From the Fertility Experts: Fertility Chronicles is proud to present a special blog series, “From the Fertility Experts,” where leading fertility experts answer commonly asked questions for patients about their fertility health and treatment options. We hope this series can help patients navigate their personal fertility journeys.—Catherine T. Yang, Editor, Fertility Chronicles
Guest blogger Dr. Philip Chenette of the Pacific Fertility Center shares his advice:
Better pregnancy rates with lower risk have arrived for in vitro fertilization (IVF). A woman having trouble conceiving, with age-related infertility, miscarriage, or male factor, will find IVF technology over the past two years has taken a strong leap into better success rates with lower risk and better outcomes.
Two technologies underpin this progress: Chromosome screening of embryos and vitrification. Comprehensive chromosome screening (CCS) helps identify the best embryos out of a group. Vitrification, a technique of embryo freezing, allows us to save those embryos and transfer them in a later natural cycle. The two technologies together are allowing us to achieve better pregnancy rates per transfer at lower risk.
With IVF, you take drugs to stimulate egg production. Then the eggs are harvested from your ovaries, and in a laboratory, the sperm and eggs are put together to fertilize and grow into embryos. On average 10 to12 eggs are retrieved, and two to four high quality blastocyst stage embryos result on day five or six after fertilization. One or more embryos are placed directly into the uterus in a procedure called embryo transfer.
Embryo screening has improved the ability to choose the best embryo for transfer. Our new techniques of embryo screening produce pregnancy rates of 60% to 90% for patients whose embryo screening identifies chromosomally normal embryo(s) for embryo transfer. Embryos that have a correct set of chromosomes and physical features characteristic of normal development produce the highest pregnancy rates. In addition, pregnancies resulting from the transfer of a single healthy embryo have lower risks of complications such as miscarriage and Down Syndrome. The transfer of just one embryo also substantially decreases the chance of having a multiple birth, which means that complications, such as preterm labor, are also drastically lower.
IVF can be successful for women who have endometriosis, problems with ovulation, unexplained infertility, or diminished ovarian reserve. It may be one of the few viable options for women who have blocked fallopian tubes. The procedure can also be the best option if the male partner has a low sperm count or poor sperm motility.
About 48,000 IVF babies are born in the United States each year. The average cost for one cycle of IVF is $12,000. Embryo screening can increase the cost by about $5,000. The benefits of improved pregnancy rate and lower risk reduce the relative cost of treatment. Some states have mandated insurance coverage, while most leave it up to the individual health insurance plan. So, it’s definitely important to check out your plan’s coverage.
Whether or not you consider IVF, it’s important to note that the American Society for Reproductive Medicine (ASRM) recommends that couples seek medical advice after trying for a year to conceive naturally. A woman over 35 should consult a fertility specialist if she and her partner have been trying for six months.
 Editor’s Note: In the context of IVF success, the “best” embryos are embryos that have the best chance of implanting and developing in the womb to result in a viable pregnancy and live birth. This viability is highly correlated with having a normal number and types of chromosomes (structures carrying the embryo’s genetic materials) and microscopic features of normal development.