This post is a transcript of our 12/20/2010 IVF chat with Dr Aimee Eyvazzadeh.  The post is broken up into 3 pages.  Please use the navigation at the end of each section to proceed to the next page of the transcript.

 DrAimee: Hi Everyone! I wanted to welcome you. Thank you for being here. My name is Dr. Aimee Eyvazzadeh. I’m a Reproductive Endocrinology and Infertility Specialist. We’re going to open up tonight’s discussion to questions about IVF.

Alenna: Do you have any suggestions on how to choose a clinic for doing IVF?

• DrAimee: Absolutely. A great resource for you is www.fertilitylifelines.com. You can go to that website and see if there is a doc in your area that you would like to meet.

M_walsh: What side effects can I expect from the IVF drugs I will be using?

• DrAimee: Great question. IVF meds are not risk free. Risks associated with the medications are: bloating, abdominal pain, a condition called ovarian hyperstimulation syndrome, mood changes, breast tenderness and headaches.
• There are two fertility emergencies: OHSS also known as ovarian hyperstimulation syndrome and ectopic pregnancy.
• It isn’t unusual to be more afraid of the side effects than anything else .
• That’s what most patients are afraid of especially if it’s your first cycle.

Patty: After how many IUI’s should we then turn to IVF?

• DrAimee: Another great question.
• There are no rules as to how much of one thing you should do before moving to the next.
• It’s a very personal decision.
• I have some patients that come to me and we start with IVF.
• Patty, can you tell me what your infertility diagnosis is?
• If you don’t feel comfortable answering this question, don’t worry.
• If you have a condition called male factor infertility, you can try a couple IUIs then if no pregnancy move right to IVF

• DrAimee: In that case, I would call the diagnosis male factor infertility.
• Before you even do an IUI I would want to do an evaluation of your husband.
• This is what I recommend: A male hormone profile: FSH, LH, free and total testosterone, TSH and prolactin.
• A urology evaluation for an anatomic anomaly such as a varicocoele. You can google image the term varicocoele and see what that means.
• Believe it or not, men can have an elevated FSH level or a thyroid problem that could cause low sperm counts.
• Knowing this BEFORE you do treatment will be super helpful – because treatment may mean no treatment
• and just taking pills to treat the thyroid problems and hopefully a pregnancy around the corner

Patty: Thank you Dr Aimee. I’m going to look into this before I move ahead with anything else.

• DrAimee: Feel free to email me directly too: email@draimee.org

Patty: Thank you again!

Alenna: What are some good questions I should be asking when deciding on a dr/clinic for IVF?

• DrAimee: Hi Alenna. These questions are all great!
• This is what I would ask:

1. What protocol are you putting me on and why?
2. What is my fertility diagnosis?
3. What dose of medications are you going to use and what type of medications and why?
4. Should we be doing ICSI or not?
5. Who will be doing all my ultrasounds? Who will be drawing my blood? Who will be communicating with me on a daily basis about the results of these tests?
6. How is this practice run? ie Will I see a different doctor for the retrieval and another doctor for the transfer? Or will the same doctor do all of these things for me?
7. What are your success rates?
8. Have you had success with patients with my particular diagnosis.
9. Making a decision to move forward with fertility treatment is a very serious decision so you want to make a careful decision about the doc you want to go with.

• So feel free to look up the docs in your area and interview all of them either on the phone or in person before you start a treatment plan

Alenna: In regards to ICSI, what would have you go that route with a patient?

• DrAimee: IVF is a really really expensive diagnostic test for infertility.
• What I mean by that is this: you may have a fertilization problem and won’t know it until you go through IVF.
• ICSI has an %80 percent fertilization rate associated with it.

Alenna: Got it. You’ve been really helpful. Thank you very much and happy holidays to you.

• DrAimee: I make the decision to do ICSI using the following criteria:
• A. “Unexplained infertility”
•  B. Low sperm count, morphology or motility
• C. Decreased ovarian reserve
• D. In couples doing PGD.
• You’re welcome and happy holidays to you too!

Jennifer: Hi Dr Aimee. I’m not sure I understand the difference between IVF and Micro IVF. Can you explain it?

• DrAimee: So Micro IVF also known as Mini-IVF basically means an IVF cycle with a lower dose of medications .
• IVF in this country is very very expensive.
• An average patient will spend close to $16,000 including medications for their IVF cycle.
• The average medication bill for a patient of mine is about $5500.
• So when you do Mini-IVF you’re usually using a combination of pills and shots and your medication costs come down by thousands of dollars.
• I recommend Mini-IVF for those who have very few follicles to start with. So if you’re going into IVF thinking you’ll only get 2-3 eggs, no need to take $6000 worth of medications.
• You may as well take a fertility pill such as femara or clomid and combine it with lower dose shots and approach IVF that way.