All4Baby » IVF https://all4baby.co.za From Pregnancy to birth to baby and beyond. The place to find, chat, and share. Fri, 04 Jul 2014 10:55:59 +0000 en-US hourly 1 http://wordpress.org/?v=394 What to expect from IVF https://all4baby.co.za/falling-pregnant/infertility/1203/expect-ivf/?utm_source=rss&utm_medium=rss&utm_campaign=expect-ivf https://all4baby.co.za/falling-pregnant/infertility/1203/expect-ivf/#comments Thu, 03 Jul 2014 08:07:58 +0000 https://all4baby.co.za/?p=1203 They are words that no infertile couple wants to hear: “Your best option for having a baby is IVF”. Robyn Wolfson Vorster explains what you can expect from the IVF process.

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In vitro fertilisation (IVF), words to strike fear into the bravest hearts. But, what does it mean and how can you navigate the process?

IVF is a medical technique used for couples experiencing a variety of infertility problems—in particular, male factor problems, endometriosis, advanced maternal age or blocked or damaged fallopian tubes.

Here is an explanation of the process:

Before you begin

Before you start, the doctor will complete a thorough diagnostic and treat you and your partner for any conditions that might compromise your fertility (including medical conditions like auto-immune problems or elevated sugar levels, lifestyle issues like a high BMI, smoking or excessive alcohol intake, and emotional conditions like stress).

If the doctor diagnoses IVF as a solution for your fertility problems, you and your partner will need to assess the cost and emotional challenges of the process and decide if it is right for you to go ahead.

The IVF process

If you choose to begin IVF, the doctor will determine which programme is best for you (either short course or long course IVF—these differ in duration but contain many of the same elements).

The clinic staff will then create a detailed, patient-specific programme for you which usually includes the following stages:

1. First Scan

IVF begins with a scan to establish the state of the lining of your uterus.

2. Hormone injections

If the doctor is happy with the results of the scan, you will begin hormone injections.

These can be self-administered but if the thought of injecting yourself is stressful, ask your partner for help or visit your clinic or pharmacy daily and request that the nurse does them for you.

Typically, there are two sets of injections and the timing of administering them depends on your programme. They are:

  • A GnRH Antagonist which is given subcutaneously. This injection is designed to take control of your cycle, suppress the release of the body’s hormones and prevent premature ovulation.There are very few related side effects but some women do report headaches and hot flushes.
  • A FSH or FSH/LH injection, given subcutaneously or intramuscularly. This is designed to hyperstimulate the follicles in the ovaries to produce as many eggs as possible. You may feel bloated and uncomfortable so try to drink lots of water.

3. Follicle scan

After five days of the FSH or FSH/LH injections, the clinic will scan you to determine the number and size of the egg follicles.

Usually the follicles are small at the first scan. If so, you will continue hormone injections and scans until the biggest follicle reaches 18mm or more in size.

4. Ovulation injection

This injection(which can again be self-administered) is usually given at a specific time in the evening.

Egg retrieval will then take place 38 hours after the ovulation injection—about eight hours before the egg is due to be released from the ovary.

5. Aspiration

The clinic will tell you what time to check into the clinic for the egg retrieval.

The procedure is only about 15 to 20 minutes but takes place under strong sedation, so plan to take the day off work.

The doctor will retrieve the eggs and your partner will produce a sperm sample to fertilise the eggs. When I woke up from the procedure, the number of our eggs was written on my hand (clinics know that women need details and their partners are often bad at remembering or communicating them).

This can be an emotional day because your hopes and expectations are linked to the number of eggs and how mature they are.

Ask your partner to drive you home and be available to support you if the news is bad.

6. Embryo fertilisation (naturally or through ICSI)

Once the eggs are retrieved, the laboratory scientist will place them in a dish along with the sperm. The dish is put in an incubator where fertilisation occurs.

If necessary (usually when there is male infertility or when fertilisation has failed to occur or has occurred abnormally in the past), the lab will use ICSI (intracytoplasmic sperm injection) to fertilise the eggs. During ICSI, the lab will select and then inject a single sperm into a single mature egg.

