The IVF Treatment Process
There are basically five steps in the IVF treatment process which includes embryo transfer:
Step 1:
Monitor and stimulate the development of healthy egg(s) in the ovaries
Fertility medications are prescribed to control the timing of the egg ripening and to increase the chance of collecting multiple eggs during one of the woman's cycles. This is called ovulation induction. Multiple eggs are desired because some eggs will not develop or fertilize after retrieval. Egg development is monitored using ultrasound to examine the ovaries and urine or blood test samples to check hormone levels.
Step 2:
Retrieve the eggs
Your eggs are retrieved through a minor surgical procedure which uses ultrasound imaging to guide a hollow needle through the pelvic cavity. Sedation and local anesthesia are provided to remove any discomfort that you might experience. The eggs are removed from the ovaries using the hollow needle, which is called follicular aspiration. The egg retrieval procedure usually takes about 20 to 30 minutes, depending on the number of mature follicles you have. Some women may experience cramping on the day of retrieval, which usually subsides the following day; however, a feeling of fullness or pressure may last for several weeks following the procedure.
Step 3:
Obtain the sperm
On the day of the egg retrieval, your male partner will need to produce a sperm specimen for the IVF laboratory to use to fertilize the eggs. Alternatively, semen must be obtained from the donor. The man providing the semen should abstain from ejaculation for 3 - 5 days before the egg retrieval.
Step 4:
Fertilization and early embryo growth
In a process called insemination, the sperm and eggs are placed in incubators located in the laboratory which enables fertilization to occur. In some cases where fertilization is suspected to be low, intracytoplasmic sperm injection (ICSI) may be used. Through this procedure, the embryologist picks up a single sperm and injects it directly into the egg in an attempt to achieve fertilization. The eggs are monitored to confirm that fertilization and cell division are taking place. Once this occurs, the fertilized eggs are considered embryos.
Step 5:
Transfer embryos into the uterus
The embryos are usually transferred into the woman's uterus anywhere from 1 - 6 days later, but most commonly it occurs between 2 - 3 days following egg retrieval. At this point, the fertilized egg has divided to become a two-to-four cell embryo. The transfer process involves a speculum which is inserted into the vagina to expose the cervix. A predetermined number of embryos are suspended in fluid and gently placed through a catheter into the womb. This process is often guided by ultrasound. The procedure is usually painless, but some women experience mild cramping.
These steps are followed by rest and watching for early pregnancy symptoms. About two weeks after the retrieval, a blood test, and sometimes an ultrasound, will be used to determine if implantation and pregnancy has occurred.
Surplus Embryos
Sometimes couples have extra embryos available after an IVF procedure. In such cases, couples may decide on cryopreservation (freezing) to store embryos a future IVF cycle [read more].