list of questions for IVF consult!

SweetieShellieH

So here's my list so far. I hope my RE doesn't freak out seeing this list (which may still grow longer!)

We totally need a sticky post on this board with a billion and one questions we can ask the RE about IVF (especially if you're an IVF virgin), so all we need to do is copy and paste the ones we want to ask ... that's just me though lol

Let me know if there is anything you think I might want to ask but haven't thought about yet!

• Would I be required to take birth control pills prior to starting an IVF cycle? If so, when and for how long? Would I have to increase my Levothyroxine dosage because it?

   

• Because I have a history of high anti-thyroid antibodies, would I be put on ASA and prednisolone along with my current dose of Levothyroxine?

   

• What would be the recommended protocol? Which medications/injections would I be required to take?

   

• Would we have to freeze sperm samples as a backup, or is it not a requirement?

   

• Would ICSI be used to fertilize all mature eggs collected?

   

• Are fresh embryo transfers preferred over frozen embryo?

   

• At what stage do you normally transfer embryos? How are they graded?

   

• Can you explain what happens during egg retrieval and an embryo transfer?

   

• Given my age, would a single embryo transfer be recommended?

• Ovulation is almost always painful for me. Does that put me at a higher risk of developing ovarian hyperstimulation syndrome? Even if it does not, do you have recommendations to help prevent this from occurring in your patients? What happens if it does occur?

• What type of progesterone is used post-retrieval/transfer - Progesterone Suppositories or Progesterone in Oil? If pregnancy occurs, for how many weeks would I be required to continue progesterone?

• Given our circumstances, what is the likelihood of IVF working for us?

• Can we start now please???

mrs.willie

That's a great list. I would also ask what can cause them to have to cancel the transfer. I'd heard of OHSS, which I was told the RE would look at E2 and other levels to decide which trigger to use to try to prevent OHSS. I had no idea that my P4 had to be under a certain level to do the transfer or that it would rise being on Ganirelex, which suppresses ovulation. My P4 was over 3 and they like it below 2, so I had to do a freeze all and an FET. Good luck at the appt!

SweetieShellieH

@mrs.willie I will add it to the list

gsancho

I would also ask what their protocol is for updating you on embryo progress.  Some people get updates daily, others only the day after ER and the day before ET (and then again day of ET), etc.  For me I only got an update after fertilizations and didn't hear back for 5 more days, which was unexpected since I'd seen so many ladies on here get more updates.

And maybe how they decide between a 3dt and 5dt?  Aside from the progress of the embies, it looks like some places chose 3dt regardless of embryo grading if there are only 2 growing little ones...while others still consider waiting until 5dt.

AMShark

Wow.  Nice list.  I was not as prepared as you will be going in, and I have to say, I'm a little jealous.

The things that I was most nervous about during IVF were the meds and the timing.  I would ask if they will provide training on mixing the medications, and giving yourself the injections.  Do they recommend the YouTube videos from your pharmacy or drug manufacturer, and do they provide written instructions for when you actually start, and you're in your bathroom panicking.

I'd also ask if they can provide a detailed timeline (even a sample timeline) of how the process is expected to flow, - starting with BCPs and the practice transfer.

GL!

SweetieShellieH

wow soo many things I hadn't thought of! Glad I posted this!!

tptbabe

IFinTN said:

@tptbabe has a good list...paging!!

Ask and ye shall receive (No tickers on this thread. Good or bad thing?)

 

https://forums.thebump.com/discussion/comment/80533766/

Mozzarella13

I wish I had seen this before now!! I do think it'd be great to combine those previously discussed questions into a sticky, as regardless of whether it's a first cycle or 5th, we all need a little inspiration at our WTF appts!!

jbasore1123

Mozzarella13 said:

I wish I had seen this before now!! I do think it'd be great to combine those previously discussed questions into a sticky, as regardless of whether it's a first cycle or 5th, we all need a little inspiration at our WTF appts!!

I agree with turning it into a sticky

Mozzarella13

Paging @Rumbera28‌ can we turn this into a sticky somehow of a list of questions to ask RE about IVF?

Mozzarella13

Thanks @Rumbera28‌ that was super quick I had my WTF last week and would have had a longer list to torture RE with if I'd seen this beforehand!

Mrs.Ess

Thank you ladies for this list!! I have typed it up and printed it for my appointment.. RE is going to hate me... LOL

Mozzarella13

Thanks so much @NariaDreaming‌!! I think this is going to help a lot of us!!

