What is IVF? Step by Step of the IVF Process to Get Pregnant

Summary

Dr. Natalie Crawford, a fertility specialist, offers an in-depth step-by-step guide to In Vitro Fertilization (IVF), explaining the process from initial consultations to egg retrieval and embryo transfer. She discusses the importance of understanding ovarian reserve, the use of medications for egg stimulation, and the decision between conventional fertilization and ICSI. Crawford also touches on genetic testing, embryo freezing, and the considerations for fresh versus frozen embryo transfers, providing a comprehensive overview of the IVF journey.

Takeaways

• 🧬 IVF stands for In Vitro Fertilization, a process where egg and sperm are fertilized outside the body in a lab.
• 🌱 The body naturally releases more than one egg per month, but IVF aims to stimulate all eggs to grow in a single cycle.
• 🩺 Before starting IVF, an assessment of ovarian reserve is necessary, which includes an ultrasound and an AMH blood test.
• 💊 The IVF protocol involves suppression and stimulation medications to override the body's natural cycle and encourage egg growth.
• 📈 Suppression can vary and may include Lupron, birth control pills, or other hormone blockers to synchronize egg growth.
• 💉 Stimulation involves taking FSH hormone shots to encourage egg development, with monitoring visits to track progress.
• 💉 The egg retrieval is a minimally invasive procedure performed under anesthesia, where eggs are extracted from the ovaries.
• 🧐 Two fertilization methods exist: conventional fertilization and ICSI (Intracytoplasmic Sperm Injection), with the latter being used in cases of unexplained infertility or male factor issues.
• 🌱 Embryos grow to the blastocyst stage, which is the stage of implantation, and can be transferred, frozen, or biopsied for genetic testing.
• 🧪 Genetic testing of embryos is crucial as it helps identify normal embryos, which have a higher chance of leading to a successful pregnancy.
• ⏳ The IVF process from start to a positive pregnancy test typically takes about four months, depending on the specifics of the protocol and treatments.

Q & A

What does IVF stand for and what is its basic process?

IVF stands for In Vitro Fertilization, which means that egg and sperm are fertilized outside the body in a lab. The basic process involves growing eggs, retrieving them, and fertilizing them with sperm outside the body to form embryos.

Why does the body typically release more than one egg during IVF?

During IVF, the goal is to stimulate the growth of all the eggs that would normally be released in one menstrual cycle. This is done to increase the chances of getting viable eggs for fertilization, as the body naturally selects only one dominant follicle to mature each month.

What is the role of FSH in the IVF process?

FSH, or Follicle Stimulating Hormone, is used in the IVF process to stimulate the growth of multiple follicles, each containing an egg. In a typical menstrual cycle, FSH would stimulate only one follicle, but in IVF, higher doses are given to encourage multiple follicles to mature.

What is ovarian reserve and how is it assessed?

Ovarian reserve refers to the number of eggs available for potential fertilization. It is assessed through an ultrasound to count the antral follicles and a blood test for Anti-Mullerian Hormone (AMH) to determine the expected number of eggs.

What are the different types of IVF protocols and what do they involve?

IVF protocols include suppression and stimulation medications. Suppression can involve Lupron, birth control pills, or other blockers, while stimulation involves FSH shots. The protocol chosen depends on the individual's ovarian reserve and the clinic's approach.

What is the purpose of the trigger shot in the IVF process?

The trigger shot is administered when the follicles are at an appropriate size, signaling that the eggs are mature. It induces final maturation of the eggs and prepares them for retrieval, which occurs about 36 hours after the shot.

How is the egg retrieval procedure performed and what are its risks?

Egg retrieval is performed under anesthesia using a large needle guided by a vaginal ultrasound to access the ovaries and extract the eggs. Risks include infection, bleeding, and damage to nearby organs, though it is generally considered a low-risk procedure.

What are the two types of fertilization methods used in IVF and how do they differ?

The two types are conventional fertilization, where sperm and eggs are mixed in a dish, and ICSI (Intracytoplasmic Sperm Injection), where a single sperm is injected directly into a mature egg. ICSI is used when there are concerns about fertilization ability.

Why is genetic testing of embryos important in the IVF process?

Genetic testing of embryos is important to identify and select genetically normal embryos, which have the highest potential for a successful pregnancy. It also helps in planning for future pregnancies by knowing the number of viable embryos available.

What is the difference between a fresh embryo transfer and a frozen embryo transfer?

A fresh embryo transfer occurs shortly after the egg retrieval, while a frozen embryo transfer involves thawing and transferring an embryo at a later time. Frozen transfers may be chosen to allow for genetic testing, to reduce the risk of ovarian hyperstimulation, or to synchronize uterine and embryo development.

What are minimal stimulation IVF and InvoCell, and when might they be used?

Minimal stimulation IVF uses lower doses of medication to retrieve fewer eggs, often to save costs or reduce the risk of ovarian hyperstimulation. InvoCell is a device that holds eggs and sperm in the vagina for fertilization and early embryo development before transferring the embryo. It may be used for cost or convenience, but is not suitable for all cases.