IVF / ICSI FAQ
IVF / ICSI
How do I become an IVF patient?
Patients are accepted by physician referral only. All referrals are reviewed and triaged accordingly by the clinic physicians. Every effort will be made to ensure timely review of urgent referrals.
Is there a wait-list for IVF?
Once pre-IVF testing is complete, treatment can commence immediately. There is no wait-list for IVF.
How much does IVF cost?
The costs of fertility treatments are non-insured medical expenses. Patients will receive a detailed cost breakdown according to the treatments recommended for their individual situation.
Does provincial health care or private insurance cover the costs of IVF?
All fertility treatments including IVF are uninsured services and therefore not covered under the Alberta Health Care Plan. Patients are responsible for all expenses related to their IVF treatment. These medical expenses can be claimed on your personal income taxes. Some private insurances may cover parts of the cost of IVF treatment and/or medications.
What type of screening requirements are needed before I can start my IVF cycle?
Testing is required for both partners to optimize treatment outcomes. Generally, Pre-IVF screening includes an assessment of ovarian reserve, semen analysis, infectious disease screen and uterine cavity assessment.
Does the clinic treat single or same sex couples for IVF treatment?
Yes, the clinic welcomes single and same sex couples. Please obtain a referral from your family physician to begin the process.
Is there an age cutoff for IVF treatment?
Yes, the clinic will accept referrals for single patients or couples, up to the age of 45 for the female. If donor oocyte or donor embryos are used, the primary cycle including embryo transfer must be completed before the female patient’s 51st birthday. All subsequent transfers with frozen embryos remaining from the primary cycle must be completed by her 55th birthday unless a gestational surrogate is used.
How many eggs can I expect to get?
The number of eggs retrieved is related to the female partner’s ovarian reserve (age, day 3 FSH, antral follicle count, or Anti-Mullerian Hormone level). Generally, the younger the female and the better the ovarian reserve the greater the likelihood of retrieving more eggs. The average number of eggs retrieved in a good prognosis patient is 12. Older patients and/or women with increased FSH levels can expect a lower number of eggs.
What if I have too many eggs?
If over response (called ovarian hyperstimulation) occurs this can result in potentially serious side-effects and complications of ovarian stimulation. However, several options exist to reduce the risk. These options will be discussed and individualized accordingly. In general, options include:
- continuing with the cycle including embryo transfer and monitoring for ovarian hyperstimulation syndrome (OHSS),
- continuing with the cycle and considering a single blastocyst transfer to decrease the likelihood of severe OHSS,
- continuing the cycle and freezing all embryos for use in a later Frozen Embryo Transfer,
- canceling the cycle and restarting at a lower dose of stimulation medication.
What if I have too few eggs?
The clinic recommends having a minimum of four mature follicles on ultrasound prior to proceeding with egg retrieval. Depending on individual circumstances, several options exist including:
- continuing with egg retrieval and embryo transfer despite the low number,
- converting to Intrauterine Insemination (IUI) if the fallopian tubes are open and adequate sperm count exists,
- canceling the cycle and restarting with a higher dose of medication or an alternate protocol
- considering Egg Donation or Embryo Donation cycle
If no alternate protocol exists, egg donation may be recommended.
What is a day 3 FSH and estradiol level?
These are blood tests measuring the level of follicle stimulating hormone (FSH) and estrogen on the third day of your period. These blood tests give us an indication of ‘ovarian reserve’, in other words, how hard your pituitary gland has to work to stimulate your ovaries based on the number of follicles (immature eggs) that are present. These values give the physicians information used to determine the most suitable IVF protocol and medication dose to optimize success.
How much time does treatment require?
This will depend on where you live and your proximity to the clinic. During the ovarian suppression (down regulation) phase of treatment there should be minimal disruption to your daily life. An appointment is required for the suppression check. This is performed generally after two weeks of ovarian suppression medications. Once gonadotropin (FSH) injections begin, you will attend morning appointments on the fourth and seventh day of injections. Following that, you may be required to have ultrasounds and/or blood tests either every 1 to 3 days as necessary depending on your rate of stimulation.
Based on an average of 12 days of stimulation injections, egg retrieval 35 hours following last injection and transfer of day 3 embryo or day 5 blastocysts, the entire treatment takes approximately 2 weeks. The pregnancy test is done fourteen to sixteen days after embryo transfer.
Depending on individual circumstances, patients may return to work after a few days rest, or choose to take the entire duration off. The clinic recommends minimizing stress and heavy lifting during this time.
How many embryos can I have transferred?
Individual recommendations will be made to determine the number of embryos for transfer in order to optimize success rates and the opportunity for a singleton pregnancy. The clinic is committed to reducing the multiple pregnancy rate to reduce the risk to both the fetus and mother. One day 5 blastocyst will be replaced whenever possible.
Several patient-specific considerations are taken into account including:
- age of female partner
- stimulation cycle
- quality of embryos
- number of frozen embryos
- previous fertility history
- risk of ovarian hyperstimulation syndrome
What are the chances of multiple births?
A single, healthy pregnancy is the goal of the clinic. Your estimated chance of success with treatment including risks of multiple births will be individualized and discussed upon consultation with your physician. The multiple birth rate is related to the age of the female partner at the time of egg retrieval, number of embryos implanted, the quality of these embryos and other complicating factors. Further details are available from your physician at the RFP.
Can I expect to see the same physician at each visit?
All RFP physicians work closely as a team to share the responsibilities for the IVF program. The physicians share similar treatment philosophies and protocols so the patient can be assured of continuity of care. After you have entered into an active treatment cycle, you may see any one of the our seven physicians during the cycle.
How long does my partner need to take off work?
Although partners are encouraged to attend as many treatment appointments as possible, this is not mandatory. Male partners are required to be in Calgary the evening prior to egg retrieval and remain in town until the day following egg retrieval (after the fertilization check) in order to provide a fresh semen sample if necessary. Partners may leave Calgary once fertilization has been established and all appropriate consents have been completed.
What if embryo transfer falls on a weekend or holiday?
The clinic is open 7 days a week for the active treatment of IVF patients.
How do the Regional Fertility Program success rates compare to the rest of Canada?
Pregnancy and live birth rates compare favourably with other IVF programs across Canada. Further details are available from your physician at the RFP. The Canadian Fertility and Andrology Society (CFAS) collects statistics voluntarily from participating clinics across Canada. National birth rates, links to other Canadian clinics and relevant patient resource information are available under the Public Affairs & News tab of the CFAS website.
Can I have satellite monitoring for another clinic at RFP?
Satellite monitoring may be provided on a case by case basis. The process begins by having a referral faxed to the clinic. Once received, the referrals are triaged and approval/decline letters are sent out to the referring physician within 14 days. Should the referral be approved, an initial consult would be scheduled with one of our physicians approximately 6-8 weeks to discuss medical history and monitoring needs.
Satellite monitoring is an uninsured service and therefore payment is the responsibility of the patient. An initial deposit of $1550 is required to begin a cycle. A $650 administration fee starts the cycle followed by a fee per test ordered by the host clinic. A fee schedule will be reviewed with you upon acceptance of your referral.