In Vitro Fertilization (IVF)
IVF is a form of assisted reproductive technology (ART). This means special medical techniques are used to help a woman become pregnant. The patients with following this will be indicated for IVF.
• Male Factor Infertility
• Age-Related Infertility
• Absent or Damaged Fallopian Tubes
• Unexplained Infertility
• Recurrent Intrauterine Insemination Failure
• Tubal and Pelvic Adhesions
• Preimplantation Genetic Diagnosis (PGD)
There are five basic steps to IVF:
Step 1: Ovarian Stimulation
Stimulation drugs or Hormones, are given to the woman to boost her egg production. Normally, a woman produces one egg per month. The fertility drugs stimulate the ovaries to produce several eggs. During this step, the woman will have regular transvaginal ultrasound to examine the ovaries about 3-4 times and blood tests to check hormone levels.
Step 2: Egg retrieval
A minor surgery, called follicular aspiration, is done to remove the eggs from the woman’s body. The surgery is normally done as an outpatient procedure in the our clinic. The woman will be given medicines so she does not feel pain during the procedure. Using ultrasound as a guide, the health care provider inserts a thin needle through the vagina and into the ovary and sacs (follicles) containing the eggs. The needle is connected to a aspiration device, which pulls the eggs and fluid out of each follicle, one at a time. The procedure is repeated for the other ovary. The woman may have some cramping after the surgery, but it usually goes away within a day.
Step 3: Insemination and Fertilization
The man’s sperm is placed together with the eggs and stored in an environmentally controlled incubator. The mixing of the sperm and egg is called insemination. The sperm usually enters (fertilizes) an egg a few hours after insemination. If the doctor thinks the chance of fertilization is low, the laboratory staff may directly inject the sperm into the egg. This is called intracytoplasmic sperm injection (ICSI). Many fertility programs routinely do ICSI on some of the eggs even if everything is normal.
Step 4: Embryo culture
When the fertilized egg divides, it becomes an embryo. Laboratory staff will regularly check the embryo to make sure it is growing properly. Within about 3-5 days, a normal embryo has several cells that are actively dividing. Couples who have a high risk of passing a genetic (hereditary) disorder to a child may consider pre-implantation genetic diagnosis (PGD). The procedure is done about 3 -5 days after fertilization. Laboratory scientists remove 1-2 cell from several cells in each embryo and screen the material for specific genetic disorders.
Step 5: Embryo transfer
Embryos are placed into the woman’s womb/uterus 3 – 5 days after egg retrieval and fertilization. The procedure is done in our clinic while the woman is awake. The doctor inserts a thin tube (catheter) containing the embryos into the woman’s vagina, through the cervix, and up into the womb. If an embryo implants in the lining of the uterus and you will get a good pregnancy result.
Normally, more than one embryo may be transfered into the uterus at the same time, which can lead to twins, triplets, or more. The exact number of embryos transferred is a complex issue that depends on many factors, especially the woman’s age. Unused embryos may be frozen and implanted or donated at a later date.