IVF: Everything You Need to Know

Every day, new parents like you share their experiences using Expectful while TTC. More and more, we’ve been hearing from moms who have conceived using IVF and hopeful parents who are considering or starting fertility treatments.

Information about fertility science can empower you, no matter where you are in your TTC journey. To better understand the IVF process and help families prepare for treatment, we interviewed two doctors and fertility specialists at CCRM, a leading pioneer in fertility science, research and advancement, that offers access to a network of physicians, fertility services, technology and labs across the US.

Tell us about yourselves and your roles at CCRM.

JK: My name is Dr. Jaime Knopman and I am a fertility doctor. At CCRM in New York, I serve as the director of fertility preservation. I am also the Chief Medical Officer of an organization called Chick Mission. We raise money to offset the cost of egg and embryo freezing for women who have been diagnosed with a malignancy. I am passionate about helping women and couples achieve their dreams of becoming parents. One of my greatest rewards is partnering with individuals on this journey. In my free time, you will likely see me running in Central Park or hanging out with my daughters.

ST: My name is Dr. Sheeva Talebian. I am director of third party reproduction at CCRM in New York. I work with individuals needing egg donor/sperm donor/surrogates but also provide comprehensive fertility services. Fertility medicine is highly emotional and I find my patients do best when they have a team supporting them. I recommend encompassing Eastern medicine, exercise and meditation during their treatment. Whether the treatment is successful or not, I am right by their side during

Can you give us a brief description of IVF and who it may be appropriate for?

IVF stands for in vitro fertilization; basically egg and sperm coming together outside of the body (in the lab). Following the meeting of these two gametes, the resulting embryo is observed for up to 7 days (the timing of the transfer is based on clinic parameters). IVF can be an option for a myriad of women/couples; couples who have been unsuccessful with intra uterine insemination (IUI), couples where the egg quality and quantity is reduced, couples where the sperm quantity/quality is reduced, those wishing to avoid passing on a specific genetic mutation, couples with recurrent pregnancy loss (miscarriage), etc. There are few individuals or cases where IVF is not an option. However, sometimes IVF is not needed; the first step for most couples is an IUI.

For anyone that’s been trying to conceive for a while, how long do you recommend waiting before considering IVF?

There is really no one answer here–it is really dependent on what other treatments have been tried, the age of the female (and male) patient and the cause of infertility. Like most treatment modalities your decision is not made on one parameter; you have to look at the whole picture. I always tell couples that infertility is like a puzzle; we as clinicians are trying to see where the pieces are not fitting and what we have to do to make them fit. Sometimes to make them “fit” you have to immediately use IVF.

If you’re preparing for IVF, when do you suggest harvesting eggs and when should you start injections?

The amount of time a woman is taking IVF medications varies; there is not one set date. While most women require about 10 days of hormonal injections, some women respond more quickly (8-9 days) while others a bit slower. When a woman does IVF more than once we can use her response in a previous cycle to base decisions on when to schedule her subsequent egg retrieval.

How many eggs do you recommend harvesting?

In many ways when it comes to eggs, the more the better. It’s like buying lottery tickets; the more you have, the better your chance of getting a good embryo. Ideally, we aim to extract (or retrieve) the most eggs we can safely. We want to pick a dosage of medication that will allow us to maximize the number of good quality eggs.

What’s the success rate of a transfer? How many transfers does the average patient receive?

Success rates post transfer historically hinged on female age and the number of embryos transferred–now with the introduction of preimplantation genetic screening, the success rates post IVF transfer between a 25 year-old and 35 year-old woman can become equal if the embryo is genetically normal. In today’s fertility treatment, most women are successful much earlier in the treatment process. At CCRM, the success rate post transfer for a screened chromosomally normal embryo can be as high as 70%.

What are the indicators of a healthy pregnancy that you test for?

We follow women in their pregnancies up to approximately 9 weeks. We perform weekly ultrasounds and blood work; we want to see the blood (hCG) levels rise and the pregnancy hit normal landmarks on ultrasound–gestational sac, yolk sac, fetal pole, heartbeat movement, etc. As women reach the end of their first trimester, their OB/GYN will take over and perform early pregnancy screening (nuchal testing, NIPT and/or CVS/amnio).

What are the emotional factors of IVF that people should be aware of before starting treatment?

Most women tolerate IVF and the fertility medications without a problem. Some women may report fatigue, difficulty sleeping, sadness, etc. As a physician, I think one of the hardest parts of IVF is relinquishing control. We cannot always tell you when events will happen or what the outcome will be. I think the lack of control over this, your body (fertility treatments cause bloating and transient weight gain) and how the process will end can be incredibly challenging.

What do you recommend people do to handle the inherent stress and challenges of IVF?

Do what you love to do–don’t stop because of IVF. Although you may need to modify your exercise routine, stopping completely is not helpful. I also recommend acupuncture, meditation and support groups. Talk to other people about what is going on; community makes the whole process easier.

What is the most healthy mindset you see people adopt through the IVF process?

Letting go–don’t try and control the process. Trust in your doctors and your team. Turn to them and your family and friends for support. Don’t beat yourself up and don’t blame yourself. None of this was your fault.

How can meditation help facilitate a positive IVF experience?

In our opinion, it can help decrease stress that one experiences going through the process. It can also help you find the resilience you need to get through the process.

Is there anything that I haven’t asked you that you’d like to share based on your experience?

JK: Fertility treatment is a journey! You have to ride the highs and the lows but if you stay on the path (no matter how circuitous it is), you will become a parent.

ST: Also, understand that fertility medicine is just as much an art as it is a science. There is not one standard treatment that is prescribed at every center. When seeking a fertility team, I recommend meeting with the doctor and asking about his/her protocols and lab experience. Also, meet with the rest of the team (nurses, medical assistants). You should have it all: an excellent lab (if you need IVF or egg freezing) and a team that is knowledgeable, accessible and compassionate.