In Vitro Fertilization procedure involves taking mature eggs from the woman, fertilizing them with sperm in a special dish in a laboratory and then transferring the resulting embryos back to the woman’s uterus 2 to 5 days after fertilization is confirmed. IVF is treatment of choice in cases of infertility when both fallopian tubes are blocked. However, IVF may also be used for unexplained infertility, endometriosis, cervical factor infertility, ovulation disorders, early ovarian aging, or when there are light to moderate forms of male factor infertility.

Approximately 25-35 percent of women who try in vitro fertilization conceive – however, the likelihood of success can vary from 0 to 70 percent depending on such factors the women’s age, the reason for the infertility, and the experience of the IVF program.

IIVF can be physically and emotionally draining, however stress and anxiety can be reduced if the patients have a clear understanding of the procedures.

IVF includes the following steps:

Initial visit:

During an initial visit, your doctor will outline the IVF treatment plan, or protocol. The patients will be asked to sign consent forms. During this visit, the doctor most likely will evaluate the patient’s uterus using a catheter to measure the size, shape, and direction of the uterus. This will help the doctor to determine where to place your embryos on the day of embryo transfer.

Before starting the IVF treatment cycle, a semen sample will be collected from male partner for analysis. If donor semen is to be used, the couple will need to select a donor.

Stimulation of Ovaries

The doctor will discuss with the patient which medication protocol might work best for her. The woman will then be given medications to stimulate her ovaries to form multiple eggs and the doctor will monitor this process with blood tests and ultrasound examination. Usually, the patient will receive a drug known as a gonadotropin-releasing hormone agonist (Decapeptyl) or a gonadotropin-releasing hormone antagonist (Orgalutran, Centrotide) – these drugs prevent the patient’ ovaries from releasing eggs too early during the IVF cycle.

The patient will then be given one or more medications known as gonadotropins, which can stimulate the patient’ ovaries to produce many eggs. The gonadotropins are given daily as an injection in-patient’ abdomen, thigh, or upper arm. The doctor will determine the most appropriate dose for every patient and will inform her of the possible risks, side effects, and benefits of these medications.

Egg retrieval

The egg retrieval is done under conscious sedation. Usually the procedure takes approximately 30 minutes and it depends on the follicles number. The procedure is done with the use of vaginal ultrasound to visualize the ovary. A needle, attached to the ultrasound probe, is used to aspirate the fluid from the follicles and the fluid is immediately examined under microscope to determine whether an egg is present. The eggs are placed in a special dish in an incubator that is supporting the needed temperature and conditions for fertilization and further development of the embryos.

After the egg retrieval the patient will spend approximately 2 hours in the recovery room. The procedure does not demand the stay in the hospital.

Mature oocyte	Fertilized oocyte with 2 pronuclei

Embryo development and embryo transfer

The fertilized eggs known as embryos are left in culture minimum 48 hours their replacement in the woman’ uterus. Embryo transfer can be done on second, third or fifth day after oocytes aspiration. The doctor and the embryologist will discuss with the couple the condition of embryos and how many will be transferred into woman’s uterus. In general, there will be transferred 1-4 embryos, depending on patient’s age and other factors such as the quality of embryos and the cause of infertility.

2-cell embryo	4-cell embryo	8-cell embryo

Pregnancy test:

The doctor will schedule a pregnancy test about two weeks after your egg retrieval and embryo transfer procedure.