There were a lot of questions provided on the SMC forum that I used during my IVF consult. I didn't use all of them, as some answers were on my RE's website. I've been working with them for a while now, so I didn't have the need to ask them any credibility questions. If you're interviewing multiple RE's, I would suggest asking the credibility questions.
I also received my IVF Calendar today! I'll update the IVF Timeline soon. I do feel more organized now that I have the calendar and can visually see things and what need to happen/when.
**WARNING** This will be a long blog post. I have my Questions and my RE's answers listed. I also included some definitions for everything in the process.
Weight / BMI / Diabetes
Q: What is the BMI Limit?
A: 40
Q: Is my weight a concern for Egg Retrieval?
A: No.
Q: Will Egg Retrieval be harder? Or a more difficult recovery?
A: No, I will be under anesthesia.
Q: Will it be hard to reach my left ovary (always hard to see on transvaginal ultrasound)?
A: It may be harder to reach, but they can press on my tummy to "move things around" to get to the ovary.
Q: What are Success Rates for retrieval?
A: 95%
Donor Sperm
Q: What type of sperm should I order (IUI, ICI)?
A: IUI
Q: Can I order ART Vials (these are cheaper)?
A: Yes, but need to double check with the embryologist.
Q: What blood type - does it matter?
A: No, only if it matters to me.
A: No, only if it matters to me.
Q: How many vials of sperm do you need on-site? (most clinics want 2, just in case one is bad, and usually from 2 separate ejaculates).
A: Want 1 on-site. But if doing PGS testing, then would need 2 (one to send for testing)
A: Want 1 on-site. But if doing PGS testing, then would need 2 (one to send for testing)
Q: Can you partially chip/partially thaw the vial, so as to not use all of it?
A: Only if this is the "last vial" available (i.e. last vial of donor for a sibling).
Q: Do you do ICSI routinely?
Pronounced IK-SEE. This is the process where one sperm is injected directly into the egg.
Q: Do you do ICSI routinely?
A: Yes.
Q: Do you recommend ICSI? Why?
A: Using donor sperm that is frozen. Increases the % chance of fertilization.
Q: Covered by insurance?
A: No, not covered.
Q: What is the Cost?
A: $1,525.
Q: How many follicles are enough to continue with a cycle/will you cancel a cycle for non-response?
A: Non-responsive is 3 or less follicles. If there are at least 4, we will move forward.
A: $1,525.
Super Ovulation / Pre-Egg Retrieval
Q: How many follicles are enough to continue with a cycle/will you cancel a cycle for non-response?
A: Non-responsive is 3 or less follicles. If there are at least 4, we will move forward.
Q: What supplements should I take? Are the supplements I am taking ok? (bring supplements)
A: Supplements currently taking are OK.
A: Supplements currently taking are OK.
Q: Will I see the same doctor or different doctors during my cycle?
A: Will see one of the two RE's in the office for each monitoring appointment.
A: Will see one of the two RE's in the office for each monitoring appointment.
Q: Do you do a trial transfer?
A: Yes, scheduled.
A: Yes, scheduled.
Q: Do you measure E2 (estrogen) and do US monitoring during stims? Blood work?
A: Yes, blood work and U/S monitoring will be done regularly.
A: Yes, blood work and U/S monitoring will be done regularly.
Q: Who decides if my cycle will be canceled? What would make you cancel my cycle given my specific #s (AFC, etc)?
A: If I don't react to the stims. RE doesn't think this will be a problem.
A: If I don't react to the stims. RE doesn't think this will be a problem.
Q: When should I stop my supplements?
A: See IVF Calendar.
A: See IVF Calendar.
Q: What protocol do you plan to use in me? Why?
A: See IVF Calendar.
Q: How many eggs do you think you'll be able to get from a cycle?
A: Between 10-15 eggs.
A: See IVF Calendar.
Egg Retrieval
Q: How many eggs do you think you'll be able to get from a cycle?
A: Between 10-15 eggs.
Q: Where is the embryology lab relative to the retrieval and transfer room?
Q: How many embryos do you expect from me?
Q: Do you expect to get frozen blasts from me?
Q: Will I be on bedrest?
Preimplantation Genetic Diagnosis (PGD). PGD, preimplantation genetic diagnosis, is the process of removing a cell from an in vitro fertilization embryo for genetic testing before transferring the embryo to the uterus
Preimplantation Genetic Screening (PGS). PGS, preimplantation genetic screening, refers to removing one or more cells from an in vitro fertilization embryo to test for chromosomal normalcy.
