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Archive for the ‘embryo transfer’ tag

A Time Travel Exercise for the Infertile

By Tracey Minella

December 8th, 2013 at 11:08 pm

 

credit: Boains Cho Joo Young/freedigitalphotos.net


During my infertility journey, I always looked back. Usually with regrets or second-guessing. I’d criticize myself for decisions we made which seemed best at the time… and probably were best…even though the outcome wasn’t what we’d hoped. I questioned everything, including the timing of cycles and the numbers of embryos transferred, sometimes wishing for more and other times wishing for less. In short, I beat myself up.

Maybe you do that, too? If so, you need to stop.

Nothing is more counter-productive than being a “Monday morning quarterback”. And the cliché of hindsight being 20/20 is very true in infertility. Try to remember that every failure or setback is a lesson that you and your doctor will learn from to make different and better choices for your future treatment.

The holiday season is so difficult and each year the holiday marketing seems to start earlier and get more aggressive. Faces of children are in commercials and print ads wherever you turn. Maybe you’re receiving “wish lists” for nieces and nephews and the thought of walking into Toys R Us  and faking your way through Christmas makes you ill.

Need a mental break?

Here’s a little trick I’ve used when overwhelmed or depressed and since it’s National Time Travel Day, it’s the perfect time to share it:

Escape the present and fast forward to the future for a few moments. Find a quiet place and put on some soft, relaxing music…or have total silence…whichever you prefer. Be sure you won’t be interrupted. Steal at least a half hour for yourself. Close your eyes and imagine a future point in time, maybe next holiday season. Really allow yourself to see the family you dream of, whether it’s your first baby or an addition you long for to make you feel complete.

It’s important to imagine all the details. First, picture the child. Will it be a boy, a girl, or both? Blonde or dark hair? (This is your fantasy, so let go and embrace it.) Now, take yourself through traditions you dream of starting or sharing. Will you cut down a tree? Visit someone special? Send a photo holiday card? Bake cookies? Buy a Hess truck or holiday Barbie? What are your plans? How will your life change?

Yes, this may be hard. But it can be helpful. So much of infertility is beyond our control that just making these plans in your head…or in a journal…can make them seem that much closer to coming true. At least it did for me. And if you allow yourself to see your dreams and write them down year-round as they cross your mind, your holiday “to-do” list will already be written for the year your dream does come true.

Here’s hoping that those still on their journeys will find resolution in 2014.

* * * * * * **  * *

What holiday tradition are you looking forward to starting or sharing?

 

 

Photo credit: Boians Cho Joo Young/http://www.freedigitalphotos.net/images/agree-terms.php?id=100208929

 

 

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Infertility Podcast Series: Journey to the Crib: Chapter 24: I Look Pretty Good in Scrubs

By David Kreiner MD

August 5th, 2013 at 1:51 pm

 

Welcome to the Journey to the Crib Podcast.  We will have a blog discussion each week with each chapter.  This podcast covers Chapter Twenty-Four: I Look Pretty Good in Scrubs. You, the listener, are invited to ask questions and make comments.  You can access the podcast here: http://podcast.longislandivf.com/?p=126

I Look Pretty Good in Scrubs

It is easy for an IVF partner, male or female to feel left out of the process.  After all, the IVF patient is the focus of all of the attention of the physicians and nurses, from the initial consultation and exam to the testing, ordering of medications, monitoring, etc.  

 

I have seen partners, who busy with their own jobs, appear to neglect their loved one who is going through IVF.  Unfortunately, partners are much needed for their support during this critical and stressful time. In some of the worst examples, I have seen relationships suffer as the IVF patient undergoes the entire process alone building resentment that can be difficult to overcome.

 

I have also seen partners get involved by accompanying the patient for her office visits and procedures.  Many partners pride themselves with their new found skill in mixing hormonal medications and administering injections for their partners.  It helps those especially who are used to caring for their partners to be in control by administering the medication for them.  Whether it is the feeling of “playing doctor” or the knowledge that they are contributing significantly to the process, most people relate to me that giving their partners the injections was a positive experience for them and their relationship.

 

The feeling can be euphoric when partners accompany the IVF patient to the embryo transfer.  Many women feel that at this moment… when the embryo is transferred into their womb… that they are pregnant.  Life may be starting here and it is a wonderful opportunity to share with your partner. 

