IVF Process

 

What Is IVF Process?

There are many steps involved in the IVF process. While the process may seem overwhelming, please remember that we are here to guide you through it. Together, we will discuss what you can expect throughout the treatment process, review all of the medications, and learn about the testing that will be done. Although the IVF process is complex, our board certified fertility specialist will walk you through it one step at a time.

Female Infertility Evaluation

During our initial consultation, we will meet with you and discuss your case, diagnosis, and possible treatment options in detail. If you decide to proceed with IVF treatment, we will review the various tests that will be required in preparation for your cycle, and identify and review the dates of your cycle. This testing may include a mock transfer and evaluation of the uterine cavity with a hysteroscope.

Male Infertility Evaluation

The male partner or sperm donor will need to provide a semen sample for analysis. A sperm sample may be frozen to serve as a backup for the actual procedure. Once the evaluation is complete, you will be able to start your treatment cycle based on the schedule available and your menstrual cycle. We understand that you are anxious to begin treatment as soon as possible, and we will make every effort to get you started right away.

Review of Your IVF Cycle

Prior to starting the cycle, our IVF coordinator will meet with you again, review the medication schedule, and make sure that you are familiar with the medications and the methods of administration. Once the treatment is in progress, you will be coming to the office periodically (typically on days three, five, seven, and nine of your injections) for monitoring of your response to the medications. This usually includes a blood test (Estrogen, E2 level) and an ultrasound on each visit. We will notify you of your progress, and make sure that you know what will happen next.

Egg Retrieval Process

Once your ultrasound and blood test results indicate that it is time for us to retrieve your eggs, we will ask you to stop all fertility drugs and take a medication called hCG. This medication will allow us to retrieve your eggs in a timely manner. You will not be able to eat or drink after midnight the night before your retrieval. The retrieval (aspiration) is done under ultrasound guidance in a procedure room. You will be receiving medication to put you to sleep for a period of 10 to 30 minutes under the supervision of an anesthesiologist. Your male partner or sperm donor's sperm will be needed on this date.

Embryo Transfer

Following the egg retrieval procedure, you will be contacted and will receive an update of the status of your embryos. The day after the aspiration (24 hours, day 1) you will find out how many eggs have fertilized and start your progesterone supplementation. The options are a day three transfer or a day five transfer (blastocyst transfer). The final decision is made on either day 1 or day 3 (72 hours) when we will make an assessment together as to the best option for you with respect to an embryo transfer date (day three versus day five).

After the embryo transfer, you will be asked to go home and rest in bed for the remainder of the day. You will be asked to continue your progesterone supplementation until the confirmatory pregnancy tests are done 14 days after the retrieval. If you have a positive pregnancy test, you will need to continue the progesterone for the first 10 weeks of pregnancy.

Schematic Summary of an IVF Cycle

(your plan may vary from this sample cycle)

Birth control pill for 2-4 weeks

Add Lupron – and continue the Pill – for 5 days

– Stop the Pill – continue Lupron
Expect vaginal bleed 3-7 days after stopping the pill – continue Lupron only

– Ultrasound and estradiol (blood test)
If satisfactory, start Fertility Medications (Follistim, Gonal-F, Repronex or Menopur)

– After 3 days of Medications check estradiol
After 5 days of Medications check estradiol and possible ultrasound
Further monitoring until follicles are “ready”
Trigger with hCG (Ovidrel)- Average 10 days of Medications

– Egg retrieval, 2 days after hCG – Fertilization – Embryo culture

– Embryo transfer: Day 2-5 after retrieval

– Pregnancy test: 14 days after retrieval