When I started my IVF cycle, I decided to stop all exercise and take it easy.  Although I was never given any strict guidelines or instructions to stop exercise all together, I was given a list of a few dos and don’ts.  In the middle of my cycle I decided to take a stroll down the street one day to stretch my legs.  When I got back home I saw that a friend of mine had called.  When I called her back and told what I had been doing, she quickly informed me that I needed to stop exercise all together, even walking, during my cycle or I could increase my risk of having complications with Ovarian Torsion.

Before that day, I had never heard of the term Ovarian Torsion, but just like I do with any other medical term, especially surrounding fertility, I jumped on the internet to find out more about it.  What I found was that there was a link between Ovarian Torsion and the use of fertility drugs, or gonadotrophins, used in follicle stimulation.  Exercise during follicle stimulation can play a key role in the development of Ovarian Torsion.

Ovarian Torsion, or twisting of the ovaries, is considered to be rare.  What happens is that during ovarian stimulation, the ovary twists and cuts off blood supply to itself.  The risk during IVF is minimal, around 0.2%.  The risk for Ovarian Torsion increases with Ovarian Hyperstimulation Syndrome (OHSS).  Ovarian Torsion has also been present in women who have never gone through fertility treatments and is associated with other medical conditions.  Statistics show that about 20% of the reported Ovarian Torsion cases occur with pregnant women.

Part of the irony of Ovarian Torsion and fertility treatments is that if it is not treated early enough, it can actually lead to infertility, problems conceiving or the removal of the ovary.  Early diagnosis and treatment can lead to a good prognosis for the patient and the recovery of their ovary.  Untreated Ovarian Torsions can cause the ovary to die from lack of blood flow and may lead to the surgical removal of the ovary.

Studies have shown that the risk for Ovarian Torsion during ovarian hyperstimulation with fertility treatments increases when a patient exercises.  In fact, it has been reported that patients are still at risk for Ovarian Torsion after a fertility treatment until their ovary returns to its normal size, so exercise should be avoided until this occurs.

Symptoms of Ovarian Torsion include tenderness in the lower abdomen as well as severe pain in the lower abdomen.  Other symptoms associated with Ovarian Torsion are nausea, diarrhea, vomiting, constipation, mild fever and tachycardia.  Patients may experience one or all of these symptoms, but the most apparent symptom will be the extreme lower abdominal pain.  Whether you are in the middle of a stimulated cycle, have recently completed a cycle, or are pregnant you should contact your doctor immediately if you experience these symptoms in order to rule out Ovarian Torsion.

Although the exact cause of Ovarian Torsion is unknown, there are many things associated with it.  Above all else, strenuous activity and exercise should be avoided during a fertility cycle or following a fertility cycle until your ovaries are shown to be back to their normal size. Some fertility doctors go so far as to say avoid exercise and housework, such as running a vacuum cleaner, all together during your treatments.  Although the decision to avoid exercise is one that you will need to take, I say why take any chances?

Needless to say, after I read about Ovarian Torsion on the internet, I opted not to take any chances.  This meant no housework, no exercise and no leisurely strolls down the street.  Be aware of your body and how you feel during your treatments and if you begin to feel lower abdominal pain, contact your doctor immediately.  It might be nothing, but it is better to know and have a good peace of mind rather than face serious consequences from not seeking necessary medical help.

Any time someone is going through fertility treatments that involve the use of fertility drugs to increase follicle stimulation, they run a risk of developing Ovarian Hyperstimulation Syndrome (OHSS). OHSS occurs when too many follicles develop and the ovaries become enlarged.  While many people using fertility drugs report discomfort during the time of ovulation, those who experience OHSS report severe pain and discomfort among other symptoms and often end up in the hospital for treatment and monitoring.

The first thing that people want to know is what causes OHSS.  The truth is the exact cause is unknown.  Why one person develops it and someone else doesn’t is yet to be determined.  Why a person might develop it during one cycle and the same person does not develop it on a subsequent cycle is still a mystery.  All that is known is that the use of follicle stimulating fertility drugs puts you at risk of developing OHSS.

