How to Plan for an In Vitro Fertilization

The science of fertility has come a long way from the first "test-tube babies" of the late '70s. For couples who have not been able to get pregnant using other methods, in vitro fertilization (IVF) is a last resort. In IVF, the egg is fertilized in a petri dish and then implanted in the woman's womb. Couples choosing this expensive procedure--costing upwards of $12,000 for each attempt--realize that the odds of success are against them. Yet, the chance of having a long-dreamed-for child makes it all worth it.

Instructions

Difficulty: Moderately challenging

1. Ask your OB-GYN for a referral to a reputable fertility clinic or get recommendations from friends and family if possible. Research local centers on the Internet.
2. Find out if your insurance covers the procedure. Be prepared to pay, by check or credit card, whatever portion of the procedure your insurance doesn't cover. Ask about financing plans.
3. Get tested for any discernible cause of infertility in both the man and the woman. Men will have their sperm tested for quantity, motility and morphology (structure). Women will have their hormones tested and will be examined for any other possible cause, such as endometriosis. Other medical issues must be resolved before IVF can begin.
4. Understand exactly what is required while taking daily injections of hormones (such as Pergonal or Repronex), which stimulate egg production in the ovaries. Ask about possible side effects.
5. Speak frankly with both your doctor and your spouse about the likelihood of multiple births. Since more than one viable embryo is implanted at a time to increase the chances that any will survive, there is a high chance that multiple births will result.
6. Discuss the timing of all phases of the procedure with your physician. After the injection phase, the woman's eggs are harvested, fertilized by the man's sperm, and then incubated. The doctor then implants the healthiest embryos into the woman's womb. After the implantation, the woman must be on complete, immobile bed rest for 24 to 48 hours.
7. Inject progesterone daily for the two weeks following implantation to prepare your uterus for pregnancy.
8. Take a pregnancy test. If it's positive--congratulations! Now read 254 Prepare for a New Baby and 250 Budget for a New Baby.
9. Prepare for the possibility of disappointment ahead of time. The success rate of any given attempt ranges dramatically depending on the woman's age. Your financial situation will play a large part in determining how many times you can try. Unsuccessful attempts can be devastating to both of you. Would-be parents can find support and resources at Resolve.org, the national infertility organization.
10. Investigate other options should IVF prove to be unsuccessful. In ICSI, a related procedure, sperm is injected into the egg rather than simply injected into the egg's environs. Couples who have waited too long might consider using an egg donor or a surrogate mother. Adoption is another course of action (see 258 Organize an International Adoption). Couples dealing with the intense emotional storms that infertility issues create can contact Resolve.org for support and resources.

Tips & Warnings

• When looking for a fertility doctor, check the Centers for Disease Control Web site (www.cdc.gov), which maintains statistics on infertility clinics' success rates.
• Your partner (or a very close friend) will need to become proficient in giving injections.
• Be aware that the drugs and the procedure are billed separately.
• Although it is unlikely that all the embryos will survive, twins and triplets occur in about one-third of all IVF pregnancies. If more than that number of eggs have been successfully fertilized, the couple, together with their doctor, must decide whether to freeze the extra embryos, discard them, make them available for research, or donate them to another infertile couple.