Babypalooza Summer 2019

Expert Q & A
In Vitro Fertilization
BY MEGHAN RATLIFF
DEIDRE D. GUNN, MD, FACOG
Deidre Downs Gunn, MD, is a reproductive
endocrinologist and infertility
specialist at UAB, where she is the
medical director of the IVF program.
She is a native of Birmingham and
was Miss America 2005.
WHAT IS IN VITRO FERTILIZATION?
In vitro fertilization, or IVF, is an
assisted reproductive technique that
involves combining a woman’s eggs
and a man’s sperm in the laboratory,
growing the resulting embryos, and
then transferring an embryo back into
the uterus a few days after fertilization.
This usually involves taking
fertility medications to stimulate the
ovaries. During the stimulation, the
ovaries’ response to the medications is
monitored every couple of days with
ultrasounds and labwork. When it’s
time to harvest the eggs, you undergo
an egg retrieval procedure, which
is a vaginal procedure done under
sedation and usually takes about 30
minutes. The eggs are mixed with the
sperm in the lab, and usually one or
two embryos are placed back into the
uterus on day 3 or 5 following the egg
retrieval. This is called a “fresh”
transfer when it’s done a few days
after the retrieval. You can also
transfer one of your embryos that was
frozen in an earlier IVF cycle, which
is called a “frozen transfer.” After an
embryo is placed in the uterus, you
wait 10–14 days and then take a
pregnancy test to find out if the
transfer has resulted in a pregnancy.
I’VE HEARD ABOUT PEOPLE FREEZING
THEIR EGGS FOR LATER. WHAT DOES
THAT MEAN, AND SHOULD I DO IT TO
GUARANTEE MY FERTILITY IN
THE FUTURE?
There are several reasons women
might choose to freeze their eggs. For
reproductive-aged women diagnosed
with cancer who want to preserve their
fertility in the future, egg freezing can
be done before the ovaries are affected
or damaged by chemotherapy. Other
women (without cancer) choose to
freeze their eggs for a chance at future
pregnancy if you don’t have a partner
or don’t want to be pregnant right
now. The rationale is to preserve your
(younger, better-quality) eggs now
since egg count and quality decline
with age. This decline becomes worse
around age 37, on average, and it
begins to accelerate after the age of 40.
Freezing eggs now allows you to freeze
younger, better-quality eggs that can be
fertilized later using sperm from your
future partner or with donor sperm.
The important thing to remember is
that freezing your eggs is never a guarantee
of pregnancy. Also, some women
need more than one egg-freezing cycle
to obtain enough eggs for a reasonable
chance at future pregnancy.
Infertility can be caused by many different factors, and often it’s
a combination of factors in both the male and female partners.
16 Babypalooza.com