At
our
practice,
we
feel
that
it
is
our
responsibility
to
make
sure
that
our
patients
are
well
informed
about
all
aspects
of
the
fertility
treatment
plan
they
will
undergo.
There
are
a
number
of
issues
to
take
into
consideration
when
planning
to
undergo
In
Vitro
fertilization
(IVF).
At
Northern
California
Fertility
Medical
Center,
we
discuss
these
issues
thoroughly
with
our
patients,
not
to
discourage
them,
but
to
be
sure
that
they
are
prepared
and
to
maximize
the
chances
of a
positive
and
successful
experience.
Emotional
Effects
Even
the
smoothest
and
most
successful
courses
of
in
vitro
fertilization
can
be
emotionally
stressful
for
the
couple.
The
roller
coaster
of
frustration,
worry,
fear,
hope,
elation,
and
countless
other
emotions
that
are
often
experienced
in a
single
IVF
cycle
can
be
overwhelming.
In
reality,
most
couples
will
require
more
than
one
cycle
to
reach
success.
Some
will
achieve
pregnancy
only
to
suffer
a
miscarriage,
and
others
will
need
to
turn
to
alternative
options,
such
as
egg
donation,
surrogacy,
or
adoption.
This
means
that,
in
many
cases,
the
roller
coaster
can
go
on
for
some
time.
While
we
do
our
best
to
foster
a
positive
experience
for
each
patient,
it
is
likely
that
the
process
will
involve
a
certain
amount
of
frustration
and
disappointment.
For
this
reason,
the
in
vitro
fertilization
(IVF)
experts
at
Northern
California
Fertility Medical Center
recommend
that
our
patients
participate
in
some
type
of
infertility
support
program
during
treatment.
By
being
aware
of
the
stresses
of
IVF
treatment
and
taking
the
time
to
address
your
own
emotional
needs
during
this
time,
you
improve
your
chances
of
maintaining
your
physical
and
mental
health
and
achieving
success
more
quickly.
Financial
Investment
There
is
no
disputing
that
in
vitro
fertilization
is a
costly
procedure.
We
offer
financial
programs
to
make
the
cost
of
IVF
more
manageable
to
some
degree,
but
there
is
still
the
possibility
that
multiple
cycles
of
IVF
will
be
unsuccessful.
It
is
important
to
honestly
assess
the
amount
of
money
you
are
able
and
willing
to
spend
before
beginning
treatment.
Addressing
this
issue
early
on
will
prevent
you
from
experiencing
additional
stress
as a
result
of
worrying
about
your
financial
state.
Potential
Complications
In
the
majority
of
cases,
in
vitro
fertilization
cycles
proceed
smoothly
and
without
complication.
There
are
a
few
possible
complications,
however,
that
can
disrupt
the
process
and
result
in
cancelled
cycles
or
necessitate
advanced
techniques.
It
is
important
to
be
aware
of
these
potential
problems
before
undergoing
treatment.
We
have
described
these
hurdles
below
in
the
chronological
order
that
they
might
occur.
Ovarian
Cysts
During
pre-treatment
screening,
we
will
check
for
ovarian
cysts
(fluid-filled
sacs)
using
an
ultrasound.
If a
cyst
is
present,
your
start
date
may
be
delayed.
In
general,
the
cyst
will
resolve
on
its
own
in
one
or
two
months,
but
we
may
be
able
to
provide
medication
to
help
suppress
the
cyst,
or
aspirate
the
fluid
from
it
in
the
office.
Inadequate
Stimulation
Some
women
have
a
poor
response
to
the
fertility
medications
that
are
used
to
stimulate
the
ovaries
during
an
in
vitro
fertilization
cycle.
Inadequate
stimulation
will
result
in a
cancelled
cycle,
and
a
different
medication
regimen
to
be
used
in
the
subsequent
cycle.
Hyperstimulation
An
excessive
response
to
fertility
medications
results
in
the
development
of
too
many
follicles
and
may
require
the
cycle
to
be
cancelled.
Subsequent
cycles
will
be
tried
with
lower
doses
of
medication.
Drop
in
Estradiol
Level
Hormone
levels
are
checked
throughout
the
IVF
process.
Estradiol
(a
form
of
estrogen)
levels
are
expected
to
rise
or
plateau.
If
there
is
an
unexpected
drop,
a
problem
is
indicated
and
the
cycle
will
be
cancelled.
Few
or
No
Eggs
Retrieved
While
an
ultrasound
examination
will
generally
reveal
the
number
of
mature
eggs
prior
to
retrieval,
in
rare
cases,
there
may
be
far
fewer
eggs
collected
than
was
expected.
It
is
extremely
rare,
however,
for
there
to
be
no
eggs
at
all.
Further
treatment
in
these
situations
will
be
determined
on a
case-by-case
basis.
Poor
or
No
Fertilization
The
average
rate
of
fertilization
with
IVF
is
70
percent.
