IVF "Hurdles"

The majority of IVF cycles go smoothly and most patients proceed to egg retrieval and embryo transfer. Though we do not anticipate problems, it is important for you to be prepared for potential problem areas.

Presence of an ovarian cyst: At the time of a pre-cycle ultrasound a cyst may be present on the ovary. Most commonly this cyst will resolve spontaneously in one to two months. The presence of a cyst, however, may delay your start date. In some situations we will use a medication to aid in the suppression and spontaneous resolution of the cyst. In other cases, we may aspirate the fluid from the cyst in the office and proceed with the treatment cycle.

Inadequate stimulation: Some patients will exhibit an inadequate response to the medications used to stimulate the ovaries (Menotropins - Fertinex, Pergonal, Humegon). If there is inadequate follicular development as evidenced by serial ultrasounds and blood estradiol levels, the cycle may need to be cancelled and your situation reassessed for future treatment.

Hvperstimulation Syndrome: An excessive response to the medication used for ovarian stimulation may occur. A small percentage of women are extremely sensitive to these medications and may develop too many follicles. If this occurs, we may decide to "coast" for several days (continuing the Lupron only) before giving hCG and performing the egg retrieval. In some cases, h may be necessary to cancel the cycle and begin at a lower dose of medication in a future treatment cycle.

Unexpected drop in estradiol level: During the stimulation, we expect the level of estradiol to increase daily. If the estradiol level decreases significantly, the cycle may need to be cancelled.

Low number of eggs or no eggs at retrieval: Usually the number of follicles at the final ultrasound is an indication of the number of eggs, which will be retrieved. Occasionally, a much lower number of eggs than expected will be retrieved. Fortunately, it is extremely rare to find no eggs and the individual case determines recommendations for future treatment.

Poor fertilization or no fertilization of eggs: Normally, 60% to 80% of eggs fertilize in the IVF laboratory. In some situations, the rate of fertilization is much lower. Poor egg or sperm quality may contribute to this occurrence. Fortunately, h is extremely uncommon to have no fertilization. If this happens, intracytoplasmic sperm injection (ICSI) may be a necessary aid to fertilization in future treatment cycles.

Illness during cycle: Significant illness or high fever in either partner may necessitate cancellation of the cycle.

This list is not meant to be frightening or discouraging. Fortunately, the majority of patients will not encounter these problems. Our objective is to provide an optimal chance at achieving our common goal: A Successful Pregnancy!