What is IVF?
IVF stands for in vitro fertilization and is defined as the use of assisted reproductive technologies (ART) as a means of achieving pregnancy.
IVF involves removing eggs from the ovaries and combining the retrieved eggs with the designated sperm source. The sperm fertilizes the eggs in the laboratory to create embryos, which are then transferred into the uterus one at a time.
When Is IVF Recommended?
IVF is typically recommended when natural conception becomes challenging due to various factors. Some common scenarios where IVF might be suggested include:
- Female Infertility Issues:
- Blocked fallopian tubes
- Endometriosis
- Polycystic ovary syndrome (PCOS)
- Ovulation disorders
- Male factor infertility:
- Low sperm count or motility
- Ejaculation issues
- Genetic conditions
- Advanced maternal age (i.e., over the age of 35)
- Unexplained infertility
IVF Procedure Step by Step
1. Ovulation Stimulation
In a standard IVF cycle, the first step in the process begins with ovulation stimulation, designed to enhance the chances of successful egg retrieval by encouraging the ovaries to produce multiple mature eggs.
Ovulation stimulation involves the administration of hormone medications that mimic the natural hormonal processes of the body. These medications stimulate the development of multiple follicles, each containing an egg.
The dosage and duration of hormone medications are personalized for each individual, based on factors such as age, ovarian reserve, and medical history. Close monitoring through ultrasounds and hormone level assessments helps fertility specialists adjust medication dosages to ensure optimal follicular development.
Effective ovulation stimulation lays the foundation for a successful IVF cycle, offering the potential for a greater number of viable eggs to be collected and used in subsequent stages of the procedure.
2. Egg Retrieval
Egg retrieval involves the gentle extraction of mature eggs from the ovaries. Using a specialized ultrasound-guided needle, the fertility specialist carefully punctures each follicle and suctions out the fluid containing the mature eggs. The collected eggs are then transported to the embryology laboratory, where they are examined and prepared for fertilization.
3. Sperm Collection and Preparation
Typically, sperm is collected through masturbation into a sterile container. In cases where ejaculation is not possible, techniques like electroejaculation or surgical sperm retrieval may be employed. Once collected, the semen sample undergoes a meticulous preparation process. The semen is first washed and separated from the seminal fluid, removing potential contaminants and enhancing the concentration of healthy sperm. This concentrated sperm sample is then evaluated for motility, morphology, and count.
Advanced techniques such as sperm selection using gradient centrifugation or specialized culture media may be utilized to further optimize the selection of the highest-quality sperm. The prepared sperm sample is finally combined with harvested eggs in the IVF laboratory, increasing the chances of successful fertilization and subsequent embryo development. The precise and controlled procedures involved in sperm collection and preparation play a pivotal role in achieving favorable outcomes in IVF cycles.
4. Fertilization in the Laboratory
After the eggs and sperm have been collected, the next step is fertilization, which involves the union of eggs and sperm in the laboratory so that embryos can be formed. The standard method of fertilization involves culturing the retrieved eggs in a petri dish with a sample of prepared sperm, which allows for natural fertilization.
In some cases, the fertility specialist may recommend an additional procedure called intracytoplasmic sperm injection (ICSI), where a single sperm is carefully selected and directly injected into an egg using a specialized micromanipulation tool. This method is often utilized when there are concerns about sperm quality or previous fertilization challenges.
5. Embryo Culture & Selection
After fertilization occurs, embryos are carefully cultured in controlled environments that mimic the conditions of the human body. This nurturing environment allows embryologists to monitor embryonic development and growth closely. As the embryos progress through various stages, they are assessed for their morphological characteristics, cellular division rates, and overall health. This evaluation aids in the selection of the most viable embryos for transfer into the uterus, increasing the chances of a successful pregnancy.
6. Embryo Transfer
Once a viable embryo has cultured and been selected, the next step in the IVF process is transferring the embryo to the recipient’s uterus. During a regular embryo transfer, typically performed a few days after fertilization, the procedure involves gently placing the embryos into the uterine cavity, where they can implant and develop into a pregnancy.
Another option is frozen embryo transfer (FET), which has gained prominence as a technique offering flexibility and improved success rates. In FET, embryos that were not used in the initial IVF cycle are cryopreserved and stored for later use. This allows for a more controlled uterine environment to be prepared, enhancing the chances of successful implantation.
7. Pregnancy Testing & Monitoring
Following the embryo transfer, patients must wait a few weeks before taking a pregnancy test administered by the fertility clinic. Known colloquially as the “two-week wait,” this period is laden with anticipation, as it marks the delicate phase when implantation might occur. During this time, it’s strongly recommended that patients refrain from taking an at-home pregnancy test, as the results can be misleading or incorrect.
If the pregnancy test yields a positive result, the journey continues with careful monitoring by fertility specialists. Regular appointments and ultrasounds are scheduled to track the pregnancy’s progress during the first trimester, ensuring the developing embryo’s health and viability. Most aspiring parents will continue to see their fertility specialist for monitoring for about 8 to 10 weeks of pregnancy before transitioning their care to an obstetrician/gynecologist (OBGYN).
This transition signifies a shift in focus from assisted conception to pregnancy, marking the onset of a new chapter in the remarkable journey toward parenthood.
