Sometimes we’re able to treat infertility with ovulation induction, sometimes with intrauterine insemination, sometimes there’s some surgical Corrections we make. But for other patients in vitro fertilization or IVF is going to be the best treatment to help them grow their families.
Some common indications for IVF include age-related infertility, damaged fallopian tubes, endometriosis, unexplained infertility, male factor infertility, or for genetic testing for pregnancy loss or inheritable genetic diseases or for genetic screening for gender selection, what we call family balancing.
What is IVF? IVF is where we remove eggs from your body mix with sperm in the laboratory to grow embryos and then transfer embryos back inside of the uterus.
The IVF process can be broken down into several steps. The first step to IVF is ovarian stimulation. In a conventional IVF cycle, we would use hormonal medications which are injections to help stimulate the ovaries to grow more than one egg. Some patients would opt for mini IVF which would be a way of using less injections which would result in getting less eggs or a natural IVF where we just try and get the one egg that you’re growing that month. When you use injections it takes approximately ten days and over the course of those 10 days, the patients are coming in every couple of days for ultrasounds and blood tests so we can monitor how you’re responding, adjust medications and add medications as you go along. Once the follicles are the right size, the next step is to get eggs out of the body and that’s called an egg retrieval.
And while you’re asleep and under anesthesia, a small needle is inserted into the ovaries to remove the eggs. This procedure is relatively safe with very low risk less than 1% takes about 15 to 20 minutes and because you’re asleep you won’t have any pain and you won’t remember anything.
The next step is fertilization and that’s where the sperm is mixed with the eggs in the IVF laboratory. We can either do that by putting a droplet of the sperm into the egg and letting it sit overnight and the sperm do their own thing or we can do that through ICSI or intracytoplasmic sperm injection where a single sperm is injected directly into the egg.
The fourth step is embryo culture so after the eggs are mixed with the sperm, we have fertilized eggs that grow into embryos and those embryos are cultured in the laboratory for five days.
And the next step is going to be the embryo transfer. Once the embryos are ready and the uterine uns lining is ready we use a very small catheter to deposit typically just one or two embryos at the top of the uterus. This procedure is quick and typically painless. Before we transfer the embryos we can actually do genetic testing on the embryos to make sure that they are chromosomally normal which would give you the best chances of a pregnancy.
Any embryos that are leftover can be frozen and those embryos can be used in two or three years when you’re ready for your next child. Success rates with IVF really depend on the couple but more specifically on the age of the female. As women get older it gets more difficult to get pregnant and the chances of success are going to decrease in general as a woman ages. For some women who aren’t able to use their own eggs because of age or other reasons, we can use a donor egg for IVF and that’s where we would get eggs from a younger woman mix them with sperm to make embryos and put those embryos back inside your uterus.
Some women might not be able to carry a pregnancy, they might not have a uterus, their uterus might not be healthy enough there might be medical concerns with carrying a pregnancy and in those situations, we’re able to transfer the embryo back into a surrogate or what we now call it gestational care a woman who’s actually able to carry the pregnancy for you. After the egg retrieval is done you’ll be in the recovery area for maybe 30 or 45 minutes and then you’re actually able to go home. You’ll go home that day with usually Tylenol and hot packs and by that night typically you’re gonna feel a lot better and by the next day, you should be able to go back to work or normal daily activities.