 

I strongly recommend that you don those scrubs, hat and booties and join your partner as the physician transfers your embryo/s loaded from the laboratory dish by the embryologist. Watch on the ultrasound screen as he carefully releases the drop containing your embryo/s into her womb.  Inside that drop may be your baby in nine months.

* * * * * * **  * * * *

Was this helpful in answering your questions about the partner’s role in IVF? Do you have an experience you’d like to share about going through IVF as a couple?

 Was your partner involved? How? Did it bring you closer?

Please share your thoughts about this podcast here. And ask any questions and Dr. Kreiner will answer them.

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Infertility Podcast Series: Journey to the Crib: Chapter 4

By David Kreiner MD

March 4th, 2013 at 9:59 pm

Welcome to the Journey to the Crib Podcast.  We will have a blog discussion each week with each chapter.  This podcast covers Chapter Four: Where Do You Go? You, the listener, are invited to ask questions and make comments.  You can access the podcast here: http://podcast.longislandivf.com/?p=34

 

Where Do You Go?

 

I try to help the reader understand the published statistics offered online by SART, the national organization of IVF programs that provides a registry of IVF programs who submit their data for audit by SART.  Rates are offered with a numerator and a denominator with the critical goal of a live baby per retrieval or transfer being the most crucial statistic.

 

The benefits and disadvantages of large programs are discussed basically offering that larger programs tend to have more experienced and often skilled personnel albeit with more waiting time for monitoring.  Some programs may provide more personalized care, some more psychological or emotional support and some offer adjunctive therapies such as acupuncture and mind body programs.

 

I emphasize the importance of the embryology lab as well as the skill of the physician performing the embryo transfer.  The technique of the transfer is described including factors that I believe may affect success rates.

 

* * * * * * **  * * * *

Please share your thoughts about this podcast here.

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Five Facts About Embryo Transfers

By Tracey Minella and David Kreiner MD

December 15th, 2011 at 4:07 pm

One is the loneliest number. Eight makes you an Octomom. But there’s more to Embryo Transfers than just those extremes.

And the standards regarding how many embryos to transfer back to a woman’s uterus have changed as the assisted reproductive technology improves and IVF success rates continue to rise.

Two decades ago, it was standard to transfer up to four embryos per fresh IVF cycle. Even more if you were older or had prior failed IVF cycles. Today, cutting edge clinics like Long Island IVF and East Coast Fertility have success rates so high that Single Embryo Transfers (SETs) are often highly encouraged. And transferring more than two embryos is generally discouraged in most cases.

So, nowadays, one is no longer the loneliest number…it’s often the luckiest number!

Below, Dr. Kreiner shares five facts about embryo transfers that curious patients need to know:

  • After a few days of development, the best appearing embryos are selected for transfer
  • The number chosen influences the pregnancy rate and the multiple pregnancy rate
  • A woman’s age and the appearance of the developing embryo have the greatest influences on pregnancy outcome
  • Embryos are placed in the uterine cavity with a thin tube
  • Excess embryos of sufficient quality that are not transferred can be frozen

After a few days of development, one or more embryos are selected for transfer to the uterine cavity.  Embryos are placed in the uterine cavity with a thin tube (catheter).  Ultrasound guidance may be used to help guide the catheter or confirm placement through the cervix and into the uterine cavity. Although the possibility of a complication from the embryo transfer is very rare, risks include infection and loss of, or damage to the embryos. 

The number of embryos transferred influences the pregnancy rate and the multiple pregnancy rate. The age of the woman and the appearance of the developing embryo have the greatest influence on pregnancy outcome and the chance for multiple pregnancy.  While it is possible, it is unusual to develop more fetuses than the number of embryos transferred. It is critical to discuss with your doctor the number to be transferred before the transfer is done.

In an effort to help curtail the problem of multiple pregnancies (see multiple pregnancies), national guidelines published in 2006 recommend limits on the number of embryos to transfer (see Tables below). These limits should not be viewed as a recommendation on the number of embryos to transfer. These limits differ depending on the developmental stage of the embryos and the quality of the embryos and take into account the patient’s personal history.  

Recommended limits on number of 2-3 day old embryos to transfer

Embryos

age <35

age 35-37

age 38-40

age >40

favorable

1 or 2

2

3

5

unfavorable

2

3

4

5

Recommended limits on number of 5-6 day old embryos to transfer

Embryo Prognosis

age <35

age 35-37

age 38-40

age >40

favorable

1

2

2

3

unfavorable

2

2

3

3

In some cases, there will be additional embryos remaining in the lab after the transfer is completed.  Depending on their pregnancy potential, it may be possible to freeze them for possible use in a subsequent cycle. 

