Conceiving with In Vitro Fertilization (IVF): A Step at A Time

In Vitro Fertilization is a procedure that helps thousands of couples all over the world to have a baby. Like many others around us, you must have heard this too. Depending on who you ask, IVF will be made to sound you like a miracle or an intense medical process with no guarantees. However, you should know exactly how it works. Here is the entire process of IVF decoded step by step that will clear your apprehensions and deepen your understanding of it.

Step 1 – Your Menstrual Cycle

IVF cycle begins on the first day of the menstrual period. The fertility specialist initiates administration of oral contraceptives that help regulate hormone levels more precisely, while simultaneously limiting any potential cysts from developing, as cysts can compromise fertilization. It also helps with synchronizing the egg follicles and allows better control of the timing of the cycle. The contraceptives are typically taken anywhere from two to four weeks.

Step 2 – Ovarian Stimulation

Now that your ovaries and hormones are in sync, you’re ready to begin the ovarian stimulation process that usually lasts for about 8 to 12 days. For this, your fertility specialist will use a single or a combination of hormonal injections which can vary from 1-2 for the cycle or 1-2 per day. These injections stimulate your ovaries into producing more eggs than it typically would with a natural cycle. Having several eggs available for IVF increases the chances of pregnancy. During this period, you will be monitored via transvaginal ultrasound for measurements of the egg follicles growth as well as blood tests. When everything looks just right, your doctor gives you a shot of human chorionic gonadotropin (hCG), which officially stimulates the eggs’ release.

Step 3 – Retrieving the Eggs

Egg retrieval is a hospital day procedure where the eggs are collected from your ovaries. Timing is of the essence at this point. Once your doctor has given you the hCG injection, the eggs are retrieved in 36 hours. It is done using anaesthesia because it is mildly invasive. During this process, pain medication is given to reduce any discomfort. A very thin needle is passed through the upper vaginal wall. With the use of vaginal ultrasound, fluid is removed from the follicles under gentle suction. Immediately after aspiration of the follicle, the oocyte (egg) is isolated from the follicular fluid. The egg is placed in a culture dish containing nutrient media and then transferred to the incubator. The average number of eggs collected is 8-15.

Step 4 – Fertilizing the Eggs

The next step of the IVF process is the fertilization of the egg. If you’re a couple planning on using fresh sperm, the male will produce a sample the morning of the egg retrieval. If you are using frozen or donor sperm, it will be available from the lab. The most active sperm is selected to be mixed with the egg in a special chamber. Sometimes the sperm is directly injected into the egg. Then, the sperm and egg are placed in an incubator and monitored to make sure that a healthy embryo develops. It generally takes three additional days for fertilized eggs to be tested for viability. Assuming there is at least one (hopefully more) viable embryo, you will be scheduled for embryo transfer.

Step 5 – Embryo Transfer

The final step of the IVF process is the embryo transfer. First, the embryos are examined to select the healthiest ones for transfer. You won’t even need to be anesthetized as the doctor uses a tiny, slender, plastic tube to transfer a five-day-old embryo into your uterus. Because multiples pregnancies are considered high risk, it is very rare to transfer more than a single viable embryo these days. If you have more than one viable embryo as a result of the egg fertilization process, the remaining embryos will be cryogenically frozen for your future use.

Step 6 – Pregnancy testing

The tiny embryo will float around in your uterus and can take up to 2 weeks to officially implant or attach to the uterine lining. Implantation stimulates the pregnancy hormone required to signal you are pregnant. The time between the embryo transfer and the blood test is often called the ‘two-week wait’ (2WW). This can be a very anxious, scary, and exciting time. You may have severely mixed feelings which are completely normal. Hopefully, you will be successful and become pregnant with your first round of IVF treatment.

Unfortunately, this is not always the case, and some couples may choose to continue trying with subsequent rounds of the IVF treatment if the first is not successful.

Summing up…

The process of in vitro fertilization is a long and often tiresome one. Even once you go through everything that it entails, there is no guarantee of a successful pregnancy or birth. It’s important to take many things into consideration such as your health, your age, and your financial situation. Discuss all aspects of these things with your partner and your healthcare professional and make whatever decision you truly feel is best for your family.

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