IVF TORONTO

IVF is most beneficial to those for which other fertility treatments have failed, if there are no known causes of infertility (unexplained infertility), or when there are many causes of infertility at play, such as:

• Advanced female reproductive age when egg quantity, and/or quality, has declined

• Damaged or blocked fallopian tubes

• Endometriosis

• Present Genetic Disorders

• Polycystic Ovarian Syndrome (PCOS) or Premature Ovarian Insufficiency (POI)

• Decreased sperm count, blockage or other male factors

IVF is also an option when an individual or couple:

• Requires fertility preservation options due to a medical issue or surgery that could compromise future fertility health

• Wishes to preserve fertility for personal or social reasons

• Requires the use of donor sperm, egg or surrogacy to complete their family

Many factors can affect the success rate of IVF including:

Age - Egg quality and quantity, both predictors of IVF success rates, decline with age.

Ovarian Reserve - The quantity of an individual’s eggs, known as ovarian reserve, can impact an IVF cycle.  Tests such as antral follicle count (AFC) and anti-Müllerian hormone (AMH) levels can assess ovarian reserve.

Underlying cause of infertility - Certain pre-existing conditions such as endometriosis, PCOS or POI, or endometrial receptivity issues, may affect IVF outcomes. 

Sperm health - Sperm health (count, motility, morphology and DNA integrity) directly affect fertilization rates.

Lifestyle - Factors such as smoking, body weight, alcohol use, diet, and stress can all negatively impact IVF success.

Stimulation protocols and lab factors - The experience and expertise of the fertility clinic and medical team can influence success rates.

Embryo quality - The quality of the embryo transferred directly impacts success. Quality is assessed based on factors such as cell division rate, embryo morphology and genetic integrity.

Your Pollin Fertility specialist will be able to give you guidance on optimizing your chances for IVF treatment success which may include diet and lifestyle changes, a supplement plan and in some cases, additional diagnostic testing and procedures prior to starting your cycle.

Reciprocal IVF, also known as partner-assisted reproduction, shared motherhood, partner IVF or co-IVF, is an option for same-sex female and/or transgender male partners in which one partner wishes to carry the pregnancy while the other partner wishes to use their eggs to create an embryo. The partner providing eggs undergoes an IVF cycle and their eggs are combined with donor sperm to create embryos. An embryo is then transferred into the uterus of the partner wishing to carry the pregnancy.

The use of fertility hormones during treatment are generally considered safe when used under the supervision of a qualified medical professional.  However, like any medical intervention, they do carry some potential risks.  A primary concern, which is closely monitored throughout your treatment cycle, is the potential for Ovarian Hyperstimulation Syndrome (OHSS) which is usually temporary and resolves on its own.

It’s essential for individuals undergoing fertility treatments to discuss any concerns about potential short and long-term risks with their fertility specialist.  In many cases, the benefits of achieving a successful pregnancy often outweigh the potential risks.

OHSS, or Ovarian Hyperstimulation Syndrome, is a medical condition where the ovaries become enlarged and painful due to the increased fluid retention and enlargement of the ovarian follicles.  OHSS can occur in a small percentage of individuals who undergo fertility treatments where injectable hormones are used to stimulate the ovaries to produce multiple eggs. 

Common symptoms include abdominal bloating or pain, nausea, vomiting, and difficulty breathing. While rare, in severe cases, OHSS can cause fluid build up in the abdomen or chest, dehydration, electrolyte imbalances, and even blood clots.  Severe cases may require medical intervention, such as draining fluid from the abdomen. 

Pollin practices preventative measures, such as careful monitoring of hormone levels and adjusting medication dosages and protocols during the treatment cycle to help reduce the risk of OHSS.

The egg retrieval procedure is fairly quick, with the length of time being dependent on how many follicles are present.  A typical retrieval will take approximately 20-30 min not including pre and post procedure time spent in the clinic.

The experience can vary from person to person, but it’s typically not described as painful due to the administration of sedation and comfort medications given prior to the procedure.  While mild discomfort during or after the egg retrieval is possible, it’s generally manageable and temporary.  Your care team will ensure you are well informed and as comfortable as possible throughout and after your procedure.

Damage to the ovaries during an egg retrieval is extremely rare. It is important, like with any medical procedure, that the retrieval is performed by an experienced fertility specialist who follows established protocols and guidelines to minimize risk and maximize outcomes.

All embryos need to “hatch” prior to implantation. Frozen embryos can often have difficulty hatching due to thickening of their outer cell layer called the zona pellucida. Assisted hatching is a laboratory procedure performed by a highly skilled embryologist whereby a small hole is made in the zona pellucida using a laser to facilitate hatching prior to a frozen embryo transfer. Assisted hatching is associated with an increase in implantation and pregnancy rates.

Preimplantation genetic testing for aneuploidy (PGT-A) is a screening test that can be performed on embryos created via IVF to evaluate their number of chromosomes prior to embryo transfer. Embryos with the correct number of chromosomes are more likely to result in a healthy pregnancy.

After eggs are retrieved and fertilized in the lab, the embryologist will perform assisted hatching on the embryos to help obtain cells for testing. When the embryo reaches the blastocyst stage, a few of the cells on the outside of the embryo are biopsied and sent for genetic analysis.

PGT-A benefits:

• Reduced miscarriage rates

• Higher IVF success rates per transfer

• Fewer cycles of IVF treatment needed saving both time and finances

• Greater chance of having a healthy child

• Fewer wasted transfers due to implantation failure

Following your embryo transfer it’s essential to take care of yourself both physically and emotionally to optimize the chances of a successful outcome.

We advise all of our patients to:

Follow your post-transfer instructions provided by your care team: including any restrictions on activities, medications to take, and appointments to attend.

Take it easy: Relax and avoid strenuous and stressful activities for a few days after the transfer. Now is the time to partake in some self care and focus on activities that bring you joy and a sense of calm if you are able.

Stay hydrated: Drink plenty of water, which can help support overall health and potentially improve blood flow to the uterus.

Avoid alcohol, smoking, and recreational drugs: Consumption of these substances are known to potentially harm embryo implantation and development.

Eat a healthy diet and continue supplements as directed: A balanced diet rich in whole foods such as fruits, vegetables, lean proteins and whole grains will potentially improve fertility outcomes. Continue to take any supplements prescribed to you by your specialist or naturopath.

Avoid intense heat: Excessive heat exposure can potentially harm embryo implantation. Avoid hot baths, saunas or hot tubs especially during the 2-week wait.

Have a support system in place: Going through the 2-week wait after a transfer can be an emotionally challenging time for some individuals. Ensuring you have a support system around to provide encouragement and emotional support will make a world of difference. If you would like resources for support groups, please ask your care team.

The timing of a pregnancy test after embryo transfer (“The two-week wait”) varies depending on your specific protocol, however it is typically conducted 9-11 days post transfer to allow for the implantation of the embryo.

If you choose to take a home pregnancy test during the two-week wait, it’s essential to understand that the results may not be conclusive, and it’s still advisable to confirm with a blood test in the clinic.

Although it is often safe to attempt to try another treatment cycle shortly after an unsuccessful cycle, it is advisable that you speak to your fertility specialist about reasons why the cycle was unsuccessful and strategies to improve outcomes in a subsequent cycle. Some strategies may simply involve a protocol change and minimal delay to trying again, while others may require further investigations and lifestyle modifications that may warrant a longer interval.