* * * * * * * * * ** * * *

How many embryos have you had transferred at one time? What was the hardest thing about your decision on the number?

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Avoiding IVF Disasters

By Tracey Minella and David Kreiner MD

September 7th, 2011 at 3:22 pm

With all the natural disasters happening lately…hurricanes and earthquakes and floods… and with the worst weather season ahead of us, you might be feeling a bit uneasy. It’s bad enough that infertility forces us to relinquish control of our baby-making, but not knowing if the next storm is going to further disrupt our lives adds more edge to life’s daily worries.

Although we can’t avoid most natural disasters, Dr. Kreiner explains how he and his ECF team have managed to avoid IVF disasters for over 25 years:

Practicing medicine for the past 30 years, I have developed an enormous respect for those things that happen to people that are beyond our control.  Sometimes, the issue of preventability is a gray one and defies definitive blame assignment.  Yet, when the dust settles there remain victims who are harmed for whom we are all sympathetic.  It is for this reason that we are compelled to do everything within our power to ensure that tragic errors do not occur.

Elsewhere in society there are potentially devastating outcomes to human error and, like in medicine, it may be difficult to unravel how much fault is from natural calamity and how much we could have avoided with more rigorous human controls.

Last March, the world was exposed to perhaps the worst of Mother Nature’s natural disasters: a severe earthquake with multiple aftershocks, followed by a massive Tsunami.  Aside from the horrendous devastation that took place in Japan, ongoing danger persists from damage to several nuclear power plants.  

These unintentional, uncontrollable catastrophes occur naturally and are arguably nobody’s fault.  And although some claim that nuclear power is dangerous because of the history of accidents like at Chernobyl and Three Mile Island, nuclear power plants continue to be constructed throughout the world because many perceive that the benefits of this alternate source of energy outweigh the risks.  We are assured by those responsible that these plants are safe even in the face of the worst disasters… until we learn they are not.

 It is our human condition to speculate how to prevent these complications from occurring.  In IVF, perhaps the greatest potential disaster we face is the mixing up of embryos.

 In February, 2009, a case of a mix-up of frozen embryos in a Michigan IVF program occurred to a couple who already had a set of twins as a result of a successful IVF.  Their embryos were mistakenly transferred into the wrong woman, who then carried the pregnancy and after delivery handed the baby back to his biological parents. Reports of the mix-up have triggered calls from some to make IVF illegal.  This sounds like the recent calls to decommission nuclear power plants and stop production of new facilities.

Mixing up gametes and embryos is tragic and society must do everything humanly possible to prevent it… except disallow the practice of IVF. As with other societal advances, accidents are rare but have unfortunately happened in the field of IVF. But, weighed against the benefit of all the babies who otherwise would never have been born, we should strive to improve the safety of IVF, not eliminate it.

Many of the greatest advances have had tragic results, unintended accidents that could sometimes been avoided. Sometimes, like the post-earthquake nuclear disasters in Japan, they are spawned by natural causes.  But other times, there is an element of human error often preventable with the institution of carefully designed safeguards with a system of checks and balances.

Significant risk, including that of injury or death, is part of nearly everything we do in life today. The construction industry has always been plagued with accidental deaths. Not a bridge or a great high rise has been completed without misfortune. Do we stop construction? No, we ensure that all possible regulations that could protect those involved are in place and followed as strictly as possible to prevent further accidents.

Cardiac bypass surgery and other surgeries save lives and relieve suffering but, occasionally, patients intended to benefit are hurt or even killed accidentally. Rules and regulations are instituted to avoid problems such as performing the wrong operation on the wrong patient, using the wrong medication, operating on the wrong limb. Yet situations do occur rarely, usually because of a human slip. Rules are broken and mistakes result. When they do, hospitals review the procedures and protocols to better insure a sufficient system is in place to catch future errors before they effect patient care.

Just as we have safeguards in the operating room, we have them in place for identifying gametes and embryos with checks and balances that should prevent a mix-up such as the one in Michigan.

