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IVF

In Vitro Fertilization – IVF – Infertility Treatments – Frisco, TX*

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Overview

At the Frisco Institute for Reproductive Medicine (FIRM) in Frisco, TX, we are fortunate to have an exceptional team of experienced doctors with access to a world-class IVF lab where collaborative efforts have helped build many families. Drs. Mehta, Guerami, and Meintjes are constantly evaluating our laboratory and stimulation protocols to confirm that all conditions are optimal for successful conception. The term in vitro is Latin for "in glass," refers to the method of combining eggs and sperm in a Petri dish in a fertility clinic laboratory. When the sperm fertilizes an egg, an embryo is created that will be transferred directly into the woman’s uterus.

In preparation for IVF, the woman takes medication that stimulates her ovaries to produce mature eggs, which are retrieved surgically. The man provides a sperm sample, either naturally or via surgical aspiration. If male factor infertility is present, the couple may opt to use intracytoplasmic sperm injection (ICSI), a form of artificial insemination, or use the sperm of a donor. During the transfer, an embryo is placed into the woman’s uterus, where it will hopefully implant itself in the uterine lining and continue to develop during a full-term pregnancy into a healthy baby.

Considering IVF?

IVF is an effective assisted reproductive technology for both men and women with a range of infertility conditions. It is the primary treatment option for women with damaged, abnormal fallopian tubes, or for men with very poor sperm quality.

For patients with other conditions, fertility specialists may recommend trying a different treatment first and considering IVF as a second-line approach. This approach is often taken because IVF is a complex process and it is also the most expensive assisted reproductive technology. IVF can be beneficial for patients with:

  • Low ovarian reserve
  • Age-related infertility
  • Anovulation
  • Endometriosis
  • Male factor infertility
  • Unexplained infertility

In addition, patients may choose to undergo IVF treatment who would not otherwise be able to experience pregnancy or biological parenthood, including those who must use donated sperm or eggs.

What to Expect

At FIRM, we are confident in our high-quality clinical and excellent laboratory capabilities. Our goal is to help as many couples as possible achieve the dream of a healthy baby. Consequently, we should offer treatment to a patient with all the tools at our disposal, even if that patient does not necessarily have the highest chance to achieve success. As long as patients have a realistic and true expectation of their chances, we are obligated to offer them an opportunity. Therefore, we do not exclude patients from treatment for fear of affecting our statistics.

Sometimes, the medical, financial and psychological risks associated with IVF far outweigh the possibility of a successful outcome. When treatment is objectively futile, it is our responsibility to discourage further treatment and to encourage the couple to move on to the next step, such as embryo donation or the use of donor eggs if appropriate.

IVF Technique

FIRM emphasizes elective single embryo transfer (eSET), which is when, by choice, only one embryo is placed in the womb at a time. A twin pregnancy is extremely risky with approximately 50 percent of twin pregnancies resulting in the premature birth of the babies. Premature birth is a leading cause of stillbirth, cerebral palsy, lower birth weight and developmental problems, such as malformations, poor eyesight, and learning disabilities.

With the improved culture techniques and cutting-edge technology at the Institute, pregnancy rates after the initial transfer of one fresh embryo, and the later transfer of one frozen embryo, are significantly higher compared with transferring two fresh embryos at the same time. Furthermore, when transferring only one embryo, the chance for an uncomplicated pregnancy and the resultant birth of a healthy baby is increased significantly.

IVF Risks

According to the American Society for Reproductive Medicine, serious complications from the medications or procedures used during IVF treatment are rare. As with any medical procedure, there are potential health risks involved. Following are the types of risks associated with the different aspects of IVF treatment.

Fertility Medications

The drugs prescribed for ovarian stimulation may cause side effects that include:

  • Allergic reactions
  • Gastrointestinal discomfort
  • Headaches
  • Changes in mood
  • Soreness or bruising at the site of medication injections

IVF medications can also cause ovarian hyperstimulation syndrome (OHSS), which affects 10 percent of women undergoing IVF. OHSS is an overstimulation of the ovaries that causes enlargement of the ovaries, abdominal fluid retention and weight gain. Generally, OHSS causes mild to moderate pain, bloating and decreased appetite. About one percent of patients who experience OHSS will develop more serious symptoms, including:

  • Intense nausea or vomiting
  • Dark-colored urine and decreased urinary frequency
  • Severe abdominal pain
  • Sudden, significant weight gain (10 pounds or more over a 3 – 5 day period)
  • Blood clots in the legs
  • Shortness of breath

If severe OHSS occurs, the fertility doctor may recommend delaying or rescheduling the embryo transfer until the woman recovers. In some cases, OHSS can occur after embryo transfer and may last until the 10th week of pregnancy before resolving.

