A Quick Overview of IVF Treatment
In-vitro Fertilization is a widely performed assisted reproductive technology (ART) among couples who can’t get pregnant naturally after one year of trying. The procedure works for both female and male-factor infertility. It may sound simple, but the entire procedure is pretty complex and can sometimes take 2-3 weeks or longer.
IVF is a series of steps, starting with ovarian stimulation (getting your ovaries to release mature eggs) and ending with embryo implantation. Before you set any unrealistic expectations, know that IVF isn’t a suitable treatment option for every couple. Whether or not it works for you depends on your age and the cause of infertility.
Important Procedures in IVF
Let’s take a look at the common elements of IVF:
- Preimplantation Genetic Testing (PGT): For parents opting for IVF due to a genetic disorder that they might pass on to their offspring, a PGT can be used. The test screens the embryos for chromosomal or genetic abnormalities and selects the healthiest embryo for implantation
- Gestational Carrier: A gestational carrier refers to a surrogate — a woman who carries the child of aspiring parents. It’s recommended when the mother’s body won’t support pregnancy due to uterine conditions or health issues
- Assisted Hatching: This procedure facilitates implantation by creating a hole in the embryo’s outermost layer so it can attach easily to the uterine lining.
- Sperm, Eggs, or Embryos: These three are the most crucial elements of an IVF procedure. Sperm is combined with the eggs either naturally or through Intracytoplasmic Sperm Injection and is then left for fertilization. The fertilized eggs are called embryos.
- Sonohysterography: It’s a diagnostic tool that involves injecting saline solution into the uterus during ultrasound and screening your reproductive organs for polyps, fibroids, and other unusual issues. It’s scheduled before IVF to ensure your uterus is a safe environment for the fetus to develop
- Hysteroscopy: During the IVF treatment, your fertility specialist may recommend hysteroscopy, which diagnoses and removes unwanted growth in the uterus, which might interfere with the implantation.
- Cryopreservation (Eggs or Embryos): IVF also works for couples who aren’t planning pregnancy at a young age for medical or personal reasons. They can choose to have their eggs, sperm, or embryos frozen, which are later thawed and transferred to the woman’s uterus.
IVF Stages
In-vitro fertilization may sound daunting to couples who’ve never heard of assisted reproductive technology. The process doesn’t guarantee pregnancy, making it even more difficult for couples to decide if it’s the right option. To help you navigate through this journey with ease, we’ve listed down the steps during IVF. Here’s what you can expect during each stage:
Step 1: Ovarian Stimulation
Your ovaries release one egg every month. If you have irregular ovulation or absent ovulation, your doctor will prescribe hormone shots that stimulate your ovaries to release more than one egg at a time.
This prepares multiple eggs for retrieval and fertilization.
The procedure involves injecting Follicle-stimulating hormone (FSH), Luteinizing Hormone (LH), and chorionic gonadotropin (hCG) shots. The dosage and duration of these shots are determined based on your ovarian health and how you respond to the medication.
You will be monitored with ultrasounds and bloodwork to track the egg’s maturation.
Step 2: Egg Retrieval
The next step is egg retrieval. At this point, your fertility specialist will collect mature eggs from one or both ovaries. It’s done either through transvaginal or abdominal ultrasound. A thin needle is guided to the ovaries. The needle is attached to a suction device, which extracts the eggs from the follicles. The process takes around 15-20 minutes. The collected eggs are stored in an embryology lab, where they are mixed with sperm for fertilization.
Step 3: Sperm Retrieval
Sperm retrieval is performed in your doctor’s clinic, or your partner can collect the sperm sample at home and send it to the fertility clinic. It’s done through masturbation mostly, but if the male partner is diagnosed with azoospermia or other fertility issues, the doctor can get sperm out of the testicles through testicular aspiration. The sample goes to the lab, where professionals separate the semen from the sperm and choose the healthy sperm for fertilization.
Step 4: Fertilization
The most crucial stage in an IVF cycle is fertilization. Once the egg and sperm samples are collected, they are united in a petri dish for overnight fertilization. If that doesn’t work, the embryologist might opt for ICSI, which involves injecting sperm into the egg manually to boost the chances of fertilization.
Step 5: Embryo Culture
The embryologist carefully monitors the fertilized eggs. They see if the eggs divide and develop properly and transform into an embryo. At this point, the couples may decide to have preimplantation Genetic Testing, in which the doctors take a small sample (a few cells once the fertilized egg reaches the blastocyst stage) and send it to the lab for screening. The eggs with appropriate chromosomal makeup are picked for implantation.
Step 6: Embryo Transfer
It takes fertilized eggs 3-6 days to be ready for transfer. The procedure takes place in your doctor’s office. A catheter (long, thin tube) with a thin needle attached to its end is inserted into the uterus through the vagina. One or more embryos are transferred to the woman’s uterus through the catheter. If it’s successful, the embryo will attach to the uterine lining, resulting in an implantation and a successful pregnancy. You can use the home pregnancy test kit 10-12 days after embryo transfer. If the results are positive, you’ll be referred to a gynecologist. If it’s negative, you’ll likely get your period in a few days.