In our operating room, patients are identified while they are awake by the embryologist, nurse, physician and anesthesiologist by full name and birth date. As soon as the ovaries are aspirated, the eggs are identified and put in dishes with the patient’s full name and birth date on them. When the dishes are changed to replace the media, again matching names are put on the new dishes with a unique case number. A partner’s sperm specimen is labeled by him and processed in tubes labeled to match the partner’s name and the corresponding patient’s name and the case number. This is double-checked with the patient’s record which will also reflect the unique case number. It is reviewed by two embryologists for accuracy prior to fertilization. Finally, when the embryo is loaded in a catheter for transfer, the identity of the dish from the embryo is checked by the physician, embryologist, nurse and the patient herself prior to the transfer being performed.

Every attempt is made to confirm the identity of the gametes and embryos repeatedly throughout the IVF process from retrieval through transfer. A similar system of double checks of patient and embryo identity exists for frozen embryo transfers as well.

In over 25 years of practicing IVF, my program has not mixed up gametes or embryos.

There are approximately 3 million babies born through IVF and only a few rare mix ups reported. Perhaps we don’t hear …or know…about every mix up. I’d estimate that less than 1/100,000 pregnancies from IVF have occurred with some mix up in the embryo or gamete. When it occurs, it is tragic and requires the attention of our field and a refocus on those checks and balances we have in place to prevent such mishaps.

When it comes to institutions whose impact on society is of such great magnitude, it is essential that governing regulatory agencies ensure that all possible checks and balances are in place to ensure the greatest degree of safety.  All involved must work hard to maintain the highest standards and then we can only pray that we have done everything possible so that such disasters never have such devastating consequences.

* * * * * *** ** * * * * *

Do you feel that your embryos are safe? Is there any other safeguarding procedure(s) you think should be implemented?

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Infertility Poetry Challenge with Rewards!

By Tracey Minella

August 22nd, 2011 at 10:14 am


In honor of National Poet’s Day, East Coast Fertility offers a fun little challenge to everyone stopping by today, whether from ICLW or our regular bloggers…and a fun little reward for your efforts. [Plus don't forget to enter our video contest before 8/28...maybe you will win a romantic dinner OR the free Micro-IVF cycle grand prize! See August 1st post for details! Click here: http://www.eastcoastfertility.com/about/blog/blog-entry/archive/2011/august/article/ecfs-extreme-family-building-makeover-video-contest/?tx_ttnews%5Bday%5D=01&cHash=a6f7a8f9f3d38be671d74bd524251f81]

Infertility can bring out a wide range of emotions in those who suffer from it…mostly frustration and sadness, but sometimes humor. Poetry is the perfect outlet for some of these emotions. We need to vent. We need to laugh.

This poem comes to you on Poet’s Day,

With a challenge and reward coming your way.

Since infertility is close to my heart,

I will give the poem a start.

Continue with four new lines (or even just two);

Or an original poem written by only by you.

You’ve got until Friday, just so you know it,

So don’t even waste a minute.

A Starbucks card for the first ten poets–

But you’ve got to be in it to win it!

Ode to an Embryo

After all the water I had to drink

I felt that my bladder would burst

Now I just lay here, waiting and think

Will it quench my motherhood thirst?

Lying here with legs akimbo

In a welcoming state of mind

Did you stick– or are you in limbo?

Will the fertility gods be kind?

Phew, that’s the heavy, emotional stuff. Or, there’s always the more light-hearted and fun kind of poem. Something like:

Roses are red

Violets are blue

Stick embryos stick

We paid for the glue!

Or something personal directed at your favorite nurse or doctor, like maybe:

I went to a doctor named Kreiner

‘Cause I heard there was nobody finer.

Getting pregnant took years

And a bucket of tears

Then two babies came from my vagi-ner.

Spit out your coffee, did you? Well, okay, maybe that was a tad out there. I’m a blogger, not a poet.

The point is to vent or have a laugh…and earn a Starbucks card. No need to be Emily Dickinson or Robert Frost.

Go on. Post something. You know you have something to say.

* * * * * * *

If you are one of the first ten to post a poem, please email your name and address to lmontello@eastcoastfertility.com on or before Monday August 29, 2011 in order to claim your gift card.  

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What is an Embryo Transfer? Five Things to Know

By Tracey Minella and David Kreiner MD

April 14th, 2011 at 12:00 am


One is the loneliest number. Eight makes you an Octomom. But there’s more to Embryo Transfers than just those extremes.

And the standards regarding how many embryos to transfer back to a woman’s uterus have changed as the assisted reproductive technology improves and IVF success rates continue to rise.

