Name of the Procedure:

Common name(s): IVF Sparing, IVF Cancellation
Technical or medical term: In vitro fertilization procedure cancelled after aspiration, case rate (HCPCS S4021)

Summary

In vitro fertilization (IVF) is a procedure where eggs are fertilized outside of the body and the resulting embryos are transferred to the uterus. In some cases, the process is cancelled after egg aspiration, meaning that the IVF cycle does not proceed to embryo transfer.

Purpose

This procedure is designed for individuals having difficulty conceiving naturally. The goal is to facilitate pregnancy by fertilizing eggs outside the body. However, in certain situations, the IVF process may be cancelled after the eggs are aspirated.

Indications

• Unexplained infertility
• Low sperm count or quality
• Blocked or damaged fallopian tubes
• Endometriosis
• Genetic disorders requiring preimplantation genetic diagnosis

Preparation

• Medications to stimulate the ovaries to produce multiple eggs
• Blood tests and ultrasounds to monitor the development of eggs
• Fasting before the egg retrieval procedure
• Avoidance of certain medications as advised by the doctor

Procedure Description

1. Egg retrieval: A needle is used to aspirate eggs from the ovaries under ultrasound guidance.
2. Cancellation: After aspiration, the procedure is discontinued. Reasons for cancellation can include poor egg quality, insufficient eggs, or medical advice.

Tools and Equipment:

• Ultrasound machine
• Aspiration needle
• IV sedation or local anesthesia

Duration

The egg retrieval typically takes about 20-30 minutes. If the IVF cycle is cancelled after aspiration, this marks the conclusion of the procedure.

Setting

This procedure is performed in a fertility clinic or a hospital's dedicated fertility unit.

Personnel

• Fertility specialist (Reproductive Endocrinologist)
• Nurses experienced in fertility treatments
• Anesthesiologist or sedation nurse, if applicable
• Ultrasound technician

Risks and Complications

Common risks:

• Mild cramping and bloating
• Light spotting Rare risks:
• Infection
• Ovarian hyperstimulation syndrome (OHSS)
• Injury to nearby organs

Benefits

While the cycle is cancelled, the aspiration step is necessary for assessment. It provides critical information for future cycles and helps in refining treatment protocols for better outcomes.

Recovery

• Rest for the remainder of the day after the procedure.
• Mild pain or discomfort can be managed with over-the-counter pain relievers.
• Follow-up appointment with the fertility specialist to discuss next steps.

Alternatives

• Intrauterine insemination (IUI)
• Natural cycle IVF
• Adoption or surrogacy

Pros and Cons:

• IUI is less invasive but has a lower success rate.
• Natural cycle IVF eliminates medication use but may result in fewer eggs retrieved.
• Adoption and surrogacy are alternative paths to parenthood but involve different processes and considerations.

Patient Experience

Patients may experience mild discomfort or cramping similar to menstrual cramps during the aspiration. Post-procedure, they might feel tired and need rest. Emotional support is crucial as a cancelation can be disappointing. Pain management includes mild pain relievers and rest.