Why Choose IVF?

Making a decision to start or grow your family through IVF is exciting. For over two decades, RMIA has helped thousands of patients become parents.

People undergo IVF for many reasons. Some patients may have previously undergone a procedure, like removing the fallopian tubes, and need IVF to bypass the normal route of embryo passage. Others may have medical reasons requiring someone else to carry a pregnancy and need IVF to create embryos that are then transferred to a gestational carrier. Some women or couples may require the use of donor sperm, eggs or both, while others may have a genetic condition that requires testing of IVF-created embryos in order to have a healthy child. Finally, for patients who have already tried other fertility treatments without success, IVF is the next logical step in their path to parenthood.

No matter what brought you to IVF, we are here to help you achieve your goal of a successful pregnancy. Thank you for trusting us with your care. We are honored to serve you.

How IVF Works

In general, the strategy behind IVF is simple: recruit multiple eggs to develop simultaneously, remove the eggs from the body before they release on their own (ovulate), and then combine the eggs with sperm to create embryos.

Under normal circumstances, a reproductive-aged woman has a group of eggs that compete each month to be the one that gets to ovulate. The unsuccessful eggs do not get recycled; they are lost forever.

The goal of fertility treatment is to capture some (for IUI cycles) or as many (for IVF cycles) of the eggs in the race, thus creating more winners. IVF does not waste eggs that are needed for future cycles and can only recruit the eggs that are ready to develop at that time.

Similarly, fertility treatment does not have a way only to recruit healthy eggs to compete. We must work with the group of eggs that is currently available.

IVF Medications

Although patients use multiple medications during an IVF cycle, there are four primary types of medicines used:

• Medications to stimulate the ovaries to develop multiple eggs at the same time. These are synthetic hormones that are similar to those naturally produced by the pituitary gland in the brain. They include Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). Most women will use a combination of both of these hormones. Examples include Gonal-F, Follistim, Menopur.
• Medications that keep the eggs from releasing too soon. These block the body’s natural inclination to ovulate. Examples include Lupron, Ganirelix, Cetrotide.
• A final shot or trigger shot that causes the developing eggs to become mature. Examples include Novarel, Pregnyl, Ovidrel, Lupron.
• Hormonal support after the embryo transfer. Examples include Endometrin, Prometrium, Progesterone in oil injections.

Many factors are considered when developing your individualized IVF protocol. These include your age, your ovarian function markers, your weight and the response you have had to prior fertility therapy.

Although the number of eggs obtained in an IVF cycle can vary, women under 35 years often have 10-15 eggs retrieved, while women 35 years and older may have fewer. In particular, women over 40 years may have 5 or fewer eggs. If a cycle appears to have less than 3 dominant follicles on ultrasound, we may recommend canceling the cycle or converting it to IUI.

The final shot that causes the eggs to become mature is often referred to as the trigger shot. The type of trigger that you will use depends on if you are doing a fresh or frozen embryo transfer and what your ovarian reserve is.

Progesterone is needed after an embryo transfer to support the uterine lining and early pregnancy. Progesterone is continued for several weeks into the pregnancy.

Customized IVF Protocols

IVF protocols are constantly evolving. We also learn with each IVF cycle how an individual patient uniquely responds. If one protocol is not as successful as we hope, we can often make modifications to try and obtain a better response in the next cycle.