In vitro fertilization (IVF) describes a complex combination of procedures designed to treat or overcome a range of infertility factors. Generally, IVF involves fertilizing eggs with sperm outside of the mother’s body, and then implanting healthy embryos into the mother’s uterus, where at least one can “hatch” (break out of its protective shell) and implant itself into the uterine lining. IVF allows us to test embryos for genetic diseases using PGT-M (formerly PGD) and embryo biopsy, and offers a number of other advantages by using your eggs and sperm, or donor eggs and sperm, if necessary. To learn how IVF performed at our San Antonio infertility center can help you start or add to your family, contact us today and schedule an appointment.
The Basics of IVF
The term "in vitro" literally means “in glass.” IVF involves fertilizing a woman's egg in a laboratory and transferring the fertilized egg to the uterus of the patient or surrogate. By conducting fertilization in a controlled setting, we can better regulate reproductive processes and help to ensure a safe and successful pregnancy. We can determine if this treatment is right for you by conducting a fertility evaluation at our office.
How the Fertility Treatment Works
IVF treatment is a multi-step process that includes four primary phases:
- Ovulation induction: To begin IVF treatment, the patient is given fertility medications to stimulate the development and release of eggs.
- Egg retrieval: During this procedure, the doctor will use an ultrasound-guided needle to retrieve healthy eggs from the ovaries. To prepare the eggs for incubation and fertilization, ideal samples are identified through a process known as oocyte selection. To prepare semen, we will remove inactive cells and seminal fluid through a process known as sperm washing.
- Fertilization: To induce fertilization, both the sperm and eggs will be placed into a special medium and left to incubate for up to 48 hours. The sperm-to-egg ratio can be as high as 75,000:1 in order to help ensure successful fertilization. If no eggs are fertilized during the incubation period, then direct injection of a single sperm into an egg (ICSI) may be recommended. After the eggs have been fertilized, they will be left to develop, or culture.
- Embryo transfer: Once the eggs have been fertilized and allowed to culture into embryos, they will be transferred to the uterus. When the embryos are allowed to culture for two to three days, we can transfer them to the uterus during the cleavage stage. Conversely, by allowing the embryo to culture for five to six days, we can transfer them during the blastocyst stage. Completing uterus transfer during the blastocyst stage usually results in a better chance of live birth. However, it also limits the number of total embryos that can be transferred. We can determine which stage to perform transfer during your initial consultation. During embryo transfer, we will use a special catheter to carefully deposit healthy embryos into the uterine cavity.
We can explain each of these steps in greater detail during an appointment. After IVF, you will return to our office and undergo a pregnancy test to determine if treatment was successful.
Who Are Typical IVF Candidates?
IVF treatment has helped a wide range of patients become pregnant. Typical IVF candidates are women who:
- Have Tubal Issues: Since IVF treatment involves fertilizing an egg outside of the body, the fallopian tubes are bypassed entirely. Women who are missing their fallopian tubes, or who have fallopian tubes that are blocked, will often turn to IVF to help them conceive.
- Suffer from Fertility Disorders: Disorders such as endometriosis (a condition in which tissue grows abnormally on the outside of the uterus) or polycystic ovary syndrome (a condition brought on by a hormonal imbalance) can prevent women from naturally conceiving a child. IVF can help women suffering from these conditions become pregnant.
- Experience Abnormal Ovulation Cycles: With the help of fertility drugs, IVF treatment can enable the controlled fertilization of a woman's eggs and cultivation of an embryo. If your ovulation cycle is abnormal, IVF can help you maximize the potential of your eggs.
- Do Not Produce Healthy Eggs: If you are unable to produce healthy eggs, IVF is still a potential treatment option with the use of donor eggs. These eggs will be fertilized with sperm from your partner or a donor.
- Have a Partner with Male Factor Infertility: If your male partner has a low sperm count or cannot produce healthy sperm, IVF may still be an option. In these cases, we can often use intracytoplasmic sperm injection (ICSI), a procedure where a single healthy sperm is used to fertilize an egg.
- Would Like to Undergo PGD or PGS: Preimplantation genetic testing for monogenetic/single gene diseases, PGT-M (formerly PGD) and preimplantation genetic testing for aneulploidy (formerly PGS) are available at Fertility Center of San Antonio. These preimplantation tests screen embryos to ensure they have the correct number of chromosomes and do not have the presence of specific single genes that cause disease. These tests increase your chances to have a healthy embryo.
