What you should know about your IVF Cycle

If you’ve gone through an IVF cycle and didn’t get pregnant, this is what you should know.

First of all, it’s not your fault. The fact that you didn’t get pregnant in an IVF cycle doesn’t mean that you weren’t meant to be a mother. It doesn’t mean that your uterus is a “hostile” environment. It doesn’t mean that you aren’t compatible with your partner. The truth is that much of what goes into whether you get pregnant or not from any given fertility treatment cycle, especially IVF, has to do with probability and chance.  Depending on your age or situation, you may have a fifty percent chance of getting pregnant. This means that fifty percent of patients won’t get pregnant. This doesn’t mean you should stop trying.

Paying for fertility treatments is not easy. There are some states that require employers to pay for up to 6 IVF cycles. You really get IVF for free in some States. Patients are more likely to do several cycles before getting pregnant when they have IVF coverage compared to those who don’t because patients with coverage don’t feel the financial strain on top of the emotional strain when they hear negative results. Now take California for example. Most women have few infertility insurance benefits if any at all. IVF coverage is not very common. So this means that many women expect to get pregnant their first cycle and the emotional strain is compounded by the financial strain when money was spent on something that didn’t work.

I’m writing this post to teach you how to learn from an IVF cycle if you didn’t get pregnant. You may learn something that may help you optimize your chances the next time.

Meet with your doctor as soon as you learn that you are not pregnant. By meeting with your doc immediately, everything is fresh in her mind about your cycle. Ask the following questions:

1. If you don’t already know your infertility diagnosis, now is a good time to ask. Why did I do IVF?
2. Why do you think I didn’t get pregnant?
3. Would your doc do anything different with the dose or type of medications you were on to prep you for the cycle, during and after the cycle? Your doc may want to change the type of cycle she put you on and may want to increase or decrease your dose of medications. Your doc may want to add a medication that wasn’t used before. Asking these questions will help optimize your chances next cycle.
4. How many eggs were you expecting? How many eggs did we get? How many were mature? Mature eggs are the goal in an IVF cycle. You want as many mature eggs as possible because the mature eggs are what will get fertilized by sperm and result in embryos. Did your hormone levels rise during your cycle as expected?
5. How many eggs were fertilized? Is this what you expected?
6. If you did not do ICSI, ask if your doc would recommend ICSI (procedure done where the sperm is injected into the egg) the next time? If you did do ICSI ask if you should still do it the next time.
7. What was the quality of embryos transferred? What is the typical success rate given the quality of embryos you had transferred? How many embryos were transferred. Would you transfer the same number of embryos the next cycle or increase the number of embryos transferred? What day were the embryos transferred on? Does your doc recommend a day 3 transfer next time? A blastocyst transfer the next time?
8. How did the embryo transfer go? Was the transfer more difficult than expected? Is there anything you would do differently at the time of transfer looking back?
9. Ask your doc if you can discuss your case with the embryologist. The embryologist may have insight as to what went wrong and what could be improved upon.
10. Have my fallopian tubes been evaluated? Is there a chance that I have a hydrosalpinx (fluid in the tubes)?
11. Has my uterine cavity been evaluated? Is there a chance that I have a uterine polyp in my cavity that is affecting my pregnancy chances?
12. If you didn’t do acupuncture, ask about what role acupuncture may play in your treatment cycle. It may help you.

I see many patients who have gone through an IVF cycle before seeing me. I go through this list whenever I review a patient’s chart. This helps me design the ideal IVF cycle for my patients. I tell all my patients, that we always try to design the best IVF protocol for our patients, but until a patient actually goes through a cycle, we don’t know if it really is the best. We just do what we think is best based on everything we know. I hope this list helps you get the most out of your next IVF cycle and all the success you deserve. If you haven’t gone through an IVF cycle, use this list as a sort of check list of what you should know as you get started and as you’re going through your treatment.