Here at the Center for Advanced Reproductive Medicine & Fertility, we get a lot of questions about what we do, what the process is, how patients are affected by the procedure, and more. Below, please find some of the most frequently asked questions and our answers. If you have a question not addressed below, please call our office at 732-339-9300 or contact us online.
Questions about treatment
- How much time does treatment require?
- I work full-time. Will I need to take time off to have treatment?
- How long does my husband/partner need to take off work?
- Can I come in for monitoring in the afternoon?
- How much does treatment cost?
- Are medications included in the cost of a cycle?
- Does your office provide my medications?
Questions about biology
- What is an embryologist?
- What is a follicle?
- What if I have too many eggs?
- What if I have too few eggs?
- Will my treatment be successful?
- What if embryo transfer falls on a weekend or holiday?
- How many embryos are transferred during IVF?
- Am I depleting my store of eggs by doing an IVF cycle?
Questions about pregnancy
- What happens if I become pregnant?
- What are the chances of multiple births?
- Is there a higher miscarriage rate for IVF patients?
- Is it normal to lightly spot or have twinges/cramping early in pregnancy?
Questions about treatment
Once gonadotropin (FSH) injections begin, you are required for early morning appointments for ultrasound and/or blood tests every few days and daily as you approach egg retrieval. It is important to note that depending on your individual stimulation protocol and response, treatment time can be as much as three weeks.
Depending on the type of cycle your doctor feels is best for you, we can minimize your time away from work as we open at 6:30 or 7:00 AM, and most patients can visit us on their way to work. Monitoring visits typically last 20 minutes. On occasion, you will need more time. You will need to be off from work on the day of the egg retrieval and embryo transfer.
How long does my husband/partner need to take off work?
Although partners are encouraged to attend as many treatment appointments as possible, it is not mandatory. Male partners are required to be in the office on the day of egg retrieval in order to provide a fresh semen sample, if necessary. On the day of the embryo transfer, your partner is usually present as well.
Monitoring appointments need to be scheduled in the morning, so there is ample time for the lab work to be processed and evaluated by your physician.
How much does treatment cost?
Cost for fertility treatment varies, depending on a variety of factors (what treatment is recommended for you, how much medication you will need, whether insurance covers a portion of treatment, etc.) Our business office representatives work closely with you to utilize your maximum insurance benefits. Please contact us for specific questions, or see the following pages:
Are medications included in the cost of a cycle?
Typically medications are not included in the cost of a cycle, as the amount of medication needed will vary from patient to patient.
Does your office provide my medications?
The Center for Advanced Reproductive Medicine & Fertility does not provide fertility medications for your cycle, but a prescription will be given to you or can be faxed to the pharmacy of your choice.
Questions about biology
An embryologist is a specialist in embryo development. Embryologists are responsible for sperm washing, IVF, ICSI, pre-implantation genetic diagnosis, and research into new techniques such as egg freezing.
This is a fluid-filled structure in the ovary which houses the developing egg (oocyte). The covering of the follicle contains cells which produce the female hormone estrogen, called estradiol. After release of the egg (ovulation), these hormone producing cells switch to producing the implantation supporting hormone called progesterone.
Over response to medication, called ovarian hyperstimulation, can occur. Though this can be potentially serious, several treatment options exist. These options will be discussed and individualized accordingly. In general, options include:
- Continuing with the cycle including embryo transfer and monitoring for ovarian hyperstimulation syndrome (OHSS)
- Continuing with the cycle and considering a single embryo transfer to decrease the likelihood of severe OHSS
- Continuing the cycle and freezing all embryos for use in a later frozen embryo transfer
- Canceling the cycle and restarting at a lower dose of stimulation medication
What if I have too few eggs?
The clinic recommends having a minimum of 2-3 mature follicles on ultrasound prior to proceeding with egg retrieval. Depending on individual circumstances, several options exist including continuing with egg retrieval and embryo transfer despite the low number; converting to superovulation and intrauterine insemination (IUI) if the fallopian tubes are open and adequate sperm count exists; canceling the cycle and restarting another cycle with an alternate protocol. If no alternate protocol exists, egg donation may be considered.
Your doctor at The Center for Advanced Reproductive Medicine & Fertility will advise you as to your specific treatment options, and will also explain to you your chances of success, taking into consideration your type of infertility, your age and your treatment. No medical procedure, especially regarding the treatment of infertility, can guarantee a certain outcome. You can learn more about your chances of success with IVF here.
What if my embryo transfer falls on a weekend or holiday?
The Center for Advanced Reproductive Medicine & Fertility is open 7 days a week for the active treatment of IVF patients.
How many embryos are transferred during IVF?
A number of variables may be considered prior to a mutual patient-physician decision regarding how many embryos will be transferred in an IVF cycle. Here are some:
- Patient age
- Ovarian reserve quality
- Number of fertilized eggs
- Embryo quality
- Day of transfer (past retrieval)
- Previous IVF/fertility history
- Implantation factors
- Preference of patient
- Financial considerations
- Life circumstances
- Third-party embryos/eggs (if any)
- Clinic history
Transferring one or two embryos is common under age 35. Depending on many variables, including those listed above, the number of embryos can range from one to four, with four being for exceptional circumstances and/or over the age of 40. Each clinic and patient situation is different.
Am I depleting my store of eggs by doing an IVF cycle?
A woman is born with a full complement of eggs. There are far more eggs than will ever be used during a normal lifetime and IVF has no significant lowering effect.
Questions about pregnancy
Congratulations! If you become pregnant, you will be asked to return to the office for repeat blood tests and ultrasounds to ensure an ongoing successful pregnancy. After 7-8 weeks you will be referred to an obstetrician for the remainder of the pregnancy.
What are the chances of multiple births?
A single, healthy pregnancy is our goal for every patient. The multiple birth rate is related to the age of the female partner at the time of egg retrieval, the number of embryos implanted and the quality of these embryos. If you are pursuing IVF, a detailed discussion will occur regarding how many embryos to replace in order to decrease the chance of multiples. The clinic has a 40% twin rate and < 2% higher order birth rate with IVF. More and more patients are selecting single embryo transfer to lower the chance for multiple gestation.
Is there a higher miscarriage rate for IVF patients?
The miscarriage rate is about the same for IVF as the general population. Many times older females undergo IVF and their miscarriage rates are naturally higher. Also, pregnancy testing is done two weeks after embryo transfer, so we often know about spontaneous miscarriages in the very early stages of pregnancy. These miscarriages would probably go unnoticed in the general population.
Is it normal to lightly spot or have twinges/cramping early in pregnancy?
Spotting (dark red or brown) can be quite normal early in pregnancy. However, if you experience bright red bleeding, that soaks through a pad an hour, please get off your feet immediately and call our office at 732-339-9300. Intermittent mild cramping and slight twinges on either side may also be normal. If cramping is moderate to severe, this may not be normal and you should notify our office. If you have had IVF with multiple embryos transferred, patients may experience some spotting as well.