All that being said, there are some women who seem to be at higher risk than others.  Women who are under age 30, women who are underweight, women who have used hCG for support during the luteal phase, women with polycystic ovarian syndrome, women who have been administered a GnRh agonist, women who have had a previous occurrence of OHSS and women with a large number of eggs or follicles and high estrogen levels all are at a higher risk of developing OHSS.

The best way to treat or prevent OHSS is to monitor follicles through ultrasounds and hormones through blood work.  By comparing estrogen levels and follicle development, doctors can better predict if OHSS is a possibility.  If it appears that it is a possibility, doctors should not administer the hCG until they do subsequent tests.  If you are doing IVF, some doctors may opt to collect eggs, inseminate them and then freeze the embryos for a future IVF procedure using the frozen embryos.  There is also the possibility of stopping the gonadotropin stimulation while continuing to suppress the estrogen levels to make them decline and then doing the egg collection when the estrogen levels are at an appropriate level.  Doctors might also impose such restrictions as limiting or stopping any type of exercise, household activities such as vacuuming or sexual intercourse.

Since the only way a doctor can know whether or not you have OHSS is through monitoring you with blood work and ultrasounds, you need to be aware of the symptoms of the syndrome.  If you experience any of the following, you should report it immediately to your doctor: abdominal pain, diarrhea, nausea and vomiting, abdominal bloating, breathing problems, infrequent need to urine, dark urine or sudden weight gain.

The complications of OHSS can be severe and should not be taken lightly.  Although severe OHSS is rare, it can lead to permanent damage, injury or death.  There are many complications associated with OHSS.  A common complication is twisting of the swollen ovaries (ovarian torsion) that can result in the removal of your ovaries.  Other complications include fluid in the lungs and stomach, blood clots and loss of the functions of your liver and/or kidneys.

Although the exact cause of Ovarian Hyperstimuation Syndrome or OHSS is unknown, knowing the risk categories that you fall under and being aware of your body and how you feel during fertility treatments is important and careful monitoring by your doctor is essential.  Because the complications can be severe, it is always good to be one step ahead of OHSS to prevent ever developing one of them.  Even though the development of severe OHSS is uncommon, it is better to be safe and careful during your treatment to protect your health and to help with the success of the treatment.

When couples are going through fertility treatments that involve using fertility drugs to increase follicle stimulation and the production of eggs such as IUI or IVF, there is always a risk for Ovarian Hyperstimulation Syndrome (OHSS).  This is a very serious complication that can result in a hospital stay and could be fatal if it was not monitored and treated accordingly.  When too many follicles develop, the ovaries can become swollen and enlarged.  OHSS can cause severe pain and fluid to be released into the lungs and abdomen.

To understand OHSS, we must first talk about the process of ovarian stimulation itself.  When going through fertility treatments, doctors often used medications to help stimulate ovarian production.  It is most typically used for procedures such a IUIs or IVF but is also used for other situations such as causing ovulation in women who are not ovulating on their own.

The typical drugs used for ovulation induction are Clomid and Gonadotropins.  Their job is to increase the number of egg follicles for ovulation.  You can be given different dosages of these medications depending on such things as your age, the type of fertility procedure you are doing and past stimulation results from using them.

When you are going through a fertility treatment, your doctor should maintain a regular monitoring schedule for your hormones, the number of follicles and the size of your ovaries.  They should do this through both blood work and ultrasounds.  Monitoring these things regularly is important as it is the only way to diagnose OHSS.  About 3-5% of the women using these drugs may develop OHSS during the fertility treatment, so monitoring is essential.

When a woman experiences OHSS, she will most likely begin to have the symptoms about 3-5 days after egg retrieval.  The symptoms can be mild, moderate or severe.  Most women only have mild or moderate OHSS and the symptoms will only last a few days. Sometimes pregnancy may actually cause the symptoms to last longer.

