Frequently Asked Questions
The Emory team of board certified Reproductive Endocrinologists is committed to the physical and emotional needs of our patients. We understand that infertility can create a tremendous amount of stress, which is only intensified by uncertainty. That's why we believe that providing answers and sharing knowledge is an integral part of our commitment to our patients and to the community.
How long should we continue trying to have a baby on our own before seeking help for infertility?
Most couples should try on their own for 12 cycles before seeking professional advice. Women over the age of 35 may consult their physicians after 6 months. These guidelines may be too restrictive for some couples. If a woman has very irregular cycles or there is a known or suspected risk factor for infertility, immediate consultation is welcomed.
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Are there "at home" methods we should try before seeking medical solutions?
Yes. Women should record their cycles. Ovulation occurs 14 days before the subsequent cycle starts. For example, in a 26-day cycle, ovulation usually occurs about day 12 (day one is the first day of flow). In a 34-day cycle, ovulation occurs about day 20. Over the course of several months a woman will be able to predict the timing of ovulation and assure that intercourse occurs during the most fertile days of her cycle. Try to time intercourse for every other day during this time. Once you have established a predictable cycle, you may then use over-the-counter ovulation predictor kits such as Clear Plan Easy? or First Response? to focus on a 24-36 hour window.
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What are the first steps used to determine the causes of infertility?
The initial consultation involves obtaining a complete medical history of the couple. Information about recent menstrual cycles is invaluable. Prior medical records should be available. The cause of infertility can be attributed to a problem with the woman or the man. The male partner will be asked to schedule a semen analysis to assess the number, shape and mobility of his sperm. The woman will be asked to use one of a variety of methods to confirm ovulation such as basal body temperature charts, ovulation predictor kits, endometrial biopsies or blood tests. The health of the uterus and fallopian tubes can be determined by a radiological study called a hysterosalpingogram or ultrasound. Once these factors are evaluated, couples will consult again with the fertility specialist to plan their course of therapy.
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Will fertility drugs cause me to have a multiple birth?
Eighty to ninety percent of women who have used fertility drugs give birth to one child. The majority of the multiples are twins. The Emory Reproductive Center prides itself on achieving the highest rate of pregnancy success while minimizing the risk of multiple births.
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If the problem is male infertility, how is the sperm donor selection handled?
First of all, many men who previously would have required donor sperm can now conceive through IVF. So, before assuming that sperm donation is necessary, a thorough discussion of options is invaluable. When a couple opts for the use of donor sperm, they are given information about several reputable sperm banks. They will contact the bank themselves and choose their donor together. Information such as blood types, ethnic background, coloring, interests and education is available. Once a donor is chosen, the sperm bank readily ships the frozen specimens to our Andrology Laboratory so that it is available prior to ovulation.
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How successful is in vitro fertilization (IVF)?
The answer is different for each situation. It is best answered in an IVF consultation, which can be scheduled by calling 404-778-3401 or via email at emoryIVF@emoryhealthcare.org. However, we have been making consistent, satisfying gains with IVF and our recent data are available for your review in the success rates section of this website.
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What are the reasons IVF does not work?
Sometimes a woman's response to medication is less than expected or the fertilization rate is not favorable. Still, some cycles seem perfect, but conception does not occur. If a couple decides to persist with treatment, the chance of success improves cumulatively. And, one of the remarkable things about IVF is that it can give couples with unexplained infertility insight into a previously unrecognized problem.
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Is it painful to have eggs retrieved?
Women are provided with anesthetic during the retrieval in order to allow safe, complete access to the ovary. Ultrasound guided retrievals provide a direct view of the ovary that allows the maximum numbers of eggs to be retrieved. IVF success is correlated to the number of mature eggs obtained, so this technique has been highly beneficial.
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What do I do to prepare for the retrieval?
The most critical event prior to retrieval is the injection of human chorionic gonadotropin (hCG), a synthetic hormone used to stimulate egg development. This injection is given 35 hours prior to retrieval in order to optimize egg maturity.
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Can I continue to have sex during the IVF process?
Intercourse may not be comfortable as you near the egg retrieval because your ovaries become swollen with numerous follicles (the cysts which form around each egg). However, you may continue to have intercourse until the day of the hCG injection if you feel able. You will be asked to refrain from sex when you are recovering from the egg retrieval and after the embryo transfer in order to avoid uterine contractions, which might interfere with embryo transfer.
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How long does the IVF process take?
The process lasts about three to four weeks, beginning with ovulation induction to the day of embryo transfer. The exact timing is tailored to meet each woman's individual response to medication.
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Will there be multiple sessions to assure that there are viable eggs?
Multiple sonograms and bloods tests will be done over the course of your 10 days of stimulation to assure the best chance of high quality eggs. Nonetheless, no one can guarantee that every follicle seen on ultrasound will contain a viable egg.
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Is IVF a safe, risk-free procedure?
Your physician will review all the side effects of the medications with you. No procedure is completely risk-free, but IVF has proven to be safe, and serious complications are very rare.
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How many eggs are retrieved during a typical IVF experience?
Generally, 5-15 eggs are available for insemination. However, each patient is an individual and there is no "typical" number of mature eggs.
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Once the eggs are retrieved, how many are implanted?
The number of embryos transferred depends upon your specific circumstances. We will review your options with you, taking into account your age, fertility history, medical and gynecologic history and the number of healthy embryos available. Surplus healthy embryos can be frozen for future transfer with a high degree of success. Overall, the Emory Reproductive Center is proud of its ability to generate very high pregnancy rates while maintaining an average of just 2.4 embryos per transfer. This optimizes our patients' outcome and limits the risk of multiple pregnancies.
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Is the implantation process painful?
No. Most women don't feel the actual transfer. But, we do ask our patients to drink water and keep a full bladder to allow ultrasound guidance for the transfer.
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How soon after the transfer will I know if I am pregnant?
You will be asked to come to our office for a pregnancy test 12 days after the embryo transfer.
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What happens with fertilized eggs that can not be implanted?
Some of the embryos that can't be transferred show signs that they have stopped growing normally prior to the day of transfer. They are allowed to disintegrate in the laboratory. Extra healthy embryos can be frozen and saved in the laboratory for transfer at a later date. These embryos have the same chance of success as those that are transferred initially.
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Is IVF an option for everyone?
In vitro fertilization can help most couples conceive, but circumstances will vary. Some will need to use the donated eggs of another woman or have embryos transferred to the uterus of a compassionate gestational carrier to achieve a pregnancy. This technology can be used in a variety of circumstances to help couples realize their personal dreams.
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