In Vitro Fertilization (IVF)

In vitro fertilization, commonly known as IVF, is a fertility treatment that involves fertilizing an egg with sperm outside the body, in a laboratory setting. This technique allows for the creation of embryos, which can then be transferred to the uterus, with the goal of achieving pregnancy.

Who Should Consider IVF:

You should consider IVF if you have infertility due to blocked fallopian tubes or no fallopian tubes due to surgical removal, male factor infertility (low sperm count or quality), are over 40 years old and want to maximize your chances of pregnancy, have ovarian insufficiency or premature menopause, or wish to use donor eggs or donor sperm.

You may also consider IVF if you have unexplained infertility and other treatments have failed or have a known cause of infertility, such as endometriosis or ovulation disorders, and other treatments, such as ovulation induction or IUI, have failed.

IVF is also an option for couples desiring to select the gender of the embryo for family planning purposes.

The IVF Process:

• Initial Consultation & Education: Your journey begins with an initial consultation with a fertility specialist. During this appointment, your medical history will be reviewed, and any necessary tests will be conducted to assess your fertility status.
  
• Ovarian Stimulation: Once deemed a suitable candidate for IVF, you will undergo ovarian stimulation. We ask that you call on the first day of your period (day 1 of bleeding) known as cycle day 1 to schedule an appointment for a baseline ultrasound and bloodwork. You will then administer multiple prescribed medications to stimulate the ovaries to produce multiple eggs, rather than the single egg typically released each month during a natural menstrual cycle.
  
  
• Monitoring: Throughout the ovarian stimulation phase, you will undergo regular monitoring through blood tests and ultrasounds to track the development of ovarian follicles, which contain the eggs. Depending on the results of the testing, your medication dosage may be increased or decreased or your protocol may be changed. We will be in contact with you after the bloodwork results to discuss any changes that may be needed to ensure an optimal cycle.
  
• Egg Retrieval: When the follicles reach optimal maturity, you will trigger the release of the follicles. The retrieval will be scheduled 35-36 hours after the trigger injection is given. The egg retrieval is a minor surgical procedure. Under sedation, a thin needle is guided through the vaginal wall to collect the eggs from the ovaries.
  
  Serious complications are uncommon; however common side effects include pelvic cramping, light bleeding and vaginal discharge after the procedure.
  
  A serious complication of IVF is Ovarian Hyperstimulation Syndrome (OHSS). This is a condition in which the ovarian enlargement and abdominal swelling become extreme due to overgrowth of ovarian follicles. Symptoms include severe abdominal pain, vomiting, chest pain, and shortness of breath. If you experience these symptoms, you should call your office and immediately present to the ER for evaluation. We will take every precaution to ensure you do not develop OHSS, we do this by giving you the correct dosage of medication based on your age, medical history and blood work results, as well as modifying the medications you receive for trigger. Severe cases of OHSS occur in approximately 1% of IVF cases and is typically seen with more than 20 eggs.
  
• Sperm Collection: On the same day as egg retrieval, a sperm sample is collected.
  
• Fertilization: The collected eggs and sperm are then combined in a laboratory dish in a process called fertilization. This can be done through traditional IVF, where sperm are added to the dish containing the eggs, or through intracytoplasmic sperm injection (ICSI), where a single sperm is directly injected into each egg. We will discuss with you during your consultation if you're a candidate for conventional IVF or ICSI depending on the semen analysis.
  
• Embryo Culture: Following fertilization, the embryos are cultured in a controlled environment in the laboratory for several days, allowing them to develop and grow.
  
• Embryo Transfer: Once the embryos reach the appropriate stage of development, one or more embryos are selected for transfer to the uterus. We will discuss with you if fresh or frozen embryo transfer is right for you. Fresh transfer is done within 3-5 days after egg retrieval. Frozen embryo transfer can be done as soon as your next menstrual cycle. The number of embryos transferred depends upon your age, fertility history and quality of embryos. We follow the ASRM Embryo Transfer Guidelines. You are at higher risk of multiple gestation (i.e. twins, triplets, etc) if more than 1 embryo is transferred. The embryo transfer procedure is performed using a thin catheter inserted through the cervix into the uterus, where the embryos are gently deposited.
  
• Waiting Period: Following embryo transfer, you should wait 14 days before taking a pregnancy test. If you take the test too early, you may experience a false positive due to the trigger injection.
  
• Pregnancy Confirmation: If implantation is successful, and pregnancy is confirmed, ongoing prenatal care will be provided to support the health and well-being of both the mother and the developing fetus.