Women with mild to moderate OHSS may have any of the following symptoms: pain, abdominal swelling and the feeling of being bloated.  At times ovarian cysts form and fluid shows up in the abdominal cavity.  Ovarian swelling for the mild form of OHSS is less than 5 cm and it is 5 to 10 cm for the moderate form.

Only about 1-2% of women who experience OHSS have the severe form of the condition.  The ovaries swell and become larger than 10 cm.  Nausea, vomiting and severe abdominal pain occurs.  The fluid backs up into the chest and abdominal cavity resulting in shortness of breath and swelling of the abdomen.  Severe OHSS typically requires a hospital stay to treat the symptoms and monitor the ovaries and fluid.  Kidney damage, blood clotting disorders and Ovarian Torsion (twisting of the ovaries) have all been associated with severe OHSS.

Any time that you are doing fertility treatments it is important for you to be aware of the symptoms of OHSS. Although it can only be officially diagnosed by the monitoring of a doctor, you can be aware of the changes in your body.  Extreme bloating, pain or discomfort should be reported immediately to your doctor.  Although OHSS can’t be prevented at this time, early detection can prevent the onset of severe OHSS.

Although maintaining a healthy diet and healthy lifestyle cannot guaranty the success of a fertility treatment, it can have a positive affect on the outcome.  Studies show that couples who ate a nutritional diet and took care of themselves both mentally and physically had a better success rate when going through fertility treatments such as IUI and IVF.

Let me be the first to say, when we were going through our fertility problems the last thing I wanted to hear was one more person telling me to “relax” or “try this type of food or vitamin”.  Everyone always seemed to have an answer or “helpful” hint as to what I should do to get pregnant.  What they didn’t understand was that, whatever they were telling me, I had already either thought about, read about, or tried.

What I wanted to give to you was just some guidelines on how to maintain a healthy lifestyle to increase your chances of success.  It is important for you to know that I’m not telling you that doing these things will guaranty anything, it is just simply guidelines for how to be healthier.  It is important for us to maintain healthy lifestyles no matter how we eventually become parents.

The first thing that you need to realize that now is not the time to diet or try any quick weight loss solutions.  What you are trying to do is to eat a healthy diet.  This means cutting out some foods and adding more nutritional foods to your daily food intake.  Even if you are overweight, when you start to eat a more healthy diet and use good portion control you will lose weight.  Everyone has an ideal body weight based on a height/weight ratio and you want to be close to that to better your chances of success.  Getting there by skipping meals will not help and can hurt your success rate.

You should start taking prenatal vitamins now.  Your body needs certain vitamins to be healthy and to help promote a successful pregnancy.  These vitamins include Vitamins A and E, Calcium, Iron, Zinc, Folic Acid (for women), essential fatty acids and Vitamins C and D (for men).  You can get these nutrients and vitamins from taking vitamins but the best way (and most recommended way) to get them is from eating foods rich in them.  There are plenty of sites online that will offer you tips on which foods contain different vitamins and nutrients.

While there are some foods that you should try to eat to help you stay healthy, there are some foods that can actually harm you by causing infections.  It is recommended that you stay away from deli meats and pre-packaged sandwich meats, undercooked or raw poultry and fish, unpasteurized dairy products particularly soft cheeses and unpasteurized juices.  All of these can contain bacteria that cause infections.

There are other foods and beverages that you should avoid when going through fertility treatments.  These include alcohol, caffeine, raw meats, contaminated drinking water, local water when traveling to another country, tonic water, ginger ale and artificial sweeteners.  You should also stop smoking and avoid using aspirin, decongestants and antihistamines.  Your fertility doctor will probably add to this list.

While it is important to maintain good physical health, you should not overexert yourself during fertility treatments.  It is ok to take a leisurely stroll, but most fertility doctors suggest that you avoid strenuous exercise including running, aerobics and spin classes to name a few.  Over exertion can cause problems with implantation and a successful pregnancy and has also been linked to hyperstimulation of the follicles.

