Single embryo transfer is the only effective method to reduce IVF multiple pregnancy rate, the single biggest health risk to both mother and child associated with fertility treatment. UK practice in this area currently lags behind most of Europe and Australia, principally due to the lack of adequate state funding. For this strategy to be successful, it is crucial the funding situation is improved.

The Human Fertilisation and Embryology Authority (HFEA) recently asked clinics to reduce multiple pregnancy rates from an average of 24% to 10% over the next three years. Currently in the UK, most fertility treatments involve transferring two embryos into the womb, increasing the likelihood of multiple pregnancy and the associated risks. These guidelines are designed to help clinics meet the criteria set by the HFEA, while not compromising the live birth rate.

The guidelines recommend:

- Patients should be carefully examined to assess if eSET is suitable for them. In the UK, 87% of multiple pregnancies occur in the first cycle of treatment, in women aged under 37. If patients are carefully selected (e.g. women under 37, in their first IVF cycle who have several high quality embryos), eSET plus subsequent frozen embryo transfer can be as effective as double embryo transfer, and does not compromise the likelihood of conception.

- It is essential to combine an eSET policy with an effective frozen embryo replacement programme, to maximise cumulative live birth rates per stimulated cycle. This means spare high quality embryos harvested from an ovarian stimulation cycle can be frozen, stored and subsequently reimplanted if pregnancy does not result from the initial eSET. This avoids the need for women to undergo further costly cycles of ovulation stimulation to harvest more eggs. Urgent improvements in both facilities and funding in this area are needed to meet demand.

- Three mild stimulation IVF cycles (collecting less eggs, creating fewer embryos and electively replacing one embryo) are as effective as two conventional stimulation cycles, result in fewer complications, and have proved more cost effective in other health care settings if the costs of multiple pregnancy are included. As most Primary Care Trusts fund only one cycle, couples are currently unlikely to choose this treatment, as live birth rate per individual cycle is lower.

- Standard grading schemes for embryo quality could potentially greatly aid embryo selection. Although promising, new developments to assess embryo viability require more research before being introduced into clinical practice.

- A simple algorithm based on embryo quality can help select those patients who would benefit most from eSET. Extending culture of embryos to day 5 after fertilisation (blastocyst culture) may assist in embryo selection for eSET.

- To increase the eSET uptake, patient education is essential. Couples are more likely to accept eSET if state funding for more than one cycle of fertility treatment is readily available.

- The HFEA should review its fees and data presentation structure to encourage the eSET uptake.

- To reduce the multiple birth rate, it is absolutely critical that the Department of Health issues strict guidance to Primary Care Trusts to fully implement the NICE guidelines on fertility treatment. In overall terms, eSET will save the NHS money – extra spending on fertility treatment is more than counteracted by savings on treating the long-term health problems in both mothers and children caused by multiple births.

Mr Tony Rutherford, Chair of the BFS Policy and Practice Committee, said:

“The key to success with this strategy is more NHS funding. The British Fertility Society strongly believes that the health benefits to children, the reduction in distress for families and the enormous cost savings for society make an overwhelming case for single embryo transfer in certain situations. Transferring only one embryo to those women most at risk of having twins is the only effective method to reduce the multiple birth rate after IVF treatment. It is imperative that elective single embryo transfer is made the norm for these women in the UK, as it is elsewhere in Europe.”

“The only way in which this strategy can be effectively implemented for the benefit of both mothers and babies is for the NHS to increase funding to allow full implementation of the NICE guidelines on fertility treatment.”

Mrs Rachel Cutting, from the Association of Clinical Embryologists, said:

“New advances in embryology mean we can tackle the risks of multiple births much more effectively than ever before. These guidelines provide a clear, evidence based approach to judging embryo quality, the optimum time to transfer embryos, and the importance of an effective cryopreservation programme. The Association of Clinical Embryologists is committed to working towards a reduction in the number of multiple births, but this can only be achieved if adequate funding is provided by the state. Embryologists are key to helping to reduce multiple pregnancy.”

General information

Currently 1 in 4 IVF births in the UK results in twins or triplets, compared to 1 in 80 births following natural conception. Multiple pregnancy significantly increases the likelihood of miscarriage and death, prematurity and low birth weight in the infant. It can also lead to long term health problems for children, such as cerebral palsy, and risks to mothers such as pre-eclampsia, diabetes and heart disease. For more information see http://www.oneatatime.org.uk/

The NICE guidelines for fertility treatment state that infertile patients aged 23-39 should receive three full cycles of IVF, where a fully funded cycle includes cryopreservation and subsequent transfer of frozen-thawed embryos. Currently, these guidelines are fully implemented by less than 10% of Primary Care Trusts.

