When looking for an IVF treatment or clinic, all patients need to ask themselves a few basic questions:

• Is this treatment the best method for me ?
• What are the benefits of this treatment ?
• What are the disadvantages of this treatment ?
• What medications would I need to use (and the risks associated with them) ?
• What is the cost of treatment ?

The chart below provides answers to all these questions to help patients understand which method is the right one for them.

Step 1: Ovary Monitoring & Stimulation

First we must monitor the woman's ovaries to see how many follicles are present. Follicles are fluid filled sacs where the egg grows in the ovary and typically only one egg grows in each follicle. The first monitoring appointment provides a baseline of a woman's cycle and allows the doctor to evaluate her ovarian condition and to create an individualized treatment plan for the patient. Afterwards the doctor may prescribe fertility medication to increase the number of follicles and aid in maturation of the follicles. We here at Life IVF Center specialize in Natural cycle and Minimal Stimulation IVF treatment, where we provide patients either with no medication or minimal amount of medication to grow better quality eggs. These treatment methods help reduce the risks associated with many of the fertility drugs such as: weight gain, hormonal changes, and ovarian hyper-stimulation syndrome (OHSS),

Step 2: Egg Retrieval

After several monitoring we are able to track when the woman is ready to ovulate. She will then be instructed to use an ovulation triggering medication (such as Lupron) at a specific time so the egg(s) will be ready for the Egg Retrieval procedure. Egg Retrievals are time sensitive and specific; it is crucial that the instructions from the doctors and nurses are followed accordingly. If medication is administered not at the prescribed time, it will affect when the Egg Retrieval procedure will occur.

Step 3: Sperm Collection

Once an Egg Retrieval procedure has been performed and there are confirmed eggs, a sperm collection will occur. At Life IVF Center, we offer several options for those who are unavailable to provide a fresh collection; such as sperm freezing or the use of sperm donors. The use of sperm donors must be arranged far in advance to an Egg Retrieval procedure.

Step 4: Fertilization

Once sperm has been collected, it will be washed, analyzed and prepped for fertilization at our on-site IVF lab. Patient's have two options to fertilize the egg(s), IVF or ICSI. The IVF method is the well known concept where the sperm is placed in a dish with the egg, and the strongest sperm will be the one to penetrate and fertilize the egg.

ICSI (Intra-cytoplasmic Sperm Injection) is a manual method that is becoming more popular, but does require a rightly skilled embryologist to perform. The embryologist carefully selects the best individual sperm and then manually injects the sperm into the egg with a super-fine needle to create a fertilized egg. The sperm selection process performed by the embryologist is very important to the success of the embryo. The embryologist will first wash the sperm and remove the dead sperm, and then perform a sperm "swim contest" in order to choose the best "swimmer" as the winner. The "winner" will then be examined microscopically to ensure it is a normal shaped sperm. We here at Life IVF Center have the best ICSI fertilization rate in the country. Both of our Senior Embryologist, Molly and Andrew, currently have ICSI fertilization rate of 98%, well above the national average.

Step 5: Culturing and Cryo Preservation

After the embryo has been created through fertilization, our on-site IVF lab, will routinely culture the embryo to a day-5 blastocyst stage. We here at Life IVF Center believe that culturing an embryo to the day-5 blastocyst stage helps to select the best quality embryo for transfer and increases the odds of success for our patients. In addition, it also allows for an embryo biopsy to be performed for genetic testing screening, which helps to select normal embryos for transfer; significantly increasing the pregnancy rate and decreasing the miscarriage rate.

For a small subset of patients, we may let patients undergo a Fresh Embryo Transfer, meaning the embryo will be transferred in the same cycle it was retrieved. However for most of our patients we do recommend a Frozen Embryo Transfer, which has recently been shown to improve pregnancy rate. There are 4 main reasons why frozen embryo transfers produce better pregnancy rates:

• During the egg retrieval cycle, fertility drugs are used to promote follicle growth, which may have negative effects on the uterine lining.
• During the egg retrieval cycle, fertility drugs are used to promote follicle growth, which may have negative effects on the uterine lining.
• The growth of an embryo in laboratory conditions is slower than in the body, so often the in lab embryo growth does no synchronized with uterine condition.
• In the past, the Fresh Embryo Transfers had better results because the method used to freeze embryos was not optimal. With the new Vitrification method, the embryo survival rate after thawing is close to 100%.)

