In Vitro Fertilization (IVF)
Has IVF Become Safer or Easier to Undergo Than in the Past?
Many patients who are considering infertility treatment have questions including “has IVF become safer or easier to undergo than in the past?” There are a number of misconceptions including high order multiple pregnancies, difficult injections for weeks, low success rates and months and months of treatment. In the past, twins triplets and even quadruplets were not uncommon. This was due to our inability to choose the best embryos for transfer, so 3-4 embryos were often transferred. Over the last 10 years, our lab procedures, ability to grow embryos for 5-6 days to the blastocyst stage, and ability to determine the best embryos for transfer has led to only one or two embryos being transferred and therefore very rare are triplets or higher order pregnancies.
Why are Elective Single Embryo Transfers Preferred?
Today we generally transfer only a single embryo in women under 38, 1-2 embryos in women 38-40 and 2 to 3 embryos in women over the age of 40. This has led to a twin rate of 2% and very rare triplet pregnancy. Most Massachusetts insurance companies limit the number of embryos to 1 or 2 embryos depending on the patient’s age. Another advantage of limiting the number of embryos for transfer is that many patients have additional embryos to cryopreserve which can be used in the future.
What to Expect with IVF?
In the past, intramuscular injections were required to stimulate the ovaries, and now injections are small subcutaneous injections with needles only a quarter inch long, similar to insulin needles. In general these self administered injections are taken for 10 to 12 days. Patients need to come in for an ultrasound and blood test perhaps three or four times during this time. Once the follicles are greater than 16mm and should contain healthy mature eggs, the patient returns for the egg retrieval.
How Long Does IVF Take?
This entire process generally takes just 10 to 12 days. After the eggs are retrieved they are fertilized and the embryos are grown for five days. At this point the patient comes in for one or two embryos, so the entire process generally takes just 2 to 2 1/2 weeks. During this time women are able to go to work and continue all their normal activities.