Notes

These guidelines will be published in full in the September edition of the journal Human Fertility 2008, 11(3): 1-16. DOI: 10.1080/146470802302629. Human Fertility is the official journal of the British Fertility Society. Human Fertility website: http://www.informaworld.com/HumanFertility

The British Fertility Society is a national multidisciplinary organisation representing professionals practising in the field of reproductive medicine. We are committed to promoting good clinical practice and working with patients to provide safe and effective fertility treatment. For general information, please visit our website: http://www.fertility.org.uk/.

The BFS Summer College 2008 is taking place on 2-5 September in Liverpool. For more information: http://www.fertility.org.uk/meetings/2008/summer/

The Association of Clinical Embryologists is the professional body of and for embryologists in the UK. ACE was founded in 1993 to promote high standards of practice in clinical embryology and to support the professional interests of embryologists working in the UK. For general information see: http://www.embryologists.org.uk/

ABSTRACT

Elective Single Embryo Transfer: Guidelines for Practice British Fertility Society and Association of Clinical Embryologists

Rachel Cutting1, Dave Morroll2, Stephen A Roberts3, Susan Pickering4 & Anthony Rutherford2 on behalf of the BFS and ACE

1Centre for Reproductive Medicine and Fertility, Jessops Wing, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK, 2Reproductive Medicine Unit, Leeds Teaching Hospitals NHS Trust, Clarendon Wing, Leeds General Infirmary, Leeds, UK, 3Health Methodology Research Group, University of Manchester, Manchester, UK, and 4Edinburgh Fertility & Endocrine Centre, Royal Infirmary of Edinburgh, Edinburgh, UK.

Assisted conception treatment is the single most important cause in the increase in multiple pregnancy and births over the last 25 years. Multiple births are associated with significant peri natal morbidity and mortality. Europe has led the way in reducing multiple births by widespread adoption of an elective single embryo policy, which in Belgium is linked to an increase in state funding. Randomized controlled trials suggest that an eSET policy must include the ability to cryopreserve and transfer any remaining quality embryos to obtain parity with a double embryo transfer. This document provides a review of the available evidence with guidelines for practice, to help facilitate the introduction of an eSET policy in the UK.

British Fertility Society

(source: Medicalnewstoday )

For couples that are experiencing infertility, the desire to have a child can be overwhelming. Every month that passes is another missed opportunity. Depression, grief, sadness, and despair eventually set in and at some point most couples become desperate enough to gamble with tens of thousands of dollars on expensive procedures like InVitro Fertilization (IVF) without fully understanding what they are getting themselves into. For the vast majority of couples who try IVF, false hopes turn false, and things that sound too good to be true prove to be so.

Before you decide to spend your precious savings on IVF or any of its latest forms such as Intracytoplasmic Sperm Injection (ICSI) you owe it to yourself to find out more about NaProTechnology (NPT), a medically sound and scientifically supported approach to treating the cause of your infertility. “NaPro” means “natural-procreative” and as the name implies, it refers to the application of diagnostic and medical technologies toward achieving pregnancy “the natural way” through intercourse as opposed to a laboratory procedure.

Here are 10 reasons to choose NPT rather than IVF:

1. NaProTechnology Focuses on Disease

If a couple cannot get pregnant, it makes sense that the first thing the doctor must do is to find out why. This is THE goal of the complete NPT program. With IVF, the cause of infertility is not important and in the underlying problem it is completely ignored.

2. Success Rates are Better with NaProTechnology

Recent data from the Pope Paul VI Institute in Omaha, NE, show that NaProTechnology success rates are 1.5 to 3 times better than IVF (23.5% versus 38.4%-81.8%). In a 4 year study of 95 NPT couples who had been trying to conceive for an average of 6.1 years and had 176 failed attempts at an Artificial Reproductive Technique (ART) Boyle[1] reported that there were 123 conceptions. Life table analysis demonstrated increasing success the longer that couples remained in the NPT program with 26.2% pregnant at 12 to 17 months rising to 32.6% at 18-25 months.

3. Destruction of Embryos

An analysis of ART data[2] from 1983 to 1986 demonstrated that the transfer of 1,372 embryos (3.2 per woman) resulted in 81 live births. From this data, it is necessary to create 16.9 living embryos to produce one live birth. The higher reported rates of success for IVF procedures usually means more embryos are being transferred which increases the risk of multiple births.

