What information do I need to gather before setting up an appointment with ZFC? It is very useful to gather copies of your fertility medical records yourself and to maintain a master copy for your own records and to forward a copy of these to us ahead of your telephone consultation. In addition, a typed narrative in your own words of your infertility journey, thus far, is also extremely helpful. Any laboratory tests that have been performed on you and your partner are additionally helpful and may save us repeating expensive tests as you proceed to in vitro fertilization.
What routine testing is required prior to IVF at ZFC? All female and male partners undergoing IVF at ZFC require precycle testing, some because of California legal requirements to exclude infectious diseases and others for making treatment decisions within the cycle. Lists of these tests are available and they vary depending on whether a couple is doing conventional IVF or possibly IVF with an egg donor or a surrogate or both an egg donor and a surrogate. These lists will be available to you after your telephone consultation.
What testing of the immunological system is performed and what are the possible treatments? At Zouves Fertility Center we do screen all patients embarking on IVF for evidence in their blood of auto antibodies which may suggest that implantation may be adversely affected. In patients without a history of recurrent pregnancy loss or recurrent failed IVF, we would do a full panel of the antiphospholipid antibodies (APA) as well as both thyroid antibodies (thyroglobulin antibody and microsomal antibody). If these are abnormal or if patients have recurrent failed IVF or recurrent pregnancy loss, we would add to this testing an evaluation of the cellular side of the immune system through a test called the natural killer assay or the NK assay. Sometimes it may be appropriate to check the chromosomes on both partners to be sure that there are no inherited genetic problems contributing to the recurrent loss. Some patients may share certain immunological markers in which case both partners should be tested for the DQ alpha allele. Some patients with recurrent loss may also have inherited disorders which make their blood clot more readily and testing for these inherited thrombophilias would include a test called Leiden Factor V, Protein C deficiency, and the MTHFR test. Treatments for identified immunological factors may include any or all of the following; baby aspirin, heparin or Lovenox, immunization with paternal or nonpaternal leukocytes (LIT), precycle treatment with 30 days of Etanercept which is the name for Enbrel and possibly Intralipid as well.
Which injectable fertility medications are used by Zouves Fertility Center? We use a combination of a pure FSH product (Gonal F or Bravelle) with a product containing LH (Repronex or Pergonal). We use approximately 80% of the pure FSH product and 20% of an LH product and these injections can be given intramuscularly or subcutaneously. See all Fertility Medications here.
How do out of state patients do IVF cycles at Zouves Fertility? The cycle monitoring and treatment is no different whether you live close to the clinic or out of state or even outside of the United States. All of your precycle testing can be performed through your local doctor and you need to arrive in San Francisco after approximately one week on the injectable fertility medicine. You should plan to stay a minimum of eight and a maximum of 14 days for a conventional IVF cycle. The reason for the range of stay relates to how fast or slow the ovaries respond to the medication and whether the transfer is done on day three or day five after egg retrieval. Click here for information on International Patients.
