Selection Criteria for IVF
In Vitro Fertilization Program
Two issues are considered in advising patients about IVF: Have simpler and less costly treatments been tried, and is there a reasonable chance of achieving pregnancy with these procedures? Based on these considerations the following criteria are used in selecting couples for the IVF program:
Medical Indications:
- Tubal absence.
- Endometriosis or tubal disease unresponsive to treatment.
- Ovarian dysfunction.
- Male factor infertility.
- Unexplained infertility.
- Selection of unaffected embryos to prevent a genetic disease.
In addition, to initiate treatment, couples must meet the following criteria:
1. Age criteria
A. Women using their own eggs:
Under 40 years of age is preferred a better chance for pregnancy. Women 40 to 42 years of age with regular menstrual cycles may be accepted provided they consent with full understanding that the expectation for pregnancy and live birth reduces with age. Women may initiate a treatment cycle of in vitro fertilization as late as six weeks prior to their 43rd birthday. No oocyte retrievals will be performed on women greater than 42 years of age. (Exception: Women 43 years of age may be accepted if they meet certain criteria. If accepted,oocyte retrieval must be performed rior to the 44 birthday.)
B. Women using donor eggs:
Eggs from an anonymous donor may be utilized up to a woman’s 47th birthday. Eggs from a known (or identified) donor may be utilized up to a woman’s 50th birthday. All women age 43 and above must be cleared for pregnancy by a high-risk obstetrician.
C. Women using frozen embryos:
Frozen embryos must be used by a woman’s 50th birthday. All women age 43 and above must be cleared for pregnancy by a high-risk obstetrician.
2. Marital status:
Based on legal considerations, only married couples may be accepted when donated embryos will be used. However, unmarried couples using either donor eggs (with their own sperm), their own eggs and sperm or donor sperm (with their own eggs) may be treated when both partners consent and document their commitment to recognize any child borne of that procedure as their own. A couple is defined as two adults (a man and a woman or two women). Single women (two women presenting as a couple) may utilize donor sperm. Single women without a partner may use donor sperm or a known sperm donor who is willing to sign consent forms.
3. Substance abuse:
No partner currently abusing alcohol, narcotics or illicit drugs will be accepted until completion of a suitable (i.e. suitable to our program therapist) substance abuse program. Prior substance abuse may require random drug screening. A positive random drug screen (narcotics, alcohol, etc.) will result in cycle cancellation/treatment termination. All smokers will be encouraged to quit and should attend a smoking cessation program. Evidence indicates stimulation is poorer and the live birth rate for smokers is reduced.
4. Emotional health:
Persons diagnosed or exhibiting severe psychiatric disturbance will not be allowed to participate in our Assisted Reproductive Technologies (ART) program until completion of corrective therapy. Additionally, couples who show evidence of a severely dysfunctional, unstable, or abusive relationship will be required to receive therapy prior to initiation or continuation of ART services. In each case, acceptable therapy is defined as acceptable to the program counselor. Further, all people who participate in the ART program must be able to give informed consent prior to ART procedures.
5. Physical health:
Good general physical health; absence of serious untreated chronic illness.
6. Being significantly overweight can affect both the ability to stimulate the ovaries (higher cancellation rates and fewer follicles stimulated) as well as our ability to retrieve the eggs because of poor access to the ovaries. IV sedation can be a serious risk because of the large amounts of drug required and the resultant depression of breathing. These same breathing problems may create problems performing the actual egg retrieval. Significant obesity makes pregnancy itself high risk. We will evaluate access to the ovaries on the initial visit and if ovary(ies) are not visualized, we may recommend significant weight loss before doing an IVF cycle.
7. * Infectious Disease Testing:
Blood tests for HIV, Hepatitis (B surface antigen and C antibody) and RPR (Syphilis) are required for both partners. These should be ordered by your local physician and results may be mailed or faxed to us or hand carried to your preliminary appointment.
8. *Other testing (childbearing female partner only):
Documentation (blood test) of immunity to rubella and a recent pap smear (within past year).
*If this testing is not done and results available prior to your preliminary appointment, participation in an IVF treatment cycle may be delayed. Male partners will not be allowed to freeze a semen sample at preliminary appointment if results of infectious disease testing are not available.
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