When you are going through the fertility process, it is important to discuss diet, nutrition and exercise with your doctor.  They will more than likely already have a list of dos and don’ts prepared to offer you a guideline on how to maintain a healthy lifestyle and eating habits during your fertility treatments.  In order to help increase your chances of having a successful fertility treatment, it is essential that you follow these suggestions as closely as you can.

Traditionally, IVF patients underwent transfer of their embryos at about day 3 after egg retrieval.  This was considered acceptable and the norm.  We are now seeing more clinics wait until about day 5 to do transfer to allow the embryos to reach what is called the Blastocyst stage.

With the improvement of the media culture in labs, the embryologists are able to sustain embryos longer, allowing them to further divide and reach the Blastocyst stage.  During this stage they are considered to be much stronger and healthier than some of the embryos that were transferred at day 3.  Waiting for a day 5 Blastocyst transfer allows the embryologists to have a better sense of which embryos have the greatest possibility of surviving transfer and implanting.

It makes sense that they are able to better predict the success rate.  The reason for this is that when a pregnancy occurs without the use of IVF, implantation occurs in the Blastocyst phase.  So, if you are transferring embryos that have already reached this stage, they are naturally better equipped for implantation.

Doing a Blastocyst transfer also decreases the risk of having a pregnancy with multiples as fewer embryos are transferred at one time.  Since they are stronger and have a greater chance of surviving, there is no need to transfer more than 2-3 at once.  This also typically leaves more to be frozen if you need to do IVF in the future.

However, typically the longer the embryos are kept in the media in the lab, the fewer there will be that survive.  The reason being is that only the strongest of the embryos will make it to the Blastocyst stage in the lab.  There is not any evidence that, even though the other embryos were not strong enough to make it in the lab, they wouldn’t make it through transfer either.  It is possible that embryos not strong enough to make it to Blastocyst stage in the lab would make it if they were transferred at day 3.  Many clinics will watch the embryos closely around day 3.  If they feel like they are not going to make it to a day 5 transfer, they will go ahead and transfer them earlier to have the best chance of them surviving.

The experience of the embryologist can play a big role in transferring the embryos at the Blastocyst stage.  Talk to your fertility clinic about their Blastocyst success rate, whether or not they tend to do a 3 or 5 day transfer and about the experience of their embryologist.  Most clinics have a preference as to how long they wait to do a transfer and this can vary from clinic to clinic.

Research has shown that transferring embryos in the Blastocyst stage has a good success rate.  However, since so many factors play into how long a clinic might wait to transfer, it is important for you to know that day 3 transfers still have a good success rate if they are good, strong embryos that are growing appropriately.  Blastocyst transfer is fine for some people, but a day 3 transfer might be better for you if your doctor is unsure whether or not the embryos will make it any longer in the lab.

Charting your Basal Body Temperature or BBT is an excellent way to help you to learn about your cycle and which days of the month are your most fertile.  It is also a valuable tool to help determine if you are not ovulating or ovulating later or earlier in your cycle than is normally expected.  In the world of fertility treatments and testing, charting your BBT is one thing that you can control and do not have to rely on anyone else to do for you.

To chart your BBT you must first purchase a BBT thermometer and either download a BBT chart or make your own.  There are plenty of BBT charts that you can download for free.  I chose to make may own chart because it was something I could have control over and I could personalize it however I wanted to.

The best time to start charting is on the first day of your next menstrual cycle.  Place the thermometer next to your bed and as soon as you wake in the morning reach over and put it in your mouth.  Do not get out of bed, sit up, talk, drink a glass of water or do anything else. The first thing you need to do every morning is to take your temperature or you will not get an accurate reading.  You should take your temperature at the same time every morning.  This means setting the alarm on the weekends so that you take your temperature at the same time that you do during the week.

As soon as you take your temperature mark it on your chart.  If you don’t do it right away and the reading is lost on the thermometer it is easy to forget if it read 97.2 or 97.4.  Each day, connect the dot from the day before.

