IVF: In Vitro Fertilization

IVF: In Vitro Fertilization

In vitro fertilization, commonly referred to as IVF, is a laboratory procedure where eggs are fertilized by sperm outside of the womb. During IVF, eggs are retrieved from a woman’s ovaries and combined with a semen sample from the male in a laboratory dish (in order to become fertilized). Once an embryo is created, it is either transferred into the uterus to achieve pregnancy or cryopreserved for future use.

When Is IVF Recommended?

IVF is often used to treat individuals who have low ovarian reserve related to advanced age, ovulation disorders, blocked or damaged fallopian tubes, endometriosis-related infertility, inherited genetic diseases, recurrent miscarriages, or low sperm count or motility. In vitro fertilization is also used by couples who have tried other fertility treatments without success. Every patient has a unique medical situation.

The IVF Process

IVF can be a challenging step on your journey to parenthood. In order to help you understand what is involved in IVF, we have provided a step-by-step breakdown of the in vitro fertilization process:

• Step 1 — Ovulation Induction
  Normally, the ovaries recruit one egg to ovulate each month. With ovulation induction, hormonal medications are prescribed to stimulate the production of several eggs instead of one. Each egg matures inside of a “follicle,” or small cyst. Having multiple eggs is advantageous because some will not fully develop or become fertilized after retrieval. Treatments usually begin on the third day of menstruation and consist of about 10 days of injections.
• Step 2 — Egg Retrieval
  To retrieve the eggs, a ultrasound-guided needle is inserted through the vaginal wall to remove the fluid in each follicle on the ovaries. If there is a mature egg in the follicle it will be withdrawn along with the fluid. An average number of eggs collected is 10 to 12, but this can vary depending on the specific fertility problems the couple is experiencing. During egg retrieval, patients are given a light sedation and experience little discomfort following the procedure.
• Step 3 — Sperm Retrieval
  A semen sample is provided by the male partner or donor, who is asked to refrain from sexual intercourse for 2-4 days before retrieval.
• Step 4 — Laboratory
  The eggs and sperm are then prepared in the laboratory clinic for in vitro fertilization. Eggs are identified and examined for maturity while the sperm is washed to remove inactive cells and seminal fluid.
• Step 5 — Fertilization
  After preparation is complete, the sperm and eggs are placed into a laboratory dish so that fertilization can take place. They are incubated together for about 18 hours. If the male has low sperm count or low motility, a single sperm may be injected into a single egg, a process called intracytoplasmic sperm injection (ICSI). The day after your retrieval, you will receive the information regarding how many eggs were normally fertilized. A normally fertilized egg is an embryo. The embryos then remain in culture media in a temperature-controlled embryo until the day of transfer. It is best to minimize any disturbances to the developing embryos.
• Step 6 — Embryo Transfer
  An embryologist will examine each of the embryos to determine which is of the best quality. In preparation for embryo transfer, progesterone supplements may be taken. One or more embryos will then be transferred into the woman’s uterus. The embryos are placed in a fluid through a catheter and into the uterus. This is often a painless procedure, although it may cause minor cramping. The number of embryos transferred will depend on the patient’s age and pregnancy history.
• Step 7 — Follow-Up
  After nine days of waiting, a blood test is performed (HCG) to determine whether you are pregnant. With expert treatment, attentive care and just a little luck, you will have a positive result. Then it is time to start planning for the new addition to your family!

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