[0.53] Brigid and Dr Pat introduce Dr Raelia Lew.

Dr Raelia’s Podcast: Knocked Up

Dr Raelia’s Instagram: @drraelialew

[2.28] Listener Ali asks about the induction of IVF pregnancies, and why IVF pregnancies are induced and the reason as to why the stage during pregnancy where induction occurs varies so much.

[3.29] Dr Raelia talks about how all pregnancies are unique and not all IVF pregnancies need to be induced, and how depending on risk factors and the reason for assisted reproduction, once a woman is pregnant via IVF, that pregnancy may be able to be treated like a ‘normal’ pregnancy.

[7.01] Brigid asks about IVF pregnancies being classed differently.

[8.21] Dr Raelia talks about deteriorating placenta’s and whether this is more prevalent in IVF pregnancies.

[8.40] Dr Raelia talks about the conversations that a should occur around the induction of an IVF pregnancy and the questions that the woman should ask her care provider around why they have come to this decision.

[10.40] Dr Raelia talks about embryo biopsies and genetic testing in the early stages of an IVF pregnancy.

[13.17] Dr Pat asks Dr Raelia which IVF pregnancies may require further testing. Dr Raelia talks about aneuploidy testing and why it is used in mainly genetic condition related IVF pregnancies.

[16.15] Dr Raelia answers a listener’s question on whether genes can change after implantation. Dr Raelia talks about how embryos are dynamic and are constantly undergoing cell division.

[18.12] Dr Raelia talks about routine aneuploidy testing and embryo biopsies and whether they both need to occur.

[20.13] Brigid summaries what Dr Raelia was talking about, and how most IVF pregnancies will only have a NIPT at 10-13 weeks.

[21.46] Dr Raelia uses Spinal muscular atrophy (SMA) to explain how IVF can be used to avoid a couple have a baby with the genetic condition when both parents are carriers.

[23.07] Dr Raelia talks about how many patients use IVF because of a known genetic condition and how many use IVF because they suffer from infertility. Dr Raelia talks about how slightly more of her patients see her because they are suffering from infertility, however she also sees a lot of patients for IVF because the couple are both carriers of a known genetic condition.

[23.42] Dr Raelia lists some of the infertility related reasons why people may use IVF, such as male infertility, endometriosis related infertility and unexplained infertility.

[24.04] Dr Pat and Brigid ask Dr Raelia about dating IVF pregnancies and how they are dated, whether that be off a previous cycle, a transfer date or a 6week ultrasound with a heartbeat or if there is a different method. Dr Raelia talks about why she dates off an embryo transfer date.

[25.50] Dr Raelia talks about adjusted dating and how this works.

[27.15] Brigid asks if there are more risk factors for IVF pregnancies and if they are more prone to certain conditions. Dr Raelia talks about research that has been done on the impact the way an embryo has been transferred can have on a woman developing preeclampsia and other obstetric concerns.

[28.15] Dr Raelia talks about how some cycle types increase the risk of developing preeclampsia and other obstetric concerns. Dr Raelia talks about why this may happen and how it is generally a relative risk.

[31.25] Brigid asks if this is also the case for gestational diabetes and prematurity.

[31.50] Brigid asks if the rate of caesarean sections increase for IVF pregnancies. Dr Raelia talks about how there is an increased demand for elective caesareans for IVF pregnancies, Dr Raelia talks about how this is normally due to risk reduction and how the best thing to do is support someone’s choice and not stigmatise. Dr Pat talks about his own experience with patients and how majority of them are over risk and they see a planned caesarean as the best option for them.