Poor
egg
or
sperm
quality
may
contribute
to a
decreased
percentage
of
fertilized
embryos.
It
is
very
uncommon
for
there
to
be
no
fertilization
at
all.
ICSI
is
an
option
when
this
rare
circumstance
does
occur.
Illness
If
either
partner
suffers
from
a
significant
illness
or
high
fever
during
treatment,
the
cycle
may
need
to
be
cancelled.
Cryopreservation
The
low-temperature
storage
of
embryos
is a
valuable
technology
to
the
in
vitro
fertilization
(IVF)
process.
At
Northern
California
Fertility
Medical
Center,
we
regularly
cryopreserve
embryos
that
are
created
through
IVF
but
not
immediately
transferred
to
the
patient’s
uterus.
This
allows
for
the
embryos
to
be
thawed
and
transferred
during
subsequent
cycles
should
the
initial
cycle
be
unsuccessful.
This
prevents
the
woman
from
undergoing
repeated
courses
of
ovarian
stimulation
medications.
Before
undergoing
in
vitro
fertilization,
however,
it
is
best
for
a
couple
to
discuss
their
feelings
about
cryopreservation
and
how
they
would
like
to
address
the
issue
of
having
additional
embryos
in
storage
once
pregnancy
is
achieved.
This
is a
sensitive
and
very
personal
issue
that
is
best
considered
beforehand
to
avoid
future
conflicts
or
stresses.
Selective
Pregnancy
Reduction
Although
we
do
our
best
to
minimize
the
occurrence
of
multiple
pregnancies,
it
occasionally
happens
that
more
than
one
or
two
embryos
successfully
implant
in
the
uterus
and
continue
to
develop.
Unfortunately,
this
often
puts
an
unsafe
amount
of
stress
on
the
woman’s
body
and
can
endanger
the
fetuses
as
well.
Selective
reduction
of
pregnancy
is a
procedure
that
will
reduce
the
number
of
fetuses
and
allow
those
that
remain
to
grow
to
full
viability.
We
must
emphasize
that
our
program
does
not
advocate
the
performance
of
abortion.
We
feel
that
selective
pregnancy
reduction
can
be
justified
when
it
diminishes
the
chances
of
serious
pregnancy
complication
and
protects
the
lives
of
the
mother
and/or
the
remaining
fetus(es).
When
required,
this
procedure
is
generally
performed
at
the
end
of
the
third
month.
The
chances
of
complete
miscarriage
or
damage
to
the
surviving
fetus(es)
are
very
low.
Couples
who
are
considering
in
vitro
fertilization
and
have
questions
about
selective
pregnancy
reduction
are
encouraged
to
raise
the
issue
at
their
convenience.
We
will
be
happy
to
discuss
the
matter
and
answer
any
questions
upon
request.
Talking
to
Children
and
Family
Members
Despite
the
fact
that
in
vitro
fertilization
and
the
whole
range
of
assisted
reproductive
technologies
have
become
more
and
more
common
in
the
last
several
years,
infertility
treatment
can
still
be a
difficult
topic
to
discuss.
There
are
still
many
widely-held
misconceptions
about
the
causes
of
infertility,
and
you
may
encounter
people
who
do
not
understand
what
IVF
is
or
why
it
is
necessary.
You
may
even
receive
a
negative
response
about
your
decision
from
close
friends
or
family
members.
That
is
why
it
is
worthwhile
to
consider
how
you
will
talk
about
your
IVF
experience
before
you
decide
to
undergo
treatment.
You
and
your
partner
should
discuss
whom
you
feel
comfortable
telling
about
your
decision
and
who
does
not
need
to
know.
You
should
also
consider
how
you
will
bring
up
the
subject
and
how
you
will
handle
different
possible
reactions.
If
you
already
have
a
child
or
children,
discuss
how
much
information
they
should
be
given
and
how
it
should
be
explained
so
that
they
understand
what
you
feel
they
need
to
know.
Another
eventuality
to
consider,
even
though
it
seems
a
long
way
off,
is
how
you
will
disclose
this
information
to
the
child(ren)
you
are
creating.
What
will
you
tell
them
when
they
begin
to
ask
questions
about
their
beginnings?
How
will
you
reassure
them
that
having
a
"high-tech"
conception
does
not
make
them
any
different
from
other
children?
While
it
is
not
necessary
to
determine
concrete
answers
for
every
question
right
away,
it
is
best
to
take
these
issues
into
consideration
when
deciding
whether
or
not
to
undergo
in
vitro
fertilization.
The
experienced
professionals
at
Northern
California
Fertility
Medical
Center
can
offer
suggestions
and
guidance
on
these
and
other
matters.
The
more
prepared
you
are
for
all
aspects
of
the
treatment
process,
the
better
your
chances
of a
positive
overall
experience
will
be.