Q: Do you do any kind of genetic testing on eggs/embryos, and if so, what would you recommend for me?
A: Embryology lab is on premises (right next door).
A: Recovered - 95%, Mature - 75%, Fertilized - 70%, Growth ~ 50%, Normal ~ 60%
A: Yes, expecting 3-5 to make it to day 5.
A: No.
Q: How long will the Egg Retrieval take?
A: 15 minutes.
Genetic Testing (PGD and PGS)
Preimplantation Genetic Diagnosis (PGD). PGD, preimplantation genetic diagnosis, is the process of removing a cell from an in vitro fertilization embryo for genetic testing before transferring the embryo to the uterus
Preimplantation Genetic Screening (PGS). PGS, preimplantation genetic screening, refers to removing one or more cells from an in vitro fertilization embryo to test for chromosomal normalcy.
Q: Do you do any kind of genetic testing on eggs/embryos, and if so, what would you recommend for me?
A: Yes, they do the testing. No, it's not recommended for me.
Q: What are the costs?
A: Over $5000 for 8 embryos, cost goes up if more embryos are tested.
A: Over $5000 for 8 embryos, cost goes up if more embryos are tested.
Q: Is there a medically necessary reason to perform PGD/S testing for me?
A: No.
A: No.
Q: If I do not have any eggs to make it to testing, will I get refunded?
A: N/A
A: N/A
Q: If I choose to test later, what are the odds that the embryos will survive the freeze/refreeze?
A: Good survival rate to freeze/refreeze.
A: Good survival rate to freeze/refreeze.
Q: Can I do a fresh transfer and then test the remaining embryos?
A:Yes, can do a fresh transfer and then test the rest.
Q: Do you recommend assisted hatching?
A: No.
Q: What is max # of embryos you would transfer?
A:Yes, can do a fresh transfer and then test the rest.
Assisted Hatching
Definition: Assisted hatching is a lab technique that was developed when it was observed that embryos that had a thin zona pellucida had a higher rate of implantation during in vitro fertilization (IVF). Embryologists create a small hole in the outer lining using micro manipulation techniques under a microscope during the fourth day of embryo development.
A: No.
Egg Transfer
Q: What is max # of embryos you would transfer?
A: 2
Q: Do you recommend three day or five day transfer? What determines when the transfer is?
A: Five Day transfer is recommended. If only 2 make it to day 3, might suggest an earlier transfer.
A: Yes.
A: Individual
A: Limited, will get more details closer to.
A: More details to come closer to.
A: Not recommended. But RE has 2 acupuncturists that can come on site.
Freeze
A: Day 5
Q: Do you use slow freezing or vitrification (vitrification has better success for FETs)?
A: Vitrification
A: Vitrification
Q: If a fresh transfer is not successful, what’s the protocol for a FET? How long would I have to wait?
A: 6-8 weeks
A: 6-8 weeks
Q: What happens to left ovary embryos when I have completed my family?
A: I have the chose to: 1) Donate, 2) Discard, 3) send to research.
A: I have the chose to: 1) Donate, 2) Discard, 3) send to research.
Q: Heard that FET’s have higher success rates vs. Fresh. What is your experience?
A: RE doesn't believe there is data to support that FET's have higher success rates. He recommends a fresh transfer.
Q: What pre-cycle screening tests are required, what are their costs, and will insurance cover the tests?
A: RE doesn't believe there is data to support that FET's have higher success rates. He recommends a fresh transfer.
Regarding Cost and Convenience
Q: What pre-cycle screening tests are required, what are their costs, and will insurance cover the tests?
A: Already done.
Q: How much does the ART procedure cost, including drugs per treatment cycle?
A: Have to wait to hear from pharmacy.
Q: Will I be required to pay in advance? If so, how much, and what payment methods are acceptable?
A: Yes, I will need to pay on 11/18 and provide consent forms.
A: Yes, I will need to pay on 11/18 and provide consent forms.
Q: What are the costs of embryo freezing, storage, and transfer? What does insurance cover?
A: Cost for freezing is $500.
A: Cost for freezing is $500.
Q: At this point, am I considered unexplained infertility?
A: Yes
Next Steps: see IVF Timeline
A: Yes
- Wait for pharmacy to call and order meds.
- 11/16 @ 10 a.m. Saline Ultrasound and Mock Transfer
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