If you are considering IVF treatment, we can review your candidacy during a personal consultation.
Is It Right for Me?
It is important to understand that IVF is not right for everyone. There are several conditions that can preclude you from IVF treatment. These include:
- Fibroid tumors
- Ovarian dysfunction
- Abnormal hormone levels
- Uterine abnormalities
IVF can also provide an opportunity for our doctors to detect genetic diseases that may impede your pregnancy or affect your child’s quality of life after birth. PGT-M and embryo biopsy can be used to examine a minimal number of embryonic cells to detect genetic abnormalities.
It is important to understand that if you are unable to produce healthy eggs of your own and are not open to the use of donor eggs, then IVF is not for you. Although IVF produces similar pregnancy rates for women of all ages, it is important to remember that women over the age of 40 may be at increased risk for miscarriage. We can discuss this risk with you and answer any questions you may have regarding pregnancy and age.
When performed by skilled fertility specialists, the risks of IVF in terms of your health are minimized. In addition to health risks, there are other risks to consider, including multiple pregnancies and the risk of failed treatment. Before undergoing treatment, we will help you prepare during a personal consultation and review common IVF success factors. We will also explain how your health, age, medical history, and other factors can affect IVF results.
If you are a candidate for IVF who plans to use your own eggs to carry a child to term, you may be a candidate for Nature’s IVF, also known as INVOcell™. This treatment differs from traditional IVF in that incubation takes place in the hopeful mother's vagina using an FDA-approved device instead of an incubator. Many choose this option because of its more affordable cost and high success rates. We can evaluate your candidacy for this procedure during a consultation.
Understanding the Treatment Process
IVF involves multiple steps. If you are using your own eggs, we will induce ovulation through specific hormone therapies at the beginning of your menstrual cycle. Ovulation induction stimulates the production of multiple eggs, rather than a single egg, since some eggs may not be successfully fertilized. Typically, our team will retrieve the eggs 34-36 hours after the final hormone injection, before ovulation can begin. A number of different retrieval techniques can be used, depending on your specific needs and condition, and the process usually lasts under half an hour.
After your partner’s sperm or sperm from another donor source are collected, we will separate the healthy specimens from the seminal fluid in our andrology and embryology laboratory. After the eggs and sperm have been collected, fertilization can be achieved in one of two ways. Standard IVF Insemination involves mixing healthy sperm with mature eggs and allowing them to incubate overnight. During an intracytoplasmic sperm injection (ICSI), a single healthy sperm is injected into each egg. If the male's semen quality or sperm count is affecting your ability to conceive, your doctor may recommend ICSI.
The embryo is transferred into the uterus three or five days after the egg retrieval, depending on your unique case. If treatment is successful, the embryo should implant in your uterus’ lining within six to ten days after the eggs are retrieved.
Success rates will vary from clinic to clinic, and the Fertility Center of San Antonio is proud to boast higher than average IVF success rates. We are happy to help you understand the success rates and more about the IVF process during a consultation.
The Benefits of IVF
IVF is an amazing treatment option that can help patients who suffer from several types of infertility. At Fertility Center of San Antonio, we use advanced diagnostic techniques to discover the cause or causes of each patient's infertility. Some patients pursue IVF after other treatments have been unsuccessful. Others undergo IVF as a primary treatment option based on their diagnosis. In both cases, this treatment option has demonstrated consistently high success rates at our clinic.
In addition to addressing several types of infertility, IVF provides some additional benefits. We provide preimplantation genetic diagnosis (PGD) and preimplantation genetic screening (PGS).
PGS testing screens the number of chromosomes in an embryo. This is performed in the laboratory after the egg and sperm have joined. PGS allows our specialists to select only embryos that have 46 chromosomes that are free from conditions like Down syndrome and Turner syndrome.
PGD tests for genetic defects in an embryo's individual genes. It can rule out embryos that have genetic defects that cause hemophilia, spinal muscular atrophy, Huntington's disease, and more.
Breaking Down the Success Rates
The process of choosing the right fertility clinic will be shaped by a number of factors, including the practice’s IVF success rates. At the Fertility Center of San Antonio, we are proud of our impressive record in helping our clients become parents. Understanding IVF success rates can be confusing at first, and at our San Antonio, TX, practice, we want to ensure that all our patients are fully educated on the IVF process. We have compiled some helpful tips on what the numbers mean in an IVF success report, and what to look for in the charts.
