For many couples, in vitro fertilization (IVF) is the last resort in conceiving a child. If you’re standing on IVF’s doorstep, you’ve probably got a long list of questions and concerns. For most women it boils down to one thing: Will I be able to have a baby?
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That’s the one question modern medicine can’t answer.
“The biggest treatment we have — the top of the line, so to speak, — is IVF, at least for the foreseeable future,” says fertility specialist Rebecca Flyckt, MD.
IVF is a type of assisted reproductive technology (ART) with a higher fertility rate than other treatments, says Dr. Flyckt. Depending on the woman’s age, the likelihood that she will deliver a baby through the IVF process averages from about 31 to 41 percent and can be as high as 65 percent.
An intense process
If you decide to use IVF, be prepared to go all in. The course of treatments is time-consuming and costly.
“I tell patients that this process is like having a part-time job,” Dr. Flyckt says. “It’s very different than taking a fertility pill.”
Nicole Herbst, 40, knows this firsthand.
“When my husband, Rob, and I started IVF, they had to take control of my whole menstrual cycle, stop me from ovulating and stimulate my follicles to produce more eggs,” she says. “Rob gave me injections in my abdomen — four a day. He was such a good nurse!”
What you can expect
Dr. Flyckt breaks the IVF procedure into phases:
- Phase 1: Increase follicle production with fertility shots and stop ovulation. Expect to have multiple office visits with blood tests and vaginal ultrasounds.
- Phase 2: After the eggs mature, minor surgery retrieves them. An embryologist prepares the eggs and places them in a petri dish. Next, sperm is introduced, usually by injecting a single sperm into each egg.
- Phase 3: Once fertilized, the egg’s cells continue to divide until embryo(s) transfer day, which can occur on Day 3 or Day 5. Transferring on Day 5 can help with embryo selection. All embryos can be screened for diseases such as cystic fibrosis, muscular dystrophy, Down syndrome, etc., if this is desired.
Be prepared to make several decisions on embryo transfer day. These include how many embryo(s) to transfer into your uterus — Cleveland Clinic follows the American Society of Reproductive Medicine guidelines — and what to do with any remaining embryos, which can be frozen.
“Embryo transfer day is a happy day for the couple,” Dr. Flyckt says. “The procedure is done in the procedure room using a soft catheter inserted into the uterus to gently ‘push’ an embryo or embryos in. You’re awake as this happens and are able to watch the procedure on a monitor. Afterwards, you’ll rest for a few minutes and then be sent home with instructions.”
Weighing the costs
Herbst and her husband, Rob, went through two IVF procedures. Their first IVF failed.
“It’s important to take care of yourself through this process and seek what support is available to you financially and emotionally,” Herbst says. “During our first IVF, I felt pressure and anxiety, which affected my hormone levels.”
When they started the second IVF, they questioned whether they could afford to go through with it. The drugs were not covered by insurance.
“We were spending money out of our savings and asking ourselves, ‘Is this worth it in the end?’ You can invest all this money and you might not have a baby in the end,” she says.
The Herbsts’ IVF proceeded to egg harvesting and embryo transfer. Two weeks later they learned Nicole was pregnant!
In March 2014, Nicole delivered a baby girl at Fairview Hospital.