Is IVF Right for You?
IVF is the treatment of choice for a wide variety of infertility cases and is a great option for couples with a long history of infertility. Generally, IVF can help women of childbearing age and beyond. Singles and same sex couples are also good candidates for IVF because the procedure can be used in combination with donated eggs and sperm and surrogacy.
In a natural cycle, only one egg is allowed to grow and ovulate each month. With IVF, we use medications to directly stimulate the ovaries to produce a greater number of follicles (which contain eggs) to be produced and reach maturity. However, the body has its own defense against multiple pregnancies and the brain can trigger ovulation of the largest follicle, causing all of the remaining follicles to stop growing. Thus, we use special medications to prevent ovulation from occurring until several eggs have properly matured.
After the medication treatment has started, we closely monitor the ovaries by ultrasound and hormone level testing. For patients with low ovarian reserve, more aggressive stimulation protocols may be used. Choosing the correct stimulation protocol is one of the most important decisions in IVF planning. At IVFMD we take great care in assessing every patient’s situation when designing the ovarian stimulation protocol.
After about 10 days of ovarian stimulation, most of the follicles should mature to size. An injection called HCG (Human Chorionic Gonadotropin) is administered to induce the final maturation of the eggs, and 34-36 hours later, eggs are collected through the vagina under ultrasound guidance and transferred to our lab. You will be sedated by an anesthesiologist for about 20 minutes until the retrieval is complete. Mild pelvic soreness and cramping after the procedure is normal and should resolve within a couple of hours.
Once the eggs are in our lab, they are fertilized the same day either through conventional IVF, incubating the egg and a large number of sperm overnight, or through intracytoplasmic sperm injection (ICSI), injecting a single sperm into each egg. Regardless of which insemination method is used, the eggs are checked the following day to see if they have been fertilized. Typically, about 70% of the mature eggs are fertilized.
The fertilized eggs are cultured for 5-7 days, which is the same number of days an embryo takes to travel from the distal end of the tube into the uterus during natural conception. The embryos are cultured in very special conditions where the temperature, gases and pH are precisely controlled. In order to minimize fluctuations in the air and temperature of the incubator, we check the embryos on day 1, 5 and 6, counting day 1 as the day after retrieval. Patients are informed of the progress of their embryos after each check. If fresh embryo transfer is planned, the woman takes progesterone to prepare her uterine lining during this period. Nowadays, in most cases, embryos are frozen once they reach maturity for future transfer in a Frozen Embryo Transfer cycle.
On day 5 of culture, one with the best grading scores is loaded into a soft catheter and delivered into the uterus under ultrasound guidance. The remaining embryos are frozen for future use if they meet freezing criteria.The embryo transfer is painless and does not require sedation or anesthesia, however it is one of the most critical factors contributing to the IVF cycle outcome. A family member can be present with you during the embryo transfer process.
What happens after the embryo transfer?
After receiving your embryo, you can rest easy at home for the remainder of the day. The embryo will hopefully implant on the same day. You can resume normal activity by the next day.
What stands out about IVFMD’s approach to IVF?
When designing an IVF protocol, our fertility specialists consider the unique characteristics of each patient to design an optimal treatment plan. Our doctors will often combine the best features of different stimulation protocols to best fit the patient’s needs. Each of our fertility specialists have extensive experience in treating women with low ovarian reserve.
What is the success rate of IVF?
IVF success depends mostly on egg quality and quantity. Sperm quality also plays an important role. Embryos that have normal chromosomes give the best chance of a live birth. Transferring one such embryo gives a 50-60% chance of a live birth.