WHAT YOU CAN EXPECT WHEN OPTING FOR IVF

Deciding to proceed with in vitro fertilization (IVF) in order to conceive can be quite an emotional and exciting decision. Understanding what to expect from the IVF process will leave you better prepared to tackle what lies ahead. IVF is generally considered when other attempts at conception have failed. However, IVF will be considered the first line of treatment if using an egg donor, if there are serious cases of male infertility or damage to the woman’s fallopian tubes.

IVF Steps and Process

IVF involves a step by step process and requires much pre-preparation before the embryos are placed in the female partner’s uterus. The steps involved in IVF are as follows:

·         Pre-evaluation of the uterus, ovarian function and sperm quality

·         Ovulation induction

·         Ultrasound monitoring

·         Egg retrieval

·         Collection of sperm

·         Fertilization

·         Embryo culture

·         Embryo transfer

A single cycle of in vitro fertilization, including medication takes a time span of two- 8 weeks.

Ovulation Induction- Many different drugs can be prescribed and your dose and choice of medication will be determined by age, diagnosis, egg quality and antral follicle count.

Medications typically used are:

• Ovarian stimulation medication: This includes hormone  injections containing FSH, HCG or LH or both which will increase egg production and develop multiple eggs at a time. 15 eggs is an ideal number of eggs to develop for one cycle.
• Medication for egg maturation: When the follicles are ready for the egg to be performed, the medication to allow final maturation of the eggs will be injected.
• Medication for the Prevention premature ovulation to ensure that the eggs aren’t released before the egg retrieval.
• Medication for preparing uterine lining: The uterine lining needs to be sufficiently thick to aid implantation of the embryo. Hence, a Colorado fertility doctor will prescribe a medications that will thicken the lining after egg retrieval before implantation.

Ultrasound monitoring

To determine if the eggs are ready to be removed, a vaginal ultrasound will  be done by your doctor. Blood work that measures levels of hormonal markers are also important at this phase. Estrogen levels increases as the follicle grows, and progesterone remains low until after retrieval has occurred.

Egg retrieval

Egg retrieval starts with sedation and the use of pain medication. After the patient is adequately sedated a Transvaginal ultrasound aspiration is used to retrieve the eggs. With this procedure, a thin needle is inserted through the wall of the vagina into the follicle. After all follicles are aspirated the patient recovers for about 1 hour at the office. Additionally, there may be pain or cramping after this procedure.

Collection of sperm

Sperm utilized for IVF can be collected on the day of the egg retrieval  by masturbation or the IVF office can use a previously stored frozen sample.  Frozen samples are often used if the male had a MESA or sperm aspiration procedure in the past.  Additionally,  frozen samples will be used if using a sperm donor or gestational carrier is used.

Fertilization

Eggs can be fertilized by one of two methods.  The sperm can be put in the petri  dish with the eggs or sperm can be injected directly into the eggs (ICSI).  The method utilized for fertilization will depend on the diagnosis and sperm quality.

Embryo Culture

After fertilization the fertilized eggs are watched in culture for several days.  Fertilized eggs are called embryos.  The embryos can be transferred between day 2 and day 6 after fertilization. The day of transfer will depend on embryo quality, number of good quality embryos  and the patients age.

Embryo transfer

Embryos are placed tin the uterus with a thin catheter often under ultrasound guidance.  This procedure is not typically done with sedation and generally is not painful.  The number of embryos to transfer will depend on the patients age and embryo quality.

In some situations, IVF may also be cancelled due to any of these reasons:

• Overstimulation of follicles, increasing risk of ovarian hyperstimulation.
• Early ovulation.
• Inadequate number of follicles developing.
• Other medical concerns.