Terminology Tuesday: The IVF Process

This week we will discuss the IVF process.  IVF may sound like a complex and scary procedure.  However, once you learn more about the process, IVF is not that scary after all.

Before an IVF cycle is initiated, the couple will have their treatment plan designed by their infertility doctor. There are numerous types of stimulation protocols.  Because of the immense variety of protocols, I will outline the 5 steps that all IVF protocols have in common:

Step One – Ovarian Stimulation

The patient self-administers injectable fertility medications to stimulate the production of multiple eggs. These medications, termed gonadotropins, are administered daily over a period of a couple of weeks. The medications are administered subcutaneously at home. While taking these medications, the patient’s progress is monitored at their infertility doctor’s offices through the aid of transvaginal ultrasounds and by testing serum estradiol levels every few days.

Step Two – Egg Retrieval

Once the eggs are of a mature size, as determined through office monitoring, the patient administers an injection of hCG (human chorionic gonadotropin). The injection of hCG helps mature the eggs and prepare them for the retrieval. Approximately 36 hours later the egg retrieval takes place. This procedure is an outpatient procedure and the patient is asleep during the harvesting if the eggs.  At Dallas IVF, egg retrievals are performed transvaginally in an operating room with anesthesia administered by a board certified anesthesiologist. A thin needle, which is attached to the side of an ultrasound probe, pierces the top of the vagina, and the eggs are retrieved from the ovaries. A typical egg retrieval can last about 10 to 15 minutes. The patient recovers quickly following the procedure and is often discharged about an hour later from the facility.  At Dallas IVF, we instruct the patient to go home and rest, but can return to work the following day.

Step Three – Fertilization

A few hours after the eggs are retrieved; they are fertilized with the male partner’s sperm. This can be accomplished either through the ‘conventional’ method of placing the sperm in the Petri dish with the eggs, or through intracytoplasmic sperm injection (ICSI). In conventional IVF, the sperm naturally swim up to and then penetrate the egg. With ICSI, individual sperm are injected into the eggs to promote fertilization if the couple has a male factor infertility.

Step Four – Cell division

Once an egg is fertilized with sperm, it is called an embryo. The embryo begins as a single cell but then begins to divide and grow. With time, the single cell splits into two cells.  Then, the two-cell embryo splits into 4 and then into 8 cells. On the third day following an egg retrieval, most healthy embryos are at or about the 8-cell stage. Unhealthy embryos often stop dividing. The healthy embryos are incubated for 2 more days for a total of 5 days.  On day-5, embryos should contain about 120-150 cells and are called blastocysts.

Step Five – Embryo Transfer

The placement of the embryos back into the uterus is termed the uterine embryo transfer. This usually occurs on the 5th day following the egg retrieval when embryos are at the blastocyst stage. At times, when a woman only has a few embryos dividing, the transfer may occur on day 3.

For more information about the IVF process, visit our website at www.DallasIVF.com.