Preparing for IVF

Due to the emotion, time and finances that are invested in the process, the IVF treatment period can be quite challenging. At First Steps Fertility, we strive to make every patient’s journey through this process as easy as possible.

At our clinic all patients are taken through a private or group orientation session by their fertility doctor shortly before their treatment begins. During this session the doctor will answer all questions about the treatment and detail what patients can expect.



Maximizing Your Chances of Success

Women
One of the most common questions women ask is “What should I do to maximize my chances of becoming pregnant?”

We strongly recommend that our patients maintain a healthy lifestyle that includes:
• Eating a balanced diet similar to that recommended by the Canada Food Guide.
• Not smoking cigarettes and/or marijuana, as have both been linked to infertility.
• Reducing alcohol and caffeine intake.
• Participating in moderate exercise, especially in the time leading up to the beginning of the treatment cycle and even during the early phases of treatment.
• Getting enough sleep and minimizing stress.
Many women use massage therapy, meditation, gentle yoga, and/or acupuncture to relax

With respect to supplements, we recommend prenatal vitamins to ensure patients get their daily requirement of folic acid. Taking a prenatal supplement may reduce the risk of certain central nervous system defects if it is initiated six weeks prior to conceiving, and continued throughout the first trimester.

Men
In addition to following the guidelines listed above, men should also:
• Minimize heat exposure and prevent injuries to their groin.
• Abstain from intercourse or ejaculation at least two days prior to the IVF procedure, but for no more than five days.
As part of every fertility work-up, a semen analysis and other specialized testing will be ordered prior to starting IVF. The results of these tests will guide our recommendations.

In some cases due to timing, travel plans and/or performance issues, the production of a sperm sample for freezing may be recommended before undergoing an IVF treatment cycle. Generally, the count and motility of the sperm will decrease after the freezing process. This means only a portion of a previously frozen sample will be suitable for ICSI. To increase the chances of conception men are often asked to provide a fresh sample on the day of egg retrieval.

Consent process
Before beginning any treatment, all patients and their respective partners must sign the consent forms and their signatures must be witnessed.

Infectious disease screening
All patients involved in the treatment process must be screened for transmissible infectious diseases. These test results need to be documented at least six months prior to the initiation of the treatment.

Other screening
In a cycle prior to the start of IVF, the doctor will order a recent day three screen of the patient’s ovarian reserve. This will help to determine the choice of treatment and the dosage of any medications. This screen consists of hormonal measurements of a patient’s FSH value (follicle stimulating hormone), as well as her antral follicle count (AFC).

Another routine screening test done prior to IVF cycles is a sonohysterogram. This involves an injection of sterile saline into the uterine cavity and a 3D ultrasound. This test allows for a clear and thorough examination of the uterine cavity preceding embryo transfer.

Depending on the specifics of a patient’s history, the doctor may discuss other possible testing, such as a diagnostic laparoscopy, hysteroscopy or endometrial biopsy as part of the preparation for IVF.


What are the risks?
Ovarian Hyperstimulation Syndrome (OHSS)
Ovarian hyperstimulation syndrome (OHSS) occurs when there are too many developed eggs in the ovaries and hormone levels in the blood become excessive. This condition affects 1% of the women who receive IVF treatments. The symptoms include the accumulation of fluid in the abdominal cavity and engorged ovaries. OHSS is treated with rest, intravenous fluids, close monitoring, and draining of the abdominal fluid. In most cases the symptoms of OHSS resolve on their own over time.

Multiple Pregnancies
With IVF, 10-35% of the pregnancies result in twins, with 1-5% resulting in triplets. Because multiple pregnancies run a greater risk of pre-term delivery, the doctor will be sure to discuss the optimal number of embryos to be transferred, based on a given patient’s age and overall health, before the IVF treatment begins.