7. Embryo development (the waiting period)

The clinic will decide when to do the embryo transfer (either on day three or five after aspiration). In the period between aspiration and transfer you will phone the clinic every day to get an update on the growth of your embryos.

This can be a very stressful time, especially if the embryos are poor quality. Remember that stress at this point can no longer affect your embryo quality but it can impact negatively on your experience of IVF as well as your emotional preparedness for the embryo transfer and early pregnancy.

If you are feeling overwhelmed, it is best to seek some help.

8. Embryo transfer

The clinic will schedule a time for the embryo transfer. This is a minor procedure, not requiring an anaesthetic.

Before transfer, the clinic will talk about the number and quality of embryos and give you a more accurate estimate of the likely success of the procedure.

Depending on the quality of the embryos, this may be an emotional and challenging day but do try to stay hopeful.

9. Waiting stage

Following the transfer, you will be given medication to maintain a healthy uterine lining which will result in heightened emotions and symptoms that resemble pregnancy.

Symptoms can include; tender breasts, bloating and frequent urination. This is a period of high stress where emotions can vacillate wildly from hope and optimism to despair.

Try to keep busy and not attempt anything too physically or emotionally strenuous during this time.

10. Pregnancy test

This takes place 11 days after the transfer. The clinic will perform a blood test and then communicate the results.

If the test is positive (and I sincerely hope it will be), you will continue on your medicine and return to the clinic for regular scans. Many clinics will continue to care for you through the first trimester following which you can see an obstetrician.

A negative result can be devastating though. It is common to go through all of the stages of grieving: shock, disbelief, numbness, anger, depression and lots of “why” questions. This is normal but friends and family may not understand so it may be a good time to seek external help (especially if you find that you cannot move on).

Hard as it is, it is also important to speak to your doctor about factors that may have contributed to the failure,as well as next steps.

Having a plan can make the difference between depression and continued hope.

Top tips

1. Cost

IVF is expensive – leading clinics quote between R35 000 and R50 000 per IVF cycle depending on the procedures used (this excludes medication).

Although semi-government hospitals offering IVF may be cheaper, you will still need to budget for it or obtain IVF-specific finance (speak to your clinic about options).

South African medical aids don’t fund IVF but pressure groups continue to lobby them so watch this space.

2. Your emotions

IVF is very stressful. Be sure to set up a good support structure and if necessary seek professional help to cope with it successfully.

3. Readying yourself

Prepare well. Infertility experts understand that a large number of factors contribute to a couple’s success with IVF. Try to make any necessary health, psychological and lifestyle-related changes prior to the treatment to maximise your chances of success.

About the Author: Robyn Wolfson Vorster is a writer, survivor of IVF and a passionate adoption advocate.  She is mom to a biological son (7), an adoptive daughter (2) and two step-daughters in their twenties.

Acknowledgements: Medical content derived from Medfem clinic and Vitalab. With grateful thanks to Mandy Rodrigues for the content about how you will feel.

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Avos and olive oil may boost success of fertility treatments https://all4baby.co.za/falling-pregnant/infertility/1135/avos-olive-oil-may-boost-success-fertility-treatments/?utm_source=rss&utm_medium=rss&utm_campaign=avos-olive-oil-may-boost-success-fertility-treatments https://all4baby.co.za/falling-pregnant/infertility/1135/avos-olive-oil-may-boost-success-fertility-treatments/#comments Mon, 30 Jun 2014 09:33:37 +0000 https://all4baby.co.za/?p=1135 A diet rich in olive oil and avocados may boost the success of IVF treatments in women.

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For women trying to get pregnant through IVF treatments, a new study finds that eating avocados and olive oil might boost their chances of success.

Dr. Jorge Chavarro and colleagues at the Harvard School of Public Health in the US looked at how intake of different types of fats affected success of IVF treatment in 147 women, mostly in their 30s.

