Understanding Conception and IVF Treatments

What happens during IVF treatments and how does the in vitro fertilization process work? Human conception is a relatively simple and yet immensely complex process. Think about your IVF cycle as natural conception process aided by our fertility specialists. It may also be helpful to understand the process of natural conception.

The natural conception process begins on the first day of your menstrual cycle. In IVF, we also call this day Cycle Day 1. During the next 12 to 14 days occurs what fertility specialists refer to as follicular phase, the event that results in the ovulation of a mature egg. It’s called “follicular phase,” because the eggs develop in a fluid-filled sacs called the follicles. On Cycle Day 1, your body starts developing follicles. Women of reproductive age begin to develop many eggs during each monthly cycle. Naturally, however, usually just one of the eggs will reach maturity while the rest undergo a process of degeneration, and are absorbed by the body forever. When that one egg is mature, it is released from the ovary. The egg will be capable of being fertilized for only the next 12 to 24 hours. If not fertilized within that time, it is simply reabsorbed by the body. You may be wondering how IVF patients develop more than 20 eggs during a single IVF cycle. With IVF medications, our fertility doctors help your body to develop more than one egg during the first 10 days of the cycle.

Fertility Treatments AbroadOn day 14 of the typical 28-day cycle, woman’s egg is mature and ovulation occurs. As the egg begins it descend through the fallopian tubes, it meets with sperm and gets fertilized. Ovulation triggers many other changes in the body. For example, as a result of changes in the levels of hormones, the cervical mucus becomes penetrable. At the same time, the lining of the uterus is getting ready to accept an ebryo implantation. In contract to the natural process, our IVF doctors will retrieve the mature eggs on Cycle Day 12. It is important to note that it may take up to 17 days to retrieve your eggs, if your ovaries do not respond well to stimulation meds. Normally IVF medications are taken for 10 days. However, if patient’s ovaries don’t respond well, the patient may be instructed to take medication up to five days longer.

Understanding In Vitro TreatmentsTypically, our IVF clinics perform egg retrieval on Cycle Day 12. The very same day, the eggs are fertilized with sperm either by conventional insemination or by ICSI. The eggs will be checked the following day to document fertilization and again the next day to evaluate the early cell division. Until recently, embryos were cultured for three days and then transferred to the uterus or cryogenically frozen for later use. Our IVF clinics now have the ability to grow the embryos for five until they reach the blastocyst stage. Blastocysts have a greater chance of implantation. This, in turn, allows our IVF doctors to transfer fewer embryos and lower the risk of multiple births while increasing the chance of pregnancy.

The final step in the IVF cycle is the embryo transfer. As it is the case with the natural fertilization, not all embryos will grow in the laboratory dish. The embryo(s) that continue to divide and grow is transferred into patient’s uterus about the time it would arrive there in a natural conception. Unused embryos can be cryopreserved for later use.

Visit our website to learn what you will do each step of the way, as you go through your IVF treatments.

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Ask Our Fertility Doctors

IVF

Issues pertaining to infertility and fertility treatments are complex and certainly create a lot of questions in the minds of individuals who are either undergoing fertility treatments or seriously considering those. Since it would be impossible for us to provide answers to all the questions we receive on our website, we decided to set up a more appropriate venue for questions our clients may have. This is how this blog was born. Our fertility doctors (e.g. reproductive endocrinologists, OB/GYN doctors, embryologists, etc.) agreed to answer questions pertaining to infertility and fertility treatments.

In case you are wondering about qualifications of our doctors, during the selection process of our IVF clinics, we went an extra mile to ensure our clients will receive the same high quality IVF advice and/or treatments as those available in the U.S. Our partner clinics follow the standards of the American Society for Reproductive Medicine (ASRM) and are accredited in the U.S. Our partner doctors are board certified and often hold Ph.D. on top of their M.D. degrees.