Step 6: Embryo Transfer

The final step in IVF is the Embryo Transfer procedure. Patients have the choice of doing either a Fresh Cycle Embryo Transfer or a Frozen Embryo Transfer. With the Fresh Cycle Embryo Transfer, the Embryo Transfer procedure usually occurs a few days after the Egg Retrieval procedure after the woman has been given progesterone supplements to aid in the thickening of the uterine lining. For the Frozen Embryo Transfer, we offer patients two options; Natural Cycle Embryo Transfer or Hormone Replacement Embryo Transfer. For Natural Cycle Embryo Transfer we monitor follicular growth early in the woman's cycle and after ovulation has occurred, we thaw an embryo and transfer it 6 days after ovulation. For Hormone Replacement Embryo Transfer, we start a woman early in her cycle on estrogen to help build the uterine lining. When the uterine lining reaches optimal thickness she will begin a progesterone treatment for 6 days. After the 6 days, the embryo transfer will then occur. At Life IVF Center we strongly recommend single embryo transfers because we believe singleton pregnancies are safer and provide the mother a better chance to have a healthy baby. We will consider transferring two embryos for those who prefer a twin pregnancy.

Tubal Blockage

Fertilization occurs in the fallopian tube, the highway for the eggs to the uterus. So if a woman has a blocked or damaged fallopian tube the egg will not be able to be fertilized, let alone travel to the ovary. Tubal blockage can result from STI's, pelvic inflammatory disease, or tubal ligation (sterilization) surgery. This is usually the easiest infertility issue to overcome for a woman, if this is their primary cause of infertility, as IVF provides the means for the egg to be fertilized and then transported to the uterus. Surgery is also an option to clear the tubal blockage, but there is always a chance scar tissue may result, which could still make it difficult for an egg to travel through. Even though it is the easiest infertility issue to overcome, like male infertility, there are no symptoms that indicate there is tubal dysfunction until a couple tries to conceive and will find out after examination.

Endometriosis

Endometriosis is a condition where the uterine lining, endometrial tissue, grows in areas outside of the uterus. Endometriosis can be difficult to diagnosis because there can be no symptoms or symptoms that may be mistaken for other conditions. But common symptoms include painful periods, pain during intercourse, chronic pelvic pain, or painful bowel motions or urination during menstruation. Endometriosis affects a woman's ability to conceive as it can cause tubal blockage or affect a woman's ability to ovulate. IVF is necessary for severe cases and surgery may also be necessary to remove any abnormal tissue growth.

Advance Maternal Age

As a woman approaches menopause, her hormone levels begin to change and due these changes, her ability to produce an egg and ovulate is affected. A woman may have trouble conceiving once they are past 35 and that is why many doctors recommend woman who are over 35 that have had unprotected intercourse for 6 months or more and are unable to get pregnant to begin seeking fertility treatment. For many fertility clinics, age is a determining factor for whether they will accept the patient or not for treatment, as they know the chances of pregnancy begins to diminish greatly for a woman over 35. We here at Life IVF Center, never turn a woman away because of age and believe all women should have the opportunity to conceive with her own eggs.

Diminished Ovarian Reserve (DOR)

Diminished Ovarian Reserve (DOR) is commonly associated with advance maternal age because as a woman ages, her ovarian reserve naturally decreases. However there are many women of all ages that do have a Diminished Ovarian Reserve and may not realize they have this condition until they are trying to conceive and are unable to get pregnant. Another indicator can be irregular or missed periods, but irregular or missed periods can also be signs of other medical conditions. This again is another infertility factor that a woman may not be aware of until she has begun trying to conceive and finds it difficult, where then after testing, her hormonal levels will reflect that she has DOR. The usual indicators are a high FSH and low AMH levels.

Polycystic Ovary Syndrome (PCOS)

Polycystic Ovary Syndrome is due to an imbalance in hormones that prevents ovulation in a woman. Instead of producing and maturing one egg per cycle, a woman with PCOS may produce many cysts on her ovaries, which then can impact her hormonal levels and her ability to produce an egg. Symptoms of PCOS are more apparent than other causes of infertility; these symptoms are irregular or missed menstrual cycles, excessive hair growth, and weight gain. PCOS can be a limiting factor in IVF as many fertility clinics will not accept woman with PCOS as they do not respond well to the fertility drugs as their hormonal levels are already abnormal. However here at Life IVF Center, with Minimal Stimulation IVF we are able to provide just the right amount of medication to stimulate a woman's ovaries accordingly to help her produce eggs and ovulate.

Unexplained Infertility

Probably the most difficult and frustrating infertility diagnosis for any couple is unexplained infertility. This does affect about 12% of couples struggling with infertility, where after extensive testing and fertility treatment, no cause can be determined. For a couple with this diagnosis it is always difficult to know what level of treatment they may need to succeed as they do not know which treatment options could be the most productive for them. At Life IVF Center, we believe in a holistic approach to IVF, and do not require a woman to take an extensive amount of fertility medication and customize their treatment plans accordingly, to provide the least invasive IVF treatment for any couple.