IVF Prerequisites
Bay IVF - Advanced Reproductive Care                                Palo Alto  650-322-0500

 

Prerequisites for In Vitro Fertilization & Embryo Banking

There are very few prerequisites before your treatment can start.

  • Lifestyle and reproductive health

    Environmental factors have a significant impact on reproductive health. Please review Lifestyle and Reproductive Health page and Reproductive Health Check-off Form for a complete list of environmental reproductive health requirements and a source for dietary supplements.

  • Female partner's age

    The probability of a successful IVF treatment becomes exceedingly low by the age of 44. You must be 43 and 11 months or younger at the time your IVF treatment begins. Patients 44 and older should strongly consider Donor Egg IVF or Frozen Donor Egg IVF as the most meaningful treatment to achieve a successful pregnancy.

  • Female partner's weight

    For adequate ovarian response and your safety during the egg retrieval procedure, your weight must be no greater than the following high limits:

     

Height 4ft 10in 4ft 11in 5ft 0in 5ft 1in 5ft 2in 5ft 3in 5ft 4in 5ft 5in 5ft 6in 5ft 7in 5ft 8in 5ft 9in 5ft 10in 5ft 11in 6ft 0in 6ft 1in
Max. Weight (lb) 143 148 153 158 164 169 174 180 186 191 197 203 209 215 221 227
Height 4ft 11in 5ft 0in 5ft 1in 5ft 2in 5ft 3in 5ft 4in 5ft 5in 5ft 6in 5ft 7in 5ft 8in 5ft 9in 5ft 10in 5ft 11in 6ft 0in
Max. Weight (lb) 148 153 158 164 169 174 180 186 191 197 203 209 215 221

 

If your weight is above the maximum, please consider following the Lifestyle and Reproductive Health recommendations as closely as possible. You will not only lose weight at an optimal rate, but you could also significantly improve your chances of achieving a successful pregnancy.

Your weight should be at or below the maximum by the time your IVF ovarian stimulation starts.

You can go ahead with scheduling your initial appointment at Bay IVF provided you plan to reach the required weight before your treatment begins.

  • Pathogen testing

    This testing is required by the State of California. You and your partner (if applicable) must be tested for Hepatitis B-Surface Antigen, Hepatitis C-Antibody, HIV I&II, HTLV I&II, and RPR.

    The blood for these tests should be drawn as soon as possible and no later than the menstrual period at the beginning of your treatment. You can go to a laboratory of your choice, or we can draw your blood at our center.

    If you have had any of these tests done within the last 12 months, they do not need to be repeated.

  • Ovarian Reserve Assay (ORA)

    ORA assesses the likelihood that normal quality eggs can be produced. It consists of the measurement of Follicle Stimulating Hormone (FSH), estradiol (estrogen, E2), and Anti-Mullerian Hormone (AMH) blood levels.

    This test involves a single blood draw. To schedule the test, please call Bay IVF at 650-322-0500 on the first day of your menstrual period. ORA must be completed before your treatment begins.

    FSH stimulates the ovaries to produce eggs. If the ovaries cannot produce normal quality eggs, the FSH level is increased. Estradiol production by the ovaries influences FSH secretion and is also related to the egg quality. FSH should ideally be less than 7.0 and estradiol less than 30.

    Interpretation of ORA results depends on the number of antral follicles, seen as small dark circles within each ovary, during your initial ultrasound examination at Bay IVF. There is a moderate variation in the number of antral follicles from cycle to cycle, and any prior antral follicles assessment you may have had does not necessarily apply.

    The number of antral follicles within unstimulated ovaries is related to the quality of the eggs. Ideally, there should be approximately 20 antral follicles in both ovaries combined. Patients who persistently (there is slight daily variation in the number of antral follicles) have a total of three or fewer antral follicles may require IVF with donor eggs. The majority of women will have 12 to 24 antral follicles.

