Each month we host a free, live online seminar where patients can ask the physicians of Fertility Solutions questions about infertility. The seminar for January was about ‘Preimplantation Genetic Diagnosis (PGD)’. Topics change monthly, with our last two seminars focusing on endometriosis and unexplained infertility. View the live Q & A chat about PGD below:
IVF 101 – An introduction to IVF
(06/13/2012)
7:31
Anne Devi Wold:
What is your biggest concern about IVF?
Wednesday June 13, 2012 7:31 Anne Devi Wold
7:34
Anne Devi Wold:
IVF stands for in vitro fertilization. Fertilization of an oocyte by sperm occurs at the end of the tube. The fertilized embryo traels 3 days in the tube and reaches the uterus for implantation. . IVF was initially used for patients who did not have functioning tubes 32 years ago.
Wednesday June 13, 2012 7:34 Anne Devi Wold
7:37
How maNY OF YOU KNOW COUPLES WHO HAVE CONCEIVED USINF IVF
1-4
( 67% )
5-10
( 33% )
0
( 0% )
10
( 0% )
Wednesday June 13, 2012 7:37
7:44
Anne Devi Wold:
Any questions?
Wednesday June 13, 2012 7:44 Anne Devi Wold
7:45
Anne Devi Wold:
This is quiet group. Please let me know what you would like to hear about IVF
Wednesday June 13, 2012 7:45 Anne Devi Wold
7:49
Anne Devi Wold:
I anyone there?
Wednesday June 13, 2012 7:49 Anne Devi Wold
7:50
Anne Devi Wold:
Should we quit?
Wednesday June 13, 2012 7:50 Anne Devi Wold
7:59
Anne Devi Wold:
I am sorry, I could not see your questions: CF; if sperm donor is negative, the chance of having an affected child is very low but not zero. There may be rare mutations that were not picked up by the test on the sperm donor
Wednesday June 13, 2012 7:59 Anne Devi Wold
8:00
Christina:
So you would not normally test the embryo in that scenario?
Wednesday June 13, 2012 8:00 Christina
8:02
Anne Devi Wold:
If your over 40, you may use PGS although the research is controversial. Pregnancy rates are not higher because many abnormal embryos will not be transferred but miscarriage rates would be lower. The technology is usually not covered by insurance any cost 3500.00
Wednesday June 13, 2012 8:02 Anne Devi Wold
8:02
Christina:
Thank you!
Wednesday June 13, 2012 8:02 Christina
8:03
Anne Devi Wold:
Antagonsit is started when you have at least one follicle that is over 14 mm and estrogen level over 400 pg/ml. This could be anywhere between day 6 to 8
Wednesday June 13, 2012 8:03 Anne Devi Wold
8:05
Anne Devi Wold:
Specific meds; HCG is not flexible It has to be administered 36-38 hours after the trigger. The other meds can be administered at the same time every day , 1-2 hours would not make a difference
Wednesday June 13, 2012 8:05 Anne Devi Wold
8:07
Christina:
Do you automatically perform assisted hatching if you deem it necessary?
Wednesday June 13, 2012 8:07 Christina
8:08
Anne Devi Wold:
Chrisitna: Not necessarily. The technology is not perfect, you would submit the embryo to a biopsy and then test for all chromosome based on a single cell. There could be 5-10% cancer of error. Some normal embryos do not survive after all the manipulation
Wednesday June 13, 2012 8:08 Anne Devi Wold
8:08
Anne Devi Wold:
Chrisitna: On day 3 transfers in women over 37 years. Day 5 embryos do not need hatching
Wednesday June 13, 2012 8:08 Anne Devi Wold
8:11
Anne Devi Wold:
Tobey: You should be evaluated to assess your ovarian reserve and uterine cavity. In addition you partner needs a semen analysis. If ovarian reserve testing is normal and sperm counts are normal, you would be good candidate for tubal reversal. Otherwise you are better off with IVF
Wednesday June 13, 2012 8:11 Anne Devi Wold
8:13
Anne Devi Wold:
Depends on your age. If you are below 35, I would suggest one embryo. It also depends on how sever the pre-eclampsia was in your previous pregnancy?
Wednesday June 13, 2012 8:13 Anne Devi Wold
8:14
Christina:
I’m sure this varies case-by-case, but do you have a rough idea of how many eggs you get on average from a 40 yo woman? I’m probably going to start my first round and I’m curious what would be a ‘typical’ number…
Wednesday June 13, 2012 8:14 Christina
8:17
Anne Devi Wold:
Please let me know.? The best option is to call directly based on what location you would like to be seen. Providence: 401 277 1390 Dedham: 781 326 2451. You should also ask for a physician of your choice in all the locations. Do not trust the stats on Top Docs or any other commercial paid ads (these are all a scam). I would ask your peers of ob/gyn. You need to be comfortable with your physician and the nurse.
Wednesday June 13, 2012 8:17 Anne Devi Wold
8:19
Anne Devi Wold:
The rate of success is higher when you are younger. If pre-eclampsia was sever you are better off with singl3e embryo transfer if you are below 40 years of age
Wednesday June 13, 2012 8:19 Anne Devi Wold
8:20
Anne Devi Wold:
Tobey, you may be better off with IVF.
Wednesday June 13, 2012 8:20 Anne Devi Wold
8:22
Anne Devi Wold:
Christina: the number of eggs retrieved in dependent on your ovarian reserve. Some 40 year old women will have 15 eggs but most will have less tha8 eggs. In addition to the number, the quality of the eggs is lower as you age. Even if you have 20 eggs , 80% of these are not normal
Wednesday June 13, 2012 8:22 Anne Devi Wold
8:24
Anne Devi Wold:
Veronica: I have no explanation for the shortage. It probably has to do with drug manufacturing companies trying to increase prices with the insurances. The birth control pill is used sometimes to prevent cyst (if you are prone to them) or to control the day you get your period.
Wednesday June 13, 2012 8:24 Anne Devi Wold
8:29
Anne Devi Wold:
The number of eggs at any age is very variable: amount of stimulation meds, number of antral follicles, levels of FSH, etc. The number is not as important as the quality. You cold have 2 eggs and get pregnant
Wednesday June 13, 2012 8:29 Anne Devi Wold
8:31
Anne Devi Wold:
Being overweight will decrease your chances of pregnancy with or without IVF. You need to lose 10% of your current weight to achieve better results. Ovarian reserve is very variable. Success rate with IVF could be anywhere between 35-45% per cycle
Wednesday June 13, 2012 8:31 Anne Devi Wold
8:33
Anne Devi Wold:
Please feel free to e-mail me with more questions at [email protected]. Thank you all for your interest. I will be closing the session now. Tobey: Most IVF center use BMI of 42 for IVF. They are turned away if >42 (BMI)
Wednesday June 13, 2012 8:33 Anne Devi Wold
8:34