Right before you ovulate you might see a slight drop in temperature, but not all women experience this.  When your temperature is elevated for at least 3 days, you know that ovulation has occurred.  When you are about to start your menstrual cycle, your temperature will drop again.  For me, when my temperature dropped was a hard day because I knew I wasn’t pregnant again.  However, sometimes my temperature would drop and it would be over 24 hours before I started my cycle. Since I knew my temperature had dropped, I didn’t have to play the all too familiar “am I pregnant or not” game that so many of us experience when going trough fertility problems.

After you have charted for at least three months you can begin to notice patterns.  You will be able to tell around which days you ovulate and exactly how long your cycle lasts.  It is a good idea to wait until your temperature has been elevated for about 20 days before you take a pregnancy test.

There are a number of factors that can affect your BBT and give you an inaccurate reading on a particular day.  Whether you are on vacation, have experienced a significant event in your life, the room is a lot colder or hotter than normal or you have taken your temperature over an hour before or after you normally do can all affect the accuracy of the reading.

In addition to charting your BBT, you should also chart your cervical mucus.  Cervical mucus changes during your most fertile days and becomes similar to the consistency of egg whites when you are at your most fertile days.  This information is important to note when you are charting your cycle.

Charting your Basal Body Temperature is an easy process that can help give you or your doctor answers about what is happening to cause your fertility problems.  It might indicate that you are not ovulating or that you are ovulating early or later in your cycle than expected.  Since most clinics require you to do charting when you start working with them, it is an important step that you can take now so that you will a step ahead when you go to your fertility clinic for the first time.

For those of you who are just beginning your fertility journey, one of the first places you may start before even going to a doctor is to chart your Basal Body Temperature (BBT).  Women chart their BBTs for many reasons.  Some chart it to do natural family planning so that they know when they have ovulated and when it is safe to have intercourse.  Others chart it to get to know their cycle so they know when is the best time to try to get pregnant.  If you are having problems getting pregnant, charting your BBT can sometimes be helpful in determining what the problem is.

Basal Body Temperature essentially means your body’s core temperature.  In order to get the most accurate reading, it should be measured first thing in the morning as soon as you wake up.  A woman’s BBT is usually right around 97ºF during the first half of your cycle.  When a woman ovulates, their BBT typically rises one degree or more, indicating that ovulation has occurred.  This elevation in the BBT lasts until right around the time menstruation begins.

When charting your BBT as part of the fertility process, your BBT can sometimes key you in on reasons that you might not have gotten pregnant up to this point.  Charting your BBT can help those of you who have unusually long cycles or shorter cycles to determine the best time of the cycle to try to get pregnant.  For instance, if you have a long cycle, your fertile days might not be until later in your cycle, so you would need to try at different times than someone who has a “normal” 28 day cycle.  BBT can also indicate if you are not ovulating or ovulating very early or very late in your cycle which can indicate problems.

In order to get the most accurate temperature, it is best to use a BBT thermometer that is specifically designed to show even the slightest change in your temperature.  They can be found in drug stores or pharmacies in grocery stores and discount department stores such as Wal-Mart.  They will specifically state that they are basal body temperature thermometers.  They used to be available in both mercury and digital thermometers, but the mercury thermometers are harder to find.  The digital thermometers are easier to read and give a much faster reading.

When charting your BBT, it is also helpful to chart your cervical mucus and cervical position to better understand your cycle and predict your most fertile days.  Since your BBT indicates when ovulation has already occurred, it is best to chart these other things so that you can begin to know how your body changes right before ovulation or during your most fertile times.

Charting your BBT is an excellent place to start if you are having fertility problems.  Many clinics or doctors will actually require that you chart your BBT for 3-5 months before they start treatments so that they can identify anything that is out of the ordinary in your ovulation cycle.  Therefore, if you can begin charting early on in the process, you can bring your BBT charts with you on your first visit to the fertility clinic.  By looking at your charts, your doctor may be able to determine the next course of action in your fertility process such as clomid to help induce ovulation.

