Couples with an “infertility diagnosis” that can be appropriately treated with In Vitro Fertilization (IVF) should be counseled concerning their related “medical history” as well as their own chance for success with IVF.
The related “medical history” includes any coexisting medical conditions that might be affected by the IVF medications (or procedures), coexisting medical conditions that may alter the couple’s chances for pregnancy with IVF, and any maternal medical contraindications for becoming pregnant. Appropriate medical (or perinatal = high risk pregnancy) consultations and treatment plans should be developed prior to entry into the IVF program so that an organized course of (medically appropriate) action can result in a healthy outcome and optimal reproductive success.
The (often severe) emotional stress associated with the IVF procedure should be addressed. There are techniques that may be used to reduce this stress, including open discussions between the partners about their concerns and fears. If the couple appears to have potential problems with coping at this level of stress then consultation (and appropriate followup) with a psychologist (or other professionals trained in this area) is often very helpful.
Assessment of the couple’s chance for pregnancy with IVF depends on several factors. The age of the female partner and (the assessment of) her ovarian reserve are two of the most important factors. Additional information used to determine whether a reasonable recruitment of mature eggs is likely for a particular woman includes her ovarian response during any prior controlled ovarian hyperstimulation or IVF cycles.
Large top quality IVF centers report a consistent and close association between the age of the (egg providing) female and the reproductive (pregnancy) success rates. Assessment of ovarian reserve (for the egg providing female) also provides important information that is associated with IVF success rates. The available evidence (predominantly from donor egg IVF programs) suggests that it is the aging of the eggs rather than the aging of the woman’s uterus that is responsible for the observed age related decline in IVF success.
The information gathered concerning the (egg producing) woman’s ovarian reserve and chronologic age is also very useful in selecting a (fertility drug) stimulation protocol. The protocol (of medication) that is chosen to stimulate a particular woman’s ovaries has a dramatic effect on the results (time course and number of mature eggs produced) of ovulation enhancement.