4. Infanticide: “Selective Reduction”

One of the most objectionable things about IVF is that it can result in a situation where a woman is forced to deal with a dangerously high multiple pregnancy rate. Pregnancy risk increases dramatically with the number of babies in the womb. Frequently, women are compelled to selectively “reduce” (i.e., kill) additional babies in the womb due to unacceptably high pregnancy risk.

5. Natural Sex versus a Laboratory Procedure

In IVF, the sperm and eggs (gametes) are collected through masturbation (male) and harvesting (female) where they meet in a laboratory to form embryos which are then reintroduced into the woman’s body. NPT, on the other hand, relies on a natural act of intercourse to achieve pregnancy.

6. NaProTechnology is more cost effective

According to Collins[3], the median cost of one cycle of IVF in the United States in 2001 is $9,226. $20-30,000 expenses are not unheard of, however, because IVF clinics prefer to sell discount packages (multiple cycles) in order to increase success rates and allow for “shared” risk. In comparison, at one medical center in Duarte, CA (Santa Teresita), NPT has been cited as costing approximately $9,290 which includes a physician evaluation, hormone and ultrasound evaluation, and outpatient surgical treatment of infertility.

7. Pregnancy Outcomes

There is growing concern that IVF may have significant adverse effects on the children conceived with this procedure. In a study of birth defects after ICSI and IVF procedures, Hansen et al.[4] reported that ICSI and IVF babies were more than twice as likely to have been diagnosed with a major birth defect by the end of one year of life (8.6% and 9.0%) as compared to naturally conceived babies (4.2%).

8. You could get pregnant again!

Because natural fertility is restored with NPT, these couples are often able to get pregnant again. In the Boyle study[1] of 89 births in women who had failed ART, there were 14 women with 2 live births, and 1 woman with 3 live births. Since IVF does nothing to correct the cause of infertility, there is no benefit toward subsequent pregnancies.

9. What will you have to show for it?

Ironically, in some cases IVF procedures cause additional harm to the female reproductive system in the course of treatment. For example, some IVF clinics will perform surgical removal of a blocked and swollen fallopian tube in order to increase success rates[5]. In these cases, when IVF fails, fallopian tube repair is no longer an option. This approach is contrary to the natural and restorative orientation of the NPT physician and surgeon[6]. NPT is designed to restore (not destroy) reproductive function. If nothing else, NPT couples have had the underlying cause of the problem addressed which often results in better overall health.

10. What happens after you get pregnant?

This is perhaps the most important question. Frequently, couples who pursue IVF have not thought about what happens next. Success equals pregnancy. Unfortunately, ignoring the underlying problem that leads to infertility in the first place can adversely affect the pregnancy and even lead to miscarriage. With NPT, restoring health and fertility begins before conception and continues throughout the pregnancy with the aim of preventing miscarriage and promoting the optimum health of the newborn baby and mother.

References

1. Boyle, P., NaProTechnology (NPT) – After previously unsuccessful Artificial Reproductive Technology (ART). 2004. 2. Cvetkovich, L.L., The reproductive technologies: A scientific overview, in The gift of life: The proceedings of a national conference on the Vatican instruction on reproductive ethics and technology, M. Wallace and T. Hilgers, Editors. 1990, Pope Paul VI Institute Press: Omaha, NE. 3. Collins, J., Cost-effectiveness of In Vitro Fertilization. Seminars in Reproductive Medicine, 2001. 19: p. 279-289. 4. Hansen, M., et al., The risk of major birth defects after Intracytoplasmic Sperm Injection and In Vitro Fertilization. New England Journal of Medicine, 2002. 346: p. 725-730. 5. Nackley, A.C. and S.J. Muasher, The significance of hydrosalpinx in in vitro fertilization. Fertility and Sterility, 1998. 69: p. 373-384. 6. Hilgers, T.W., The Medical and Surgical Practice of NaProTechnology. 2004, Omaha, NE: Pope Paul VI Institute Press.

David Picella helps couples who are trying to conceive naturally without the use of expensive artificial reproductive techniques. You can read more articles published by him and by other experts in this area at: http://www.majella.us

* When the man’s sperm count is on the low side or abnormal, yet potentially capable of fertilizing an egg. Here IVF may be useful because fertilization can possible be manipulated and observed by the scientific team. This does not necessarily require sperm injection, or zona drilling, but simply very careful preparation of the sperm in suitable laboratory solutions.

