In-Vitro Fertilization

In-Vitro Fertilization (IVF) is a form of Assisted Reproductive Technology (ART) in which a man’s sperm and a woman’s eggs are mixed in a laboratory dish or a single sperm is injected into a single egg (ICSI) to encourage fertilization. Today, IVF is a common form of fertility treatment used to address many causes of infertility.

The 5 Steps of IVF

Step 1: Ovarian stimulation or ovulation induction

Fertility drugs are taken to mature multiple eggs usually for 7 – 10 days. Multiple eggs are stimulated since not every egg will fertilize or develop after fertilization in a lab dish. During this step, the woman will have serial vaginal ultrasound examinations and blood work to monitor the development of ovarian follicles (egg sacs) and check hormone levels. When the follicles are ready, human chorionic gonadotropin (hCG), Luteinizing hormone (Lh) is given, which will cause egg maturation.

Step 2: Egg Retrieval

The eggs are retrieved usually 35 to 37 hours after the final injection by trans- vaginal ultrasound aspiration. The physician inserts a needle attached with the ultrasound probe through the vagina to retrieve eggs from the follicles. The number of eggs retrieved varies based on several factors, including, but not limited to the age of the woman.

Step 3: Fertilization

ICSI (injecting the sperm into the egg) is often recommended when achieving fertilization may be difficult, there are male factor infertility issues or when planning Pre-Implantation Genetic Testing (PGS) or Pre-Implantation Genetic Diagnosis (PGD).

Step 4: Embryo Culture

Fertilized eggs divide and become 2 to 4 cell embryos 2 days after the egg retrieval. Embryos that have developed normally 5 days after fertilization are called blastocysts. When planning PGD/PGS, the embryo biopsy is performed on day 5 or day 6 embryos – blastocysts.

Step 5: Embryo Transfer

Generally 5 days after fertilization, embryos are placed into the woman’s uterus. No anesthesia is necessary for this procedure. The number of embryos transferred depends on the condition of each patient, i.e. embryo quality, the patient’s age, or previous IVF results. The transfer is performed by placing a flexible catheter through the cervix and into the uterus. Ultrasound guidance is used to assist the physician with the placement of the embryo. Patients can use remaining embryos for future cycles by cryopreservation. Cryopreservation of embryos makes future cycles much simpler and less expensive as a woman does not need to go through the ovarian stimulation and egg retrieval process again.

Learn more about how to administer medications during your fertility treatment time frames with these video tutorials.