Total IVF Cycles Performed Per Year
Initially, you will want to verify that a fertility clinic is performing an adequate number of IVF cycles every year. The total number of cycles performed annually is a sign that the clinic is experienced and proficient in IVF. The general consensus is that a clinic should be averaging more than two cycles a week, or about 120 a year. At the Fertility Center of San Antonio, we perform over 500 IVF cycles a year, or about 10 a week.
Fresh vs. Thawed Embryos
During a fresh IVF cycle, a woman’s eggs are taken from the ovaries, inseminated in the lab, matured in an incubator, and implanted back into her uterus. In this case, the embryologist or doctor chooses the healthiest embryos for implantation.
A fresh cycle differs from a thawed embryo cycle, which uses frozen and thawed embryos. Success rates tend to be lower with thawed embryos compared to fresh embryos. Due to the extra steps involved in the freezing and thawing process, there is a greater potential for mishandling or damage to the embryos.
Non-donor vs. Donor Eggs
The majority of women will use their own eggs (non-donor) as part of an IVF cycle. Conversely, patients can use eggs donated from another woman. The decision to use donated eggs is often linked to age, and tends to be a more common practice for patients 40 and older.
Age-related Success Rates
In addition to identifying whether you will be using frozen, thawed, non-donated, or donated eggs, you will also want to identify your age group. Considerations about IVF and age include:
- Under 35: this group has the most favorable chances of IVF success
- 35-37: this segment still has favorable statistics for successful IVF results
- 38-40: this age group has a somewhat favorable IVF outcome; good statistics in this group are a strong sign of high quality care
- 41 and over: in this age category, fertility doctors may recommend egg donation, since IVF with non-donated eggs can be challenging
Percentage of Transfers Resulting in Live Births
The percentage of transfers resulting in live births is the best way to evaluate a fertility clinic's IVF success rate. This statistic indicates how many completed cycles resulted in a live birth - or pregnancy carried to term. This number excludes retrieval without transfers, or IVF cycles that were started but not finished for any number of reasons. The Fertility Center of San Antonio boasts success rates that are higher than the national average.
Choosing the right fertility clinic is the first step on your IVF journey. Patients need to feel comfortable with the professionals at the clinic, while knowing that the facility has a proven record of success. The Fertility Center of San Antonio offers both: professionals with a personal touch and impressive success rates.
Potential Risks of IVF
IVF has helped many hopeful parents realize their dreams, but it carries some risks that patients must first consider. Some IVF risks pose a threat to a mother's health, while others can lead to a more complicated pregnancy overall. For many patients, the risks of the procedure are well worth the potential benefits. Meanwhile, you can minimize your risks by choosing a reputable, credentialed clinic with an excellent track record.
Ovarian Stimulation Risks
In the first stage of IVF, our specialists administer fertility medication to stimulate egg follicles and cause the ovaries to release eggs. These medications can result in ovarian hyperstimulation syndrome (OHSS). Studies show that most women who undergo IVF experience mild symptoms of OHSS, such as nausea and headache. About 10% experience lower abdominal pain. In about 1% of cases, OHSS can become much more serious, resulting in symptoms such as blood clots and kidney failure. Our fertility specialists will carefully monitor you while you are taking fertility medications to ensure your safety.
Egg Retrieval Risks
Once our specialists have determined that the time is right, egg retrieval can begin. Risks of egg retrieval include:
- Pelvic infection
- Injury to the ovaries, other reproductive organs, or surrounding tissues
- Pain and soreness
We utilize advanced ultrasound technology to guide this process and minimize the risks associated with egg retrieval.
Embryo Transfer Risks
Once the eggs have been collected, they are joined with your partner's sperm or donor sperm in our laboratory. Once one or more embryos have been fertilized, they are transferred to the uterus. This process is performed using a catheter placed within the uterus. Embryo transfer risks can include:
- Cramping and discomfort
- Injury to the uterus or surrounding tissues
As with egg retrieval, we use ultrasound technology to make sure embryo transfer is performed safely. In a successful embryo transfer, one or more embryos will attach to the uterine wall and initiate pregnancy.
