In 2015, the most recent year for which data is available, nearly 73,000 babies were born in the United States with the help of assisted reproductive technology (ART). In vitro fertilization, commonly known as IVF, is one of the oldest and most frequently used ART procedures.
Who can benefit from IVF?
During IVF treatment, the fertilization step takes place outside the body--providing a solution that bypasses the need for the male's sperm to navigate the woman's reproductive tract.
Because of this, IVF can provide hope for patients facing many different causes of infertility.
- Women with damage or blockages in their fallopian tubes that have very low chances of becoming pregnant without fertility treatment
- Men who have a low sperm count or issues with sperm motility may have difficulty fertilizing their partner's eggs
- Women planning to carry the pregnancy using her own eggs, but has experienced challenges conceiving with IUI
- LGBTQ female-female couples in which one partner would like to donate the egg while the other partner carries the pregnancy; This is often referred to as “reciprocal IVF."
- LGBTQ male-male couples using donor eggs and a surrogate
How Does IVF Work?
The most common IVF procedure involves a four-step process.
Step 1: Controlled Ovarian Hyperstimulation
The success of IVF largely depends on growing multiple eggs at once, but the body normally only matures and releases one egg at a time each month. To increase the chances for successful fertilization during the IVF process, the woman producing the eggs will be given certain medications to help the body produce more than one egg in this ovulation cycle. Additional medications are used to prevent ovulation.
It is important to follow your medication schedule and doses exactly in order for ovulation induction to be successful. A medication schedule chart may help you keep track of the days of your cycle, when to take each medication and the dose of each medication.
Throughout your cycle, you will have several ultrasounds and blood test to determine how well the ovulation medications are working. Individuals react differently to these medications and some people may need an adjustment in their medication or dosage.
Step 2: Egg retrieval
When the follicles have matured, you will be instructed to give yourself an injection of HCG (human chorionic gonadotropin). About 34 to 36 hours later, your doctor will remove the eggs from the ovaries. The retrieval is done under intravenous sedation to prevent pain and keep you comfortable during the procedure. Following retrieval, the eggs are then transferred to our lab for the next step--fertilization.
Step 3: Fertilization
In the IVF lab, the embryologist will prepare the eggs and sperm. A semen sample that has been washed, removing all seminal fluid leaving only the most mobile and healthy sperm, is then mixed with the eggs.
In cases when there is a sperm problem with fertilization, low sperm motility, low sperm count or abnormally shaped sperm, a procedure called Intracytoplasmic Sperm Injection (ICSI) may be recommended. With this procedure, a single sperm is injected directly into the egg to achieve fertilization.
The eggs and sperm are carefully monitored for the next 18-24 hours to ensure that fertilization occurs. If fertilization occurs, the embryologist will incubate the fertilized eggs and monitor them for about 2 to 5 days to make sure they develop properly.
Step 4: Embryo Transfer
Once several embryos have been created, we have the opportunity to run genetic testing before transferring them to the uterus.
This is either pre-implantation genetic diagnosis (PGD) for patients with identifiable genetic defects like cystic fibrosis, thalassemia, or sickle cell disease or pre-implantation genetic screening (PGS), which may allow us to identify embryos with the right number of chromosomes and then transfer only those embryos with the best chance to implant successfully.
To transfer the embryos, your doctor will place a speculum inside your vagina (like for a Pap smear), then under ultrasound guidance will insert a small catheter through your cervix into your uterine cavity, and transfer the embryos through the catheter.
Your doctor may suggest freezing any high-quality extra embryos so that they can be used for future pregnancy attempts.
How Soon Will I Know If IVF Worked?
Approximately 14 days after the day of egg retrieval, you will have a pregnancy test. A positive result on the pregnancy test means that the embryo has implanted in the endometrial lining on your uterus and that you are pregnant.
How Laurel Fertility Care Can Help
Since 2005, the fertility specialists at Laurel Fertility Care have worked with single parents, heterosexual and gay couples in over 15 countries and helped them to bring over 1,000 babies into the world--many of them through the use of IVF.
It’s important to know that fertility treatments are not a one-size-fits-all process. Laurel Fertility Care will work closely with you to determine the fertility treatment plan that will have the highest likelihood of a successful pregnancy. To learn more about the IVF procedure and other available fertility treatment options, request a free telephone consultation or call (415) 673-9199.