What To Expect During IVF Treatment Cycle

IVF Protocol

Once in a while our clients ask us what typically happens during an IVF cycle and how many days does it take. Even though every clinic’s IVF protocol is slightly different and infertility treatments are adjusted for a couple’s individual needs, here is what takes place during a typical IVF treatment cycle broken down by day.

Day 1: AM Dose 20 units of Lupron to be injected. PM Dose 300u of Gonal F and 150 of HMG. [First Day of heavy menses a baseline ultrasound is needed, to rule out ovarian cyst and view of antrial follicle count. Estradial blood test required as well.]
Day 2: AM Dose 20 units of Lupron to be injected. PM Dose 300u of Gonal F and 150 of HMG.
Day 3: AM Dose 20 units of Lupron to be injected. PM Dose 300u of Gonal F and 150 of HMG.
Day 4: AM Dose *IMPORTANT* Lupron reduces to 10 units starting today until the end of treatment. Ultrasound and estradial blood test are needed [Depending on Estradial result & ultrasound, dose change will be given for Day 4 and Day 5.]
Day 6: Ultrasound and estradial blood test are needed [Depending on estradial result & ultrasound, dose change will be given for Day 6, Day 7.]
Day 8: Ultrasound and estradial blood test are needed [Depending on Estradial result & ultrasound, dose change will be given for Day 8 & Day 9.]
Day 9: Tentative Ultrasound and estradial blood test
Day 10: Possible Day of HCG, decision is based on how you respond to treatment
Day 11: Start antibiotic in PM. No visit, no injectable medications, no ultrasound.
Day 12: Oocyte Retrieval, Sperm is needed.
Day 13: Fertilization check & report back to patient
Day 14: Embryos are not disturb
Day 15: Day 3 Embryo Transfer
Day 18: Patient is OK to travel 3 days after transfer
Day 26: Progesterone and Estradial blood test
Day 29: Pregnancy Test! Beta HCG, repeat Progesterone and Estradial test.

Call us today for a free consultation with a doctor and our affordable IVF package details or click here to get started.

(877) 365-5135

Extracting Teeth Prior To Putting Dental Implants In

Extracting Teeth & Waiting Before Putting Dental Implants In

We were recently asked whether it would be OK for a patient to extract teeth here in the US prior to her trip to our office. That is, the patient wanted to extract her teeth, wait a few days, and then travel to our clinic later to put implants in. Our doctors do not recommend this type of arrangements.

It is not recommended to have teeth extracted and then wait a few days to put implants in. Typically, after an extraction, one must wait around 3 months before putting implants in. The patient may also experience some bone loss there, if the implant is not put in right away. Therefore, we either extract the teeth in our clinic, or the patient has to wait a few months in the States, if he or she does extractions here.

Insurance and Medical Treatments Overseas

Insurance Reimbursement for Medical Procedures Abroad

A number of our clients asked us whether MedVacation would take insurance from their insurance companies. The answer to this question is “it depends!” We will happily provide you with the information that we currently have about insurance companies. Moreover, we would like to mention some other tools like Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA) that you can use to pay for your medical treatments outside the U.S.

Today, a very small number of health insurance companies in the States will reimburse you for your medical procedures performed outside the U.S. Here is a list of insurance companies that we know pay or are rumored to have paid for various medical procedures outside the U.S.

•Blue Cross Blue Shield
•Delta Dental
•United Health

Moreover, as it is the case with Blue Cross Blue Shield, you will have to call your insurance company to find out whether it will reimburse your treatments. We were told that the company has around 50 independent “mini” companies so to speak with their own rules and regulations. For instance, depending on the state you are from, the insurance company may reimburse you for IVF treatments, but not for dental work.

As a rule, you must have PPO coverage to qualify and will also be responsible for a co-pay. Co-pay may range between twenty and forty percent. Furthermore, you may have to pay for your treatments yourself and file for reimbursement once the procedures are done. Those insurance companies that do pay for medical procedures overseas typically pay only for the surgery or the medical procedure and do not reimburse the travel and lodging expenses.

As we mentioned earlier, there are several tax-advantaged medical savings accounts available to taxpayers in the United States for medical reimbursement. The most common among them is Flexible Spending Account (FSA). Health Savings Accounts (HAS) are less common. We will not go into the differences between these medical savings accounts. You may, however, be able to pay for your overseas medical treatments with money from one of these accounts.

If you think your insurance company may pay for your overseas medical treatments, let us know and we will be delighted to talk to your insurance provider on your behalf.

U.S. Health Care System Does Not Fair Well When Compared to Health Care Systems in Other Countries

Here is an interesting article about the quality of our health care in comparison to systems in six other countries.  In this article, the author uses six developed nations.  Nevertheless, based on the report produced by the UN, the health care system in the US is ranked lower than those of Costa Rica and Colombia.


U.S. Scores Dead Last Again in Healthcare Study

By Maggie Fox, Health and Science Editor

WASHINGTON (Reuters) – Americans spend twice as much as residents of other developed countries on healthcare, but get lower quality, less efficiency and have the least equitable system, according to a report released on Wednesday.

