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in-vitro fertilization (ivf)

ivf is about a month-long process where your ovaries are stimulated to produce eggs. those eggs are retrieved and then fertilized in our lab with sperm. once fertilized, the embryo is then transferred back into your uterus or frozen for a future transfer. if you will be transferring an embryo 5-6 days after your retrieval, this is called a fresh ivf cycle. if your embryos will be frozen and transferred at a later date, this is called embryo banking with a frozen embryo transfer (fet) at a later time. remaining embryos are also frozen for future use. for those diagnosed with infertility, ivf will provide the best chance for a successful pregnancy. ivf is often referred to as the gold standard for fertility care. 

ovarian stimulation

our goal during ovarian stimulation is to retrieve as many mature eggs as possible. the more mature eggs we retrieve, the better chance you have that one will be fertilized, transferred back into your uterus, and develop into a healthy baby.

ovarian stimulation involves the injection of medications for 8-14 days, to encourage your ovaries to produce a lot of eggs. the medications stimulate two vital fertility hormones, follicle stimulating hormone (fsh) and lutenizing hormone (lh). 

egg retrieval

about 36 hours after the trigger shot (which induces ovulation), the eggs are retrieved under conscious sedation via a transvaginal ultrasound with a guided needle.

this is an out-patient procedure and most women go home a few hours following the procedure. you may have some discomfort the day of the procedure. most women report their body is back to normal and the physical symptoms from the cycle have subsided by their next period.  

fertilization

our embryologist will evaluate the condition of your eggs and only the healthiest sperm from the sample are used to fertilize the eggs. we use intracytoplasmic sperm injection or icsi to increase fetilization rates. in this process, the embryologist injects a single healthy sperm into the egg. unlike most clinics, we do not charge extra for this. icsi is a part of all mate packages. 

icsi can help circumvent certain male infertility problems including poor sperm quality, low sperm count, anatomical abnormalities, or post-vasectomy infertility.

the embryologist evaluates which eggs have been successfully fertilized by examining the cell division. before transfer, the embryologist will evaluate the embryos based on their likelihood of successfully implanting in the uterus. those embryos with the best characteristics, which are dividing properly and at a normal rate, are chosen for transfer.

embryo transfer

after the embryo has developed, it will either be frozen, biopsied, and sent out for testing, or on day 5-6 an embryo will be transferred into your uterus. (if your embryo is frozen, the transfer will happen at a later date).

the embryo transfer procedure is even simpler than the retrieval procedure. a very soft catheter is gently inserted through your cervix and the embryo is released into the middle of the uterus through the catheter. after that we wait and hope the embryo sticks! 

pregnancy test

after the two week wait (which can feel like a lifetime) you will take a pregnancy test in the clinic to see if the ivf transfer was successful. we look for specific pregnancy hormones with that test. even though the wait can feel extremely long, we don’t recommend at home tests, as the hormones from your ivf cycle can lead to incorrect results. if you are pregnant you will be monitored closely in our clinic for 8 weeks. then you will go see your regular obgyn. 


additional resources

  • why are three ivf cycles recommended?

    a full cycle of ivf treatment covers ovarian stimulation, egg retrieval, insemination, and embryo replacement. most women will usually see success rates of 20-35% per cycle, but the likelihood of getting pregnancy does decrease after each successive round. the cumulative probability of 3 full ivf cycles increases the chances of a successful pregnancy to 45-53%. many people will only need one cycle of ivf to achieve a successful pregnancy, while others may need 3 or more. it depends on your body and it’s reaction to medication and ivf. 

  • how painful is ivf?

    exactly what you experience throughout the ivf process can be very different from what someone else has experienced. there may be some level of physical discomfort throughout the process. the ovulation drugs are not painful. the needles are too small to cause any pain. there may be a slight stinging sensation but nothing to worry about. during the egg retrieval process you will not experience any discomfort, however after the procedure it is common to experience some level of cramps. the embryo transfer procedure is done with the assistance of a small catheter. if you have come this far with treatment, there is nothing to worry about during the embryo transfer, the procedure is relatively painless. 

  • what is the ovarian reserve check?

    ovarian reserve refers to a woman’s remaining egg supply that can produce babies. your fertility depends on the quality and quantity of eggs that exist within your ovaries, as well as how well the ovarian follicles are responding to hormonal signals from the brain. ovarian reserve is one of the most important predictors of your pregnancy potential. 

  • how long until i get pregnant?

    an average ivf cycle takes about 6-8 weeks from consultation to transfer. if you are using a gestational carrier or surrogate, this time may increase. an average cycle timeline looks something like this: 

    day 1: ultrasound and bloodwork (ovarian stimulation) 

    day 2: (ovarian stimulation) 

    day 3: (ovarian stimulation) 

    day 4: ultrasound and bloodwork (ovarian stimulation) 

    day 5: (ovarian stimulation) 

    day 6: ultrasound and bloodwork (ovarian stimulation) 

    day 7: (ovarian stimulation) 

    day 8: ultrasound and bloodwork (ovarian stimulation) 

    day 9: (ovarian stimulation) 

    day 10: ultrasound and bloodwork (ovarian stimulation) 

    day 11: trigger shot

    day 12:

    day 13: fertilization & egg retrieval 

    day 14: embryos culture in the lab for 5-6 days

    day 15: embryos culture in the lab for 5-6 days

    day 16: embryos culture in the lab for 5-6 days

    day 17: embryos culture in the lab for 5-6 days

    day 18: transfer or pgt on frozen embryo 

    day 19-33: two week wait

    day 33: pregnancy test