The In Vitro Fertilization (IVF) Process
In Vitro Fertilization (IVF) is an extremely effective fertility procedure for people hoping to build their family. IVF is a complex process with multiple phases.At SRM, we are committed to helping you understand what to expect in each phase of the IVF timeline and will support you every step of the way.
IVF Step By Step
IVF Ovarian Stimulation Phase
In a normal menstrual calendar cycle, a single egg develops prior to ovulation. The egg grows within a fluid-filled sac called a “follicle,” which can be viewed on ultrasound. In the ovarian stimulation phase of theIVF cycle, injectable gonadotropins are given over the course of 8 to 12 days, in order to stimulate multiple eggs/follicles to mature. There will be several quick monitoring appointments during the IVF cycle, in which SRM will draw blood samples to observe the level of estradiol (a form of estrogen) in your blood. Vaginal ultrasound monitoring of the ovaries will also be used to track follicular growth.
HCG/LUPRON INJECTION AND IVF EGG RETRIEVAL
When ultrasound and blood estradiol levels indicate that the follicles are ready, you will be notified to give the HCG or Lupron injection at a specific time. IVF egg retrieval is usually performed 36 hours after the injection. Typically, a transvaginal ultrasound is used to guide a needle biopsy of both ovaries in order to remove the eggs. There is no incision on your body and you are asleep for this procedure. If a male partner is providing sperm, he collects a fresh semen specimen the day of IVF egg retrieval. You will go home the day of the procedure, but we recommend that you do not return to work or do anything strenuous.
FERTILIZATION OF THE EGGS AND EMBRYO CULTURE
During the next step of the IVF process, eggs are fertilized the afternoon of the egg retrieval either by direct incubation next to sperm, or with intracytoplasmic sperm injection (ICSI) where an individual sperm is selected and placed inside each egg to help the fertilization process. The eggs will then be incubated overnight. Over the next few days, the eggs will be examined for signs of fertilization, and growing embryos will be tracked as they divide and grow. Some patients require special IVF therapy such as assisted hatching to enhance implantation.
The final step of IVF is the embryo transfer, where the embryo(s) is gently placed inside your uterus. Similar to a Pap smear, you will be awake while a soft fine catheter is used to place the embryo inside with ultrasound guidance. Your partner or a friend may be with you during the transfer.
Any remaining viable embryos will be frozen/cryopreserved. These embryos can be used in future IVF treatments without the above procedures (ovarian stimulation and egg retrieval) thus simplifying future IVF attempts. Embryos survive freezing and thawing extremely well.
Follow-Up Blood Tests and Obstetrical Appointment
Your pregnancy test will be 9–11 days after the embryo transfer. When we have determined that the hCG level (pregnancy hormone) is rising appropriately, we will schedule an obstetric ultrasound with an SRM provider.