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Questions you probably are afraid to ask about IVF, Part 2.

As we talk with many women every day, we come across with numerous questions they have about IVF. We have already written a first part with some of that questions, and now we collected and answered another 8 common IVF questions. You can always write to us with your own questions, so we can add them to our articles and help others that may have the same questions as you! Don’t be afraid to ask, we are here for the same purpose, to help you achieve your goals.

  1. Can I have sex during IVF?

There are two stages at the IVF process where you should behave differently in terms of sexual intercourse.

Prior the embryo transfer: Sex during the stimulation phase of an IVF cycle is permissible as long as the couple is using a form of barrier contraceptive, such as condoms.

Some IVF patients may produce too many follicles causing ovarian hyperstimulation. In these cases, patients are advised to avoid sex because the ovaries are very enlarged and cystic.

Intercourse could lead to the rupture of a cyst on the enlarged ovaries or a twisting of the ovary on its blood supply. Although extremely rare, these types of complications should be proactively avoided.

After the embryo transfer: Intercourse is discouraged following an embryo transfer during an IVF cycle. Pelvic Rest is recommended for 5 to 7 days after embryo transfer. This is to ensure that a pregnancy test can reliably be administered.

  • 2. How many follicles for IVF should I have?

A follicle is a sac filled with fluid in which an immature egg develops, and are located in the ovaries. When a follicle grows to an ideal size, ovulation occurs, which results in the rupture of a follicle and the release of an egg from the ovary. Antral follicle counts (along with female age) are by far the best tool that doctors currently have for estimating ovarian reserve, the expected response to ovarian stimulating drugs, and the chance for successful pregnancy with in IVF.

Total number of antral folliclesExpected
response to injectable stimulating drugs and chances
for IVF success
Less than 4Extremely low count.
Very poor (or no) response to stimulation is expected.
Cycle cancellation is likely.
Possibly should consider not attempting IVF at all.
4-9Low count, possible/probable poor response to the stimulation drugs.
Likely to need high doses of FSH product to stimulate ovaries adequately.
Higher than average rate of IVF cycle cancellation.
Lower than average pregnancy rates for those cases that make it to egg retrieval.
9-13Somewhat reduced count.
Higher than average rate of IVF cycle cancellation.
Slight to moderate reduction in chances for pregnancy success as a group.
14-21Intermediate (and “normal”) count.
Response to drug stimulation is sometimes low, but is usually good.
Pregnancy rates as a group are slightly reduced compared to the “best” group.
22-35Normal (good) antral count.
Excellent response to ovarian stimulation.
Likely to respond well to low doses of FSH drugs.
Very low risk for IVF cycle cancellation. Some risk for ovarian overstimulation if a Lupron trigger is not used for final egg maturation injection.
Excellent pregnancy success rates.
Over 35Very high count.
Polycystic ovary type of ovarian response.
Likely to have a high response to low doses of FSH product.
Higher risk for overstimulation and ovarian hyperstimulation syndrome if a Lupron trigger is not utilized.
Very good pregnancy rate overall.
Table from Advanced Fertility Centre of Chicago

  • 3. What are the 5 stages of IVF?

The most common question regarding IVF. The whole process of IVF can be concluded in these 5 main stages: ovarian stimulation, egg retrieval, sperm retrieval, fertilization and embryo transfer. For more details you can read our thorough article about IVF in Greece here.

letters shaping the word IVF and two red hearts

  • 4. How to calculate pregnancy weeks after IVF?
  • IVF with own eggs (with or without ICSI) – Egg retrieval date + 266 days (or 38 weeks)
  • IVF with fresh donor egg cycle (with or without ICSI) – Egg retrieval date + 266 days (or 38 weeks)
  • Fresh donor embryo cycle – Egg retrieval date + 266 days (or 38 weeks)
  • 3 day FET – Transfer date + 266 days (or 38 weeks) – 3 days (for embryos)* *Sometimes your embryos’ age is more than 3 days, so it’s important to subtract the exact age of the embryos. 
  • 5 day FET – Transfer date + 266 days (or 38 weeks) – 5 days (for blastocysts)* *If the blastocysts’ age is more than 5 days, you need to subtract their exact age.

You can find a useful IVF and FET due date calculator here.

  • 5. Can you choose gender with IVF?

In Europe and especially in Greece, gender selection is used only for medical reasons and is conducted through PGD and PGS. PGD allows for the prevention of genetically transmitted diseases as well as the determination of the desired selected gender, with a nearly 100% accuracy rate of babies born risk-free of genetic disorders, because only embryos unaffected by the genetic condition are returned to the womb.

PGS is the test that checks if an embryo has a normal chromosome number (46) and is most commonly used to detect Down Syndrome (where number of chromosomes are 47).

PGD and PGS are a highly accurate method that offers a valuable diagnostic tool to couples at high risk of transmitting a genetic disorder to their future offspring.

We should again point out that it is forbidden to choose genders for any social reasons, rather than medical ones.

  • 6. How to improve egg quality for IVF?

According to Dr. Hirshfeld-Cytron there are some lifestyle changes than can improve egg quality. Avoiding smoking, eating healthy, maintaining a normal BMI, and managing stress (as difficult as it may sounds) are some of those ways.

  • 7. What is a normal BMI for IVF?

Another very common question about IVF. It has been reported that women with BMI more than 35 kg/m2 are at high risk during ART. Therefore, many prior studies have investigated the impact of raised BMI on the pregnancy outcomes of IVF/ICSI but with disparate results. Some studies conducted on the patients undergoing IVF/ICSI using donated oocytes reported the negative impact of BMI, whereas others reported no difference in the reproductive outcomes in obese and normal donated oocytes recipients. Similarly, there has been a debate on the effect of BMI on IVF patients using vitrified/frozen embryos.

The risks associated with obese women who conceive naturally are similar to those who conceive with IVF. The increased risk of early pregnancy loss is also observed in obese women. Many studies suggest that the pregnancy outcome followed by ART is not influenced by BMI. However, they might require a high dose of gonadotropin and a longer period of stimulation.

Results are inconclusive and affected by other factors too, but in general maintaining a normal BMI and leading a healthy lifestyle will most probably help.

a DNA chain from fruits and vegetables

  • 8. Is there IVF for lesbians?

There are multiple ways a lesbian couple can be benefitted from IVF.

  1. Using their own eggs, through reciprocal IVF. It is the process in which one partner acts as an egg donor to the other.
  2. Egg donation.
  3. IVF with sperm donation.
  4. Surrogacy.

If you have any other question feel free to ask us and we along with our cooperating doctors will do our absolute best to help you.

IVF although a common fertility treatment, is accompanied with stress and reasonable concerns. That is why you should find the right fertility specialist to guide you through the process. And that is we offer our undivided help and support to each and every one of you.

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Questions you probably are afraid to ask about IVF, Part 2.