 

Number of antral follicles in both ovaries combined:
4 to 9

 

  FSH
10.0 or Lower
FSH
10.1 to 11.0
FSH
11.1 or Higher
E2
50 or Lower
OK OK X
E2
51 to 75
OK X X
E2
76 or Higher
X X X

 

Your treatment can start if:

  1. Your FSH level is 10.0 or less, and estrogen level is 75 or less.
  2. Your FSH is 11.0 or less, and estrogen level is 50 or less.

 

 

Number of antral follicles in both ovaries combined:
10 to 20

 

  FSH
11.0 or Lower
FSH
11.1 to 12.0
FSH
12.1 or Higher
E2
50 or Lower
OK OK X
E2
51 to 75
OK X X
E2
76 or Higher
X X X

 

Your treatment can start if:

  1. Your FSH level is 11.0 or less, and estrogen level is 75 or less.
  2. Your FSH is 12.0 or less, and estrogen level is 50 or less.

 

 

Number of antral follicles in both ovaries combined:
21 to 30

 

  FSH
11.0 or Lower
FSH
11.1 to 12.0
FSH
12.1 or Higher
E2
50 or Lower
OK OK X
E2
51 to 90
OK X X
E2
91 or Higher
X X X

 

Your treatment can start if:

  1. Your FSH level is 11.0 or less, and estrogen level is 90 or less.
  2. Your FSH is 12.0 or less, and estrogen level is 50 or less.

 

 

Number of antral follicles in both ovaries combined:
31 or greater

 

  FSH
10.0 or Lower
FSH
10.1 or Higher
E2
Any Level
OK X

 

Your treatment can start if Your FSH level is 10.0 or less.

 

AMH level also reflects the quality of eggs; the result should ideally be between 2 and 3. Lower or substantially higher levels signify less than optimal egg quality. AMH result is used to optimize your ovarian stimulation.

Most women will have normal Ovarian Reserve Assay results. An abnormal result does not necessarily mean that you cannot get pregnant with your own eggs. If the test results are abnormal, we typically recommend repeating the test up to three times.

  • Measurement of the uterus (not required for Embryo Banking)

    It is important to place embryo(s) 15 MM below the top of the endometrial cavity. A thin embryo transfer catheter is passed through the cervical canal to the top of the uterus to measure the length of the endometrial cavity.

  • Sonohysterogram (not required for Embryo Banking)

    We perform a sonohysterogram (saline ultrasound) to assess the endometrial cavity of your uterus. A thin, soft catheter is passed through the cervix into the uterus, and a small amount of sterile saline solution is instilled. A transvaginal ultrasound is used to visualize the contours of the endometrial cavity.

    The presence of polyps, fibroids, or scarring inside the uterus can significantly reduce the probability of implantation. If any polyps, fibroids, or scarring are found, their removal would require a simple outpatient procedure by your OB/GYN or a specialist.

    This ultrasound image shows a normal endometrial cavity. Polyps and fibroids (myomas) would show as lighter shade "filling defects" within the dark saline-filled endometrial cavity.

Sonohysterogram

 

Having the measurement of the uterus and sonohysterography during your initial visit will result in a significant cost saving.

  • Semen evaluation

    The male partner will have a semen evaluation at Bay IVF to determine the best laboratory method for future semen preparation. This test should be done prior to or at your initial Bay IVF visit and needs to be scheduled no later than the Ovarian Reserve Assay.

    There should be a minimum of 2 days and a maximum of 7 days of sexual abstinence prior to collection. The specimen must be obtained by masturbation.

    If you plan to collect outside of Bay IVF, the specimen must be delivered to Bay IVF Laboratory within one hour of collection. Please make sure you have a Bay IVF Laboratory sterile semen container.

  • Parents genetic testing (optional)

    All future parents should consider genetic screening for over a hundred of the most common genetic diseases. Please let us know at the time of your initial appointment at Bay IVF if you wish to have your blood sample sent for genetic screening.

Please use the following links for additional information about In Vitro Fertilization and Embryo Banking.

 

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