In vitro fertilization (IVF) is a method of assisted reproduction that involves combining an egg with sperm in a laboratory dish. If the egg fertilizes and begins cell division, the resulting embryo is transferred into the woman’s uterus where it will hopefully implant in the uterine lining and further develop. In addition to standard in vitro fertilization treatment, options like intracytoplasmic sperm injection (ICSI), preimplantation genetic screening (PGS), egg donation, and gestational surrogacy are made possible through this process by the IVF doctors of Fertility and Genetics in South Florida. IVF has given millions of infertile couples around the world the chance to become parents.
- Birth Control
- Ovarian Stimulation
- Egg Retrieval
- Embryo Transfer
- Supplements and Follow-up
The first step of the IVF process is the use of birth control to suppress the ovary to prevent ovulation until the desired time, as well as prevent ovarian cysts.
Next we use medications to stimulate multiple egg production, rather than the single egg normally produced by the body each month. Once menstruation begins, fertility medications are given daily to stimulate the maturation of oocytes (eggs). When the eggs are fully mature, an additional medication is given and the patient is prepared for egg retrieval. During this stage, we monitor the progress of ovulation induction with ultrasounds and blood estrogen levels over several days
The mature eggs are harvested using a simple outpatient procedure known as ultrasound-guided transvaginal oocyte aspiration. Here the doctor will collect the oocytes and follicular fluid. This process takes between 20 and 30 minutes. To avoid any discomfort, strong, short acting intravenous sedation is provided. You will then recover for about one hour in order for the medications to wear off. The semen will also need to be collected on the same day as the egg retrieval procedure.
Once the follicular fluid is removed from the follicle, the eggs are identified by the embryologist and placed into an incubator. The eggs are fertilized with sperm either by conventional insemination or by Intracytoplasmic Sperm Injection (ICSI). The eggs will be checked 24 hours later for fertilization and again the next day to evaluate for early cell division. Once the eggs have divided they are considered embryos and are placed in a solution called media to promote growth. The embryos are cultured for three days and then transferred to the uterus and/or cryopreserved. We now have the ability to grow the embryos for five or six days until they reach the blastocyst stage. For some couples these blastocysts may have a greater chance of implantation, allowing us to transfer fewer embryos and lower the risk of multiple births while increasing the chance of pregnancy.
The embryo transfer will occur a few days after the oocyte retrieval. This procedure is quick and painless and there will be no anesthesia used. With a very fine catheter the doctor will pass gently through the cervix and deposit the fertilized egg or eggs directly into the uterine cavity. You will then rest for an hour or two following the procedure.
You will begin taking progesterone the day of your oocyte retrieval and continue daily until your pregnancy test. We will continue to test and monitor your hormone levels during this time and up until your test. If the pregnancy test is positive, you may be advised to continue for several more weeks.
Variations of IVF
Gamete Intrafallopian Transfer (GIFT)
GIFT is a procedure whereby mature eggs and sperm are placed directly into the woman’s fallopian tubes where natural fertilization takes place.
Zygote Intrafallopian Transfer (ZIFT)
ZIFT is a variation of IVF and GIFT in which the eggs are fertilized in the laboratory and early developing embryos are placed in the fallopian tubes. Both GIFT and ZIFT may be performed in our office surgical suite.
Frozen Embryo Transfer (FET)
Frozen Embryo Transfer is a procedure in which embryos frozen from a previous IVF cycle are thawed and placed in the womb. Frozen embryo transfer increases the efficiency of a single fresh IVF cycle as multiple frozen embryo transfers can be attempted without the need for ovarian stimulation. Embryos can be frozen at different stages of development. If frozen and stored properly, their potential viability remains unchanged for many years.
Preimplantation genetic screening (PGS) – Preimplantation genetic screening (PGS) is a procedure used prior to implantation that can evaluate the status of an embryo with regard to chromosomal makeup.
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