The United States ranked last when compared to six other countries — Britain, Canada, Germany, Netherlands, Australia and New Zealand, the Commonwealth Fund report found.

“As an American it just bothers me that with all of our know-how, all of our wealth, that we are not assuring that people who need healthcare can get it,” Commonwealth Fund president Karen Davis told reporters in a telephone briefing.

Previous reports by the nonprofit fund, which conducts research into healthcare performance and promotes changes in the U.S. system, have been heavily used by policymakers and politicians pressing for healthcare reform.

Davis said she hoped health reform legislation passed in March would lead to improvements.

The current report uses data from nationally representative patient and physician surveys in seven countries in 2007, 2008, and 2009. It is available at http://www.commonwealthfund.org/Content/Publications/Fund-Reports/2010/J….

In 2007, health spending was $7,290 per person in the United States, more than double that of any other country in the survey.

Australians spent $3,357, Canadians $3,895, Germans $3,588, the Netherlands $3,837 and Britons spent $2,992 per capita on health in 2007. New Zealand spent the least at $2,454.

This is a big rise from the Fund’s last similar survey, in 2007, which found Americans spent $6,697 per capita on healthcare in 2005, or 16 percent of gross domestic product.

“We rank last on safety and do poorly on several dimensions of quality,” Schoen told reporters. “We do particularly poorly on going without care because of cost. And we also do surprisingly poorly on access to primary care and after-hours care.”


The report looks at five measures of healthcare — quality, efficiency, access to care, equity and the ability to lead long, healthy, productive lives.

Britain, whose nationalized healthcare system was widely derided by opponents of U.S. healthcare reform, ranks first in quality while the Netherlands ranked first overall on all scores, the Commonwealth team found.

U.S. patients with chronic conditions were the most likely to say they gotten the wrong drug or had to wait to learn of abnormal test results.

“The findings demonstrate the need to quickly implement provisions in the new health reform law,” the report reads.

Critics of reports that show Europeans or Australians are healthier than Americans point to the U.S. lifestyle as a bigger factor than healthcare. Americans have higher rates of obesity than other developed countries, for instance.

“On the other hand, the other countries have higher rates of smoking,” Davis countered. And Germany, for instance, has a much older population more prone to chronic disease.

Every other system covers all its citizens, the report noted and said the U.S. system, which leaves 46 million Americans or 15 percent of the population without health insurance, is the most unfair.

“The lower the performance score for equity, the lower the performance on other measures. This suggests that, when a country fails to meet the needs of the most vulnerable, it also fails to meet the needs of the average citizen,” the report reads.

(Editing by Sandra Maler and Cynthia Osterman)

Surrogacy in India

One more reason to work with medical tourism agencies which have partnership with IVF clinics in countries with favorable laws.

India’s Rent-a-Womb Industry Faces New Restrictions

By HILLARY BRENHOUSE Hillary Brenhouse – Sat Jun 5, 6:50 pm ET

Since the day they were delivered more than two years ago, twin toddlers Nikolas and Leonard Balaz have been stateless and stranded in India. Their parents are German nationals, but the woman to whom the babies were born is a twentysomething Indian surrogate from Gujarat. The boys were refused German passports because the country does not recognize surrogacy as a legitimate means of parenthood. And India doesn’t typically confer citizenship on surrogate-born children conceived by foreigners. Last week Germany relented, turning over travel visas, and the entire Balaz family is finally going home – though only after a long legal battle that took them deep into the convoluted world of inter-country adoption.

“We can only wish them good luck,” India’s Supreme Court told local media. But it also reiterated the urgent need for legislation to regulate one of India’s fastest-growing industries. Hundreds of foreign tourists spill into the country every year to hire women to incubate their children. India has become the world capital of outsourced pregnancies, whereby surrogates are implanted with foreign embryos and paid to carry the resultant babies to term. In 2002 the country legalized commercial surrogacy in an effort to promote medical tourism, a sector the Confederation of Indian Industry predicts will generate $2.3 billion annually by 2012. Indian surrogate mothers are readily available and cheap. Unlike most countries in which surrogacy is lawful – and bucking the norm in heavily bureaucratic India – the procedure can take place without reams of government red tape. (Read ‘India’s Medical Emergency.’)

That may soon change. A draft bill to direct assisted reproductive technology (ART) is likely to be introduced this year in Parliament. The new legislation will beef up surrogacy guidelines authored by the Indian Council of Medical Research (ICMR) that have often gone unheeded by the few hundred Indian fertility clinics accustomed to writing their own rules. Among them is the Akanksha Infertility Clinic in the town of Anand, in the western state of Gujarat, where the Balazs found themselves. “We are lost when there are no laws,” says Akanksha medical director Dr. Nayna Patel, who has become the face of the industry abroad since being spotlighted on the Oprah Winfrey Show in 2007. “But the people drafting the bill have to remember to take care of the clinics, too.”

