Top Orange County IVF Doctor Explains
In Vitro Fertilization, or IVF, was first introduced to the world in 1978. Since then, millions of IVF babies have been born and its success and affordability continue to improve year after year.
IVF itself is the process of removing eggs from the body, mixing eggs with sperm in the laboratory to form embryos, growing embryos in the laboratory for several days, and then transferring an embryo(s)back into the uterus.
An IVF cycle can be broken down into several steps:
Step 1: First day of your period
The first day of your menstrual cycle marks the beginning of an IVF cycle. That day you will want to contact the office to let them know you started bleeding.
Step 2: Ovarian stimulation
Every month women will normally ovulate (release) one egg. With IVF, the fertility specialist will prescribe medications which stimulate the ovaries to grow more than one egg. By growing more than one egg, we are able to increase your chances of success.
The medications are injections that are given daily for usually around 10 days starting with your period. Over the course of those 10 days you will be coming into the office every few days so the doctor can monitor how you are responding. The monitoring is with vaginal ultrasounds and blood tests. When the ovaries are ready, you will use a different injection to “trigger” your ovulation. Right before you are about to ovulate, your fertility specialist will have you back for the egg retrieval.
Step 3: Egg retrieval
An egg retrieval is exactly like it sounds, the eggs are removed from your body. This is done using a long thin needle that goes through the top of the vagina and into the ovary. But don’t worry. You are a sleep and under anesthesia so you won’t feel or remember anything. The whole procedure usually takes less than 20 minutes. Afterwards, you will recover for about 30-45 minutes and then go home to rest for the day.
Step 4: Fertilization
The eggs are mixed with sperm in the laboratory. This mixing can be done by natural fertilization, where a droplet containing thousands of sperm are placed with the egg overnight or it can be done by ICSI (Intracytoplasmic Sperm Injection). ICSI is when a single best sperm is injected directly into the egg.
Step 5: Growing Embryos
A fertilized egg is called an embryo. These embryos are watched and nurtured as they grow in the laboratory for 5-6 days. They are placed in a special incubator with a mix of amino acids that mimic the way your body would nurture the embryo. An embryo grows from a fertilized egg to a 2 cell embryo to a 4 cell to a 6 and 8 cell embryo to a morula (where the cells start to compact together) to a day 5 embryo called a blastocyst. A blastocyst is an embryo that can be placed into the uterus to achieve a pregnancy.
Unfortunately, not all eggs can be fertilized or will be fertilized by sperm. For the eggs that are fertilized, not all will grow and reach the blastocyst stage. This loss of eggs and embryos is expected and is why we stimulate the ovaries so we can start with a lot of eggs.
Stage 6: Embryo transfer (with or without Preimplantation Genetic Testing)
The embryo transfer is a very simple process. The embryo is placed in a small tube called a catheter and the catheter is passed through your cervix and into your uterus where the embryo is gently placed. This is done while watching with an ultrasound and is painless.
Some patients choose to test the embryos to make sure they have the right number of chromosomes before transferring them back into the uterus. Most chromosomally abnormal embryos will not lead to a pregnancy but if it does, almost all will miscarry. One exception is Down’s Syndrome, or Trisomy 21. Other patients choose to skip the testing.
Step 7: Pregnancy Test
Approximately nine days after your embryo transfer you will come back to the office for a pregnancy blood test. This test will measure the levels of the hormone hCG (human chorionic gonadotropin) in your blood. hCG in your bloodstream means you have a positive pregnancy test and it’s time to celebrate!
About Dr. Marcus Rosencrantz
Reproductive Health and Wellness Center was founded by Dr. Rosencrantz. After almost a decade at Kaiser as the head of the Reproductive Endocrinology and Infertility division and founder of their IVF program in Orange County. Dr. Rosencrantz followed his dream of opening his own fertility center where he uses innovative fertility medical treatments like IVF combined with wellness solutions like nutrition. He was recently selected one of Orange County’s Top Fertility Doctors by the OC Medical Association.