Endometriosis has long been associated with fertility problems.  In my fertility support group alone 7 out of 25-30 women were diagnosed with fertility problems due to endometriosis.  What is hard to believe is that, although the link between fertility problems and Endometriosis is recognized, the exact cause or reason for this link is still unknown.

Endometriosis occurs when the endometrium lining or tissue lining of the uterus spreads outside the uterus to various places including the fallopian tubes, ovaries and abdominal cavity.  Although many women exhibit symptoms of endometriosis, it is only diagnosed through laparoscopic surgery so that the doctor can visibly see the spreading of the tissue.

Some women have endometriosis without knowing it and never have fertility problems.  About 40% of women who have fertility problems are found to have endometriosis.  It can cause the tubes to be blocked and can impede in ovulation.

While many women complain of having such things as a painful menstrual cycle or painful intercourse, some women do not know that they even have endometriosis until laparoscopic surgery is performed to look for the cause of fertility problems.  It is highly unusual for a woman with severe scarring to not have at least a few symptoms of endometriosis.

The main theory regarding the cause of endometriosis is that it is caused when menstrual blood back flows into the pelvic cavity during menstruation.  This back flow eats away at the endometrium and causes scarring.  There also appears to be a genetic predisposition for endometriosis as it is not uncommon for sisters, mothers, grandmothers and aunts to all have the disease.

Treatment for endometriosis includes surgery to remove the scar tissue, although it typically will eventually return, and hormone therapy using such medications as lupron.  Unfortunately, the use of lupron lowers your estrogen levels and impedes the production of FSH and LH which will keep you from getting pregnant.  Because endometriosis can be so painful, this is an option that many women are willing to choose to avoid the pain.

You should discuss your severity of endometriosis with your doctor before beginning any fertility treatments.  Depending on how severe it is and where it is found in your reproductive tract will greatly affect your options as far as IVF and IUI.  Blocked fallopian tubes or scarring on your ovaries require further testing and possible surgeries.

Although the exact cause of endometriosis is unknown and the reason it causes fertility problems is unclear, it is obvious that there is a link between endometriosis and fertility problems.  Going through fertility problems and discovering you have endometriosis seems to be a catch 22.  Now you know what is causing the problems, but how and why is it happening?  I encourage you to contact the Endometriosis Association for further information, suggestions and support.  One of the best ways to deal with a disease like endometriosis is to become an expert on the subject.  Through this knowledge you will better be able to decide what your next step is going to be in your fertility journey.

Cryopreservation is the process of freezing embryos, eggs or sperm for future use.  For the purpose of this article, we are going to discuss Cryopreservation in relation to frozen embryo transfer with IVF.

Cryopreservation of embryos is done for many reasons.  Sometimes embryos are frozen during an IVF cycle because more embryos are produced than needed, so the extra embryos are frozen.  Other times there might be a disruption in an IVF cycle and the embryos are frozen for a future cycle.  If a man or woman is going to go through a cancer treatment, they can start the IVF process and have embryos frozen for future use.

When embryos are frozen, they are frozen between day one to day six after the sperm penetrates the egg.  If the quality of an embryo is poor or they are not dividing well, most clinics will not freeze them.  Depending on how far along they are in the dividing process, when embryos are thawed they will either be transferred to the woman almost immediately after they are thawed or allowed to divide for a few days before transfer takes place.  Either way they are monitored for awhile to evaluate how they are doing and whether or not they were damaged or destroyed during thawing.

Frozen embryo transfer with IVF is different than a regular IVF cycle.  There tends to be less medications involved in a frozen cycle.  Some clinics will even do a natural cycle, meaning they will monitor a woman’s hormone levels and will transfer the embryos when the time is right.  Other clinics opt to do a cycle with medications to regulate a woman’s cycle and better be able to monitor the best time to transfer the embryos.  In either case, you can expect to do progesterone injections after transfer to help with implantation.