* For certain women who have problems with the cervix perhaps ‘hostile’ mucus, IVF bypasses the cervix and its mucus.

* For women who are not ovulating spontaneously, but who produce eggs on fertility drugs without conceiving. In this situation, the ability to force the ovary to produce many eggs and then select the best ones for fertilization and transfer means that IVF may be suitable option.

* For some women with endometriosis or with very carefully investigated infertility which remains unexplained. We think that endometriosis is an excellent indication for IVF and have had particular success.

* For couples who have several factors together which are causing infertility; commonly a combination of poor male fertility and tubal disease are the most usual indications.

* Most recently, for certain couples who are at high risk of having genetically abnormal babies.

STAGES OF IVF TREATMENT:

1. TESTING A COUPLE’S SUITABILITY BEFORE TREATMENT

Preliminary preparation for an ART procedure may be as important as the procedure itself.

* Testing for ovarian reserve may be recommended in order to predict how the ovaries will respond to fertility medication.

* Blood Tests to assess the general health of the couple (ask the clinic for a complete list)

* Hysteroscopy to assess the inside of the uterus to look for problems like fibroids, polyps, or a septum may need to be corrected before IVF.

* Laparoscopy may be required to assess problems like endometriosis and to treat problems like hydrosalpinx; a fluid-filled, blocked fallopian tube which reduces IVF success should be removed prior to IVF.

* Semen analysis and culture

* Lifestyle issues should be addressed before ART. Smoking, for example, may lower a woman’s chance of success by as much as 50%. All medications, including over-the-counter supplements, should be reviewed since some may have detrimental effects. Alcohol and drugs may be harmful, and excessive caffeine consumption should be avoided. Some vitamins especially folic acid is started.

2. DOWN REGULATION

The process of stimulating the ovaries to produce eggs is a controlled one and requires that the body’s own internal capacity to regulate that growth be stopped. Otherwise the eggs may mature early and their collection may not be possible. For this purpose an injection is started usually in the previous cycle (D21) or sometimes even in the same cycle. At a particular time, (usually D2) blood levels of Estradiol (E2) and LH are tested to confirm the down regulation before starting stimulation.

3. OVARIAN STIMULATION

The best chance of successful pregnancy is obtained when more than one embryo is placed in the uterus at the same time. This is because so many early human embryos, normally fertilised, are lost or do not develop into babies. Consequently, one way of overcoming this natural loss is to put back several embryos simultaneously during IVF. During ovarian stimulation, also known as ovulation induction, ovulation drugs, or “fertility drugs,” are used to stimulate the ovaries to produce multiple eggs rather than the single egg that normally develops each month. Multiple eggs are needed because some eggs will not fertilize or develop normally after egg retrieval. Drug type and dosage vary depending on the program and the patient. Most often, ovulation drugs are given over a period of eight to 14 days. Ovulation drugs include clomiphene citrate, human menopausal gonadotrophins (hMG), follicle stimulating hormone (FSH), recombinant FSH and LH, and human chorionic gonadotrophin (hCG). Gonadotropin releasing hormone (GnRH) agonists or GnRH antagonists are used in conjunction with these medications to prevent premature ovulation.

4. ASSESSING THE DEVELOPMENT OF THE EGGS

Egg collection is generally timed to within a few hours of when the woman is expected to ovulate. If eggs are not collected very close to this time, they may not fertilise properly. This is the main reason why so many tests are often done to confirm the status of the woman’s hormones and, thus, development of her eggs.

* Hormone tests: As the follicle swells, the hormone oestrogen (Estradiol or E2) is produced in increasing amount. Regular blood test can detect this increase.

* Ultrasound: The swelling follicle can be directly measures using Trans vaginal ultrasound. This is usually done daily. We know from experience that, when the follicle is about 20 mm across, ovulation is imminent.

Using ultrasound examinations and blood testing, the physician can determine when the follicles are appropriate for egg retrieval. Generally, eight to 14 days of FSH and/or HMG injections are required.

5. Egg Retrieval

When the ovaries are ready, hCG or other medications are given. The hCG replaces the woman’s natural LH surge and helps the eggs to mature so they may be capable of being fertilized. The eggs are retrieved before ovulation occurs, usually 34 to 36 hours after the hCG injection is given. However, 10% to 20% of cycles are cancelled prior to the hCG injection.

