At CNY Fertility, we recommend women eat a high fat, moderate protein, low carbohydrate AKA ketogenic diet , take high-quality supplements that can improve egg quality, and prescription medications if necessary to reduce inflammation, improve implantation, and regulate the immune system.
A of the effects of coenzyme Q10 found it boosted ovarian response in younger women with low ovarian reserve. Another supplement, DHEA, is more controversial, but concluded it might boost poor ovarian reserve. Similarly, acupuncture can be helpful. An alternate trigger shot is frequently a good idea and freezing embryos for FET to give the body time to recover.
A high fat, moderate protein, low carb diet is critical for getting pregnant with PCOS. And be sure to store your injectables correctly. Remember to set an alarm! The time before, during, and immediately after an IVF cycle can be very stressful. Make sure you are reaching out for the necessary support you need to handle the stress and anxiety. Support groups are a tremendous resource for emotional support. Mentors who have been in your shoes offer a caring ear and great advice.
The egg retrieval procedure is one of the most important steps in the IVF Process. It, along with the steps leading up to and coming after the egg retrieval make IVF the most effective fertility treatment as it works its way around a number of key fertility issues. The egg retrieval is a relatively simple procedure with little risks.
After the egg retrieval, the woman usually prepares for an embryo transfer. Paul C. Magarelli MD PhD. Association between the number of eggs and live birth in IVF treatment: an analysis of treatment cycles 2.
Pretreatment with coenzyme Q10 improves ovarian response and embryo quality in low-prognosis young women with decreased ovarian reserve: a randomized controlled trial 3. Beginning of dialog window.
It can also result in more follicles being ready to respond once you begin your ovarian stimulation medications. You will self-inject these medications each day using a tiny needle. During the retrieval, you will receive light IV sedation to keep you comfortable while your doctor retrieves your eggs directly from the ovaries using transvaginal aspiration. Next in the IVF process, our team will identify your eggs in the follicular fluid that your doctor has removed, and place them in a special solution culture media in a petri dish.
Approximately five hours later, our embryologists will fertilize the eggs using traditional IVF fertilization or intracytoplasmic sperm injection ICSI. Approximately 18 hours after insemination or ICSI, our embryologists will look at your eggs under a high power microscope in order to determine whether fertilization has occurred. Successful fertilization is indicated by the presence of two pronuclei one pronucleus from the egg and one from the sperm. Usually 3 to 8 cells are sent for testing performed at an outside lab, while the embryos are frozen and remain in the IVF laboratory.
After receiving the genetic test results, the selected embryo is chosen, thawed and transferred into the uterus, usually within 1 to 2 months after the egg retrieval. The number of embryos produced depends on several factors including the age of the couple. In the past, multiple embryos were transferred in the hope of maximizing success but this often resulted in twins or rarely triplets, both of which are associated with pre-term birth and other serious complications to both babies and mother.
The safest approach is to limit transfer to a single embryo. To maximize the chance for success, the healthiest embryo is selected by the embryologist based on a grading system used to evaluate each embryo.
A soft, flexible, and thin catheter is used to transfer the embryo into the uterus. An abdominal ultrasound is used to make sure that the tip of the catheter places the embryo at the best location for the embryo to implant. Pain and discomfort are rare, and the experience has been compared to how it feels to get a pap smear.
Good embryos not used for transfer are usually frozen in case the cycle is not successful or a couple wants more children following a successful first cycle. Hopefully, the development of the embryo continues in the uterus and the embryo hatches and implants in the uterine lining within days following embryo transfer. Once the first egg has been released all the remaining follicles will stop growing.
Thus, we must use another type of medication to prevent the interference of Mother Nature. These medications Lupron or a GnRH antagonist act on the brain and pituitary to prevent the release of LH to cause premature ovulation.
Once the risk of premature ovulation has been eliminated, ovarian stimulation can proceed until the follicles become mature and ready for egg retrieval.
Once the pituitary can no longer interfere with the growth of the follicles, stimulation of the ovaries can begin with close monitoring of the ovaries by ultrasound and hormone levels. This is where there can be great variation as patients can benefit from different stimulation protocols depending on their unique situations.
Choosing the correct stimulation protocol is one of the most important decisions in IVF planning. The reserve of the ovaries, as determined by the AMH level and the antral follicle count, plays a critical role in helping us decide the stimulation protocol. Patients who have normal egg reserve can use the regular IVF protocols, whereas patients with low egg reserve can benefit from one of the aggressive protocols. After about 10 days of ovarian stimulation with injectable medications, most of the follicles should mature to size.
About 36 hours after HCG triggering, the eggs are aspirated through the vagina under ultrasound guidance in the office. The patient sleeps for about 20 minutes under deep IV sedation given by an anesthesiologist.
Once the retrieval is complete the patient wakes up almost immediately after the IV medications are discontinued. Most women have mild pelvic soreness and cramping after the procedure but this is self limited, resolving within a couple of hours after the retrieval.
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