SweetieShellieH

Updated my list 

And just heard a voice-mail from the clinic to confirm our appointment on Friday!! Had a mini heart attack when I saw they called thinking that perhaps they were going to move it AGAIN!! Breathed a sigh of relief! 

So here's my questions again. Some are the same, some new, some are the same but longer!

Percentage wise, what are the chances of us achieving pregnancy using IVF as opposed to IUI?Jason found that Arimidex caused mood changes (easily angered, panic attacks, etc.) Would he be required to take it again?We both would prefer to move forward with IVF rather than continuing with IUIs & want to begin right away. How soon can we start IVF?Is there any testing pre-IVF that we need to do or repeat? I am on Cycle Day 9. Would we have to wait until my next Cycle Day 1?Would I be required to take birth control pills prior to starting an IVF cycle? If so, when and for how long? Would I have to increase my Levothyroxine dosage (because of the increase in thyroxine-binding globulin due to estrogen)? Is my history of migraines a concern (auras only occasionally)?Because I have a history of high anti-thyroid antibodies, would I be put on ASA and prednisone along with my current dose of Levothyroxine (for better ovarian response and to reduce implantation failure)?I take a Prenatal Vitamin, Vitamin D 2000-IU (past history of extremely low levels), Selenium 200mcg, Zinc 50mg, CoQ10 400mg, Omega 3 (600mg EPA, 300mg DHA) & Vitamin E 400 IU daily. Should I add, remove, or adjust any supplements? What would be the recommended protocol? Which medications/injections would I be required to take and at what dosage? Do the nurses teach how to give injectables? Are there side effects I should watch for?Are we required to store a frozen sperm sample as a back-up?
Can you explain what happens during egg retrieval and an embryo transfer? Would you be performing these or might another doctor at the clinic on your behalf? Would Jason be allowed in the room for either of the procedures? How would I be sedated during egg retrieval? I have been diagnosed with mild sleep apnea. Does this pose a problem with sedation?Would ICSI be used to fertilize all mature eggs collected? How are the sperm selected for ICSI (pICSI)? How are embryos graded? At what stage of development are embryos normally transferred (Day 3 or 5) and how is that decided? Can we get photos of the embryo(s) which will be transferred?How often are we updated on the progress of fertilized embryos? Would the embryologist be the person informing us of any updates, or a nurse?Given my age, would a single embryo transfer be advised? Under what circumstances would multiple embryos be recommended for transfer? Is a fresh transfer preferred over frozen? By what process are embryos frozen? Do you only freeze embryos above a certain grade?There were problems with inserting the catheter during one of the inseminations due to the angle of my cervix/uterus (which caused a lot of pain & cramping during the hour following insemination). Because of this, would you do a “mock transfer”? At what stage of a cycle would the mock be performed? Is an actual transfer ultrasound guided?Are there recommendations on ways to prevent ovarian hyperstimulation syndrome? What happens if it does occur? Are there other possible risks we should be aware of?What type of progesterone is used post-retrieval/transfer – Prometrium or Progesterone in Oil injections? If pregnancy occurs, for how many weeks would I be required to continue progesterone?What type of (if any) restrictions would I have after egg retrieval and transfer? Bed-rest, modified duties at work, etc.?What would cause cancellation of a cycle, retrieval, or transfer? Are there points in the IVF process where we should abstain from intercourse?

tptbabe

Looks good to me!

I have a question for you, since you have a question about PICSI in there and I know you're in the same area as me Do you know if your clinic performs PICSI? It's looking like we'll have to switch clinics if DHs DNA frag test comes back very high, which we feel is a big possibility.

SweetieShellieH

@tptbabe I have no idea at the moment. I didn't even know it was a thing until I read your questions and looked it up!

tptbabe

Well poo Thanks anyways! Let me know if you find out if you don't mind please? Thanks! Good luck on Friday!!!!

SweetieShellieH

@tptbabe oh oh oh oh I found a paper that my doctor and the lab director of my clinic did on ICSI and mentions PICSI !!!  So perhaps there is a good possibility that my clinic does it  

Here's the link if you want to read it (FYI, it's 18 pages long, 28 if you count the references!!!)

Intracytopasmic Sperm Injection - Factors Affecting Fertilization 

tptbabe

Oh, I've read that before!!! That's a good sign I know that the urologists MSH (where we go, and where DHs uro is) have done some work with it, but they don't offer it through the clinic apparently

 

Good luck today!