Egg retrieval is usually accomplished by transvaginal ultrasound aspiration, a minor surgical procedure. Some form of anaesthesia is generally administered. An ultrasound probe is inserted into the vagina to identify the mature follicles, and a needle is guided through the vagina and into the follicles. The eggs are aspirated (removed) from the follicles through the needle connected to a suction device. The egg retrieval is usually completed within 30 minutes. Some women experience cramping on the day of the retrieval, but this sensation usually subsides by the next day. Feelings of fullness and/or pressure may last for several weeks following the procedure because the ovaries remain enlarged.

6. Insemination, Fertilization, and Embryo Culture

After the eggs are retrieved, they are examined in the laboratory The best quality, mature eggs are placed in IVF culture medium and transferred to an incubator to await fertilization by the sperm. Sperm, obtained by ejaculation or a special condom used during intercourse, are separated from the semen in a process known as sperm preparation. Motile sperm are then placed together with the eggs, in a process called insemination, and stored in an incubator. Fertilization occurs in the laboratory when the sperm cell penetrates the egg, usually within hours after insemination.

Visualization of two pronuclei the following day confirms fertilisation of the egg. One pronuclei is derived from the egg and one from the sperm. Approximately 40% to 70% of the mature eggs will fertilize after insemination or ICSI. Lower rates may occur if the sperm and/or egg quality are poor. Occasionally, fertilization does not occur at all. Two days after the egg retrieval, the fertilized egg has divided to become a 2-to 4-cell embryo. By the third day, the embryo will contain approximately six to 10 cells. By the fifth day, a fluid cavity forms in the embryo, and the placenta and foetal tissues begin to develop. An embryo at this stage is called a Blastocyst. If successful development continues in the uterus, the embryo hatches from the surrounding zona pellucida and implants into the lining of the uterus approximately six to 10 days after the egg retrieval. Embryo Transfer The next step in the IVF process is the embryo transfer. Embryos are usually transferred to the uterus on the 2nd or 3rd day after the egg retrieval. A short anaesthesia is given although not absolutely necessary. The physician identifies the cervix using a vaginal speculum. Two or three embryos suspended in a drop of culture medium are drawn into a transfer catheter, a long, thin sterile tube with a syringe on one end. The physician gently guides the tip of the transfer catheter through the cervix and places the fluid containing the embryos into the uterine cavity. The procedure is usually painless, although some women experience mild cramping.

Cryopreservation

Extra embryos remaining after the embryo transfer may be cryopreserved (frozen) for future transfer. Cryopreservation makes future ART cycles simpler, less expensive, and less invasive than the initial IVF cycle, since the woman does not require ovarian stimulation or egg retrieval. Once frozen, embryos may be stored for several years. However, not all embryos survive the freezing and thawing process, and the live birth rate is lower with cryopreserved embryo transfer. Couples should decide if they are going to cryopreserve extra embryos before undergoing IVF.

SUCCESS RATES

Currently the success rate per oocyte retrieval cycle is about 30%. Failures bring with it a lot of frustrations and depression but one must have faith as the cumulative success rates over 3-4 attempts is about 70%. The success rates depend on a lot of factors and especially the woman’s age. The live birth rate for each IVF cycle started is approximately 30% to 35% for women under age 35; 25% for women ages 35 to 37; 15% to 20% for women ages 38 to 40; and 6% to 10% for women over 40.

DONOR SPERM, EGGS, AND EMBRYOS

IVF may be done with a couple’s own eggs and sperm or with donor eggs, sperm, or embryos. A couple may choose to use a donor if there is a problem with their own sperm or eggs, or if they have a genetic disease that could be passed on to a child. Donors may be known or anonymous. In most cases, donor sperm is obtained from a sperm bank, and sperm donors undergo extensive medical and genetic screening. The sperm are frozen and quarantined for six months, the donor is tested for sexually transmitted diseases including the AIDS virus, and sperm are only released for use if all tests are negative. Overall, the use of frozen sperm rather than fresh sperm does not lower success rates.

Donor eggs are an option for women with a uterus who are unlikely or unable to conceive with their own eggs. Egg donors undergo the same medical and genetic screening as sperm donors, although it is not currently possible to freeze and quarantine eggs like sperm. The egg donor may be chosen by the infertile couple or the ART program. Egg donors selected by ART programs generally receive monetary compensation for their participation. Egg donation is more complex that sperm donation and is done as part of an IVF procedure. The egg donor must undergo ovarian stimulation and egg retrieval. During this time, the recipient (the woman who will receive the eggs after they are fertilised) receives hormone medications to prepare her uterus for pregnancy. After the retrieval, the donor’s eggs are fertilised by sperm from the recipient’s partner and transferred to the recipient’s uterus. The recipient will not be genetically related to the child, but she will carry the pregnancy and give birth. Egg donation is expensive because donor selection, screening, and treatment add additional costs to the IVF procedure. However, the relatively high live birth rate for egg donation, between 40% to 45%, provides many couples with their best chance for success. Overall, donor eggs are used in nearly 10% of all ART cycles.

