IVF (In Vitro Fertilization) is a fertility treatment where an egg and sperm are combined outside the body in a lab to create an embryo. The embryo is then placed in the woman’s uterus to hopefully result in pregnancy.
IVF is often used by couples who have trouble getting pregnant naturally. It helps people with issues like blocked fallopian tubes, low sperm count, or unexplained infertility. It can also help women with conditions like PCOS or endometriosis.
Egg retrieval is a fairly rapid procedure. Obviously the length of the procedure depends on how many follicles are present. Also the accessibility of the ovaries will determine how long the procedure will take. Accessibility means how easy is it to reach the ovaries with the ultrasound probe, whether they have a tendency to move away from the probe and so on. The typical egg retrieval will take from 20-30 minutes.
We do our egg retrievals under anesthesia so the patient is asleep for the procedure. Our anesthesiologists use medications which heavily sedate the patient so she is “asleep” however, she is not anesthetized so that breathing tubes are not necessary. The beauty of this approach is that the patient feels absolutely nothing, remembers absolutely nothing, and has few if any of the typical side effects of anesthesia such as nausea and vomiting.
The data we have available tells us that it does not. There have been many women who have undergone multiple egg retrievals. The fact that they have responded to stimulation on subsequent occasions and gotten eggs and pregnancies on these occasions implies that the ovaries are OK after egg retrieval. There have been some limited studies looking at the appearance of the ovaries in women who have had egg retrievals and subsequent laparoscopic surgery. In those patients, the findings were normal.
Vaginal bleeding is not uncommon after an egg retrieval. Usually this bleeding is from the needle puncture sites in the vaginal wall. It is usually minor (spotting).
Not necessarily. Although we will usually get an egg from most mature sized follicles, most women will have a mixed group of follicles after ovulation induction. Some of those follicles will have immature eggs or post mature eggs which may not be identifiable so they will seem to have been “empty” follicles.
The embryo transfer does not require any anesthesia. It is performed using a speculum that allows the doctor to see the cervix, and is very similar in technique to an intrauterine insemination (IUI). Usually the woman feels only the speculum and nothing else.
It is really not necessary from the conception point of view. In nature, the embryo floats freely in the endometrial cavity for a number of days before implantation and it will do the same in an IVF cycle. We do recommend that our patients take it easy following transfer, but routine work activities are certainly reasonable. If there is an increased risk of Ovarian Hyperstimulation, we will recommend bed rest.
When the above criteria are followed, approximately 25-30% of pregnancies are multiple. The vast majority of these are twin pregnancies. The rate of triplets is approximately 5% and that of quadruplets is much less than 1% when the above criteria are followed. These odds are related to the number of transferred embryos.
Ultimately the answer is no. If an embryo is of poor quality because it is genetically abnormal, there is nothing that can be done to salvage it. However, there are procedures which we do that can improve the chances of a borderline embryo. These include carrying aspiration of fragments as well as assisted hatching. It has been shown that procedures such as these can increase implantation rates in couples with a poor prognosis.
Embryos which progress to the blastocyst stage and are good quality can then be cryopreserved, if that is the couple’s wishes. If couples do not elect to freeze the extra embryos for later use, they can donate their embryos for research, for stem cells research, to another couple, to an embryo adoption agency, or simply discard them.
Since hCG is used to finalize egg maturation and to schedule egg retrieval, a pregnancy test (which is a measurement of hCG hormone in the urine or blood) will be positive for a number of days following egg retrieval. Some women will metabolize the hormone quickly and it will be out of the blood stream in a couple of days, while others may take up to 9 days to do so. Simultaneously, a pregnancy starts secreting hCG in measurable amounts in the blood approximately 1-2 days before the expected period. Keeping these two issues in mind, then, we recommend that a pregnancy test be performed 10-12 days after the embryo transfer.
Yes, you can choose the gender of the baby via a process called preimplantation genetic testing (PGT) which can help detect genetic conditions and also identify the gender of the embryos.
Yes, you can use donated eggs or sperm in IVF if you are not able to use your own. Egg and sperm donors undergo screening to ensure they are healthy and suitable for donation. We select the right donor for you based on your physical characteristics, such as eye, hair and skin color.
You can transfer up to 3 embryos per cycle.
We find that most couples will get pregnant within 2 tries. Occasionally, there may be a reason to do a third attempt but that is not common. More than this would really require extenuating circumstances such as a miscarriage due to a non-recurring reason. This issue has been looked at extensively. The simple answer is that there is no increased risk of birth defects after IVF. Human beings have an overall rate of birth defects of approximately 2% at birth. The rate has been shown to be the same for IVF pregnancies.
We find that most couples will get pregnant within 2 tries. Occasionally, there may be a reason to do a third attempt but that is not common. More than this would really require extenuating circumstances such as a miscarriage due to a non-recurring reason.
There is no evidence that IVF harms a woman’s future fertility. In fact, some women find that after going through IVF, their bodies become more regular, and they are able to conceive naturally later on.
There is no strict age limit, but IVF success rates decline with age. Women under 35 have the highest success rates, while women over 40 may need to consider donor eggs. Contact us now so that we can discuss in details your specific case and help you build your family.