IVF at a Glance
In vitro fertilization is an option for many couples who cannot conceive through conventional therapies. In IVF, fertilization occurs outside the woman’s body. The woman’s eggs and the man’s sperm are united in the laboratory. Once fertilization occurs, the early embryo(s) are transferred to the woman’s uterus.
Eligibility Criteria
IVF is an option for couples who have tried unsuccessfully to conceive or for whom other treatments have failed.
IVF was initially developed to help women conceive who had blocked, damaged, or absent fallopian tubes. Other eligible patients are those with infertility due to a condition not responsive to conventional therapy, including one or more of the following:
- » Tubal blockage or failed tubal reversal
- » Endometriosis
- » Cervical factor
- » Pelvic adhesions
- » Male factor
- » Unexplained infertility/ failed conventional therapy
- » Genetic testing (PGD) for inheritable diseases
- » Genetic testing (PGD) for possible reasons for multiple miscarriages
To be considered for IVF, a woman must either have a uterus capable of carrying a child, or a compassionate gestational carrier. For optimal results, the woman should not be more than twenty percent over her ideal body weight. We consider and evaluate women between the ages of 40-43 for IVF on an individual basis based on previous testing, such as FSH levels and/or responses to gonadotropin therapy.
Cycle Monitoring
To begin the process of IVF, the woman is given fertility drugs to stimulate egg production and control the timing of ovulation. This helps maximize the number of eggs produced, thereby increasing the chance that at least one will be fertilized, and will implant itself in the uterus. Frequent blood tests to monitor hormone levels and ultrasounds to monitor follicle development are required. Stimulation protocols may vary depending on multiple factors.
Egg Retrieval
The eggs are harvested primarily through a transvaginal ultrasound-guided procedure. The ultrasound-guided egg retrieval is performed on an outpatient basis with monitored I.V. sedation. Recovery from the sedation requires thirty minutes. The patient is discharged from the surgery center with instructions to rest for the remainder of the day.
Once the eggs are retrieved and the sperm sample collected, they are immediately given to our embryology laboratory for incubation. Our IVF lab is located adjacent to our operating room. The man’s semen is specially prepared in order to select the most viable sperm. In conventional IVF, the sperm are then placed together with the eggs in an incubator for 12-18 hours to allow for fertilization. When sperm quality is compromised, the eggs are inseminated with a single sperm by means of a micromanipulation procedure known as ICSI (intracytoplasmic sperm injection). This may also be used on half of the eggs to enhance fertilization in some circumstances. Following normal fertilization, early embryonic development is closely observed on a daily basis.
Embryo Transfer
Within 72 hours after egg retrieval, the embryos are generally ready to be transferred into the woman’s uterus through a thin tube, or catheter, gently inserted through the cervix. This is a non-surgical procedure performed under ultrasound guidance with no need of sedation. The woman may wish to rest for the remainder of the day in order to maximize the chance for success. About ten to twelve days following the embryo transfer, the woman’s blood is drawn and tested to determine if pregnancy has occurred.