Two decades ago, it was standard to transfer up to four embryos per fresh IVF cycle. Even more if you were older or had prior failed IVF cycles. Today, cutting edge clinics like East Coast Fertility have success rates so high that Single Embryo Transfers (SETs) are often highly encouraged. And transferring more than two embryos is generally discouraged in most cases.

So, nowadays, one is no longer the loneliest number…it’s often the luckiest number!

Below, Dr. Kreiner of East Coast Fertility shares five facts about embryo transfers that curious patients need to know:

  • After a few days of development, the best appearing embryos are selected for transfer
  • The number chosen influences the pregnancy rate and the multiple pregnancy rate
  • A woman’s age and the appearance of the developing embryo have the greatest influences on pregnancy outcome
  • Embryos are placed in the uterine cavity with a thin tube
  • Excess embryos of sufficient quality that are not transferred can be frozen

After a few days of development, one or more embryos are selected for transfer to the uterine cavity.  Embryos are placed in the uterine cavity with a thin tube (catheter).  Ultrasound guidance may be used to help guide the catheter or confirm placement through the cervix and into the uterine cavity. Although the possibility of a complication from the embryo transfer is very rare, risks include infection and loss of, or damage to the embryos. 

The number of embryos transferred influences the pregnancy rate and the multiple pregnancy rate. The age of the woman and the appearance of the developing embryo have the greatest influence on pregnancy outcome and the chance for multiple pregnancy.  While it is possible, it is unusual to develop more fetuses than the number of embryos transferred. It is critical to discuss with your doctor the number to be transferred before the transfer is done.

In an effort to help curtail the problem of multiple pregnancies (see multiple pregnancies), national guidelines published in 2006 recommend limits on the number of embryos to transfer (see Tables below). These limits should not be viewed as a recommendation on the number of embryos to transfer. These limits differ depending on the developmental stage of the embryos and the quality of the embryos and take into account the patient’s personal history.  

Recommended limits on number of 2-3 day old embryos to transfer

Embryos

age <35

age 35-37

age 38-40

age >40

favorable

1 or 2

2

3

5

unfavorable

2

3

4

5

Recommended limits on number of 5-6 day old embryos to transfer

Embryo Prognosis

age <35

age 35-37

age 38-40

age >40

favorable

1

2

2

3

unfavorable

2

2

3

3

In some cases, there will be additional embryos remaining in the lab after the transfer is completed.  Depending on their pregnancy potential, it may be possible to freeze them for possible use in a subsequent cycle. 

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TTC? Try Separating and Washing Your Sheets

By Tracey Minella and David Kreiner MD

March 18th, 2011 at 12:00 am

Not the ones you sleep on, silly. I’m talking about your sheets of cumulus cells. If you want to improve your chances for pregnancy, washing and separating these sheets of cells at the time of your IVF retrieval, and placing them in the dish with your embryos, may be just what the doctor ordered to get your pee stick to come back positive.

This revolutionary procedure is known as co-culture. Unfortunately, many IVF programs do not offer this pregnancy rate-boosting option. So, when seeking an IVF program, be sure to ask if co-culture is available.

Dr. David Kreiner of East Coast Fertility explains the benefits of this exciting and promising weapon in the IVF arsenal:

Successful IVF is dependent on many factors.  The quality of the egg and embryo, the placement of the embryo into the uterus and the environment surrounding implantation are all paramount to the ultimate goal of creating a pregnancy that leads to a live baby.

Typically, patients present with their own gametes so the genetics and pregnancy potential of the eggs and sperm is usually predetermined when patients first present to an IVF program.  As a specialist in REI and IVF, I have dedicated my career to optimizing those other factors that we may influence.

In the late 1990’s I recorded data on all my embryo transfers including distance the catheter tip was placed into the uterine cavity, number of cells and grade of the embryos, difficulty of the transfer, use of tenaculum etc.  I presented my results at the ASRM in 2000 that highlighted the two step transfer to the middle of the uterine cavity and replaced the tenaculum with a cervical suture when needed and this radically improved pregnancy rates.

The uterine environment has been optimized through screening for anatomic issues in the uterine cavity with a hydrosonogram to identify polyps, fibroids and scar tissue that may impede implantation.  Hormonally, we have supplemented patient’s cycles with progesterone through both vaginal and parenteral (intramuscular) administration as well as estrogen that we monitor closely after embryo transfer and make adjustments when deemed helpful.

