Prerequisites for Minimal IVF

The following prerequisites must be completed before your treatment can start:

• IVF Diet and Lifestyle

  Environmental factors have a significant impact on reproductive health. Please review the IVF Diet and Lifestyle page for a complete list of environmental reproductive health requirements and a source for dietary supplements.

• Female partner's age

  Compared with conventional In Vitro Fertilization, Minimal-IVF commonly results in fewer eggs developing within the ovaries. It is important that the egg quality is sufficiently high: You must be 40 and 11 months or younger by the start of Minimal-IVF ovarian stimulation to be a candidate for the Minimal-IVF treatment.

  Patients between the ages of 41 and 43 should consider conventional In Vitro Fertilization, and patients 44 years and older should strongly consider Donor Egg IVF or Frozen Donor Egg IVF as the most meaningful treatment to achieve a successful pregnancy.

• Menstrual cycle length

  Minimal-IVF ovarian stimulation requires both ovaries and regular menstrual cycles every 21 to 35 days without the need to take any hormonal medications, including birth control pills, to regulate the cycles.

• Female partner's weight

  For an adequate Minimal-IVF ovarian response and your safety during the egg retrieval procedure, your weight must be no greater than 150lb. If your height is less than 5'3", your weight must be no higher than the following limits:

   

 

If your weight is above the maximum, please follow the IVF Diet and Lifestyle 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.

• 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 Clinic.

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

• Antral follicle count (AFC)

  You will have an ovarian ultrasound during your initial visit at Bay IVF to count the number of antral follicles, seen as small dark circles within each ovary. 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 ideally be approximately 20 antral follicles in both ovaries combined. Too few or too many antral follicles indicate that normal-quality eggs may be infrequent or even absent within the ovaries.

  There must be between 10 and 24 antral follicles in both ovaries combined for Mini-IVF. Women with very low or very high AFC are not good candidates for Mini-IVF ovarian stimulation. The majority of women will have 12 to 24 antral follicles.

• 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 egg quality. FSH should ideally be less than 7.0 and estradiol less than 30.

  Interpretation of ORA results:

Number of antral follicles in both ovaries combined:
10 to 24

 

	FSH 9.0 or Lower	FSH 9.1 or Higher
E2 50 or Lower	OK	X
E2 51 or Higher	X	X

• Anti-Müllerian hormone (AMH) level

  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.

  The AMH level must be 1.5 to 4.0 inclusive for Mini-IVF. Women with very low or very high AMH levels are not good candidates for Mini-IVF ovarian stimulation and should consider conventional In Vitro Fertilization.

• Measurement of the uterus

  It is important to place embryo(s) at the top of the endometrial cavity. To measure the length of the endometrial cavity, a thin embryo transfer catheter is passed through the cervical canal to the top of the uterus.

• Sonohysterogram

  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.

 

• 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.

  Since the average number of eggs retrieved in Minimal IVF is lower compared with conventional IVF, there must not be a significant degree of male infertility to minimize the risk that none of the eggs will fertilize. The male partner must be able to produce a sufficient number of living sperm (total motility 5% or higher and normal sperm morphology 5% or higher).

• 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 Minimal IVF.