Frequently Asked Questions

There are two types of embryo transfer: fresh or frozen. In a fresh embryo transfer cycle, an embryo is transferred to the uterus after 3-5 days of observation in the embryology laboratory, and any additional embryos are frozen for future use. In a frozen embryo transfer (FET) cycle, all embryos are frozen after 3-5 days of development in the laboratory. If you wish to perform preimplantation genetic testing (PGT), embryos will be biopsied, then frozen while a culture of cells is sent to the genetic testing lab for analysis. Whether you proceed with a fresh embryo transfer or an FET, the embryo transfer process itself is very simple, and rarely requires sedation or anesthesia.

For the transfer procedure itself, the embryo is thawed at room temperature, and then warmed to body temperature (37° C). As with a fresh embryo transfer, embryos are placed inside a special catheter (a very thin tube), which is guided through the cervix and into the uterus. Embryos are gently injected into the uterus and the catheter is removed. This procedure requires no anesthesia, and is done in a position similar to a pelvic examination for a Pap smear. After transfer, the woman rests for 15 minutes and then is able to go home, where a day of rest or very gentle daily activity is recommended.

In general, the success of frozen-thawed embryo transfer procedures depends on three factors:

First, the quality and survival of the frozen-thawed embryos. Typically, only good quality embryos are frozen, resulting in a survival rate greater than 90%.

Second, the age of the woman who produced the eggs. In patients under the age of 37, the chances of pregnancy with frozen-thawed embryos are similar to a pregnancy with fresh embryos. In patients 37 years or older, pregnancy chances with frozen-thawed embryos decline in conjunction with declining fertility in general, but still can be quite good. As always it is best for patients to discuss their individual situation with their physician.

Third, the status of the uterus in the woman receiving the embryos. A healthy endometrial lining free of any interfering fibroids or polyps provides a sound environment for embryo implantation.

No. During the course of a natural menstrual cycle, your brain produces hormones that stimulate one of your ovaries to release a single mature egg. During an ovulation induction cycle, you are prescribed those same hormones, known as fertility medications. These medications stimulate the ovaries to mature several eggs at once. When these eggs are matured and successfully retrieved, these eggs can be combined with sperm to create embryos.

While some research suggests a slightly higher incidence of birth defects in IVF-conceived children compared with the general population (4 - 5% vs. 3%), it is possible that this increase is due to factors other than IVF treatment itself.

It is important to recognize that the rate of birth defects in the general population is about 3% of all births for major malformations and 6% if minor defects are included. Recent studies have suggested that the rate of major birth defects in IVF-conceived children may be on the order of 4 to 5%. This slightly increased rate of defects has also been reported for children born after IUI and for naturally-conceived siblings of IVF children, thus it is possible that the risk factor is inherent in this particular patient population rather than in the technique used to achieve conception.

Research indicates that IVF-conceived children are on par with the general population in academic achievement as well as with regard to behavioral and psychological health. More studies are under way to further investigate this important issue.

Because the IVF process bypasses the fallopian tubes (it was originally developed for women with blocked or missing fallopian tubes), it is the procedure of choice for patients with fallopian tube issues, as well as for conditions such as endometriosis, male factor infertility and unexplained infertility. Physicians review the patient’s history and help to guide them towards the treatment and diagnostic procedures that are most appropriate for them.

IVF literally means "fertilization in glass” because IVF involves retrieving eggs from the ovaries and combining them with sperm in a glass culture dish. During the IVF process, a patient’s natural cycle is carefully manipulated through the use of fertility medications. These medications stimulate the ovaries to produce not one, but a number of mature eggs. At the right time, the eggs are retrieved from the ovaries. Concurrently, the male supplies a sperm sample (or a stored, frozen sample is used). The eggs and sperm are placed in a culture dish and fertilized. An embryo is then transferred into the woman’s uterus when she is ready.

IVF is one of the most efficient forms of fertility treatment, in that it usually provides the highest rates of successful conception for any one treatment cycle. For patients with severe male factor infertility or significantly blocked fallopian tubes, IVF treatment is the only realistic treatment option. It is often recommended for older patients or when IUI and medications have not been successful.

For lesbian women, the options for conception include:

If one or both partners possess ovaries and a uterus, there are several options for family building. At NYULFC, we work with single cis-females, lesbian couples, and members of the trans community to help build beautiful families including:

• Donor Sperm Insemination (with or without fertility medications)
• Donor Sperm + IVF (with or without a gestational carrier)
• Donor Sperm + Reciprocal IVF (also called “IVF Co-Maternity,” where one partner provides the eggs and the other partner carries the pregnancy)
• Medical Fertility Preservation with Oocyte Cryopreservation for future family building prior to transition
• Elective Fertility Preservation with Oocyte Cryopreservation or Embryo Cryopreservation

Patients who choose to use an anonymous sperm donor obtain frozen samples from licensed sperm banks, which must be located in the United States. NYU Langone Fertility Center does not own or operate a sperm bank, however our Donor Egg & Third Party Reproduction team will be happy to assist you in finding this resource.

Some patients may choose to ask a friend, relative, or other acquaintance to donate sperm. Because this option may raise sensitive questions and decisions in regards to parenting, a number of actions are required prior to receiving a sperm donation including counseling and a legal agreement between the Sperm Donor and Intended Parent.

Reciprocal IVF is a fertility treatment option for couples with ovaries and/or a uterus that allows both partners to uniquely participate in the family building process. It can often be referred to as Co-IVF or Co-Maternity. Reciprocal IVF is a two-step process that consists of embryo creation with Partner A's eggs, while the remaining partner will undergo a fresh or frozen embryo transfer in hopes to become pregnant and carry the pregnancy to term.⁣ Couples will have the option to choose their donor sperm for embryo creation⁣ and embryo transfers can be fresh or frozen depending on the need for genetic testing.⁣ Some couples who want more than one child utilize Co-IVF for their second child, and switch roles if they are able to.