Our hope is that this blog will serve as a professional, discrete environment where one can ask questions and hopefully find answers pertaining to fertility treatments. Our doctors agreed to answer questions concerning:

• General questions about infertility
• Questions in regards to effectiveness of Assisted Reproductive Technology (ART)
• Questions pertaining to tests (e.g. blood work, genetic testing, PGD etc.)
• Questions about the IVF process and what happens during specific treatments
• And of course questions pertaining to symptoms and problems during the course of the treatment

We hope we can answer most of your questions and in the process help you with starting or expanding your family. Feel free to email me with your questions (Darya.Mikhailova@theMedVacation.com).

Darya Mikhailova, MD

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I am concerned that my eggs may be of poor quality. How can one determine the quality of her eggs?

We can have some basic notion about the quality of eggs by examining the size of the follicle and the level of Estradiol in the middle of the cycle. However, as the woman ages, we often deal with such factors as thickening of the external wall/skin of the egg, which in turn makes it harder for sperm to penetrate the egg.

In reality, it is impossible to determine the quality of one’s eggs until we extract those from the follicles, examine them under the microscope and see the stage of their development. There are some easier methods of testing the ovarian reserve and the quality of eggs. These are chlomiphenom test, and the tests to determine the level of Follicle Stimulating Hormone (FSH) and Inhibin B. All these tests although helpful, are still not as effective as examining eggs under the microscope.

Do ovarian cysts affect my chances of getting pregnant?

The research shows that any ovarian cysts of 10 mm or larger reduce one’s chances of getting pregnant. For instance, studies show that women who underwent IVF treatments while they had 10 mm cyst in the beginning of the cycle were twice as unlikely to get pregnant as women who didn’t have cysts (all other factors being equal). Therefore, cysts will not prevent one from getting pregnant but will significantly reduce woman’s changes of doing so.

Can I fly and how long can I be in the air, after embryo transfer?
 
Yes, you may travel by plane. Air travel does not pose any danger to pregnancy as long as constant air pressure is maintained. Modern airplanes……….. as a rule…….. don’t have sudden air pressure changes.

We received a couple of inquiries about reversing tied tubes and getting pregnant after that.

Our doctors recommend IVF treatments, if you have your tubes tied and are thinking about getting pregnant. You may have heard this already from doctors in the U.S. or from research you’ve done. Getting pregnant a traditional way after reversing tied tubes may be a dangerous endeavor.

First, our IVF doctors say that reversing tide tubes is typically not an effective procedure. Moreover, even if the reversing tied tubes procedure is done, chances of having tubal pregnancy (situation when the fertilize egg implants itself outside uterus) are very high for that person. That is the reason why doctors recommend to have IVF in this case.

To summarize the recommended treatment course for women with tied tubes, our doctors would perform ovulation induction and egg extraction without reversing tied tubes for the patient.

Several individuals asked us how many eggs are typically harvested from a donor and what happens to the unused eggs.

On average, our clinics harvest 10 to 18 eggs per donor. As a rule, we fertilize all of the retrieved eggs with sperm. Certain number of fertilized eggs grow to become embryos. Our doctors transfer 1-2 embryos (more often two) in the transfer stage of the IVF process. In rare cases, in the situation of severe infertility, the doctors may recommend transferring 3 embryos.

The embryos which are left after the IVF cycle can be frozen. Our clinics use the latest cryopreservation approach, which dramatically increase cryosurvival (percentage of eggs/embryos that are alive after thawing) of embryos. Traditionally, IVF clinics used the slow freezing method that has been used since the 1980’s. Our clinics use rapid freezing technique recently developed in Japan called Vitrification. With Vitrification, the temperature is lowered at 23,000 degrees C° per minute. That is 70,000 times faster than in traditional approach. Such rapid cooling coupled with cryoprotactant fluids prevents formation of ice crystals in embryos.

You may be wondering why it is important to have as little ice crystal formation as possible. It is important in the embryology, because ice crystal formation is very damaging to frozen eggs and embryos. In other words, eggs do not fertilize well after thawing. The slow freezing approach produces disruption in the membrane, which causes a block to the conventional fusion and penetration of sperm with the egg surface.

