In Vitro Fertilization (IVF) is an extremely effective procedure for people hoping to build their family. It is a complex process with multiple phases; we are committed to helping you understand what to expect in each phase and will support you every step of the way.
In a normal menstrual cycle, just one egg develops and matures. The egg matures within a fluid-filled sac called a “follicle” which can be seen on ultrasound. In an IVF cycle, injectable gonadotropins are used, for approximately 8 to 12 days, to cause multiple eggs/follicles to develop. Beginning around cycle day 3, SRM will draw blood samples every 1 to 3 days to monitor the level of estradiol (a form of estrogen) in your blood. Vaginal ultrasound monitoring of the ovaries will also be used to follow follicular growth.
HCG/Lupron Injection and Egg Retrieval
When ultrasound and blood estradiol levels indicate that the follicles are ready, you will be notified to give the hCG or Lupron injection at a specific time. The egg retrieval is usually performed 36 hours after the injection. Typically, a transvaginal ultrasound is used to guide a needle biopsy of both ovaries in order to remove the eggs. There is no incision on your body and you are asleep for this procedure. If a male partner is providing sperm, he collects a fresh semen specimen the day of egg retrieval. You will go home the day of procedure, but we recommend that you do not return to work or do anything strenuous.
Fertilization of the Eggs and Embryo Culture
The eggs are fertilized the afternoon of the egg retrieval, either by direct incubation next to sperm, or with intracytoplasmic sperm injection (ICSI) where an individual sperm is selected and placed inside each egg to help the fertilization process. The eggs will then be incubated overnight. Over the next few days, the eggs will be examined for signs of fertilization, and growing embryos will be tracked as they divide and grow. Some patients require special therapy such as assisted hatching to enhance implantation.
The final step of IVF is the embryo transfer, where the embryo(s) is gently placed inside your uterus. Similar to a Pap smear, you will be awake while a soft fine catheter is used to place the embryo inside with ultrasound guidance. Your partner or a friend may be with you during the transfer.
Any remaining viable embryos will be frozen/cryopreserved. These embryos can be used in the future without the above procedures (ovarian stimulation and egg retrieval) thus simplifying future attempts. Embryos survive freezing and thawing extremely well.
Follow-Up Blood Tests and Obstetrical Appointment
Your pregnancy test will be 10–12 days after the embryo transfer. When we have determined that the hCG level is rising appropriately, we will schedule an obstetric ultrasound with your primary SRM physician.