Couples who have trouble conceiving may seek alternative ways to have a baby. IVF is not the first solution when dealing with infertility. It takes place after other methods like fertility medication or artificial insemination do not work.
IVF is a method of assisted reproductive technology (ART). The ovaries are stimulated to produce several follicles (usually 10-15) by means of gonadotropin injections. Each follicle contains an oocyte (egg). When the follicles reach a certain size the oocytes are deemed mature and are collected by a process called egg retrieval. The oocytes (eggs) are combined with the sperm outside of the body in a special laboratory. This process is called fertilization and it may occur in two different ways: by placing prepped sperm near the eggs (conventional fertilization) or by injecting each egg with a healthy looking sperm (ICSI). The product of the fertilization process is the embryo, which is the first stage of human life. The embryos continue to develop in the laboratory up to a certain stage and then one or two are transferred to the uterus a mere 3 or 5 days after the egg retrieval.
Candidates for IVF
- A man or woman with unexplained infertility and the failure of other fertility treatments.
- A woman with blocked, abnormal or no fallopian tubes.
- A man with low sperm count or irregular sperm function.
- A woman with endometriosis, anovulation, decreased ovarian reserve, and the failure of other treatments.
In Vitro Fertilization Process
Mature eggs are needed for retrieval. Fertility medication is taken to insure that multiple healthy eggs are available to collect during a cycle.
You will administer gonadotropin injections to stimulate your ovaries. The goal is to produce several follicles (usually 10-15). Each follicle contains an egg. More than one egg is needed because some may not develop properly. Others may not have the ability to be fertilized after they are retrieved. The physician monitors the eggs’ development during the ovarian stimulation by means of ultrasound.
The physician retrieves the eggs once they are mature using a procedure called follicular aspiration. This is an outpatient procedure performed under light anesthesia and sedation. There are no abdominal incisions. The physician uses ultrasound to guide a hollow needle through the vagina in order to retrieve an egg from each follicle. The embryologist then evaluates and prepares the eggs for the next step, fertilization. Recovery after the egg retrieval usually lasts about two hours. Cramping is a possible side effect but this normally subsides in about a day.
Your partner or a donor provides a semen sample. The embryologist examines the sample and isolates the best sperm to use during the insemination process. The embryologist mixes the sperm with the eggs (conventional insemination), or in some cases, the eggs are injected with sperm through a process call intracytoplasmic sperm injection (ICSI). The eggs are then incubated for about 18 hours before fertilization is assessed. The fertilized egg is an embryo once cell division is determined. Embryos will be incubated for a few more days before they are ready to be transferred.
Embryo transfer takes place between three and five days after fertilization. Ultrasound helps the physician guide a thin catheter through the cervix. One or two embryos are then gently pushed into the uterus.
Multiple transfers of embryos may increase the likelihood of pregnancy but it may also increase the likelihood of becoming pregnant with more than one baby. A multiple pregnancy increases health risks for you and your babies. Preterm labor is a risk risk factor you could face. It is important to speak with your doctor about the odds of a multiple pregnancy and decide together what would be the best number embryos to transfer. We will only transfer the highest quality embryos; therefore, we recommend transferring no more than one or two embryos at a time.
Rest and limited activities improve your chances of implantation. Your nurse will administer a blood test to check your hormone levels five days after the embryo transfer. Another will follow two weeks after the embryo transfer to see if the procedure was successful and pregnancy has occurred.