In vitro fertilization is one of the most successful fertility treatments available to women and couples struggling to get pregnant or who haven’t been successful using other fertility treatment options – such as oral fertility medication or IUI.
During IVF, we retrieve eggs and sperm from the prospective parents or donors (more on that below) and put them together in the lab to yield fertilized eggs that are transferred into the mother’s uterus.
There are several steps required in a basic cycle of IVF.
Before you choose IVF, you and your partner will undergo a thorough round of infertility testing. These results determine the course of your personalized fertility treatment. Women and couples most likely to be successful using IVF include women:
- 38+ years old with fertility issues
- With endometriosis who aren’t responding to other fertility treatments
- Who have blocked or damaged fallopian tubes
- Male infertility issues due to poor sperm count or blockages
We also use IVF to support LGBTQ+ family-building goals.
If you fall into any of the above categories, your fertility specialist will probably recommend IVF, and you’ll make your way through these five basic IVF steps.
Depending on your infertility diagnosis, you may have already used an oral fertility medication to stimulate the maturity and release of an extra egg or two. For IVF, we hope to retrieve at least 10 and up to 20 mature eggs to fertilize in our lab. This requires the hyperstimulation of the ovaries by injectable fertility medications.
This process is carefully monitored via communication, appointments, and ultrasound imaging to keep track of the eggs’ maturation and ensure you aren’t experiencing worse-than-normal side effects.
Note: Injectable fertility medications result in the same symptoms as oral fertility meds, but the symptoms are more dramatic. You may experience pelvic discomfort/cramping, bloating, moodiness and irritability, breast tenderness, etc. Extreme side effects are rare, and we cease treatment immediately at the first sign that symptoms are more intense than they should be.
Once the eggs are ready, you’ll administer something called “the trigger shot,” which is a hormone shot containing human chorionic gonadotropin, or HCG, which triggers the release of the egg.
After giving you a mild sedative to relax you, your specialist uses a special needle that is painlessly inserted into your vagina and through the cervix to each of the ovaries. Then, using a transvaginal ultrasound image, s/he’ll “aspirate” or suck each of the mature eggs into the needle and then into a special container – verifying the presence of the egg with a microscope.
This procedure is not painful, although some patients experience mild cramping for the afternoon and day afterward. It’s nothing that OTC pain relievers can’t take care of.
We usually get the sperm sample from your partner on this same day. Or, by now, we have the donor sperm ready for fertilization. In either case, we wash the sperm sample and put it through a “spin cycle” so only the healthiest, most vital sperm are used to fertilize retrieved eggs.
Our embryologists now go to work introducing sperm and eggs to one another. In most cases, eggs are fertilized within a matter of hours. Or, you may opt to use intracytoplasmic sperm injection (ICSI). During ICSI, embryologists manually inject a single sperm into each egg.
Once eggs are fertilized, we let them divide as they normally would for five full days. At that point, we move forward with transferring a fresh embryo(s) OR freezing the embryos and storing them until you are ready to move forward with the embryo transfer. At this time, we might also use PGD/PGS technology to screen embryos for genetic or chromosomal abnormalities.
After PGS, we can also mark each embryo as chromosomally male or female to support gender selection.
If you choose to freeze embryos and transfer them later, you’ll let us know when you’re ready. You may be put on birth control for a cycle or two to make your cycle more predictable. When you’re ready to transfer the embryos, we’ll sync your cycle to match the natural “fertile window” so your endometrial lining is at its most receptive. We’ll also give you progesterone to increase the chances of implantation and minimize the chances of a miscarriage.
During your transfer appointment, the doctor uses a catheter and transfers the number of embryos you’ve agreed upon – typically between one and three, depending on your infertility diagnosis and pregnancy history. This procedure is also performed right in our office and is an outpatient procedure. Someone should drive you to and from the appointment as we’ll use a mild sedative.
Now, you get to experience what fertility patients refer to as the Two Week Wait (TWW). It can be excruciating, which is why we’ve put together The Two Week Wait: Boston’s Survival Guide.
At the end of your TWW, you’ll come into our office for a bona fide pregnancy test, where we hope to be delivering the good news that you are pregnant.
Are you pursuing IVF to achieve your family-building goals? Schedule an appointment at Fertility Solutions. We are a patient-centered practice, and our patients appreciate that we offer a decidedly different, more personal approach to fertility care.