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Frequently Asked Questions


Common Questions about IVF


What is Intracytoplasmic Sperm Injection (ICSI)?

The purpose of ICSI is to assist the fertilization process when a man’s sperm count is abnormal. Whether it is because the number of motile sperm is very low or the morphology is excessively poor, the technique involves the delivery of a single sperm into a single egg.

Dr. Gago recommends to all patients undergoing IVF to improve fertilization outcomes.


Do I need preimplantation genetic testing?

Preimplantation Genetic Testing (PGT) - embryos can be screened to detect chromosomal abnormalities (wrong number of chromosomes) that may lead to miscarriages, an abnormal fetus, or abnormal embryos which do not implant. PGT can detect genetic conditions such as Trisomy 21, or Down syndrome, and Trisomy 18, known as Edwards syndrome. After the PGT report comes back to the Embryologist, the embryos free of genetic defects are selected for transfers. Preimplantation genetic testing not only lowers the risk of parents passing on a genetic disorder to their child, it also increases the possibility of a healthy pregnancy and successful birth through IVF with embryos free of genetic defects. By choosing the embryos with normal chromosomes, the hope is to improve the chance of having a healthy baby. We also offer PGT-M for monogenic/single gene defects and PGT-SR for people with chromosomal rearrangement, Our fertility specialist can discuss PGT more in depth at your visit.


How many embryos should I have transferred?

The objective of infertility treatment should be the birth of a single, healthy child. Many of the treatment options presented to infertile couples, however, are associated with higher risks of multiple gestation. Moreover, many couples view multiple gestation as desirable and are unaware of the risks they pose to both mother and babies. Couples should understand these potential risks before starting treatment.

The ability to limit the number of ebryos transferred is an effective approach to limit multiple pregnancies. The Society for Assisted Reproductive Technology (SART) and the American Society for Reproductive Medicine (ASRM) have published guidelines recommending an optimal number of embryos for transfer based on patient age, embryo quality, and other criteria.


What is Assisted Hatching?

Hatching of the blastocyst is a critical component of the physiologic events culminating in implantation. Conversely, the failure to hatch may be one of the many factors limiting human reproductive efficiency. The clinical application of assisted hatching has been proposed as one approach toward the enhancement of implantation and pregnancy rates following in vitro fertilization.

The assisted hatching procedure entails the creation of a gap in the outer area of the embryo called the zona. This is done either by drilling with an acid medium, by laser, or by using a piezomicromanipulator.

Success rates following the use of assisted hatching in different ART programs have varied considerably. Well-designed studies suggest that assisted hatching might be best used in patients over 38 years old or with multiple prior failed IVF cycles.


Does In Vitro Fertilization Work?

Yes. IVF was introduced in the U.S. in 1981. Since 1985, when we began counting, through the end of 2006, almost 500,000 babies have been born as a result of reported Assisted Reproductive Technology procedures (IVF, GIFT, ZIFT, and combination procedures). IVF currently accounts for more than 99% of ART procedures. The average live delivery rate for IVF in 2005 was 31.6 percent per retrieval.


What is In Vitro Fertilization? 

In IVF, eggs are surgically removed from the ovary and mixed with sperm outside the body in a Petri dish.  After about 40 hours, the eggs are examined to see if they have become fertilized by the sperm and are dividing into cells.  These fertilized eggs (embryos) are then placed in the women’s uterus, thus bypassing the fallopian tubes.


Common Questions about Infertility

How is infertility diagnosed? 

Couples are generally advised to seek a fertility evaluation if they are unable to achieve pregnancy after a year of unprotected intercourse trying to conceive.  The doctor will conduct a physical examination of both partners to determine their general state of health and to evaluate physical disorders that may be causing infertility, then more specific tests may be recommended. For women, these include an analysis of blood work taken, pelvic ultrasound and Hysteroscopy/SIS. For men, initial tests focus on semen analysis.

If no cause can be determined at this point, more specific tests may be recommended.  For women, these include an analysis of blood work taken, pelvic ultrasound and Hysteroscopy/SIS.  For men, initial tests focus on semen analysis.


What causes infertility?

The most common male infertility factors include azoospermia (no sperm cells are produced) and oligospermia (few sperm cells are produced). There are also times where sperm cells are malformed or they die before they can reach the egg. In rare cases, infertility in men is caused by a genetic disease such as cystic fibrosis or a chromosomal abnormality.

The most common female infertility factor is an ovulation disorder.  Other causes of female infertility include blocked fallopian tubes, which can occur when a woman has had pelvic inflammatory disease or endometriosis.  Congenital anomalies (birth defects) involving structure of the uterus and uterine fibroids are associated with repeated miscarriages.


What is infertility? 

Infertility is a disease of the reproductive system that impairs one of the body’s most basic functions: the conception of children. Conception is a complicated process that depends on many factors: on the production of healthy sperm by the man and healthy eggs by the woman; unblocked fallopian tubes that allow the sperm to reach the egg; the sperm’s ability to fertility the egg when they meet; the ability of the fertilized egg (embryo) to become implanted in the woman’s uterus; and sufficient embryo quality.

Lastly, for the pregnancy to continue to full term, the embryo must be healthy and the woman’s hormonal environment adequate for its development.  When just one of these factors is impaired, infertility can result.

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