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Fertility Road Magazine 46 - September/October 2018

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The latest issue of Fertility Road Magzine brings you our latest Fertility Journeys update, a closer look at stress and infertility, natural approaches to endometriosis and a how your weight can affect your chances of getting pregnant plus lots, lots more.


FERTILITY 360 EXPERT: Craig Reisser THE VALUE OF SUCCESS RATES Understand Success Rates and Help Keep Your Surrogacy Journey on Track 44 | | fertilityroadmag | follow us @fertilityroad

FERTILITY 360 Craig Reisser, a parent via egg donation and surrogacy in the USA, shares some advice for intended parents on how to use success rates when planning your surrogacy journey. When it comes to choosing an IVF clinic a discussion of success rates is sure to be one of the key considerations. Success rates can be a notoriously complicated area for intended parents, not only because there can be so many factors that play a part in them, but also because clinics may report them in any number of ways. I certainly found this to be true when I was undertaking my own journey. Because your IVF clinic will play a pivotal role in shaping your journey, understanding how to make sure you are focussing on the right success rates for the specific IVF procedure you are planning, as well as how to apply them in a practical manner to your decision making is essential. In my view, your ideal goal with IVF should be to have the best chance of success and a healthy baby on your first attempt. Or in other words minimising the risk that you will have to repeat any aspect of the IVF process. This is the best way to keep your budget and timetable under control and your stress levels to a minimum. While my focus here is on IVF for a surrogacy journey, as this was my own personal experience, this same objective can apply equally to anyone undergoing IVF – whether using her own eggs or donor eggs, working with a surrogate or planning to carry the pregnancy herself. In an ideal world, first time success would mean two things. Firstly, only needing one egg retrieval and embryology cycle (including embryo testing if applicable) to obtain all the viable embryos that you will need to build your family. Secondly only needing a single embryo transfer for the live birth of a healthy baby. For many intended parents their actual IVF experience does not reflect this ideal and they may require more than one egg retrieval and embryology cycle and/or more than one embryo transfer to achieve their dream of a healthy baby. Each time that you need to repeat either of these steps in the IVF process there are real implications for you in terms of higher costs, a longer timetable, and added emotional stress. The real "value of success" is therefore that higher success rates can help you avoid costs, keep your timeline to a minimum, and your stress levels in check. Intended parents therefore need to know which success rates to focus on, how to apply them to make practical choices, and what they mean in terms of the likely number of times they will have to undergo each step of the IVF process to reach their goal. With this in mind, I focus on two key elements of the IVF process where achieving first time success can make a real difference in your journey: the egg retrieval and embryology cycle and the embryo transfer. These steps are distinct but intimately connected. My focus on these two aspects is not meant to diminish the importance of other elements of the IVF process that can play a part in having a healthy baby, such as genetic screening and the choice regarding the number of embryos to transfer, and which intended parents should also consider. Egg Retrieval and Embryology Cycle In my view, the real measure of success for an egg retrieval and embryology cycle is the number of viable embryos obtained, and whether this meets or exceeds the number that you can expect you may need. The number of viable embryos that you may need depends on how many children, over time, you hope to have multiplied by the number of transfers you can expect will be required to achieve a live birth. If you plan to transfer more than one embryo at a time then this needs to be factored in as well. It’s certainly true that you only need one viable embryo to have a child and success on the first embryo transfer can absolutely happen. However, the reality is that that embryo transfer success rates are not 100%. Therefore, there is a potential risk that you may need to repeat the egg retrieval and embryology cycle if you only have a single embryo at the end of this step in the IVF process. For example, if you hope for one child and can expect that you may need to undergo two transfers to achieve a live birth, then you will hope to have at least two viable embryos. If say however, you hope to also have a sibling in the future for your first child (and can expect that again you may need to undergo two transfers to achieve a live birth) then you will hope to have obtained at least four viable embryos from your egg retrieval and embryology cycle in order to minimise the risk of needing to repeat this step to create more embryos. The egg retrieval and embryology cycle is the most expensive part of the IVF process to have to repeat. It may represent some 75-80% percent of the IVF costs of a single successful journey. In addition to the medical costs you may incur for a repeat cycle, it you are using an egg donor there will also be donor | fertilityroadmag | follow us @fertilityroad | 45

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Fertility Road Magazine 46 - September/October 2018

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