In vitro fertilization (IVF) is a method of infertility treatment in which the sperm and the egg (oocyte) are combined in a laboratory dish for fertilization to occur.

During the IVF process, a patient’s cycle is manipulated and monitored with the use of fertility medications.  These medications stimulate the ovaries to produce several mature eggs. When appropriate, the eggs are retrieved from the ovaries. At this time, the male supplies a sperm sample (or a frozen sample can be used). The eggs and sperm are placed in a dish and fertilized. After fertilization, the resulting embryo(s) are then transferred to the uterus to develop naturally. If multiple embryos are created, patients have the option to cryopreserve (freeze) embryos for future use.  IVF treatment offers the highest rate of success of all the treatment options for infertility. It is also the most complex fertility treatment.

IVF is often recommended when a patient has experienced:

  • Endometriosis
  • Low sperm count
  • Uterus or fallopian tube abnormalities
  • Ovulation disorders or problems
  • Presence of antibodies that harm sperm or eggs
  • Sperm that are unable to penetrate the egg or survive in the cervical mucus
  • Unexplained infertility
  • Multiple failed IUI cycles

Success varies from patient to patient and even from cycle to cycle, depending on a variety of factors.

IVF Recommendations

The IVF process includes:

  1. Ovulation Induction
  2. Egg Retreival
  3. Insemination and Fertilization
  4. Embryo Transfer
  5. Frozen Embryo Transfer (FET)
  6. Pregnancy Testing
Ovulation Induction
(OI) Ovulation Induction is the stimulation of the ovaries to prepare and release a number of mature oocytes, or eggs. This process starts about one week before menstruation with the administration of medications to prevent early ovulation. Once menstruation begins, fertility medications are given daily to stimulate the maturation of oocytes. When the eggs are fully mature, usually about eight to ten days later, an additional medication is given and the patient is prepared for egg retrieval.
Egg Retrieval
The mature eggs are collected for in vitro fertilization using a simple outpatient procedure known as ultrasound-guided transvaginal oocyte aspiration. During the egg retrieval procedure, patients will receive a mild sedative through an IV.  This is a form of light general anesthesia where they will breathe on their own but will not feel the procedure nor remember it afterwards. This process takes between 10 and 15 minutes and recovery is brief.
Insemination and fertilization
This step in the IVF process takes place in our laboratory by our team of embryologists. Eggs mature for a few hours in the incubator and sperm are added.  This is called insemination. Insemination is followed several hours later by fertilization, when the sperm enters the egg.  Patients may also elect to include ICSI (intracytoplasmic sperm injection) as part of their IVF cycle.

Once fertilization occurs, the embryos begin dividing, growing to eight-cells by day three and up to 100 cells by day 5-6 (at this stage, embryos are called blastocysts).  The embryos are closely monitored by our embryology team and patients are made aware of their embryos growth progression.  Patients may also elect to have their embryos tested using PGT-A.
Embryo Transfer
Before the embryo transfer, the embryologist will confirm the patient's identity. This is one of the several measures we take to ensure the safety of our patient's embryos.

The embryo transfer itself is done without anesthesia, and feels similar to a Pap smear. The entire process takes about 15 minutes. The previously selected embryo(s) is loaded into a soft catheter and passed through the cervix and into the uterus.

After completing the transfer the patient will be moved to a recovery room where they will be monitored while resting for 30-45 minutes.
Frozen Embryo Transfer (FET)
Often in an IVF cycle an embryo(s) will be frozen to allow time for genetic testing or preparation of the patient’s uterus. Once euploid embryos are identified, they can be warmed and transferred to the uterus, one embryo at a time. The frozen embryo transfer procedure takes place in exactly the same way as a fresh embryo transfer. A thin catheter is inserted into the uterus through the cervix. The embryo is then introduced into the uterine cavity through this tube. The procedure takes very little time and there is minimal discomfort. One of the ways we can ease the physical, financial, and emotional burden of undergoing multiple IVF cycles is by using cryopreserved, or frozen, embryos. Storage of euploid embryos can provide patients the opportunity for fertility preservation with the intention of using the embryos in subsequent IVF cycles when the initial cycle is unsuccessful, or years later when the patient is ready to have another child.
Pregnancy Testing
Two weeks after the egg retrieval procedure, the patient will return to the clinic for a blood test to see if she is pregnant. If the test is positive, she will be scheduled for a second blood test two days later.  Two weeks after the first positive test, an ultrasound is performed to confirm a viable pregnancy.  The patient will continue to be monitored with ultrasounds bi-weekly until the pregnancy has progressed far enough to be released for routine obstetrical care.
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