IVF Pregnancy Risks
The most common risk associated with IVF is multiple pregnancy. In the hopes that at least one embryo will lead to pregnancy, multiple embryos may be transferred to the uterus. Sometimes, more than one of these embryos attaches to the uterine wall and leads to multiple pregnancies. Multiple pregnancies are manageable, but they do pose specific risks to the mother, including:
- Hemorrhage and excessive bleeding
- Premature birth
- The need for Cesarean section delivery
- High blood pressure
- Gestational diabetes
We believe patient education is essential to IVF and all fertility treatments we perform, and we will take all the time needed to help you feel informed and comfortable with this process.
How Much Does IVF Cost?
If you are considering reproductive assistance, you likely have questions about the cost of your treatment options. You can learn more about our financing options and IVF cost during a consultation at our San Antonio practice.
Only a specialist can determine if you are a good candidate for IVF, and if it is the best fertility option for you. Our helpful, caring team is here to create a supportive environment where you can explore your options for expanding your family. We offer a wide variety of services in addition to IVF, including intrauterine insemination, intracytoplasmic sperm injection, and more.
Ultimately, deciding to undergo a fertility treatment is an investment. Our doctors personalize each treatment plan, and total cost will vary somewhat from patient to patient. It is important to keep in mind that some patients may require multiple treatments or other fertility therapy to conceive.
Nature’s IVF™: An Affordable Alternative
For the right candidates, we also offer a treatment called Nature’s IVF, also known as INVOcell™, in which the incubation phase takes place within the female partner's vagina using an FDA-approved device. Many hopeful parents are choosing this option not only because of its high success rates, but also because it costs less than traditional IVF. During a consultation, we can determine if this treatment can help you.
Financing Information for IVF Candidates
In order to make our services accessible to a wide range of patients, we accept several payment options. Furthermore, in cases where insurance will not completely cover the costs of fertility treatment, we work with a variety of lenders who offer IVF financing at our San Antonio, TX, practice.
We can review your insurance policy and determine your coverage during an initial consultation. If your insurance will not cover the complete costs of IVF, we have several financing plans to help you afford treatment.
- Active Duty Military Discount
- Livestrong Cancer Charities Member
Fertility Center of San Antonio is proud to proud to offer our Precision IVF Refund Program as an option to aid most of our pateints, guaranteeing a refund if you don't have a baby after IVF treatment. The Univfy Pre IVF Report is FREE of charge to our patients! Visit our Precision IVF Refund Plan page for more infomation
Now, patients without fertility coverage or those who have exhausted their coverage can take advantage of our new affiliation with WINFertility! Click here to learn more!
- Out of Town Monitoring Plan
For patients who are live out of town, we offer a unique payment plan option. Please give us a call for more details. Needing a hotel during your treatment at a special discounted rate?
- Monthly Payment Options
Available through our partnerships with Prosper Healthcare Lending and Lending Club Patient Solutions. These options allow qualified patients to cover the costs of IVF cycles or surgery with regularly scheduled payments. Please note that monthly payment plans are not offered directly through the Fertility Center of San Antonio. Rather, we work closely with patients to help them find a provider.
Selecting a Payment Option
We will be happy to explain the payment options that are available to you during a consultation. In addition to financing plans, we also proudly offer discounts to patients who are actively serving in the military. Since each treatment is personalized, the total cost of IVF varies from patient to patient. Whether you are insured or seeking third-party financing, our compassionate and knowledgable staff will work to identify an effective payment plan based on your personal goals and financial needs.
We strive to make treatment affordable for each of our patients, regardless of their budget. In addition to accepting all major insurance companies' coverage for fertility testing, we also offer several payment options including:
- The FCSA Package Plan, which has an 18-month enrollment period. This package includes the price of initial IVF treatment and discounts on subsequent treatments if they are required.
- The FCSA Refund Plan, available to qualified patients, which provides a refund to some patients if their IVF treatments are unsuccessful.
- Out of Town Monitoring Plan, a unique payment option for our out of town patients. Please give us a cal for more details.
We are also proud to offer an active duty discount for our patients who are actively serving in the military, and accept monthly payment options through approved financial institutions.
Learn More about IVF
If you have undergone previous fertility treatments but have failed to become pregnant, you may be a good candidate for IVF. We also offer a treatment called Nature’s IVF™, also known as INVOcell™, in which the incubation period takes place within the female partner's vagina using a special device. To learn more about which treatment is right for you, schedule an appointment by contacting the Fertility Center of San Antonio today.