In vitro fertilization (IVF) is possibly the most effective and most common infertility treatment we perform at Arizona Center for Reproductive Endocrinology & Infertility. But unless you’ve gone through the procedure before or know someone who has, you probably don’t understand all the steps involved.
The first thing you should know is that IVF is the fertilization of the egg and sperm outside the body. It’s often performed after other treatment methods have failed to result in a pregnancy (although for some couples, it makes more sense for this procedure to be the first option).
While there may be some variation in how the procedure is completed, in general, it can be broken down into five steps. Here’s a step-by-step look at the process.
Step 1: Preparation (Testing and Ovarian Stimulation)
Before beginning your infertility treatments you’ll have an evaluation of your uterus and fallopian tubes to make sure there are no outlying issues that need to be remedied before starting IVF. If it’s been determined that IVF is a viable option, you’ll begin taking medication to stimulate your ovaries to mature multiple eggs for the retrieval process. This medication usually needs to be taken for about 21 days; during this time, you’ll be frequently monitored through hormone-level testing and vaginal ultrasounds.
Step 2: Egg Retrieval
Once we determine you have a sufficient number of retrievable eggs, you’ll receive a “trigger shot” of hCG or other medication, which finishes the maturation process so that the eggs are capable of being fertilized. Thirty-six hours later, you’ll have a surgical procedure to retrieve the eggs from the follicles in your ovaries. During the procedure, an ultrasound is used to guide a small needle through the top of the vagina into each ovary. At AZCREI, we use conscious sedation during the procedure, which results in a faster recovery time; so, you may feel a little pressure, but typically no pain. The actual procedure takes less than 10 minutes but we do keep patients in our office for about an hour after the procedure is completed so we can monitor their recovery. You may feel some minor cramping in the day or two following retrieval.
After the eggs have been retrieved, they’re placed in a test tube along with the follicular fluid. It’s then given to an embryologist who uses a microscope examine the eggs for maturity and quality.
Step 3: Fertilization
The mature eggs are transferred into a special culture and placed in an incubator for the fertilization process.
Fertilization can occur in two ways: through conventional insemination (where sperm is added to the culture in a small petri dish to eventually fertilize the eggs on their own) or through intra-cytoplasmic injection (ICSI). The most appropriate fertilization process for your situation depends on a number of factors, our team will discuss these options with you and help you determine the best one.
Step 4: Embryo Transfer
The embryo transfer will usually take place around three days following the egg retrieval—unless there are other factors that require us to wait; in that case, we may allow the embryos to mature up to five days or freeze them for a later date. If you opt for preimplantation genetic screening (PGS), the embryos are sent out to be biopsied and then returned for a five-day transfer. The remaining embryos that are not transferred on day five can be cryo-preserved.
For the procedure, a soft, thin catheter is used to transfer the embryo into the uterus at a spot that’s optimal for implantation to occur. If the transfer is successful, the embryo will “hatch” and implant itself in the uterine lining within one to two days following the procedure. Pain and discomfort are rare; many patients compare the experience to the feeling of a pap smear.
Any good embryos that have not been used in the transfer can be frozen and used in another cycle, or if you decide to have more children later.
Step 5: Pregnancy Test
About two weeks after the embryo transfer, you’ll have a blood pregnancy test. Once we confirm the pregnancy, we’ll continue to monitor your progress with additional testing and ultrasounds. After 12 weeks, when we’re very certain that the pregnancy is going as good as it can, you’ll be referred back to your OB/GYN for the remainder of your pregnancy.
At AZCREI, about two out of three of our patients will get pregnant on the first try using IVF; it’s an amazing solution that offers women and couples the chance to finally have a baby. To make an appointment and learn more about in vitro options, contact us online or call at 520-326-0001.