IVF is the process of fertilizing an egg outside the body and is the oldest and most frequently used ART procedure. Originally designed to bypass diseased fallopian tubes, the number of reasons to do IVF quickly expanded to include male factor infertility, endometriosis, unexplained infertility and other conditions. IVF is the basis for many of the related ART procedures, such as donor egg, embryo donation/adoption and gestational surrogacy.
The IVF procedure can be divided into 4 major steps. The first step is ovulation induction, where multiple eggs are recruited. Since the body normally matures and releases only one egg at a time each month, the female partner will be given certain medications to help the body recruit more than one egg in an effort to increase the chances for successful fertilization in vitro. By increasing the egg number, the chance of developing a healthy embryo is increased.
The next step after encouraging multiple eggs to develop is to retrieve the eggs which is done in our office under modified sedation by an anesthesiologist. The eggs are then transferred to our laboratory for the next step of fertilization. A semen sample is specially prepared and “washed,” then mixed with the eggs. The eggs and sperm are carefully monitored for the next 18 – 24 hours to ensure that fertilization occurs. Several of the best resulting embryos are then chosen for transfer into the female partner’s uterus and she will be given additional medications to prepare the uterus for implantation.
The last step of the IVF process is transferring the embryo(s) into the uterus, which is also done in our office. The female partner will be monitored closely to maximize the opportunity for a successful implantation and a successful pregnancy. At this time, a couple can choose to cryopreserve other normally developing embryos for future transfers.
There are many variations of the IVF procedure that allow it to be used to address other causes of infertility or other concerns a couple may have. For instance, to address male factor infertility, intracytoplasmic sperm injection (ICSI) may be performed to fertilized each of the mature eggs retrieved. For patients with identifiable genetic defects, such as cystic fibrosis, thalassemia, or sickle cell disease, pre-implantation genetic diagnosis (PGD) may be performed on the embryos to identify affected embryos and reduce the risk of transmission of that particular disease prior to implantation. For patients with multiple miscarriages, pre-implantation genetic screening (PGS) may allow us to identify chromosomally abnormal embryos and allow us to transfer only those embryos with a normal karyotype.
Laurel Fertility Care will provide a personalized plan for you to address your individual situation which will include a detailed schedule of medications and procedures. We will also discuss any potential risks and side-effects of your treatment plan. If you would like to discuss the IVF procedure or have questions, please contact us.