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Preparing for Conventional IVF
by Geoffrey Sher, M.D., Sher Institute for Reproductive Medicine.
The objective with In Vitro Fertilization is to consistently transfer several good quality embryos into an optimal uterine environment. This requires an individualized and meticulous approach to the evaluation and treatment of the following factors that are known to influence IVF outcome:
(1) THE NUMBER AND QUALITY OF THE EMBRYOS/BLASTOCYSTS FOR TRANSFER:
The number of embryos/blastocysts: The number of eggs a woman produces is influenced by her ovarian responsivity to gonadotropin fertility drugs such as Follistim, Gonal-F, Pergonal, Humagon or Repronex. This responsivity in turn relates to her proximity to menopause. Ovarian responsivity can be assessed by measuring FSH and estradiol (E2) and Inhibin B, on the 3rd day of a prior menstrual cycle. If the plasma FSH level is greater than 9.0MIU/ml in association with a plasma estradiol level of greater than 70pg/ml by EIA, and/or the plasma inhibin B level is less than 45 pg/ml, it would point to the likelihood that the woman would be relatively resistant to ovarian stimulation.
The quality of embryos/blastocysts: Clearly, the quality of the ivf laboratory is pivotal in ensuring that quality embryos are produced following IVF Highly technical procedures such as intracytoplasmic sperm injection (ICSI), assisted hatching (AH) and embryo biopsy, should only be performed by embryologists with the necessary experience and rehearsed skill, lest fertilization rates and embryo quality be severely compromised.
(2) THE INTEGRITY OF THE UTERINE CAVITY AND THE QUALITY OF THE UTERINE LINING:
(3) SPERM QUALITY AND FUNCTION:
(4) LIST OF TESTS SELECTIVELY PERFORMED IN PREPARATION FOR IVF CYCLE.