You're not alone. In the United States and Europe, roughly 6.1 million men and women, 10% of the reproductive-age population, are infertile. The causes are found equally among women and men, with nearly 35% cases of infertility caused by the woman, and 35% resulting from the man. (In 20% of infertility cases both partners have complications, and 10% of cases remain unexplained.)
The world of infertility treatments can be confusing and overwhelming to navigate, so we have created this step-by-step guide to help you understand how to get started and what to expect at every stage of an IVF treatment cycle at EmBIO Medical Center.
Initial Fertility Consultation: A Comprehensive Evaluation
Infertility can be a complicated thing. And, the causes are numerous. According to the Society of Assisted Reproductive Technology (SART), the most common female causes reported include tubal factor (which accounts for about 10% of all female related issues), ovulatory dysfunction (6%), diminished ovarian reserve (12%), endometriosis (5%), uterine factors (1%), and other factors (8%). In 11% of female infertility cases the causes are unknown.
While there are many causes of male factor infertility, some are seen more commonly than others. Those include blockage of sperm, infection (STD, mumps, etc.), chronic disease, erectile dysfunction (which occurs in 50% of men over 40), failure to produce sperm, exposure to harmful substances, injury, or varicocele (varicose veins in the testicle).
During your initial consultation we will complete a comprehensive fertility evaluation to help determine the cause of your infertility and the best treatment program for you. Though is not necessary, we recommend you schedule this appointment on day 2, 3, or 4 of your menstrual cycle just in case you can and wish to start right away, and because it will provide us the best picture into your fertility health.
The Fertility Consultation
During your first consultation with Dr Thanos Paraschos and your IVF coordinator (of your fertility care team), together you will discuss your medical and fertility history, any complications or issues you have been having, and your goals. Your fertility care team will also explain IVF, the treatment options, and potential solutions to why you may be having trouble conceiving naturally. Some causes that will be discussed include:
- Ovulatory Dysfunction
- Polycystic Ovarian Syndrome
- Recurrent Miscarriage
- Ectopic Pregnancy Tubal Disease
- Pelvic Adhesion Disease
- Hypothalamic Amenorrhea
- Premature Ovarian Failure
If we have suspicions about one of these conditions, tests to determine likelihood may be recommended. Some of those tests include Diagnostic laparoscopy, and an Endometrial/Endometriosis Biopsy.
Infectious Disease, Hormone, IVF Immune Testing, Genetic Testing
Once your consultation is complete, a nurse will draw blood for a variety of blood tests needed to determine your fertility health and possible treatment plans. These tests will check for various infectious diseases, immunities, hormone levels and genetic abnormalities that could affect your treatment as well as the health of your offspring. Our tests include the following:
- Cytomegalovirus (CMV)
- Hepatitis B & C
- Human Immunodeficiency Virus (HIV)
- Human T-Cell Lymphocyte Virus Types 1 & 2
- Syphilis Measles
- German measles
- Chicken pox
- Rubella Cystic Fibrosis
- Sickle Cell Traits FSH
Antral Follicle Count & Sonogram
Last, we will perform a transvaginal ultrasound (also called sonogram). This painless procedure is a small probe, much like a wand, which is inserted into your vagina. The probe emits information about your female reproductive system--your ovaries, follicles (where eggs are housed), uterus, etc. to a computer screen that both you and the doctor can see. Most women find it very interesting and informative.
Antral Follicle Count
This exam allows the doctor to count the number of antral follicles you have remaining. An antral follicle is a follicle in reserve, not ready to become mature or dominant in the month the exam is done. A follicle is the cell that contains an egg. This test gives us an idea of how much more time you have on your fertility clock & roughly a guess at the number of potential eggs you may get each cycle.
Your doctor will also look for ovarian cysts and over hyper-stimulation syndrome (OHSS), and note the thickness of your endometrial lining (we hope for 7mm at the time of egg retrieval), & the overall health of your female reproductive system.
If you are a couple planning to conceive, we will also take a sample of his semen for an analysis of sperm count, motility (movement), morphology (shape), and an analysis of the ejaculate thickness and the sperms' ability to liquefy.
Follow-up Infertility Treatment Consultation
You may begin treatment immediately following your initial consultation, or you might return to discuss the results of your blood tests, initial sonogram, and semen analysis (if this was done), determine the best fertility care strategy based on your goals, and then begin treatment on day 3 of your next menstrual cycle.
Female Infertility Treatments & Male Infertility Treatments
If it is determined that you or your male partner need a reproductive treatment or surgery to repair a problem causing your infertility, those will most likely be done before an in vitro fertilization cycle begins.
Contact us to find out how you can start your fertility treatment at EmBIO and what stages you can do from where you live!