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In Vitro Fertilization

In Vitro Fertilization, or IVF, begins with stimulation of a woman’s ovaries with injectable fertility medications. These injections are given daily for approximately 8 to 12 days in a row, in an effort to make the ovaries produce multiple eggs simultaneously. During the time the injections are being given, pelvic ultrasounds and blood estrogen levels are performed approximately every three days to determine the ovarian response. These ultrasounds and estrogen levels are frequently referred to as “monitoring”. The clinical goal of the ovarian stimulation is to produce between 15 and 20 eggs. When the eggs are mature, they are removed from the woman’s body via a minor procedure performed in the office. This “retrieval” procedure is done vaginally with the patient under IV sedation. There are no incisions, and the recovery is just long enough to awaken from anesthesia. The eggs are then fertilized in the laboratory; either directly by the sperm, or the sperm are injected directly into the egg (intracytoplasmic sperm injection or ICSI). The fertilized eggs, or embryos, are then grown in the laboratory for three to five days. Ultimately, one or two of the resulting embryos are then transferred back to the woman’s uterus via a small catheter. The woman is awake for this painless procedure. Any viable embryos in excess of the ones transferred back to the uterus are frozen for potential future use. There are three common indications for IVF. The first is treatment for a severe male factor that will not respond to medical management. The second is treatment for severe anatomical problems with the female reproductive system such as damaged fallopian tubes or a severe endometriosis. The third indication for IVF is for patients who have failed to get pregnant with more conservative fertility therapies. Other indications can include combating female age related issues, and any case requiring pre-implantation genetic diagnosis.



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