Frozen embryo transfer is less expensive than a regular IVF cycle whether or not there are medications involved.  Reason being is there are no medications involved in follicle stimulation and no egg retrieval process.  You are basically paying for the transfer and the few medications that might be involved.

Transfer of frozen embryos is the same as transfer of embryos during a regular IVF cycle.  They are inserted into the uterus using the same methods.  Success rates for frozen cycles are almost equal to IVF without frozen embryos.  The success depends on the quality of the embryos, the reason for your fertility problems and a woman’s age, just as it does with a regular IVF cycle.  When embryos are thawed, they more than likely will not all survive to be transferred during IVF.  For this reason, most doctors opt to thaw one or two extra embryos.

While your frozen embryos are stored, you will probably have to pay a storage fee to the clinic either monthly or annually.  The fee varies from clinic to clinic.  You might also have to pay a one time freezing fee as well.

You should also discuss options for unused embryos.  Ask your clinic if they have an embryo donor program.  When we did IVF, we filled out a detailed form for what we wanted done with unused embryos.  The form even included details about what we would do if we got divorced or if one of us passed away.

The decision to freeze embryos and what to do with unused frozen embryos is a personal decision and an emotional decision.  You should discuss these issues ahead of time before you are faced with having to make the decision.  Talk with you clinic about their frozen embryo success rates.  Ask them as many questions as you need to in order to feel comfortable with doing cryopresesrvation.  For many couples, the process of cryopreservation has opened doors for options that were not available to them less than 25 years ago.  It might be the option that is right for you.

When going through IVF, your doctor will discuss many different scenarios with you.  If this doesn’t work then we’ll try this.  Then, if that doesn’t work we will try this.  It can all become over whelming and the “why and how” of each scenario often gets lost.  One of these scenarios might involve doing assisted hatching in conjunction with IVF to increase your chances of achieving pregnancy.

I had not heard about assisted hatching until after I started the fertility support group and a number of women in the group had either already done IVF with assisted hatching or were preparing to try it.  We began to do research for the group so that we would all have a better understanding of how it works.

When an embryo is forming, it has a protective layer surrounding it called the zona pellucida.  For implantation in the uterus to occur, the embryo must break through or “hatch” from the zona pellucida.

For unknown reasons, some women’s embryos have a tougher, stronger zona pellucida and need assistance in the hatching process.  Other factors also play a role in the use of assisted hatching.  Women who are over age 39 are typically recommended for assisted hatching.  Poor egg quality or quantity, poor embryo quality, a day 3 elevated FSH and previously failed IVFS also contribute to the use of assisted hatching.

There are two main techniques used to make a small hole in the zona pellucida.  Assisted hatching is typically done by laser or chemical.  The embryo is held in place and a small laser or tiny, hollow acid filled needle is used to penetrate the cell.  After the hole is made, the embryo is cleaned.  Some clinics do a direct transfer whereas other clinics will put the embryo back into an incubator for a short period of time before transfer.  The transfer occurs just as it would for IVF without assisted hatching.  Some clinics will prescribe antibiotics after assisted hatching because the embryos protective outer shell is compromised during the procedure.

A small percentage of embryos might be damaged by assisted hatching.  It should only be preformed by a qualified embryologist with experience in doing assisted hatching.  You should talk to your clinic about their success rates and you can research their embryologist to make sure that you feel comfortable with them performing the procedure.  Which assisted hatching technique is used, damage to embryos and inexperienced embryologists can all negatively affect pregnancy rates

Overall, studies have shown that assisted hatching can help improve pregnancy rates.  These studies show that IVF with assisted hatching has a higher rate of success than IVF without assisted hatching.  Assisted hatching is a relatively new procedure that gives hope to couples who would not have had the option just 15 years ago.  I would encourage you to explore more information about the assisted hatching technique and your clinic’s success rates before making a decision about using assisted hatching to make sure you feel it is right for you.