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There are risks related to the egg retrieval procedure. Laparoscopy carries with it the risks of any surgery that requires anesthesia. Removing eggs through an aspirating needle entails a slight risk of bleeding, infection, and damage to the bowel, bladder, or a blood vessel. This is true whether the physician uses laparoscopy or ultrasound to guide the needle. Less than one patient in 1,000 will require major surgery to repair damage from complications of the egg retrieval procedure. In rare cases, infection may occur from the retrieval or embryo transfer.
存在与取卵程序有关的风险。腹腔镜存在任何麻醉手术的风险。取卵针取卵要承受出血，感染和肠管，膀胱或血管损伤的轻微风险。要看医生是否正确地用腹腔镜或用B超引导取卵针。取卵程序合并症需做大手术的患者少于1/1000。取卵或胚胎移植可致感染的病例罕见

The chance of multiple pregnancy is increased in all assisted reproductive technologies when more than one embryo is transferred. Although some would consider twins a happy result, there are many problems associated with multiple births; and problems become progressively more severe and common with triplets and each additional fetus thereafter. Women carrying a multiple pregnancy may need to spend weeks or even months in bed or in the hospital in an attempt to delay premature delivery. The risk of premature delivery in multiple pregnancies is high, and babies may be born too early to survive. Premature babies require prolonged and intensive care and risk lifelong handicaps due to premature birth. Some couples may consider multifetal pregnancy reduction to decrease the risks due to multiple pregnancy, but this is likely to be a difficult decision. For more information on this topic, refer to the ASRM patient information booklet titled Multiple Gestationand the ASRM patient fact sheet, Complications of Multiple Gestation. Data also suggest that IVF conceptions, even singletons, have a slightly increased risk of premature delivery or low birth weight.
所有的辅助生殖技术，只要移植的胚胎不止一个，多胎妊娠的机会都会增加。尽管有些人喜欢双胎，多胎分娩与很多问题有关；而且三胎或以上的问题变得愈加严重和普遍。多胎妊娠孕妇为了延缓早产可能要卧床或住院数周或数月。多胎妊娠早产风险高，胎儿可能出生过早而夭折。早产儿需要延长重症监护或因早产而终身残疾的风险。有些夫妇可能考虑多胎妊娠减胎降低多胎妊娠的风险。这可能是很困难的决定。要了解这个主题的更多信息，请参考美国生殖医学会患者指引‘多胎妊娠’和患者告知书‘多胎妊娠合并症’。资料还显示体外受精受孕，甚至单胎的早产或低体重儿风险也有轻微的增加。

Miscarriage may occur after ART, even after ultrasound identifies a pregnancy in the uterus. Miscarriage occurs after ultrasound in nearly 15% of women younger than age 35, in 25% at age 40, and in 35% at age 42 following ART procedures. In addition, there is approximately a 5% chance of ectopic pregnancy with ART.
辅助生殖技术后可能会流产，甚至在B超确定宫内妊娠后流产。做辅助生殖技术B超提示妊娠后流产的35岁以下接近15%，40岁占25%，42岁占35%。此外，辅助生殖技术约有5%的机会宫外孕。

辅助生殖技术是否增加出生缺陷的风险不清楚。大部分研究没有显示风险增加，但有些研究提示风险增加。如果有任何增加，都正在研究以明确风险大小。而且，严重的男性不育因素做胞浆内精子注射，男性不育的遗传病会遗传后代。