Mediterranean diet triples success

Findings revealed that diets rich in foods typically eaten as part of the Mediterranean diet, including sunflower oil and nuts and seeds, tripled the chances of success for women having the fertility treatment.

Saturated fats lead to fewer good eggs

In contrast, women who ate mostly saturated fat, found in dairy products and red meat, produced fewer good eggs for use in fertility treatment. High saturated fat intake has already been linked to lower sperm counts.

The best kinds of food to eat

“The best kinds of food to eat are avocados, which have a lot of monounsaturated fat and low levels of other sorts of fat, and olive oil,” said Chavarro. He said the study was small and more research is needed before clinical advice can be given to women. “While these results are interesting, this is the first time to our knowledge that dietary fats have been linked to treatment outcome in IVF.”

Coffee reduces success

Another new study presented at the same conference found that women who reported drinking five or more cups of coffee a day at the start of IVF treatment reduced their chance of success by 50 percent. The Danish researchers described heavy coffee drinking as being “comparable to the detrimental effect of smoking.”

(AFP Relaxnews)

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Is adoption for you? Five questions for infertile couples to consider https://all4baby.co.za/falling-pregnant/infertility/849/adoption-five-questions-infertile-couples-consider/?utm_source=rss&utm_medium=rss&utm_campaign=adoption-five-questions-infertile-couples-consider https://all4baby.co.za/falling-pregnant/infertility/849/adoption-five-questions-infertile-couples-consider/#comments Tue, 03 Jun 2014 08:40:14 +0000 https://all4baby.co.za/?p=849 Is adoption the right option for you? Adoption advocate, Robyn Wolfson Vorster shares her experience and lists the five questions you need to answer before embarking on the adoption route.

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I will always remember that moment. It was the day before we discovered that our fifth and final attempt at IVF had failed. We were celebrating my husband’s birthday when the thought popped (unbidden) into my head, “what will you do if this one fails too?” The answer was simply, “I don’t know.”

I adored my son (conceived miraculously from the only embryo we produced in our first attempt at IVF) and my step-daughters,but the thought of not having any more children was devastating.

Here I was, driven, goal-oriented and time urgent (the typical infertility profile) and for the first time, I was without a plan.

It is only now, four years later that I’m grateful there was no plan B. At the time, adoption was not an option for us because my husband wasn’t keen. So, I had to fully grieve the loss of the daughter I had dreamt about, the little girl with my features and my husband’s temperament that I was planning to conceive and birth.

Little did I know that in letting go of her, I was preparing for the daughter I was intended to have—the one we adopted. She is two now and everything I had hoped for, and more.

Adoption was definitely the right option for us. But is it for you? Ask these five questions to find out.

Question one: Are you emotionally ready to adopt?

Some people recover quickly from the struggle with infertility. For others, moving on from the failure is a prolonged and painful process (this is often a function of how long you struggled and how devastating the loss was). For the latter group, rushing to adopt can make coming to terms with your new family much harder. Emotional preparedness is essential if you want to avoid post-adoption depression or attachment problems.

My top tips for preparing emotionally are:

  1. Take time to mourn the loss of the biological child you hoped for. Your grief is completely valid and creating a memorial (for me it was a memory box), going for counseling, obtaining spiritual support or finding creative outlets are all options for dealing with it.
  2. If the grief of a failed fertility procedure is still raw or you are finding it hard to move on, consider getting some help.
  3. Process these questions as honestly as you can:
  • Are you ready to parent a child who is different from the picture that you have in your head?
  • Can adoption be the best and most perfect option for your family or is it just plan B?
  • What are your motives for adoption? We have all heard people say, “adopt, then you will definitely fall pregnant.” It does happen, sometimes. But if that is part of your thinking, it is best to acknowledge it. At the end of the adoption process you will have a son or daughter but if that doesn’t lead to biological children too will you be content with your family?

Question two: Do you and your partner both want to adopt?

If you have a partner, this is one of the first questions that your social worker will ask. You will be co-parenting so you need to be in agreement before you proceed.

