IVF (In vitro fertilization) is a procedure where the eggs are removed from a female and fertilized in the lab “in vitro” with the partner’s or donor sperm. IVF is typically the best treatment option for couples whose infertility results from tubal blockage, very poor semen quality, severe endometriosis or ovarian disorders that won’t respond to medical treatment. It also offers couples with mild male factors, mild endometriosis or unexplained infertility, the best chance of success when other treatments have failed.
The IVF process involves several steps:
The ovaries are stimulated with injectible fertility medications, which are purified concentrates of the same hormones the body naturally makes, but administered in doses greater than would normally be produced, to stimulate the growth of follicles (pockets of fluid that contain the eggs). The development of follicles is monitored using blood estrogen tests and vaginal ultrasounds.
When a sufficient number of follicles have matured, the patient receives the “trigger” injection of hcg which completes the egg development. Approximately 36 hours later, the eggs are removed directly from the ovaries by transvaginal ultrasound-guided needle aspiration. The patient is sedated intravenously during the 15-30 minute procedure and can go home after 1-2 hours.
If applicable, the patient’s partner will typically be required to collect a semen sample on the day of egg retrieval. Exceptions to this include those patients using donor sperm, those utilizing a previously frozen semen sample or those having surgical retrieval of tissue or sperm extraction.
Fertilization & Embryo Development:
Following the retrieval, the eggs are fertilized in the laboratory using the partner or donor’s sperm, then placed in incubators. In most cases, ICSI is performed, a procedure in which a single sperm is injected into each egg by a highly-trained embryologist. The next day, the embryologist evaluates the eggs for maturation that is consistent with normal fertilization. RMIA uses standardized reporting and grading system to identify which embryos are ideal for transfer and cryopreservation.
3-5 days after fertilization, the best quality embryo(s) is/are transferred directly into the uterus, via a small catheter, in a brief procedure that does not require sedation. RMIA recommends adhering to the American Society for Reproductive Medicine’s (ASRM) guidelines for the number of embryos to transfer, based on age of the patient and quality of the embryos. Any remaining embryos may be cryopreserved (frozen) for use in the future (Frozen Embryo Transfer).
Patient continues progesterone regimen until a blood pregnancy test is performed, 10-12 days following embryo transfer. If test result is positive, a second test is performed 2-4 days later. About 2 and 4 weeks after the positive pregnancy test, confirmation of pregnancy ultrasounds are performed, then the patient is transitioned back to her ob/gyn for obstetrical care.
Patients are not guaranteed success at any or all of these steps. However, RMIA has excellent pregnancy rates, which consistently exceeds the national average. Since it’s inception, RMIA has performed thousands of IVF cycles, resulting in over 3,000 successful pregnancies.
Patients must meet medical criteria to undergo treatment.
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