+ What are the success rates for me?

This should be discussed with your fertility physician. Success rates vary based on type of treatment and depend on multiple factors, including history, test results, diagnosis and age.

+ Is infertility a medical problem related to women only?

Infertility is a medical condition that is found in both men and women, and men and women are affected almost equally. With men, declining sperm counts, testicular abnormalities, and decreased reach of climax are common causes of infertility.

+ How long should a couple try to conceive before going to the doctor?

The American Society for Reproductive Medicine recommends that a woman consults her health care provider if she is under 35 years old and has been trying to conceive for more than 12 months, or over 35 years old and has been trying to conceive for over six months.

+ Can you find out earlier if you have fertility issues?

You always have the option of asking your health care provider to conduct a complete examination to determine if either partner has possible fertility issues. You can also choose to do at-home fertility testing, available for both men and women.

+ Can I use my hot tub, sauna, or Jacuzzi® during treatment?

Avoid the hot tub, sauna, or Jacuzzi during treatment and once pregnant.

+ Can I exercise during my IVF treatment?

At the beginning of your IVF cycle, you may exercise as you normally do, but as you get closer to egg retrieval, we will ask that exercise be decreased for health and safety reasons.

+ Can I have a manicure or pedicure during my IVF treatment or pregnancy?

Having a manicure or pedicure will not cause any harm during IVF treatment or pregnancy. We do advise that you make sure your nails are treated in a well-ventilated area.

+ Can I get a body massage during my treatment or cycle?

Yes, but let the therapist know that you are in treatment or pregnant beforehand.

+ Can I travel during my IVF treatment?

Please discuss with your coordinator to set up local monitoring and schedule your visits to our clinic in Orange County.

+ Zika Virus concerns?

Please let your IVF team know if you have recently had or are planning any such travel and review the latest CDC guidelines for more information.

+ Can I drink coffee or other caffeinated beverages during treatment?

Limit caffeinated beverages per day during treatment and when pregnant.

+ Can I have a glass of wine during my cycle?

We recommend that you limit drinking during treatment and avoid drinking alcohol once you are pregnant.

+ Can I eat fish/sushi/unpasteurized cheese/dairy?

We recommend cooked/pasteurized foods and low-mercury fish during pregnancy.

+ Women who are trying to conceive should boost their intake of what vitamin?

Folic acid. Women trying to conceive should add a supplement of at least 600 mcg of folic acid, either alone or as part of their prenatal vitamins to decrease the risk of fetal malformations. Folic acid may also decrease the risk of a miscarriage. The folic acid supplement should be started at least one to two months prior to conception to maximize its efficacy.

+ Should I stay on all my prescribed medications during my treatment?

You should have discussed with your physician all medications that you are currently taking prior to starting treatment, but typically you can remain on most medications unless specifically asked to stop.

+ When will I get my period after OCP (birth control pills)?

Normally, two to five days after the last pill; if no period, please contact your nurse.

+ Why am I prescribed the drug Lovenox®?

Like the better-known drug heparin, Lovenox is a blood thinner. It has some advantages over heparin of needing only a single injection per day and less monitoring. We prescribe Lovenox whenever there is potential need to prevent excessive blood clotting. In principle, this occurs in our specialty in a few situations:

(i) You have an increased risk of clotting due to your medical history or due to high hormone levels following ovarian stimulation, as happens in cases of ovarian hyperstimulation syndrome (OHSS)

(ii) If you have been diagnosed with thrombophilia, which means you have a clotting disorder, which increases the risk of blood clot formation;

(iii) In association with certain immune abnormalities, which have been associated with increased risk of miscarriage and other pregnancy related complications

In other medical specialties, there are other indications for this medication.

While the drug in prophylactic dosages (which is what you will receive) is very safe, since it is injected under the skin, you may bruise at the injection sites.

+ Is it okay if I take my trigger shot (hCG/Ovidrel®/Lupron) a few hours late tonight?

NO! Trigger shot prior to egg retrieval is the one medication that is quite time-sensitive. We recommend setting an alarm and reminders for yourself to take at the exact time you are advised. If you take your trigger shot at a different time than advised, please contact your nurse or the nurse on call, as your egg retrieval time may need to be changed.

+ How do I mix and inject fertility medication??

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+ Why should I use intravenous gamma globulin (IVIg)?

West Coast Fertility recommends the use of IVIg only rarely. This is our center’s position not only because of the extraordinarily high costs of this medication (often not covered by insurance because considered “experimental”) but also because we believe that most patients with immune problems can be treated with less involved and less costly treatments. We, therefore, in principle recommend IVIg only if:

(i) Our standard treatments to address presumed immune problems have failed;

(ii) Immune problems are very severe;

(iii) Excessive class II HLA compatibility between husband and wife has been diagnosed;

(iv) With diagnosis of an implantation rash;

(v) If a rare implantation problem is suspected;

IVIg is widely considered experimental (off-label) treatment for all of these conditions and, therefore, requires the signing of a special consent. The drug is, however, widely used in medicine for a variety of immunological conditions and, if administered properly (by slow IV infusion), considered very safe.

To save costs, some centers have increasingly been using a drug, called Intralipid® in place of IVIg. While West Coast Fertility offers Intralipid for cost reasons, we do not recommend it in replacement of IVIg.

+ Can I drive myself home after my embryo transfer?

Most transfers do not include anesthesia so you are able to drive yourself home. If your transfer does include anesthesia (which is not very common), you will need a responsible person to drive you home. (No Uber, Lyft, taxi will be permitted.)

+ Is an egg retrieval painful?

No, it is done under anesthesia (sedation).

+ Is bleeding expected after egg retrieval?

Light bleeding and cramping should be minor and most likely be less intense than your regular period.

+ How does a semen analysis work?

Prior to the semen analysis, men should avoid ejaculating for 2-3 days before their appointment. If the sample is being taken at the doctor’s office, they will take you to a private room to help you relax.

+ Can I bring my partner’s sample for him?

In order to maintain appropriate chain of custody, your partner will need to bring his sample himself with a valid photo ID, or unfortunately the sample cannot be accepted.

+ Is it okay for me to carry my toddler while on stimulation medication?

Yes.

+ What happens if I become pregnant?

Once pregnancy is confirmed, you will continue to see your fertility physician for blood testing and an ultrasound to confirm pregnancy is progressing smoothly. Once the fetus heartbeat has been verified, you’ll be referred to an OBGYN for the rest of your pregnancy.

+ Why are my partner and I being HLA (tissue) typed?

We recommend HLA (tissue) typing only in rarely occurring circumstances, primarily in cases of unexplained and/or immunologic spontaneous repeated pregnancy loss, especially if you developed an “implantation rash” during a prior early pregnancy or after embryos were placed inside your uterus.

This “implantation rash” primarily occurs in couples, who genetically (per their HLA types) are “similar,” i.e., share so-called class II HLA loci. Another characteristic of such couples is that the female often demonstrates autoimmune abnormalities in her blood and/or suffers from severe allergies.

While still a somewhat controversial issue, it is generally believed that excessive sharing of class II HLA between husband and wife increases the risk for miscarriages since the “reprogramming” of the female’s immune system, required for normal pregnancy, does not occur normally.

If you and your partner excessively share class II HLA loci, you may need additional treatments to reduce your risk of miscarriages.