Our IVF clinics do all of their embryo freezing at the blastocyst stage. Upon request from our clients, our clinics can also freeze eggs rather than embryos. We freeze embryos, because statistics show that pregnancy rates are just as high in properly frozen embryos as in fresh embryos which have never been frozen. The same cannot be said for frozen eggs; pregnancy rates for frozen eggs are 15-20 lower than those for frozen embryos.
You can email us your questions to info@theMedVacation.com

What is Medical Tourism?

Medical Tourism or Health Tourism is the term initially coined by travel agencies and mass media to describe the practice of traveling across international borders to obtain healthcare services. Today medical tourism is a rapidly growing industry that enables people residing in one country to travel to another country to receive medical, dental and surgical care of comparable quality to that available in their home countries for a fraction of the domestic cost. In addition, patients may choose to travel abroad because certain procedures are not available in their home countries, or because the wait is too long (e.g. Canadian cancer patients traveling across the border to the U.S.).

Contrary to popular belief, the concept of medical tourism is not a novel one. The first recorded instance of medical tourism dates back thousands of years to when Greek pilgrims traveled from all over the Mediterranean to the small territory in the Saronic Gulf called Epidauria. Also, Americans have been engaged in medical tourism, although they may not have called it that way. For decades, many Americans have traveled to such acclaimed medical institutions as the Mayo Clinic in Minnesota, MD Anderson Hospital in Texas, Memorial Sloan-Kettering Cancer Center in New York, and John Hopkins Hospital in Maryland.

Until recently, on the international scale, patient flow was mainly from less developed countries to developed countries. And not surprisingly, medical tourism to developed countries was a prerogative of the rich and the elite in the developing world. Recently, however, the skyrocketing costs of healthcare and long wait times for certain procedures, combined with the growing ease and affordability of international travel and tremendous improvements in both technology and standards of medical care in many countries began to change the face of medical tourism. In fact, the mechanism behind the growth of medical tourism was explained by Adam Smith in his monumental work The Wealth of Nations in 1776. According to Adam Smith, a country will “specialize in the manufacture and export of products [services] that can be produced most efficiently in that country.” Essentially, when we talk about medical tourism we are simply talking about outsourcing in the healthcare sector.

What have been the driving forces of this industry’s growth and why is medical tourism capturing so much attention in the media lately? In no particular order, below are the major factors exerting influence on the US society and fueling the growth of this industry:

  • Increasingly unsustainable health care costs in the U.S.
  • A growing number of Americans under the age of 65 who are uninsured or underinsured
  • Increasing life expectancy and an aging population
  • Rapidly rising insurance premiums paid by employers who are forced to pass a portion of those costs on to employees

It is estimated that in 2007 total spending on healthcare reached 2.4 trillion dollars. Nearly 46 million Americans, or 18% of the population under the age of 65, were without health insurance in 2007. This is a 4.9% increase from 2006. Moreover, some studies indicate that as many as 29% of people who had health insurance were “underinsured” with coverage so meager they were often forced to postpone medical care because of costs. In addition, as many as 120 million Americans lack dental coverage. Other sources purport that this number may be as high as 120 million.

Safety and quality is our first priority! We are almost certain that you have a burning question whether treatments in developing countries such as Mexico, Costa Rica, and Columbia are safe. So that you don’t lose your interest, here is a statistic from World Health Organization. In response to US providers who may tell you that all care in other countries is dangerous, we encourage you to ask them why the World Health Organization ranks the US healthcare system at number 37 globally, after Costa Rica, Columbia, and Chile? It’s possible to get excellent care overseas, provided patients do their homework or allow MedVacation to do that for them.

We would like to mention medical tourists’ satisfaction with services. According to results of the patient survey carried out by the Medical Tourism Association, when asked “How would you rate the hospital you received medical care at?” 70.7% responded “Excellent,” while 26.8% stated “Very Good.” Moreover, 63.4% of respondents indicated that they felt their overall medical experience was “better than it would have been in the USA, while 36.4% of respondents stated their experiences were “equal to what it would have been in the USA.”

www.theMedVacation.com