Patel chooses among the women who appear at the clinic, at least three a day, hoping to hire out their wombs. She pairs the surrogates with infertile couples, catering to an increasingly international clientele base – from 13 foreign couples in 2006 to 85 in 2009. And she oversees the negotiations between them. The entire process costs customers around $23,000 – less than one-fifth of the going rate in the U.S. – of which the surrogate mother usually receives about $7,500 in installments. Patel implants the women with embryos, using specimens from sperm or egg donors if necessary. Once pregnant, the surrogates are housed onsite until delivery, in a dormitory that was once a local tax office, so that they can be supervised. But under the new legislation, Patel will be permitted to supervise nothing but surgery. (Read ‘Can One Pill Tame the Illness No One Wants to Talk About?.’)

The new proposed government bill bans in-vitro fertilization (IVF) clinics from brokering surrogacy transactions. It also calls for the establishment of an “ART bank” that will be responsible for locating surrogate mothers, as well as reproductive donors. Fertility clinics will only come into contact with surrogates on the operating table. “We need to create a safe distance between the clinic and the surrogate to avoid unethical practices,” says Dr. R.S. Sharma, deputy director general of the ICMR and member-secretary of the bill’s drafting committee. “IVF clinics should only be concerning themselves with science.”

It’s a suggestion that has caused a stir in the medical community. Dr. Patel insists that she will not accept a surrogate sent to Akanksha unless she herself is permitted to perform medical and background checks. She maintains that ART banks will not have enough experience to determine whether a woman is fit for surrogacy, let alone to replicate the personal bonds she cultivates with her surrogates. “The trust they have with me is what makes the whole thing secure and safe,” she says. “And at the end, when they want to buy a house or a piece of land for farming, we get them the best deal. With this bill, we will not know what they are going to do with such a big amount of money.”

Indeed, surrogate mothers are likely to enjoy an unprecedented autonomy. They’ll have more freedom in negotiating their fee and receive mandatory health insurance from the couple or single employing them. Firm legal standards will ensure that medical professionals only be permitted to implant three embryos in a woman’s uterus per attempt. (The American Society for Reproductive Medicine advises doctors to implant just one; until recently, Dr. Patel routinely used five at a time, aborting anything more than two fetuses.) The legislation will only allow a woman to act as a surrogate up to five times, less if she has her own children, and will impose a 35-year age limit. That way, ladies motivated by desperation won’t be able to put themselves at risk.

In a push to avoid cases similar to the Balaz family debacle, the bill will also make things more challenging for foreign customers. The new legislation will require that the international couple’s home country guarantee the unborn infant citizenship before a surrogacy can even get off the ground. Such a stipulation will certainly not go over with Germany. “In fact, I’m not sure if any country will be ready to pledge citizenship before birth,” says Amit Karkhanis, a prominent Mumbai surrogacy lawyer. Countries accepting of surrogate-born children typically rely on DNA tests done post-delivery to determine the parentage of the baby.

Same-sex couples – a growing number of whom are relying on Indian surrogates – may not even make it as far as a plea for a government pledge. Just last year, Delhi’s High Court overturned a section of the penal code outlawing “carnal intercourse against the order of nature,” and the status of gays and lesbians in the country remains unclear. “Tomorrow, if the government outlaws gay relations,” says Sharma of the bill’s drafting committee, “then we will not allow gay couples to hire surrogates. The law of the land will be followed so far as this issue is concerned.”

When Australian partners Trevor Elwell and Peter West visited the country nearly two years ago, only one clinic was open to providing them surrogacy services. Now, with their surrogate-born twin girls a year old and their third baby incubating in Mumbai, Elwell estimates that a half-dozen Indian IVF clinics cater to homosexual couples. The men have found it uncomplicated to use Indian egg donors. They’ve made the switch to a facility where their new surrogate knows they are gay, and is comfortable with it. And they attained Australian citizenship for their children in a process that took no more than a few weeks. For them, as for most who flock to India hoping for a baby, informal surrogacy guidelines have been a blessing. “If the bill does complicate things, people will go to another country,” Elwell says. “There will always be somewhere this can be done. This is just the beginning.”

Do fertility clinics offer IVF treatments to women over 50?

I am over 50, but otherwise in good health. Do fertility clinics offer IVF treatments to women over 50?

Yes, our clinics do offer treatments for older women. One of our clinics recently had a successful IVF performed on a woman over 55. Those are rare cases and the clinic will make a determination whether the patient is suited for an IVF cycle and child bearing. All cases are decided on case by cases basis.

Moreover, the patient must be in good health. For various reasons, typically, women older than 50 must have a donor egg.

Embryo Adoption Program

“Do you offer embryo adoption?”

Yes, we do offer such services.  We do have frozen embryos left for embryo adoption purposes that we can offer individuals who are interested in such services.  Information on embryo donors can be provided upon request.

All inclusive donor embryo program is $10,000.  This price does include flights, visa arrangements, hotel stay, and airport transfers.

Sperm Sorting for Gender Selection

We do not offer sperm sorting, because it is less than ideal approach for gender selection.  Sperm tends not to survive this procedure.  Therefore, for gender selection purposes, we recommend and offer PGD testing.