In some cases, when both the man and woman are infertile, both donor sperm and eggs have been used. Donor embryos may also be used in these cases.

SURROGACY/GESTATIONAL CARRIER

A pregnancy may be carried by the egg donor (surrogate) or by another woman (gestational carrier). If the embryo is to be carried by a surrogate, pregnancy may be achieved through insemination alone or through ART. The surrogate will be biologically related to the child. If the embryo is to be carried by a gestational carrier, the eggs are removed from the infertile woman, fertilised with her partner’s sperm, and transferred into the gestational carrier’s uterus. The gestational carrier will not be genetically related to the child. All parties benefit from psychological and legal counselling before pursuing surrogacy or a gestational carrier.

RISKS OF ART

* Small risk of hyperstimulation. The stimulated cycle is very carefully monitored. However in any cycle there is a small risk of hyperstimulation which may result in enlargement of the ovaries. Most cases resolve with very simple treatment.

* Pregnancies involving Assisted Reproduction have higher miscarriage rates than normal.

* Removing eggs through an aspirating needle entails a slight risk of bleeding, infection, and damage to the bowel, bladder, or a blood vessel.

* The chance of multiple pregnancies is increased in all assisted reproductive technologies (about 30%) when more than one embryo is transferred. Some couples may consider multifetal pregnancy reduction to decrease the risks due to multiple pregnancies.

* First trimester bleeding may signal a possible miscarriage or ectopic pregnancy. Some evidence suggests that early bleeding is more common in women who undergo IVF and GIFT and is not associated with the same poor prognosis as it is in women who conceive spontaneously. Miscarriage occurs after ultrasound in nearly 15% of women younger than age 35, in 25% at age 40, and in 35% at age 42 after ART procedures. In addition, there is approximately a 5% chance of ectopic pregnancy with ART.

(Dr. Rajeev Agarwal is a Gynaecologist with a Special Interest and Training in Infertility. He obtained his MD from Kasturba Medical College and trained further at the Manipal Assisted Reproduction Centre. He has received various awards during his training and further received the prestigious Kumud Tamaskar Award for his research work on Polycystic Ovarian Syndrome. He has various papers and lectures to his credit. He received further training und)

IVF is a very serious matter that primarily involves couples who are experiencing difficulty in having a child, and thinking that they might need medical help. Due to this fact and for the reason that more and more couples are experiencing such problem, a number of IVF message boards were developed especially for them.

The IVF message boards were designed for a particular purpose – to provide couples with problems on conceiving an outlet where they can meet new couples who experience the same difficulty in conceiving. These forums are not just designed for the couples to sympathize themselves, but for them to talk or discuss about in vitro fertilization and every aspect of this well-known technique.

Aside from being a great channel to meet new people and make friends with them, the IVF message boards are also a great place to learn. Although there are some resources out there on the web that covers aspects of IVF, the information you can get through the IVF message boards are much worth considering. One main reason is that unlike the other resources where you are just provided with basic information about the technique, you can throw questions, even the most delicate ones, to the other members of the IVF message boards and receive honest answers from them.

With the IVF message boards, you are also allowed to share your own stories with the other readers. In return, you will get feedback, thus learn how the other members relate their stories to your own experience. What’s more, it’s a great feeling to know that you are not just the only human in this complicated world experiencing difficulties in having a child.

Perhaps what’s best about the IVF message boards is that they are there hoping to guide you along the path of achieving a pregnancy. These forums are also there to take you step by step through the cause of IVF, the investigation as well as the treatment options of infertility. The IVF message boards even serve as a guide for you to know the other assisted reproductive technologies, their success rates as well as the current legislation that govern them.

In addition, the IVF message boards offer advices, mostly about counseling, and even lists of helpful addresses related to the issue on infertility and its treatment. All of these interesting topics can be reached, especially if you have full access to the features of the IVF message boards.

Having said all these, it is now easy for us to think that there is still hope for those who have fertility problems. You can consider in vitro fertilization or IVF, and you can start knowing about this assisted technology through the IVF message boards that are now highly available online.