Single Embryo Transfer (SET) Is an embryo implantation procedure in which only one embryo is transferred into the uterus. There are many advantages to an Single Embryo Transfer over a Multi Embryo Transfer. Single Embryo Transfers reduces the possibility of a miscarriage and increases your changes for a strong, healthy pregnancy, as there is a much smaller probability of conceiving multiple children at once. At NYU Langone Fertility Center, the vast majority of our patients (over 95%) undergo SET.

Blood drawing: Discomfort and the possibility of developing a painful bruise at the needle site may occur. A blood clot in the vein may occur.

Ultrasound: This examination involves the use of a form of energy (sound waves) which at high energy levels may produce heat and tissue damage. At the extremely low energy levels utilized in diagnostic ultrasounds, no adverse effects have been observed to date.

Medications: Some of the risks associated with taking hormone medications to stimulate multiple egg production are common. Women may experience none, any or all of the following symptoms: nausea, vomiting, slight weight gain or loss, breast tenderness and enlargement, occasional vaginal bleeding, yeast infections of the vagina, vaginal discharge and wetness, hot flashes, night sweats, menstrual period cramping, headaches, fluid retention, and mood swings. Much less common side effects include appetite changes, nervousness, fatigue, and changes in sex drive. More serious but rare side effects include hypertension (high blood pressure), gall bladder disease, blood clots developing in the legs, lungs, eyes, brain, heart or elsewhere, heart attacks and strokes.

There is some evidence that treatment with fertility drugs could lead to an increased risk of cancer—in particular, breast, ovarian, and uterine (including endometrial) cancers. One must be careful in interpreting research studies of women taking fertility drugs. Since these cancers are more common in women with infertility, simply comparing women taking fertility drugs with women in the general population inevitably shows an increased incidence of cancer. When the analysis accounts for the increased cancer risk due to infertility per se, the evidence does not support a relationship between fertility drugs and an increased prevalence of breast or ovarian cancer. More research is required to examine the long-term impact fertility drugs may have on breast and ovarian cancer prevalence rates. For uterine cancer, the numbers are too small to draw conclusions.

Antibiotics: Most women will be given an antibiotic. The use of an antibiotic may cause nausea, vomiting, diarrhea, loss of appetite, rashes, sensitivity to the sun, allergic reactions resulting in shock, or blood disease including reduced platelets or fractured red cells (causing anemia or bleeding).

Ovarian Hyper-stimulation: Use of hormonal agents may result in the growth of ovarian cysts and/or mild to severe ovarian enlargement may develop, causing pain, internal bleeding, and severe disturbances of fluid and chemistry balances. This may require hospitalization. Blood clots are possible which could lead to strokes or other life threatening complications.

Aspiration of Eggs under Ultrasonographic Guidance: Pain of short duration is likely. There is a possibility of seeing blood in the urine for a day following the procedure. Perforation of blood vessels, bladder, bowel, bleeding from the ovary, and pelvic infection are possible.

Laparoscopy: Infection of the incision site or pelvic organs is possible. Perforation of bowel or bladder, internal bleeding, possible formation of scar tissue by attempted egg collection and/or manipulation of pelvic organs may occur.

Anesthesia: Sedation or general anesthesia may cause numerous possible adverse reactions from various drugs and procedures. A separate consent form, which you will sign before undergoing this procedure, outlines the risks involved in the use of anesthesia.

Embryo Transfer: This procedure may cause discomfort and may lead to infection or ectopic or tubal pregnancy which could result in hemorrhage, or excessive bleeding, and death.

Multiple Pregnancies: Replacement of more than one embryo will increase the chance of multiple pregnancies. Multiple pregnancies have an increased risk of premature birth, birth defects, maternal hypertension, low birth weight, and many other complications.

Psychological Risks: One risk is failure of the procedure to produce a pregnancy. If the procedures are not successful, you may be very disappointed. You also may experience frustration, anxiety, and/or depression, which may be severe. Mood swings may result from medications or from your psychological response to the experience of Fertility Preservation. Long-term psychological effects are unknown. Any psychological consultation associated with the treatment program is not intended to predict short or long term effects.

Risks: I understand that my frozen egg(s) may, upon warming/ thawing, degenerate. If this occurs, the egg(s) will not be inseminated and will not be replaced into my uterus. It seems that egg(s) and embryos either survive unharmed or die. To RBA’s knowledge, there is no indication at the current time that freezing of egg(s) increases birth defects. To date, children born as a result of egg cryopreservation have not had increased rates of abnormalities. It is possible that in the future more information in this area of concern may become known. I understand that there may be unforeseen risks or complications for me, a current or future male partner, or the egg(s) or embryo(s), fetus(es), or the child(ren) which develop(s) from this treatment. While it is difficult to anticipate any such risks, I acknowledge that I have been notified of their possibility.

Eggs are typically retrieved after 12-14 days of ovarian stimulation. Immediately after eggs have been retrieved, our embryology team assesses the maturity of each egg, then transfers the mature eggs to an incubator. Typically, sperm are then combined with the eggs and fertilization occurs naturally. In a fresh embryo transfer cycle, an embryo is transferred to the uterus after 3-5 days of observation in the embryology laboratory, and any additional embryos are frozen for future use. In a frozen embryo transfer (FET) cycle, all embryos are frozen after 3-5 days of development in the laboratory. Following an embryo transfer, a patient’s HCG (Human Chorionic Gonadotropin) levels are monitored carefully to determine whether or not the treatment cycle created a pregnancy. Rising HCG levels indicate a healthy start for a pregnancy.