In vitro fertilization (IVF) involves
taking mature eggs from the woman, fertilizing them with sperm in a dish in
a laboratory and then transferring the resulting embryos back to the woman's
uterus 2 to 6 days after fertilization is confirmed. Approximately 25
percent to 35 percent of women who try in vitro fertilization conceive.
IVF can be physically and
emotionally draining, however stress and anxiety can be reduced if couples have a clear understanding of the procedures and steps to
follow.
The steps to follow are the following:
Note: Steps may vary depending on your clinic.
Step ONE - Visit to her
doctor. Where he will outline the plan or protocol. Agreement forms will be
signed and cost will be reviewed. Pay special attention to the agreements
where the clinic gets your instructions on what to do with the embryos that
are not transfered, the options are: cryopreservation or donation for
research.
HER: On this first visit the doctor may want to check
her uterus using a catheter to measure the size, shape and direction
of the uterus. This will help him determine where to place the embryos on
the day of embryo transfer.
HIM: Before starting the cycle a semen sample will be
collected for analysis.
Step TWO - Stimulation of
Ovaries.
HER: Will
be given medications to stimulate her ovaries to form multiple eggs-her
doctor will monitor this process with blood tests and ultrasound. Her doctor
will discuss which medication protocol might work best. Usually, she will
receive a drug known as a gonadotropin-releasing hormone agonist (an example
is Lupron®) or a gonadotropin-releasing hormone antagonist (examples are
Antagon®and Cetrotide®- these drugs prevent her ovaries from
releasing eggs too early during the IVF cycle.
Will then be given one or more
medications known as gonadotropins, which can stimulate her ovaries to
produce many eggs.The gonadotropins are given daily as an injection in her
abdomen, thigh, or upper arm. Your doctor will determine the most
appropriate dose. Your doctor may prescribe a generic gonadotropin or one of
the currently available brand medications-examples of which are:
Follistim®,
Gonal-F®,
Profasi®
and Repronex®.
Step THREE -
Egg Retrieval and Fertilization.
HER: Egg retrieval is a surgical procedure performed in
an operating room. An anesthesiologist will be present during the procedure
and may give her an intravenous sedation to make her sleepy. During the egg
retrieval procedure, her doctor will place a needle along with an ultrasound
probe. She will not have a cut or incision in her
abdomen. The fluid from each follicle-along with the egg-is drawn through
the needle. The egg retrieval procedure usually takes about 20 to 30
minutes, depending on the number of mature follicles. The eggs are placed in
a special dish in an incubator for a minimum of three hours prior to
insemination. After the egg retrieval procedure, she will most likely be
asked to rest in the recovery suite for about one hour.
HIM: Will need to produce a sperm specimen for the IVF
laboratory to use to fertilize the eggs.
Step FOUR
- Embryo Transfer
The day after retrieval, the inseminated eggs are studied for evidence of
fertilization. To allow further cell division and growth, eggs are cultured
for another 48 to 72 hours before the resulting embryos are considered ready
for transfer. The doctor will discuss the condition of the embryos and how
many will be transferred into her uterus. In general, the doctor may
transfer two to four embryos, depending on age and other factors, such as
the condition of the uterus. The embryos are transferred to the uterus
through the cervix, using a catheter. Following the embryo transfer
procedure, the doctor may recommend rest in bed for a day.
Step FIVE
- Pregnancy test. The doctor will schedule a pregnancy test about two weeks
after egg retrieval
