Wednesday, September 11, 2013

What are the chances of having twins when you go through artificial insemination?

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Scarol


And what form of egg fertilization is more likely to make you have more than one child at a time?


Answer
I just wanted to clear up some misinformation that Doodlestuff gave you and clear up a few things so she is not misinformed any longer. Number one, IVF is not artificial insemination (AI). AI is when sperm is placed into the cervix or the uterus. With IVF, you are stimulated, eggs are collected, fertilized with sperm, and they are transferred back to you. And, according to SART - Society for Assisted Reproductive Technology who collects data from clinics in the USA (who transfers it directly to CDC) regarding IVF pregnancy rates, failed cycles, and live births, the twin birth rate is 25% and the triplet birth rate is 1.4%. Far from 1/3. With clinics that follow the strict SART guidelines, IVF twin rates decreased to 20.3%. Unfortunately the RARE clinic like the one Octomom went to did not follow the guidelines and altered those rates. With IVF you have more control than medicated AI cycles and so the multiple rate is lower. The ASRM guidelines do not recommend transferring one embryo. It is no more than two depending on a number of factors including age, prognosis, embryo quality etc. And, with one embryo transferred back to you there is a statistically significant reduction in the likelihood of live birth. Ironically enough, transferring more than one does not greatly increase your chance of multiples but does increase your odds of conception. You are more than twice as likely to give birth when having two embryos transferred than opting for a single embryo transfer. When you have been through the ringer with fertility treatments and have to dig deep in your pockets to pay $10,000+ for an IVF cycle, you will want to do anything possible to increase your odds of success.

AI does not increase the chance of multiples unless the woman has been given drugs to stimulate her ovaries. Many will monitor her ovulation and once she is close to ovulation will get inseminated with sperm. With stimulated AI cycles such as IUI, the rate of multiple gestation pregnancies is close to 30%. So with AI, your chances of conceiving multiples is higher. Some women with medicated AI cycles produce more follicles than her doctor wanted. If the women does this, the cycle is often canceled as not to risk a high order multiple (HOM) pregnancy. But, in some cases, the couple ignores their doctor's advice not to have intercourse. Jon and Kate Gosslin are an example of that. One thing to mention, if you did conceive multiples it does not necessarily mean you will carry them to term. I conceived twins via IVF after transferring 2 embryos (My other IVF attempts I did the same and only conceived a singleton twice). I lost both.

Women going through IVF today face a much lower risk of a multiple pregnancy. Most clinics, when possible, do a 5 day blastocyst transfer and transfer no more than two.

Do know that the goal of ALL fertility treatments is one baby and most doctors strive to reach that goal. Multiple pregnancies and births are risky, to the children and the mother.

Transvaginal Ultrasound : Can I Please have a detailed description of the Procedure?




Jen


I have to get a pelvic ultrasound, but I also have the option of a transvaginal ultrasound. I know the basics, they insert something in the vagina and take pictures, but I'd like to know details from start to finish. Does it hurt? Do they go past the cervix? How far do they go? Is it really better than a pelvic ultrasound?
Also is it more or less painful than a catheter?



Answer
You will lie down on a table with your knees bent and feet in holders called stirrups. The health care provider will place a probe, called a transducer, into the vagina. The probe is covered with a condom and a gel. The probe sends out sound waves, which reflect off body structures. A computer receives these waves and uses them to create a picture. The doctor can immediately see the picture on a nearby TV monitor.

The health care provider will move the probe within the area to see the pelvic organs. This test can be used during pregnancy.

In some cases, a special transvaginal ultrasound method called saline infusion sonography (SIS), also called sonohysterography or hysterosonography, may be needed to more clearly view the uterus.

This test requires saline (sterile salt water) to be placed into the uterus before the ultrasound. The saline helps outline any abnormal masses, so the doctor can get a better idea of their size.

SIS is not done on pregnant women.

How to Prepare for the Test Return to top

You will be asked to undress, usually from the waist down. A transvaginal ultrasound is done with your bladder empty.

How the Test Will Feel Return to top

The test is usually painless, although some women may have mild discomfort from the pressure of the probe. Only a small part of the probe is placed into the vagina.

Why the Test is Performed Return to top

Transvaginal ultrasound can help diagnose the cause of certain types of infertility, pelvic pain, abnormal bleeding, and menstrual problems. It can show the lining of the uterus (endometrium). The test may reveal:

Ovarian cysts
Ovarian tumors
Pelvic infection
Uterine fibroids
Transvaginal ultrasound is also used during pregnancy to monitor the growth of the fetus, listen to the unborn baby's heart beat, and to check for ectopic pregnancy and other potential problems.

Normal Results Return to top

The pelvic structures or fetus are normal.

What Abnormal Results Mean Return to top

An abnormal result may be due to many conditions. Some problems that may be seen include:

Cancers of the uterus, ovaries, vagina, and other pelvic structures
Non-cancerous growths of the uterus and ovaries (such as cysts or fibroids)
Twisting of the ovaries
Infection, including pelvic inflammatory disease
Birth defects
Some problems that may be found specifically in pregnant women include:

Ectopic pregnancy
More than one fetus (twins, triplets, etc.)
Miscarriage
Placenta previa
Placental abruption
Tumors of pregnancy including gestational trophoblastic disease
Risks Return to top

There are no known harmful effects of transvaginal ultrasound on humans.

Unlike traditional x-rays, there is no radiation exposure with this test.




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