COMMON FAQ’s – INFERTILITY AND IVF

1) When is the best time to start IVF?

• After a detailed fertility evaluation, your clinician may recommend IVF if it offers a higher chance of conception compared to IUI.
• Indications include poor ovarian reserve, tubal damage due to endometriosis or tuberculosis, hydrosalpinx, pyosalpinx, moderate to severe endometriosis, and moderate to severe male factor infertility (e.g., severe oligoasthenoteratozoospermia, azoospermia with surgically retrieved sperm).
• Genetic conditions requiring pre-genetic screening or diagnosis prior to embryo transfer.

2) What are the side effects and risks involved with IVF?

• IVF is generally safe, though some side effects may occur due to hormonal medications.
• Possible side effects include:
  – Pain, soreness, or bruising from injections (minimized with recombinant subcutaneous injections).
  – Breast tenderness.
    – Bloating and mood swings.
    – Allergic reactions to injection components.
• Risk of Ovarian Hyperstimulation Syndrome (OHSS) in about 3% of cases, which can be minimized with proper stimulation protocols.
• Small risk associated with procedures like egg retrieval and embryo transfer.

3) How many times can IVF be tried?

• No upper limit exists, but couples can decide after understanding effects of repeated stimulation.
• Most couples conceive within the first 3 IVF attempts.
• For repeated IVF failures, interventions such as laser-assisted hatching, embryo glue, pre-genetic screening, immunoglobulins, and intralipids can be helpful.

4) How painful is embryo transfer?

• Embryo transfer is a simple, non-anesthetic procedure similar to IUI.
• Usually not painful, but mild cramping may occur afterward.

5) What to do after 2 failed IVF cycles?

• After failure, the doctor identifies the cause and suggests the following options:
  – Genetic screening (PGD) for healthy embryos.
  – ERA (Endometrial Receptivity Assay) to determine optimal implantation window.
    – Immunoglobulin therapy.
    – Laser-assisted hatching.
    – Lifestyle modification, including weight loss, stress management, yoga, or meditation.

6) How long does the egg pickup procedure take?

• Egg retrieval typically takes 20 to 30 minutes, depending on the number of follicles and clinical expertise.

7) How many embryos do you transfer during an IVF cycle?

• Determined by:
  – Female age
  – Embryo quality
    – Clinical history
    – Previous embryo transfer outcomes
• Most clinicians follow international guidelines to limit embryo number and reduce the risk of multiple pregnancies.

8) What causes infertility in women?

• Required reproductive functions:
  – Healthy ovaries
  – Patent fallopian tubes
    – Normal uterus
    – Receptive endometrium

Ovarian Factors:
  – PCOS
  – Premature ovarian insufficiency
  – Low ovarian reserve
  – Menopause

Tubal Factors:
  – Blocked tubes due to infections or surgeries (e.g., TB, appendicitis, endometriosis)

Uterine Factors:
  – Fibroids, adhesions, polyps, adenomyosis, uterine anomalies, chronic infections

Pelvic Factors:
  – Pelvic adhesions or endometriosis (diagnosed via invasive methods)

9) What causes infertility in men?

• Evaluated through semen analysis (90% of cases diagnosed).
• Key parameters: sperm count, motility, morphology.
• In cases like azoospermia, advanced hormonal and genetic testing may be needed.
• In recurrent miscarriages or IVF failures, advanced sperm function and DNA integrity tests may be suggested.