In Vitro Fertilization (IVF)

In vitro fertilization, or IVF, is a fertility treatment that involves growing multiple eggs (also known as oo cytes) at once, removing them from the ovaries by a procedure known as an egg retrieval, and fertilizing them with sperm in the IVF laboratory.

This procedure was first successfully used for infertility in humans in 1977 at Bourne Hall in Cambridge, England. To date, tens of thousands of babies have been delivered worldwide as a result of IVF treatment. Over the years, the procedures to achieve IVF pregnancy have become increasingly simpler, safer and more successful.

An egg that has been fertilized by a sperm is known as an embryo. Embryos are grown for several days outside of the body, and one or more embryos are then placed back in the uterus in a procedure known as an embryo transfer to achieve pregnancy.

There are a variety of different protocols in IVF. Your doctor will determine which approach is best for you. Regardless of the details of your protocol, there are a few consistent stages of an IVF cycle that we will review here.

  1. 1. Ovarian Stimulation
    1. Ovarian Stimulation

    The ovarian stimulation phase generally begins with the onset of menses (although there are certain protocols in which this is not the case). The simulation involves taking 2-3 injections per day of medications known as follicle stimulating hormone (FSH) and luteinizing hormone (LH). These medications cause the ovarian follicles (fluid filled structures containing one egg each) to grow and mature. The ovarian stimulation lasts an average of 9-12 days, during which time you come to clinic for 5-6 ultrasounds and blood tests to monitor the progress of follicular growth. The last step in the stimulation phase is known as the trigger, which gets the eggs inside the follicles ready for retrieval. The next step, the egg retrieval, typically occurs 36 hours after the trigger.

  2. 2. Egg Retrieval
    2. Egg Retrieval

    The egg retrieval is a minimally invasive procedure done at CRH clinic. The procedure is done using IV sedation administered by anesthesiologist, so you are asleep but breathing on your own. An REI physician performs the procedure, which involves using a transvaginal ultrasound to guide a thin needle into each follicle to retrieve the egg inside. The procedure takes about 30 minutes, and you should be on your way home about 1-2 hours afterwards. Please plan to take the rest of the day off as you may be quite sleepy from the anesthesia.

  3. 3. Fertilization and Embryo Culture
    3. Fertilization and Embryo Culture

    Retrieved eggs are combined with sperm to create embryos. Our state-of-the-art embryology lab is located on-site at our clinic and staffed by a team of highly trained embryologists. Embryos are grown in the lab for 3-6 days, at which point one or more embryo(s) can be transferred back into your uterus, and the remaining embryos are frozen. Alternatively, all embryos can be frozen for transfer at a later date.

  4. 4. Starting Treatment
    4. Starting Treatment

    During the embryo transfer, a speculum is placed and a small catheter is used to place the embryo(s) at the top of the uterine cavity under ultrasound guidance. At the CRH, our transfer rooms are equipped with monitors so that you are able to visualize the embryo(s) and watch as they are transferred into the uterus. A blood test is done 10-14 days after the transfer to determine if you are pregnant. 

When Should You Consider IVF?

Some of the types of fertility that might be helped with IVF include: 

  • Absent fallopian tubes or tubal disease that cannot be treated successfully by surgery 
  • Endometriosis that has not responded to surgical or medical treatment 
  • A male factor contributing to infertility, in which sperm counts or motility are low but there are enough active sperm to allow fertilization in the laboratory 
  • Severe male factor in which sperm must be obtained surgically 
  • Unexplained infertility that has not responded to other treatments 
  • Genetic diseases that result in miscarriage or abnormal births