Assisted reproductive technologies involve a significant physical, financial, and emotional commitment on the part of the couple. Psychological stress is common; and some couples describe the experience as an emotional roller coaster. The treatments are involved and costly. Patients have high expectations, yet failure is common in any given cycle. Couples may feel frustrated, angry, isolated, and resentful. At times, frustration can lead to depression and feelings of low self-esteem, especially in the immediate period following a failed ART attempt. The support of friends and family members is very important at this time. Couples are encouraged to consider psychological counseling as an additional means of support and stress management. Many programs have a mental health professional on staff to help couples deal with the grief, tension, or anxieties associated with infertility and its treatment.
辅助生殖技术涉及夫妇重要的身体的，经济的和情感的义务。精神压力常见；有些夫妇的感情体验犹如过山车。要治疗要花钱，患者预期高，但周期失败常见。夫妇可能感到挫败，愤怒，孤独和厌恶。有时候挫败会导致抑郁和缺乏自尊，特别是辅助生殖技术刚失败后，这时候朋友和家人的支持非常重要。鼓励夫妇考虑以心理辅导作为支撑和压力控制的辅助手段。很多程序的团队有精神保健专家帮助处理夫妇与不孕及其治疗相关的忧伤，紧张或焦虑。

PREPARATION FOR ART
为辅助生殖技术做准备
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. The chance of success may be poor, for example, if tests demonstrate diminished ovarian reserve or fertility potential. Ovarian reserve may be determined by measuring FSH and estradiol levels on the second or third day of a menstrual cycle, performing a clomiphene challenge test, or counting the number of beginning follicles in the ovary (antral follicle count). An elevated FSH and/or estradiol level is associated with reduced pregnancy rates, especially in women over the age of 35 years. Uterine cavity abnormalities such as fibroids, polyps, or a septummay need to be corrected before IVF or GIFT. A hydrosalpinx, a fluidfilled, blocked fallopian tube, reduces IVF success. Some physicians advise clipping or removing the affected tube prior to IVF. For more information, see the ASRM patient fact sheet titled, Hydrosalpinx.
辅助生殖技术程序的初步准备可能象程序本身一样重要。为了预测卵巢对助孕药物的反应如何，建议做卵巢储备功能试验。成功机会可能不大，例如，如果试验结果表明卵巢储备功能或生育潜力差。卵巢功能可能取决于月经第2—3天测定的卵泡刺激素和雌二醇水平，做克罗米酚试验，或卵巢初始卵泡（窦卵泡）计数，卵泡刺激素和/或雌二醇水平高与妊娠率低有关，特别是35岁以上的女性。做体外受精或配子输卵管内转移前要纠正宫腔异常如宫肌瘤，息肉，或中隔。输卵管积水，阻塞的，闭塞的输卵管降低体外受精的成功率，有些医生主张体外受精前要结扎或切除感染的输卵管。要了解更多信息，请参考美国生殖医学会患者告知书‘输卵管积水’。

Semen is tested before ART. If semen abnormalities are identified, consultation with a specialist in male infertility should determine if there are correctable problems or underlying health concerns. For example, genetic abnormalities in the Y chromosome have been linked to some cases of male infertility; and men born without a vas deferens, a tube that transports sperm from the testicle, are often carriers of a gene that causes cystic fibrosis. In these circumstances, genetic testing may be advisable.
做辅助生殖技术前要做精液试验。如果确实精液异常，咨询男性不育专家，应该明确是不是可以纠正的问题还是潜在的健康问题。例如，Y染色体的遗传病与一些男性不育有关；出生缺如从睾丸输送精子的输精管常常是携带导致囊性纤维化的基因，在这种情况下，做遗传检验可能是合适的。

Cost and Convenience
费用和便利
* What pre-cycle screening tests are required, how much do they cost, and will my insurance provide coverage for these tests?
* 预备周期要做哪些筛选实验，费用多少，保险有用吗？

Details About the Program
方案的细节
* Is the program a member of the Society for Assisted Reproductive Technology?
* 是美国生殖医学会成员的方案吗？
* 负责给我诊治的医生有几个？

* Are one or more physicians board certified in reproductive endocrinology?
* 有一个还是多个生殖内分泌认证医生？

* How many eggs/embryos would be transferred in my case?
我将移送多少个卵子/胚胎？

* Who makes the final decision to cancel the cycle if my response to stimulation is sub-optimal?
如果我对刺激反应欠佳，是谁做出取消周期的最后决定？

Success of the Program
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