Ovarian Hyperstimulation: The IVF Cycle begins on menstrual cycle day 2 with the use of an oral contraceptive agent. Depending on your individual circumstances, this medicine may be given for a varying period of time (often 2 weeks) to prevent ovarian cysts from forming in response to Lupron.

Resources

Injection Instruction Videos

: www.asrm.org/Patients/FactSheets/Gonadatrophins-Fact.pdf

Egg Retrieval: Eggs are removed during a process called a transvaginal egg retrieval. This procedure is performed under sedation, so you will be comfortable throughout the entire process. Once you are sedated, a thin needle is placed through the back of the vagina into the ovary. Gentle suction is applied and the eggs are aspirated with follicular fluid into test tubes.  The eggs are microscopically located by an embryologist, and moved into a culture dish.

Embryo Development Photo Gallery

Blastocyst Embryo Transfer: It is our goal to transfer two blastocysts to try to prevent multiple pregnancy of triplets or greater. Your age and the quality of the blastocysts will also affect the actual number of embryos that your doctor will recommend for transfer.

Cryopreservation: The majority of couples will elect to cryopreserve viable embryos that remain in culture after embryo transfer. In doing so, they have another chance to achieve a pregnancy at a greatly reduced cost compared to the cost of a fresh IVF cycle. This can be a wonderful opportunity for those couples who do not get pregnant during an initial cycle or even for those couples who do get pregnant but desire a second child in the future.

Patients who may be candidates for IVF include:
	Patients with absent, blocked or abnormal fallopian tubes
	Those whose partners have an abnormal sperm count or sperm function
	Couples with unexplained infertility
	Women who have endometriosis who have not achieved a pregnancy with other forms of treatment.
	Women with other infertility problems such as antisperm antibodies or severe cervical factor, for whom no alternative therapy is available and other treatments have been unsuccessful.
	Any patient with longstanding infertility for which no other therapy has been successful.

Prerequisites (Requirements) for beginning an In Vitro Fertilization Cycle: Female:
	A copy of records from previous surgeries, ovulation induction, or IVF cycles
	A normal pap smear within the last year.
	Documentation of a normal uterine cavity (usually with a hysterosalpingogram (HSG), saline infusion sonohysterogram or hysteroscopy)
	Prenatal Screen (Blood test on patient)
	HIV, Hepatitis C, and antisperm antibodies (blood test on patient)
	EKG if you are over 40 years of age.
Male:
	Semen analysis and semen culture
	Sperm Penetration Assay (SPA, if normal sperm function has been documented by a recent pregnancy or fertilization, an SPA will not be needed.)
	Sperm cryopreservation is recommended so that a back-up sample is available for IVF
	Blood tests:  Blood type and Rh, hepatitis B and C, antisperm antibody test

Psychological Impact: IVF can create additional stress for those who may have already endured multiple disappointments. There is no question that it can be physically and emotionally difficult for a number of reasons. For some it may be the last step toward achieving a biological child. For many, an IVF treatment cycle may disrupt work, school and daily schedules. This is compounded when one lives a significant distance from an IVF program, resulting in long daily commuting, separation from one's spouse if commuting is unrealistic, or additional expense for unfamiliar accommodations during treatment. In the midst of this couples want to realistically confront the odds for success while remaining optimistic enough to endure a regimented treatment program.

	Become well informed about IVF. Understanding the process and knowing what to expect during each step will lessen your anxiety about the procedure. This information may be obtained through our brochures, our doctors and nurses, and multiple sites published in books, articles and on-line.
	Be realistic about your expectations. The average chance of establishing a pregnancy is 40% each treatment cycle in our program. If pregnancy does not occur, a cycle will still contribute valuable information, which can assist in planning a subsequent treatment.
	Set limitations and make decisions cooperatively with your partner.
	Make decisions ahead of time. Discuss your feelings about emotional issues such as cryopreservation, the use of donor semen, the number of cycles you would consider, and what friends or family members you wish to include in your confidence.
	Ask for emotional support from these friends or family members and talk about your feelings.
	Keep life simple. Plan activities that are entertaining and relaxing. Bring familiar items from home if you are staying in a hotel.

Cost:  We are dedicated to providing state-of-the-art assisted reproductive technologies at an affordable cost to the patient.  For patients who DO NOT HAVE insurance coverage for IVF, we have developed an "IVF Flat-rate Fee Package" (click for more information).   Patients who have IVF treatment/creation insurance coverage are excluded from participating. 

The basic cost for an IVF cycle at Nashville Fertility Center is approximately $8800.00.  This is an estimate that is subject to change, and includes the following:

	Cycle monitoring (estradiol levels, ultrasounds, progesterone level)
	Embryology Laboratory services associated with the egg retrieval, sperm preparation and insemination, embryo culture, assisted hatching (if needed), embryo transfer, embryo cryopreservation and first year of storage (if extra viable embryos are available after transfer)
	Physician and Embryology Professional fees
	Surgery Center and Anesthesia fees
Some of the following additional services may be required during your IVF cycle, and are not included in the estimated cost above:
	Intracytoplasmic Sperm Injection (ICSI)
	Preimplantation Genetic Diagnosis (PGD)
The following services/tests are not included in the estimate:
	New patient evaluation and pre-cycle office visits
	Pre-cycle prerequisite testing and evaluation on the male and female partner (these tests may be performed at NFC or at your primary physician's office)
	IVF Class
	Medications needed for the cycle.  These are purchased directly from the pharmacy.  The pharmacy will verify your prescription benefits and inform you of your cost.
	Pregnancy testing and OB ultrasounds

You will want to check with your insurance carrier to see if these charges might be covered.