The 18 months I waited for my husband to choose adoption were unbelievably hard but in the end,a child’s life and our family’s happiness were at stake so it was well worth the wait.

Question three: Are you ready for the process and the wait?

The adoption process is actually not as long and invasive as some people make it out to be. In fact, it took eleven months for our social worker to screen us and find us a baby, exactly the same amount of time as it took me to conceive my son through IVF and carry him to term.

But at the time, it felt excruciating, especially after all our years of infertility.I therefore encourage woman to be prepared for the process and the wait, and to remember that as a rule of thumb, the more specific you are about the child you want, the longer it is likely to take.

On the plus side though, while the adoption screening is intensive and requires time, honesty and self-disclosure, there are no internal examinations!And, unlike the majority of my IVF attempts, we actually got a child at the end of it.

Question four: Is trans-racial adoption an option for you?

The media is full of adoption stories involving white, coloured and Indian children but in truth these are quite rare. Because of South Africa’s demographics, the vast majority of adoptable children are black. For this reason, most agencies either have strict criteria for same-race adoptions or a closed list (that is, they will not accept new applicants). So, if  you are only willing to adopt a white, coloured or Indian child, it’s best to prepare for a long wait or for disappointment.

However, if you are prepared to adopt trans-racially (or are a black family wanting to adopt) and you are approved, you are certain to get a child, and relatively quickly.

Question five: Can you love your adopted child as much as a biological child?

This was the first question I asked my husband when we decided to adopt. He is a wonderful dad and I knew that if he didn’t love our adopted daughter as much as his biological children, I would know, and so would she. Turns out I had no reason to be concerned. He was committed, and from the first moment he held her and she snuggled into his arms,he knew that he would take a bullet for her. In the end, love is a choice and when it comes to children—biological or adopted—it isn’t a hard one.

About the Author: Robyn is a writer, survivor of IVF and a passionate adoption advocate.  She is mom to a biological son (7), an adoptive daughter (2) and two step-daughters in their twenties.

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Infertility lingo explained! https://all4baby.co.za/falling-pregnant/infertility/671/infertility-lingo-explained/?utm_source=rss&utm_medium=rss&utm_campaign=infertility-lingo-explained https://all4baby.co.za/falling-pregnant/infertility/671/infertility-lingo-explained/#comments Fri, 16 May 2014 09:05:49 +0000 https://all4baby.co.za/?p=671 More and more couples have to deal with infertility at some stage. Are you struggling with permanent, secondary or sub-infertility? We decode the lingo.

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An infertility diagnosis usually comes after a couple has been having unprotected sex for more than a year without falling pregnant. If you have been actively trying for that long, it is a good idea to make an appointment with your gynaecologist for further testing.

Permanent infertility

Unfortunately, this means that a couple is unable to achieve natural conception at all. Ulterior conception methods, such as in vitro fertilisation (IVF) usually follows a permanent infertility diagnosis.

The following conditions may cause permanent infertility;

  • Polycystic Ovarian Syndrome (PCOS)
  • Endometriosis
  • Problems with Ovulation
  • Poor egg quality
  • Problems with a woman’s fallopian tubes

Secondary infertility

This diagnosis is given to couples who struggle to fall pregnant after already having conceived a child. Secondary infertility is usually a tough pill to swallow after a previous uncomplicated conception and pregnancy.

The causes of secondary infertility are usually the same as primary infertility. These issues have just developed after you have had your first child.

Sub-infertility

A Sub-infertility diagnosis is given to couples who are less fertile than the average couple. Being diagnosed with sub-fertility doesn’t mean that you won’t be able to conceive, it just means that the road to conception will be a little longer (and harder) for you.

Where does the problem lie?

It’s a common misconception that fertility problems lie only with the woman. But, research shows that 30% of the time, it’s actually the man that is the problem. Another 30% is attributed to the woman’s inability to fall pregnant, while the remaining 40% goes to a combination of both the woman and man having fertility problems.

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