What is In Vitro Fertilization (IVF)?
IVF is a process of fertilization where the egg and the sperm are combined in a laboratory to create a viable embryo, which will be implanted into the uterus. More commonly, IVF refers to the entire treatment process. “In Vitro” means “in glass” and refers to the glass of the laboratory dish. IVF represents a combination of perfectly timed events with several phases, and we are here to help you each step of the way, and to help you understand the process, and know what to expect at each phase.
Many of our patients have realized their dream of having a baby because of In Vitro Fertilization (IVF). If IVF is a part of your personalized treatment plan, your physician will guide you through each detail of the IVF procedure steps, which we have outlined in this overview.
Prior to beginning the administration of any fertility drug, a screening ultrasound is performed to ascertain that there are no ovarian cysts which could interfere with the process.
Ovarian Stimulation and Your IVF Cycle
In the typical reproductive cycle, a single egg will develop and mature in a fluid-filled sac called a follicle. In an IVF cycle, we stimulate the ovaries to produce multiple eggs with daily injections of medications. Leuprolide acetate provides more control over the stimulated cycle by preventing a premature release of luteinizing hormone (LH), which may cause premature release of the eggs from the ovary. It also allows for synchronized follicle development producing more mature follicles of the same size. When the estrogen level is adequately suppressed, follicle stimulating hormones (FSH) and Gonadotropin injections begin. Gonadotropins stimulate development of the follicles. The daily injections will continue until the follicles are a proper size and the blood estrogen levels reach an optimal level. A hormone called Human Chorionic Gonadotropin (hCG) will then be used to mimic the body’s LH surge to bring about final maturation of the egg.
Careful monitoring of estrogen levels and follicle size optimizes ovarian stimulation and provides for increased safety. Blood estrogen level checks are performed every one to three days from Cycle Day 2 until the administration of hCG.
HCG/Lupron Injection and Egg Retrieval
When the follicles are ready – as indicated by their size and by the level of estradiol in blood – we will tell you to self-administer the hCG or Lupron injection. The egg retrieval is scheduled at Mobile Infirmary Medical Center (MIMC) approximately 36-38 hours after the hCG is administered.
What is Beta hCG? What is a Beta hCG Pregnancy Test?
Beta hCG blood pregnancy test measures the level of the hormone called human chorionic gonadotropin (hCG). Also known simply as a ‘beta’, this is the test that is administered to IVF patients following the ‘two week wait’ to verify success or failure of an IVF cycle.
What should I expect my first Beta hCG to be if my IVF cycle was successful?
Your first beta numbers can vary from single digits up to triple digits depending on when implantation took place and how long your last embryo transfer was. Don’t get discouraged if your initial beta number is low. What is important is the increase between your Beta hCG blood tests.
What to Expect during Egg Retrieval with IVF Treatment
Transvaginal egg retrievals are performed by ultrasound-guided aspiration. The ultrasound probe is inserted through the vagina. The images of the reproductive organs are viewable on a monitor. When a mature follicle is identified, the physician guides a needle through the vaginal wall and into the follicle. The egg is then removed through the needle by a suction device. Although the vagina has a reduced number of pain nerves, this procedure can be associated with some discomfort or intermittent sharp pains. Most patients require light sedation. On rare occasion, general anesthesia may be required. An experienced anesthesiologist or nurse anesthetist is available to provide either sedation or anesthesia as required or requested.
Patients will go home the same day as retrieval, regardless of whether retrieval is done under sedation or general anesthesia. In the unlikely event of a problem or suspected problem, admission to MIMC will be advised.
During the retrieval, the embryologist will immediately scan follicular fluid for the eggs. Gas composition, temperature and humidity of the environment are specifically controlled. Once identified, the eggs are evaluated for maturity and placed in culture medium.
Fertilization of the Eggs and Embryo Culture
Following the egg retrieval, the husband is asked to provide a semen specimen for the insemination of the eggs. If a donor is used the specimen will be thawed. The time of the semen collection will vary according to the maturity of the oocytes and the requirement for special treatment of the sperm. The mature eggs are inseminated with the sperm two to six hours after retrieval.
Sixteen to twenty hours after the insemination, the oocytes are examined for signs of fertilization. Twenty-four hours later, they are examined for cell division and an embryo transfer is scheduled approximately 72 hours after retrieval if cell division has begun. Fertilization does not always occur, and sometimes embryo development halts shortly after fertilization. The three to five day wait from oocyte retrieval to embryo transfer is inevitably stressful, and we ensure that patients are kept informed about the progress of their eggs during this period.
Embryo Transfer during IVF
When embryos have developed satisfactorily, they are then transferred into the uterus. This procedure is done at MIMC. Typically, up to four embryos are transferred, however, the physicians will make final decision the morning of transfer after consulting with the couple. Medication to promote relaxation will be prescribed to be taken just prior to transfer. A speculum is placed in the vagina and the cervix is cleansed. The embryologist loads the embryos into a thin catheter that is then given to the physician, who places the embryos into the uterus.
What To Expect after IVF Transfer
Bed rest is encouraged for two hours following the transfer. Decreased activity will be advised for the next 48 hours.
Learn About Other IVF Option Elective Single Embryo Transfer (eSET)
Embryo Freezing during IVF
Any embryos of sufficient quality that are not transferred may be cryopreserved to use in the future, thus avoiding another round of ovarian stimulation and egg retrieval. Our technology allows embryos to sustain cryopreservation and thawing very well.
Follow-Up after IVF Procedures
A pregnancy test will be done 10 days after embryo transfer. After embryo transfer you will receive a “report card” reviewing your cycle, egg retrieval, development and transfer.
Our IVF Success Rates
We have a long history performing IVF, and our success rates reflect our expertise. Learn more about our IVF success rates HERE.
Supporting You Through the IVF Process
IVF can be emotionally challenging and stressful and we offer support. It is our intention at The Center for Reproductive Medicine to make this experience as easy as possible. We will give you detailed information on the process every step of the way and ensure that you feel supported by our nurses, physicians and counselors.