Egg Retrieval Risks

Egg retrieval is a transvaginal surgical procedure in which a long needle is guided through the vagina into the ovary where it retrieves eggs from follicles. Aside from risks associated with the use of anesthesia during the procedure, egg retrieval carries a slight chance of pelvic and abdominal pain, internal bleeding, infection, or damage to the blood vessels, bladder or bowel.

Embryo Retrieval Risks

During the embryo transfer, a catheter is inserted into the uterus that can cause cramps, spotting, or bleeding.

Multiples in Pregnancy

Some patients will have more than one embryo transferred at a time, which increases the chance of becoming pregnant. However, it also increases the chance of being pregnant with twins, triplets or other multiples. Physicians should strive to transfer the minimum number of embryos that will result in the highest chance of pregnancy while keeping the risk of a multiples pregnancy low.

A multiples pregnancy presents risks during pregnancy and delivery for the mother. For the babies in a multiples pregnancy, there is an increased risk of premature delivery and lifelong health or developmental problems.

Psychological Stress

Often, fertility treatments like IVF can be emotionally and physically stressful for patients and their families. Fertility clinics routinely offer and recommend psychological counseling for IVF patients. FIRM’s infertility counseling and support group is led by a licensed professional counselor and provides a safe non-judgmental environment for those to share experiences and feelings due to infertility.

Truth About IVF Success Rates

Compared with other fertility treatments, IVF has the highest success rates, particularly for younger women. However, the success of this treatment depends on many individual factors, including age and the presence of other health conditions.

IVF success rates can be easily manipulated to enhance a particular program’s public image and are often confusing and misleading. Therefore, non-validated IVF statistics provide little meaningful guidance for a patient hoping to achieve a pregnancy with IVF. Statisticians and experts in reproductive technology have acknowledged this, but the public does not generally understand the disparities frequently observed in non-validated statistics. For this reason, patients should only trust data as reported by the Centers for Disease Control (CDC) or the Society for Assisted Reproductive Technologies (SART) that has been verified and reported in a standard format that allows for meaningful comparisons.

Even with this said, it is important to realize that success rates are population statistics, meaning they reflect data from a select population or group of people. A patient treated with IVF is not a percentage statistic, because when all is said and done she will be 100 percent pregnant or 100 percent not pregnant. Each couple is unique with a distinct medical history that affects their chances of having a baby.

Often, the difference between a program with excellent statistics and one with good statistics is in the prognosis mix of patients who present for treatment, and in the clinic’s criteria for who they will allow to try IVF. Program statistics can be enhanced by excluding or even wait-listing individuals who have had previous failed cycles, are of advanced maternal age, or are poor responders. Furthermore, statistics can be improved by encouraging IVF early on for younger, better prognosis patients.

When comparing pregnancy rates, one should emphasize singleton live births rather than pregnancies or overall births, as singleton births are the strongest link with a healthy baby. We know this is the ultimate goal of infertility treatment. Implantation rate (the chance of each embryo transferred to implant) is also a good parameter to look at, as the transfer of multiple embryos may initially result in higher pregnancy rates, albeit with more complications. This is due to multiple pregnancies and fewer healthy live births because of a high rate of premature deliveries.

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Our physicians provide years of experience and clinical expertise. Our IVF Laboratory Director, Dr. Meintjes, has more than 25 years of experience in reproductive physiology and embryo biotechnology and has applied this knowledge over the years to the benefit of many patients. FIRM has some of the best IVF success rates in the United States. As required by law, we report our rates annually to the CDC and these results are also made available to SART. If you would like to learn more to schedule an appointment, please call our office.

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*Individual results are not guaranteed and may vary from person to person. Images may contain models.