The greatest improvement in pregnancy rates for the past several years however has been due to a “Culture Revolution” in IVF that is the media environment bathing and feeding the embryos.  All these advances have had a great impact on IVF success rates to the point that 50% of retrievals will result in a pregnancy.  Unfortunately, older patients and some younger ones have yet to share in this success.

Many IVF programs have reintroduced the concept of utilizing a co-culture medium to improve the quality and implantation of embryos. Co-culture is a procedure whereby “helper” cells are grown along with the developing embryo. Today, the most popular cell lines include endometrial cells (from the endometrium, or uterine lining) and cumulus cells from women’s ovaries.  Both cell lines are derived from the patient, thereby eliminating any concerns regarding transmission of viruses. Endometrial cells are much more difficult to obtain and process, while cumulus cells are routinely removed along with the oocytes during IVF retrieval.

Cumulus cells play an important role in the maturation and development of oocytes.  After ovulation cumulus cells normally produce a chemical called Hyaluronan.   Hyaluronan is secreted by many cells of the body and is involved in regulating cell adhesion, growth and development. Recent evidence has shown that Hyaluronan is found normally in the uterus at the time of implantation.

Co-culture of cumulus cells provides an opportunity to detoxify the culture medium that the embryos are growing in and produce growth factors important for cell development.  This may explain why some human embryos can experience improved development with the use of co-culture.

Preparation of co-culture cells starts with separation of the cumulus cells from the oocytes after aspiration of the follicles. These sheets of cells are washed thoroughly and then placed in a solution that permits the sheets to separate into individual cells.  The cells are then washed again and transferred to a culture dish with medium and incubated overnight. During this time individual cells will attach to the culture dish and create junctions between adjoining cells. This communication is important for normal development. The following morning, cells are washed again and all normally fertilized oocytes (embryos) are added to the dish. Embryos are grown with the cumulus cells for a period of three days to achieve maximum benefit.

Performing co-culture of embryos has improved implantation and pregnancy rates above and beyond those seen with the IVF advances previously described. More importantly, it promises to offer advantages for those patients whose previous IVF cycles were unsuccessful.

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Does Your Man Know His Place?

By David Kreiner MD, and Tracey Minella

February 24th, 2011 at 12:00 am

Even when babies are conceived the way nature intended, the man’s role is small in comparison to the woman’s share of the, well, labor. He has his moment of fun…and I’m not saying his contribution isn’t significant… but afterwards he’s basically a spectator for the rest of the nine month journey. The woman, simply because it is her womb, is in charge of the pregnancy.

Conceiving with IVF doesn’t level the playing field, but does offer the man more of role in this alternative pregnancy plan. True, his “moment of fun” loses something in the collection room alone. However, IVF gives the man a way to make more than that one obvious significant contribution.

Dr. David Kreiner of East Coast Fertility offers great suggestions on ways men can find their place in IVF and support their wives and partners in the process:

A husband’s experience when going through an IVF cycle varies depending in large part on how involved he gets. When a husband participates actively with the IVF process it helps to relieve much of the stress on the wife and on the relationship. The more involved he is, the more invested he will feel in the entire experience, and the more control he’ll feel over the outcome.

Many husbands pride themselves in their new found skills of mixing medications and administering injections for their wives. It helps many men who are used to caring for their wives to be in control of administering the medication for them. Successful IVF then becomes something he played a very active role in, and he’ll relate better to the experience, his wife and the resulting baby.

Despite a lack of prior experience, most people can learn to prepare and administer the medication. Whether it is the feeling of “playing doctor” or the knowledge that he is contributing significantly in the process and supporting his wife, most men relate that giving their wives the injections was a positive experience for them and for their relationship.

Along the same line of thinking, accompanying your wife at the time of embryo transfer can be most rewarding. This can be a highly emotional procedure. Your embryo/s is being placed in the womb and at least in that moment many women feel as if they are pregnant. Life may be starting here and it is wonderful to share this moment with your wife. Perhaps you may keep the Petri dish as a keepsake as the “baby’s first crib”. It is an experience a husband and wife are not likely to forget as their first time together as a family. I strongly recommend that men don those scrubs, hats and booties and join their wives and partners as the physician transfers the embryos from the dish into her womb. Nine months later, do the same at delivery for memories that last a lifetime.

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