This helps eliminate the need for the sperm to penetrate the egg’s outer layer. ICSI is done as part of the IVF cycle.

Once fertilization takes place, the fertilized egg (embryo) grows in the IVF laboratory for about five days.  It can be transferred into the woman’s uterus at that time or a later date if genetic tests are to be performed.

The ICSI technique was first used on human eggs in 1988. It was mostly used for cases where the standard IVF procedures failed. However, it was until 1992 when the first ICSI pregnancies succeeded.

ICSI’s capacity to permit almost all types of sperms to fertilize the egg has made it one of the most reliable treatments for male infertility.

How is the Egg Retrieved for ICSI?

The egg retrieval is a surgical procedure done under sedation. The ovarian follicles are aspirated using a tiny needle with the help of transvaginal ultrasonography.

A trained embryologist will scan the follicular fluids to find the best available eggs. The retrieved eggs are then stored and cultured in a specific IVF media in the lab until fertilization.

How is Sperm Retrieved for ICSI?

For men with low sperm motility and/or low sperm count, the collection of sperm cells can occur through normal ejaculation.

For cases where vasectomy reversal fails, needle aspiration or surgical sperm retrieval is an excellent alternative to surgery. This process allows physicians to get an adequate amount of sperm for the ICSI procedure, using a tiny needle that extracts sperm from the testicles. It’s performed under sedation with little to no discomfort.

ICSI vs. IVF vs. IUI: What’s the Difference?

ICSI is usually confused with IVF and IUI. However, these procedures are all different.

IUI (Intrauterine Insemination) is a procedure where sperm from the man is “washed” so that only the best sperm cells remain. The “good” sperm then gets inserted into the uterus through the cervix with a catheter. This procedure is suitable for men with slightly low sperm counts or motility since the sperm doesn’t have to travel far to reach the egg. It’s also the least invasive of the three options.

In IVF (In Vitro Fertilization), the eggs are taken out of the woman’s body and are placed with motile sperm.  Fertilization of the egg occurs naturally but in order to increase the odds of fertilization, a large amount of healthy sperm is required.  Hence, this may not be the right choice for men with low sperm count.  After fertilization, the fertilized egg (embryo) will be transferred into the woman’s uterus.

What is the Success Rate for ICSI?

The use of ICSI as a solution to male infertility in the U.S. has increased significantly since its inception.

In 2016, IVF with ICSI comprised more than 66 percent of all assisted reproductive technology procedures.  The ICSI procedure fertilizes a higher percentage of eggs than IVF alone.  This can result in more embryos and increase a couple’s chance of conceiving by giving them more embryos to transfer, although many factors are involved in determining clinical pregnancy rates.

What are some of the Risks of ICSI IVF?

While the fertilization rates of IVF with ICSI may be high, not all fertilized eggs develop into healthy embryos. Factors such as the woman’s age, egg and sperm quality, and condition of the eggs all affect pregnancy rates.  Birth defects associated with ICSI specifically are rare with a 1 percent chance of occurrence. Some of the defects that can occur with ICSI IVF include sex chromosome abnormalities, hypospadias, Angelman syndrome,  and Beckwith-Wiedemann syndrome, and can be associated with the fact that male partner has fertility issues.  For example, a male child conceived through ICSI may have the same infertility complications as their fathers. Compared to natural fertilization, there’s also a slight risk that ICSI may allow unhealthy sperm to fertilize the egg, potentially leading to a defective embryo that fails to develop.

Keep in mind that even with regular fertilization, there’s a 3-4 percent chance of birth defects which is similar to the general population that does not have fertility issues.

Another risk of IVF or IVF with ICSI is the increased chance of multiple or higher-order births (twins, triplets, or higher). Controlling the number of embryos that are transferred into the woman’s uterus can substantially lower this risk. Like naturally conceived children, children that are from twin or higher-order multiple pregnancies may be prone to birth defects or developmental problems.  The goal of most good clinics is to transfer one or two high-quality embryos per attempt.

Final Thoughts on Intracytoplasmic Sperm Injection (ICSI)

Patients should understand the potential risks and complications of Intracytoplasmic Sperm Injection before the procedure is undertaken.  It is essential to do your research and find an expert. At Inovi Fertility & Genetics Institute, we are committed to providing the best IVF, ICSI & Personalized care in the Houston fertility market.

 

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