In Vitro Fertilization (IVF)

Often referred to as IVF, in-vitro fertilization is a form of assisted reproductive technology that combines a man’s sperm and a woman’s oocytes outside of the body, in a laboratory.  At first, IVF technology was primarily used to help treat women with tubal disease, such as blocked tubes. Now, IVF offers hope to couples with a wide array of diagnoses.

The IVF process includes four different steps:

• ovarian stimulation
• egg retrieval
• egg fertilization
• embryo transfer  

Ovarian Stimulation
Usually, ovarian stimulation involves the use of fertility medications that stimulate the ovaries to produce multiples follicles (which contain the microscopic oocytes). During the stimulation period, you will be monitored very closely in our office, and once the follicles are mature, we will schedule the egg retrieval. Ovarian stimulation usually lasts anywhere from 9 to 14 days. The goal of ovarian stimulation is to produce multiple mature follicles so that multiple oocytes are available at the time of your egg retrieval. See Ovarian Stimulation above.

Egg Retrieval
During egg retrieval, your oocytes are removed by transvaginal ultrasound aspiration. Dr. Brown will place an ultrasound probe into the vagina to easily identify and see the follicles; then, he will guide a needle into the follicle and remove the fluid. The microscopic oocyte is located in the follicular fluid that was removed and the embryologists will work carefully to identify the oocytes.  

The egg retrieval process usually lasts no longer than 30 minutes.  Patients will receive an anesthetic intravenously to keep them relaxed.  Because the procedure is performed transvaginally, you will have no incisions from the procedure.

Fertilization
After the oocytes are retrieved and are carefully examined in the laboratory by the embryologists, fertilization will occur. Typically, the male partner provides a sperm specimen the morning of the oocyte retrieval. The embryologists will evaluate the specimen and prepare it for the fertilization process. Fertilization is accomplished by either insemination or intracytoplasmic sperm injection (ICSI), a process where the sperm is injected directly into the egg. How the sperm specimen looks upon evaluation the morning of the oocyte retrieval determines which method of fertilization is performed.

To learn more about Egg and Sperm quality click here

The embryologists will evaluate the oocytes to determine if fertilization has occurred the day after retrieval.  Over the next several days, the embryologists will monitor the embryos to determine if appropriate growth is occurring.  

Embryo Transfer
Either three or five days after retrieval, embryo transfer occurs, depending on what the embryos look like the morning of day three.  The embryos are graded by the embryologists in the lab, which helps Dr. Brown decide the best day to perform the embryo transfer.  Embryo transfer is a painless procedure similar to an intrauterine insemination (IUI) or pelvic exam and is usually performed with a thin sterile catheter.

Several factors will influence the number of embryos transferred. Such as:

• age of the female partner
• infertility history
• previous pregnancy history
• quality of embryos

We will also take into consideration guidelines from the American Society for Reproductive Medicine on the number of embryos to transfer. Dr. Brown will discuss his recommendations for the number of embryos with you prior to your embryo transfer.

Although your pregnancy is our goal, it is our duty to insure that you are safe and deliver a healthy baby. We will consider this when deciding how many embryos will be transferred back into your uterus.

Exactly two weeks from the day of your egg retrieval, you will take a pregnancy test to confirm the success of the IVF procedure.