IVF: Who Is a Good Candidate?

Considering in vitro fertilization (IVF) can be overwhelming. It can be a long and challenging process, so you'll want to be sure it's right for you before you make the commitment. Fortunately, there are ways to predict – and improve – your chances of success with IVF and other methods of infertility treatment. Knowing your options is the first step in reaching your dream of starting or adding to your family.

Who's a Good Candidate for IVF?

IVF is an infertility treatment. "Infertility" means:

You're younger than 35, aren't using birth control, and haven't gotten pregnant after at least a year of having unprotected sexual intercourse.

You're 35 years or older, aren't using birth control, and haven't gotten pregnant after at least six months of having unprotected sexual intercourse.

Many different things can affect how well IVF works for you, such as:

Your age. You naturally have more good-quality eggs when you're younger. Your chances of having success with IVF start to decline at age 35.

Your weight. You'll get the best results with IVF if your body mass index (BMI) is between 19 and 24. Being underweight, overweight, or obese can make it harder for you to get pregnant.

Tobacco use. Your IVF pregnancy rate goes down by 30% if you smoke. Marijuana can affect egg and sperm quality, too.

Stress levels. Studies show that intense or ongoing stress can also interfere with parts of the IVF process.

If you're between the ages of 20 and 50, the CDC's IVF Success Estimator can give you a general idea of your chances of getting pregnant through IVF. This free online tool looks at data from people who share some of your same traits, like height and weight. Your odds can be helpful to know, but everyone is different. This tool can't predict how your own personal IVF experience will go.

Causes of Infertility

Pregnancy is complex, and there are a lot of reasons why it might not happen for you naturally. Conditions that affect your fertility include:

Blocked fallopian tubes

Your fallopian tubes connect your ovaries to your uterus. If they're blocked, sperm can't reach an egg, and a fertilized egg won't be able to implant in your uterine lining. Blocked fallopian tubes happen for different reasons, including scar tissue and infections, and they may not cause any symptoms.

Pelvic adhesions

Sometimes, surgery in your belly or pelvic area results in scar tissue around your organs. This can affect your fertility.

Pelvic inflammatory disease (PID)

An infection in your uterus, ovaries, and fallopian tubes, PID is often caused by a sexually transmitted infection (STI.) If not treated, it can cause scarring that makes it hard for you to get or stay pregnant.

Male infertility

About half of all infertility cases are due to male infertility. You might not have the usual amount of sperm, or they may not be shaped well. You're more likely to be infertile if you:

Are over the age of 40
Are overweight or obese
Use tobacco or marijuana
Drink alcohol
Have been around toxins, like pesticides
Have had testicle issues, like swollen veins or an injury
Take steroids

Endometriosis

The same type of special tissue that lines your uterus can start to grow outside of it. This can block your fallopian tubes or damage healthy eggs or sperm. Up to half of all people with endometriosis have a hard time getting pregnant on their own.

Polycystic ovary syndrome (PCOS)

One of the most common reasons for infertility, PCOS causes your ovaries to release too many hormones. That can throw off your menstrual cycle, so you miss periods and don't ovulate at regular times.

Primary ovarian insufficiency (POI)

This is when your ovaries stop working before you turn 40, which is younger than usual. Your ovaries may not release eggs on a regular basis, or they may not release any eggs. Another name for this is primary ovarian failure.

Diminished ovarian reserve (DOR)

As you get older, you have fewer eggs to be fertilized. The quality of your eggs also goes down.

Sometimes, you can't get pregnant on your own, but there isn't a clear reason why.

Other Reasons You Might Try IVF

You might also think about IVF because of:

Genetic conditions

Some health issues you're born with can make it harder to get pregnant. Among them are:

Cystic fibrosis
Tay Sachs disease
Spinal muscular atrophy (SMA)
Sickle cell disease

IVF can also help prevent you from passing a genetic condition on to your baby.

Cancer treatment

Cancer treatments like chemotherapy or radiation can make it harder to get pregnant later. In some cases, you might be able to freeze your eggs before you start treatment. Then, they can later be used for IVF.

You can't carry a baby

You could also have IVF because you're physically unable to get pregnant. For instance, maybe you were assigned male at birth and don't have a uterus.

IVF can place fertilized eggs in someone else's uterus. The other person can then carry your baby for you.

Is IVF Right for Everyone?

Your doctor may suggest other options if your estimated IVF success rate is very low. Or they may want to try an easier, less costly treatment first.

IVF can be hard on your body and your mental health. Dealing with health insurance can also be a challenge. And if your health plan doesn't cover all the costs, IVF can be expensive.

You'll need to talk these things over with your doctor before you decide to start the process.

Other Options to Build a Family

IVF isn't the only type of fertility treatment. Other procedures can be added on to it or done instead to help you have a baby. Among them are:

Donor sperm that you get from someone else
Gestational surrogacy, in which someone carries and gives birth to your baby for you
Embryo adoption, when another person donates their unused fertilized eggs (embryos) to you
Adoption is another path that many people take.

Talk with your doctor about your options. It may take some time to decide what may be best for you.

How to Talk to Your Doctor About IVF

You won't know for sure if IVF is right for you until you talk to a reproductive endocrinologist or other kind of fertility specialist. Some questions you might want to ask them include:

How likely is it that I can get pregnant on my own?
What are my chances of getting pregnant with IVF?
Why do you think IVF is the best option for me? Are there others?
What are the success rates of your clinic?
What are the costs of IVF?
How many doctors will be involved in my care?
What types of counseling and support do you have?

Your doctor will ask you and your partner lots of questions, too. Be prepared to share details about:

Your period, including how often you get it and how long you bleed
Your daily habits, like how much caffeine you have and your usual stress levels
Drugs you take, from over-the-counter supplements to recreational drug use
Your sex life, like how often you have sex and any pain or trouble you have during it

Pre-IVF testing

Before you start IVF, your doctor will order some tests. These usually include:

Ovarian reserve testing, blood tests that show how many eggs you have
Semen analysis, to check the health of your or your partner's sperm
Infectious disease screening, to look for conditions like HIV and hepatitis
Uterine exam, which provides details and images of your uterus

How to get ready for IVF

Make sure to ask your doctor about lifestyle changes you can make that could increase your chances of getting pregnant by IVF. For instance, you could:

Stop smoking and drinking alcohol
Cut back on caffeine
Check with your doctor before taking new medications or supplements
Try to stay at a good weight for your height
Stay physically active (Ask your doctor how much activity is the right amount.)

When to Get a Second Opinion

IVF is a big decision. You want to choose a doctor you trust and who will support you as you try to get pregnant.

Look for a clinic that belongs to the Society for Assisted Reproductive Technology (SART). Its members must meet high standards, follow ethical guidelines, and have their labs inspected.

Get a second opinion if you meet with a doctor and they don't:

Respect your unique situation
Answer your questions
Use the most up-to-date technology
Clearly explain the costs of treatment

Trust your gut. If you don't click with a fertility specialist, ask friends or other doctors to suggest another one.

Who Is IVF Right For?